The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension.

The current investigation is a replication and extension of a previously published study by Cooper, Vanderploeg, Armistead-Jehle, Lewis, and Bowles (2014) demonstrating that performance validity test scores accounted for more variance in cognitive testing among service members with a history of concussion than did demographic variables, etiology of and time since injury, and symptom severity. The present study included a sample of 142 active-duty service members evaluated following a suspected or confirmed history of mild traumatic brain injury. Participants completed a battery of neuropsychological measures that included scales of performance and symptom validity (specifically the Medical Symptom Validity Test, Nonverbal Medical Symptom Validity Test, and Personality Assessment Inventory). Among the factors considered in the current study, performance validity test results accounted for the most variance in cognitive test scores, above demographic, concussion history, symptom validity, and psychological distress variables. Performance validity test results were modestly related to symptom validity as measured by the Personality Assessment Inventory Negative Impression Management scale. In sum, the current results replicated the original Cooper et al. study and highlight the importance of including performance validity tests as part of neurocognitive evaluation, even in clinical contexts, within this population.