Abstract

Aims: The objective of this cross-sectional study was to examine the utility of multiple symptom validity tests (SVTs), including symptom-based measures (Cambridge Memory Questionnaire-CMQ and Kapur’s Modified Rey Memory Test-ModRey) and a performance-based memory test (Rivermead Post-concussion Questionnaire-RPQ), in a sample of test-coached simulators.

Method: Forty-two undergraduate students were recruited and randomly assigned to control (n=21) or test coaching (n=21) condition. All participants were administered the above-mentioned SVTs. Inter-test correlations were assessed by partial correlations. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cutoff scores of each SVTs and combinations of multiple SVTs.

Results: RPQ was found to be correlated with CMQ and ModRey. CMQ did not correlate with ModRey. Results of ROC analyses suggested optimal cutoff score for CMQ -69, RPQ and the qualitative score of ModRey were 81/82, 24/25 and 0/1, yielding specificity ranging from 95% to 100% and sensitivity ranging from 76% to 95%. Using a combination of all three SVTs obtained a cutoff of 1/2 (failing two or more SVTs), yielding a high specificity (100%) and sensitivity (91%).

Conculsions: Our findings lend support to the use of multiple independent SVTs to detection memory malingering. However, the evaluation procedure tested in this study should be used as an adjunct screening procedure rather than as a diagnostic assessment.