A Forced Choice Performance Validity Test for the Repeatable Battery for the Assessment of Neuropsychological Status

Objective We aimed to assess the utility of a novel and easy-to-administer performance validity test (PVT), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Forced Choice recognition trial (RFC), compared with previously developed RBANS PVTs. Method We compared the RFC with the RBANS Effort Index (EI) and Effort Scale (ES) in a sample of 62 non-litigating older adults (mean age = 74 years, 52% female) with varying levels of cognitive impairment. Results A significantly greater proportion of the sample met EI criteria for non-credible performance (EI > 2; 31%) compared with RFC criteria (RFC < 9; 15%). Among participants with Major Neurocognitive Disorder, 60% met EI criteria for non-credible performance, 32% met ES criteria (ES > 12), and 24% met RFC criteria. Conclusions The RFC may have greater specificity than other RBANS PVTs among individuals with more severe cognitive impairment. Further research is needed to establish the classification accuracy of the RFC for assessing performance validity.