A - 07 Three Brief, Public-Domain Performance-Validity Measures for Concussion Baseline Testing: Normative Performance and Sub-Optimal Cut Scores

Abstract

Purpose: We report normative data with non-athlete college students for three brief, public-domain performance validity tests (PVT) representing auditory-verbal memory (Rey Word Recognition Test; RWRT), auditory vigilance; (A-Test), and visual attention (Rey Dot Counting Test; DCT). Cut scores for suboptimal performance (SOP) were determined, and the importance of using multiple PVTs was established. Method: 150 non-athlete college students (45% female; representing four college year levels) were recruited via the college’s research participation application and assigned randomly to honest-effort, fake-bad, or instructed fake-bad groups. 50 student-athletes were selected randomly to compare athlete performance with non-athletes. Group differences for PVT measures, and receiver operating curve (ROC) cut scores for suboptimal performance are reported. Results: Only the RWRT measures met normality and homogeneity of variance assumptions. MANOVA with post-hoc Tukey tests showed no differences between groups for RWRT. For DCT and A-Test, non-parametric Kruskal-Wallis comparisons were conducted, each resulting in significant differences (all p < 0.001) between honest-effort and SOP groups. No differences were found between the two SOP groups, nor athlete baseline vs honest effort groups, but athletes differed significantly from both SOP groups. ROC cut scores that suggested suboptimal effort were DCT combination score ≥ 15; RWRT combination score ≤ 12; and A-Test omission errors ≥1. Four participants from the honest-effort group and 49 from the fake-bad groups fell below criteria for two tests. Conclusion: The DCT combination and A-Test omission scores were valid indicators of suboptimal performance. Combining multiple PVT “failures”maximized identification of suspect performers and minimized inclusion of honest-effort participants.