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ORIGINAL RESEARCH ARTICLE

Specificity of multiple performance validity tests in a mixed neurological patient sample from Indonesia

Widhi Adhiatma1,2 ,  Marc P. H. Hendriks1,2,3 ,  Magdalena S. Halim1 ,  Eugenia Emile Natasha1 ,  Octavianus Darmawan4,5 ,  Diatri Nari Lastri6,7 ,  Roy P. C. Kessels2,8*
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1 Department of Clinical Psychology, Faculty of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta
2 Department of Neuropsychology and Rehabilitation Psychology, Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Gelderland
3 Academic Centre of Epileptology, Kempenhaeghe, Heeze, North Brabant
4 Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta
5 Department of Neurology, Atma Jaya Hospital, Jakarta, Indonesia
6 Department of Neurology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
7 Department of Neurology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
8 Korsakoff Center for Alcohol-related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
Advanced Neurology, 5661 https://doi.org/10.36922/an.5661
Submitted: 29 October 2024 | Revised: 10 January 2025 | Accepted: 11 February 2025 | Published: 10 March 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Performance validity testing (PVT) is crucial in contemporary neuropsychological assessment. This study aimed to validate several PVTs— – the Reliable Digit Span (RDS), the Longest Digit Forward-1 Trial, the Longest Digit Forward-2 Trials (LDF-2), the Tes Memori Jangka Pendek Indonesia (TMJPI), and the Non-Verbal Medical Symptom Validity Test – in an Indonesian mixed neurological sample. We recruited 141 patients through convenience sampling, divided into three groups: Neurocognitive disorder due to possible neurodegenerative disease (ND; n = 49), post-stroke (n = 42), and mixed etiology (n = 47). Data were collected prospectively. The PVT cut-off scores were adjusted when specificity rates fell below 0.90. Intercorrelations between Mini-Mental State Examination (MMSE) scores, demographic variables, and PVT scores were computed. The cut-off scores were modified for each group due to unacceptable specificity rates, with the most substantial adjustment made for the TMJPI cut-off score in the ND group. Three variables (MMSE, education, and age) were significantly correlated with PVT scores, with the exception of RDS and LDF-2. The PVTs were also significantly intercorrelated. We conclude that the previously developed Indonesian PVTs can be validly applied in neurological patients. However, clinicians should exercise caution when selecting PVTs and consider the demographic backgrounds of patients to minimize false-positive results.

Keywords
Neuropsychological tests
Malingering
Cognitive dysfunction
Diagnosis
Motivation
Sensitivity and specificity
Funding
The first author is an awardee of the “Beasiswa Pendidikan Pascasarjana Luar Negeri 2019” (No: T/993/D3.2/ KD.02.01/2019) from the Directorate General of Higher Education, Research, and Technology, Ministry of Education, Culture, Research, and Technology, Republic of Indonesia.
Conflict of interest
The authors declare that they have no competing interests.
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Advanced Neurology, Electronic ISSN: 2810-9619 Print ISSN: 3060-8589, Published by AccScience Publishing
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