Ethnic differences in the detection of feigned cognitive symptoms: A comparison of neuropsychological assessment symptom validity tests between African-Americans and Caucasians

Accurate interpretation of neurocognitive performance validity tests (PVTs) requires information regarding whether African-Americans are at increased risk of false identification as non-credible. This study examined whether African-American (n = 51) and Caucasian (n = 103) patients differed on several dedicated and embedded PVTs. Exclusion criteria included compensation seeking, dementia or amnestic disorders, and low intelligence (WAIS-III Full Scale IQ [FSIQ] .05) than African-Americans on six tests (Digit Span 3-digit and 4-digit time, Digit Symbol Recognition Equation, Logical Memory Effort Equation, Stroop [A and B], Dot Counting Test E-score, and the b Test E-score). However, groups also differed on FSIQ (96.6 versus 85.4). When subjects with borderline IQ (FSIQ = 70 to 79) were excluded (resulting in 93 Caucasians and 27 African-Americans), groups no longer differed in IQ (Caucasian = 98.9, African-Americans = 94.3), and only differed on the Dot Counting Test E-score (11.70 versus 13.03). The Dot Counting Test E-score cutoff was associated with 88.5% specificity in the African-American group. Apparent differences between African-Americans and Caucasians on PVT scores appeared to be moderated by IQ scores. When participants were limited to those with low average IQ or higher (> 80), minimal group differences were detected that did not appear to have clinical relevance.