The D-KEFS Trails as Performance Validity Tests

This study was designed to examine the potential of the Delis-Kaplan Executive System (D-KEFS) version of the Trail Making Test (TMT) as a performance validity test (PVT). Data were collected from a mixed clinical sample of 157 consecutively referred outpatients (49% male, M-Age = 47.1, M-Education = 13.6) undergoing neuropsychological assessment at an academic medical center in the northeastern United States. Sensitivity and specificity of the D-KEFS Trails to psychometrically defined invalid responding was calculated across various cutoffs and criterion PVTs. The D-KEFS Trails produced classification accuracy comparable to the original version of the TMT, hovering around the "Larrabee limit" (.50 sensitivity at.90 specificity). Different cutoffs (age-corrected scaled score = 5 on Trails 1-3, <= 4 on Trails 4 and <= 8 on Trails 5) were needed to achieve the same classification accuracy across the five trials. Combining multiple cutoffs improved the signal detection performance. The study provides preliminary evidence of the utility of D-KEFS Trails as a PVT. Embedded PVTs are valuable, because they make a multivariate approach to validity assessment feasible. Combining validity indicators is superior to relying on single cutoffs. Public Significance Statement Unusually low performance on visuomotor processing speed test is more likely to reflect noncredible performance than genuine impairment. Public Significance Statement Unusually low performance on visuomotor processing speed test is more likely to reflect noncredible performance than genuine impairment.