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Classification of performance validity and symptom validity using the Trauma Symptom Inventory-2.

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The Trauma Symptom Inventory-Second Edition (TSI-2) is garnering research interest as a symptom validity test in the evaluation of trauma-related disorders. However, there has been limited empirical validation of its… Click to show full abstract

The Trauma Symptom Inventory-Second Edition (TSI-2) is garnering research interest as a symptom validity test in the evaluation of trauma-related disorders. However, there has been limited empirical validation of its validity scales in clinical and forensic real-world settings. This study evaluated the ability of the TSI-2 Atypical Response (ATR) scale to discriminate response bias in cognitive performance and symptom reporting in a large sample of disability and compensation-seeking claimants. This retrospective chart review included 296 adults with a known history of trauma exposure or claimed trauma-related psychological injury who underwent neuropsychological and/or comprehensive psychological assessment in a private neuropsychology clinic. The discriminability of the ATR scale to classify credible versus non-credible cognitive profiles and symptom reporting were analyzed by AUC-ROCs. Overall, the ATR scale demonstrated poor discriminability of assessment validity based on the Word Memory Test, Victoria Symptom Validity Test, and Minnesota Multiphasic Personality Inventory-2-Restructured Form. The ATR scale had fair discriminatory ability of only one of the over-reporting scales (F-r), with an ROC area of .73, pā€‰=ā€‰.001. However, the test publisher's proposed ATR cut-offs of ā‰„8 for screening, research, and normal groups, and ā‰„15 in forensic and clinical settings revealed significant issues with sensitivity and specificity. These results suggest that the TSI-2 should be paired with other established performance validity and symptom validity tests in clinical assessments and not be used as the primary or sole indicator of assessment validity.

Keywords: inventory; trauma symptom; validity; performance; neuropsychology; symptom validity

Journal Title: Applied neuropsychology. Adult
Year Published: 2022

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