Performance and symptom validity testing: terminology and practice standards
Finley JCA et al., Current Treatment Options in Psychiatry, Sep 18
DOI 10.1007/s40501-026-00397-w
Summary: Validity testing is central to interpreting neuropsychological results, but the terms and practices vary from clinician to clinician. This review argues that validity matters for every evaluation, not just cases where poor effort or exaggeration is suspected. It treats performance validity and symptom validity as separate concepts that are only modestly related. The authors favor describing results with neutral terms rather than labels like “effort tests.” They emphasize using several validity measures, paying attention to base rates, and not applying a fixed “two failures” rule to combinations of tests that haven’t been validated together. They also discuss digital tools while stressing that clinical judgment stays central.
Takeaways for clinicians
A useful, citable reference on terminology and multi-measure validity practice.
A reminder that how specific a combined validity rule is depends on the tests, cutoffs, and population.
Takeaways for families
Evaluations include checks to make sure scores reflect a person’s true abilities.
These checks are routine for everyone and aren’t an accusation.
