Preferential impact of processing speed and memory on Rey Auditory Verbal Learning Test and Brief Visuospatial Memory Test-revised embedded performance validity tests

This study evaluated the impact of single-domain impairment in processing speed and memory versus multidomain impairment on the Rey Auditory Verbal Learning Test Forced Choice (RAVLT FC) and Brief Visuospatial Memory Test-Revised Recognition Discrimination (BVMT-R RD) PVTs among a sample of 385 nonconsecutive mixed clinical patients referred for outpatient neuropsychological evaluation. The sample was dichotomized to form valid (<i>n</i> = 307) and invalid (<i>n</i> = 78) groups. The valid study group was subdivided into an intact cognition group (<i>n</i> = 174), single-domain processing speed (<i>n</i> = 27) and memory (<i>n</i> = 59) groups, and a combined speed and memory impairment group (<i>n</i> = 47). The impaired memory group showed acceptable classification accuracy for the RAVLT FC (≤12; 35% sensitivity/90% specificity) and BVMT RD (≤4; 33% sensitivity/90% specificity). The impaired speed group evidenced excellent classification for the RAVLT FC (≤14; 64% sensitivity/96% specificity) and acceptable accuracy for the BVMT RD (≤4; 33% sensitivity/96% specificity). For the impaired speed and memory group, classification accuracy was acceptable for the RAVLT FC (≤12; 35% sensitivity/92% specificity) and poor (although still statistically significant) for the BVMT RD (≤3; 24% sensitivity/94% specificity). Therefore, use of adjusted cut-scores among neuropsychological conditions associated with deficits in memory and/or speed is needed when using these PVTs in clinical practice.