B – 145 Examining the Relationship Between Neurobehavioral Symptoms, Mood, Anxiety, and Performance and Symptom Validity in a Post-SARS-CoV-2 Clinical Sample

Abstract Objective The incidence of symptom over-reporting and its relationship to invalid neurocognitive performance is not well understood among patients who present with chronic post-SARS-CoV-2 (Long-COVID) symptoms. This study examined the relationship between an embedded symptom validity test (SVT) in the Neurobehavioral Symptom Inventory (NSI), psychological self-report measures, and performance validity tests (PVTs). Method Fifty-seven consecutive patients (73.7%female; 40.4%White, 36.8%Black, 19.3%Hispanic; Mage=44.25, SD=12.44; Meducation=15.37, SD=2.96) referred for outpatient neuropsychological evaluation of post-COVID cognitive changes were included. All COVID infections were mild, and none required intubation/respiratory therapy. Patients were administered a fixed battery that included the NSI, Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7-Item (GAD-7), and 4 PVTs (Test of Memory Malingering (TOMM)-Trial 1, Brief Visuospatial Memory Test-Revised [BVMT-R]-Recognition Discrimination, Stroop Word Reading T-score, Reliable Digit Span [RDS]). Results Seven patients (12%) invalidated the NSI Validity-10 SVT. A significant positive correlation emerged between NSI Validity-10 and PHQ-9 (rs=.46, p<.001). No meaningful relationship was found between NSI Validity-10 and GAD-7 (rs=-.15, p=.25). A significant negative correlation was found between NSI Validity-10 and TOMM-Trial 1 (rs=-.27, p=.045), though no significant relationship emerged between the NSI and other PVTs (BVMT-Recognition Discrimination [rs=-.24, p=.074], Stroop Word T-score [rs=-.19, p=.155], RDS [rs=.11, p=.408]). Conclusion Similar to other neuropsychological populations, results show that PVTs and SVTs are dissociable among patients being evaluated for Long-COVID symptoms such that invalid symptom reporting did not associate robustly with invalid PVT performance. Over-endorsement of neurobehavioral/psychiatric symptoms on the NSI align with greater depressive complaints among patients experiencing persisting symptoms following mild COVID infection.