A – 78 Investigating Cultural Mechanisms Underlying Higher Performance Validity Failure Rate: A Pilot Study

Abstract Objective Prior research indicates that sociodemographic factors, including culture, influence Performance Validity Test (PVT) failure rates. Consequently, immigrants in Canada may be misdiagnosed or considered malingering due to inherent cultural biases in standardized assessments. This qualitative study explored the mechanisms behind these elevated failure rates and investigated whether culturally sensitive interviews could mitigate them. Method Ten recent immigrants from diverse cultural backgrounds participated in in-depth, semi-structured interviews and completed two PVTs—Rey Dot Counting Test (DCT) and Digit Span Task (DST)—administered in counterbalanced order before and after the interviews. Participants’ level of acculturation was measured using the Vancouver Index of Acculturation. Results Correlational analyses revealed that stronger retention of heritage culture was negatively associated with PVT performance (r(8) = -.555, p > .05 for the DCT; r(8) = -.712, p .05 for the forward; t(9) = -0.788, p > .05 for the backward). Thematic analysis of interviews examined how cultural factors influence PVT performance and healthcare-seeking behaviors. Four key themes emerged: emergency care perceptions, cultural attitudes toward mental health, financial barriers, and language challenges. Conclusion The findings offer insights into the interplay of cultural, structural, and communicative barriers immigrants in Canada face when engaging with healthcare systems, helping to elucidate why diverse populations may exert lower effort.