Performance and Symptom Validity Testing: Terminology, Conceptualization, Practice Standards, and Future Directions

Abstract Purpose of Review This commentary summarizes terminology and practice standards for assessing the validity of test scores obtained during neuropsychological evaluations. It also highlights conceptual gaps and emerging directions for improving validity assessment. Recent Findings The process of assessing the accuracy and interpretability of psychometric test scores is foundational to neuropsychology. However, terminology used to communicate these findings requires conceptual refinement to align with evolving practice standards and advances in psychometric theory. Such terminology must also reflect that validity problems are not reduced to poor effort or volitional exaggeration. Validity is a broader interpretive concern that applies to all practicing neuropsychologists, who must distinguish between presumed causes and patterns of invalidity, while also considering the intended use of scores relative to the patient and context. Symptom- and performance-based scores serve different interpretive purposes, and their validity should be evaluated separately. The strongest validity determinations are based on converging evidence across multiple complementary psychometric- and clinically-based indicators, with attention to base rates of invalid responding and genuinely low scores. Summary Digital technologies may help the field keep pace with evolving standards and conceptual developments. Technologies can improve validity assessment by capturing more data, analyzing it with advanced algorithms, and doing so in ways that are more accessible for patients and efficient for clinicians. However, neuropsychologists must remain stewards of these digital methods, ensuring their development and use preserve clinical nuance, empirical rigor, and ethical standards. Used appropriately, digital tools may complement rather than replace the uniquely human aspects of validity assessment.