Concordance of Embedded Performance and Symptom Validity Tests and Associations with Mild Traumatic Brain Injury and Posttraumatic Stress Disorder among Post-9/11 Veterans

OBJECTIVE The present study explored both embedded symptom (SVT) and performance (PVT) validity test scores within a post-9/11 veteran sample to elucidate the degree to which there is concordance between validity indicators, as well as how frequently one SVT and four PVT indicators were failed in screened mild traumatic brain injury (mTBI) and diagnosed posttraumatic stress disorder (PTSD). METHOD A total of 114 post-9/11 veterans were evaluated utilizing the Neurobehavioral Symptom Inventory (NSI) Validity-10, four embedded PVTs, mTBI screening, and a diagnostic interview for PTSD. RESULTS While we found concordance between embedded PVTs and the NSI Validity-10 at select cutoffs (i.e., ≥13, ≥19), symptom and performance validity indicators were clinically dissociable in that only SVT significantly predicted diagnosed PTSD and screened mTBI. CONCLUSIONS Dissociation between symptom and performance validity may be clinically useful when interpreting neuropsychological evaluation findings in post-9/11 veterans with a history of mTBI or PTSD.