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Research has demonstrated the utility of performance validity tests (PVTs) as a method of determining adequate effort during a neuropsychological evaluation. Although some studies affirm that forced-choice PVTs measure effort rather than memory, doubts remain in the literature. The purpose of the current study was to evaluate the relationship between effort and memory variables in a mild traumatic brain injury (TBI) sample (n = 160) by separating memory and effort as distinct factors while statistically controlling for the shared covariance between the variables. A two-factor solution was extracted such that the five PVT variables loaded on Factor 1 and the four memory variables loaded on Factor 2. The pattern matrix, which controls for the covariance between variables, provided clear support of two highly distinct factors with minimal cross-loadings. Our findings support assertions that PVTs measure effort independent of memory in veterans with mild TBI.

A Factor Analytic Approach to the Validation of the Word Memory Test and Test of Memory Malingering as Measures of Effort and Not Memory