Detecting suboptimal cognitive effort: Classification accuracy of the conner's continuous performance test-II, brief test of attention, and trail making test

Michelle Busse, Douglas Whiteside

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Many cognitive measures have been studied for their ability to detect suboptimal cognitive effort; however, attention measures have not been extensively researched. The current study evaluated the classification accuracy of commonly used attention/concentration measures, the Brief Test of Attention (BTA), Trail Making Test (TMT), and the Conners Continuous Performance Test (CPT-II). Participants included 413 consecutive patients who completed a comprehensive neuropsychological evaluation. Participants were separated into two groups, identified as either unbiased responders or biased responders as determined by performance on the TOMM. Based on Mann-Whitney U results, the two groups differed significantly on all attentional measures. Classification accuracy of the BTA (.83), CPT-II omission errors (OE;.76) and TMT B (.75) were acceptable; however, classification accuracy of CPT-II commission errors (CE;.64) and TMT A (.62) were poor. When variables were combined in different combinations, sensitivity did not significantly increase. Results indicated for optimal cut-off scores, sensitivity ranged from 48% to 64% when specificity was at least 85%. Given that sensitivity rates were not adequate, there remains a need to utilize highly sensitive measures in addition to these embedded measures. Results were discussed within the context of research promoting the need for multiple measures of cognitive effort.

Original languageEnglish (US)
Pages (from-to)675-687
Number of pages13
JournalClinical Neuropsychologist
Volume26
Issue number4
DOIs
StatePublished - May 1 2012
Externally publishedYes

Keywords

  • Attention
  • Forensics
  • Symptom validity

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