Detecting simulated memory impairment with the Rey Auditory Verbal Learning Test: Implications of base rates and study generalizability

The accuracy of the Rey Auditory Verbal Learning Test (RAVLT) for detecting simulated neuropsychological impairment was investigated using discriminan t function analyses and cross-validation procedures. In Study 1, a discrimi nant function analysis, using six RAVLT variables, correctly classified 80% of 50 simulating and 50 non-simulating participants. Base rates were chang ed and this discriminant function was tested in Study 2 with a 33% base rat e of simulation. The discriminant function correctly classified 75% of 20 s imulators and 90% of 40 non-simulators, yielding an overall classification rate of 85%. To determine the generalizability of this discriminant functio n to a clinical sample, Study 3 compared the RAVLT performance of 20 simula ting participants to that of 40 motor vehicle accident (MVA) patients. The discriminant function from Study 1 incorrectly classified 60% of the MVA pa tients and yielded an overall correct classification rate of 48%. The limit ations associated with generalizing from analog research and the implicatio ns of varying base rates on classification accuracy are discussed.