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Raising the bar: Preliminary investigation of alternative MSVT cutoffs for adults referred for ADHD

Year: 2025
Type: article
Abstract: This study investigated the classification accuracy of alternative cutoffs for three Medical Symptom Validity Test (MSVT) indices, Immediate Recall (IR), Delayed Recall (DR), and Consistency (CNS). Study 1 included 83 college students randomized into two simulated ADHD groups (Incentivized simulator n = 25; Non-incentivized simulator n = 28) and one control group (n = 30). Study 2 included cross-sectional data from 114 ADHD referrals at a university-based clinic (n = 91 valid group; n = 23 invalid group) who completed the MSVT and at least two additional performance validity tests. Receiver Operator Characteristic (ROC) curves in study 1 revealed significant areas under the curve for IR, DR, and CNS (AUC = .81 − .86), high to perfect specificity (.93 − .10), and moderate to high sensitivity (.45 − .75) using cutoffs of ≤85, ≤90, and ≤95. ROC curve analyses in study 2 yielded significant areas under the curve for IR (AUC = .73), DR (AUC = .74), and CNS (AUC = .78). An optimal cut score of ≤90 across all three subtests yielded modest sensitivity (.35 − .52) while still maintaining adequate specificity (.91 − .96). The manual-recommended cutoff for invalidity (IR, DR, or CNS ≤85) demonstrated high specificity (95%) but only modest sensitivity (35%) whereas the modified cutoff (IR, DR, or CNS ≤90) increased sensitivity substantially (56%) while maintaining adequate specificity (90%). This study provides preliminary support for alternative MSVT cutoffs in adult ADHD assessments. However, additional research is warranted before utilizing these alternative cutoffs in clinical contexts.
DOI: 10.1080/23279095.2025.2488355
Language: English
Field: Psychology
Open Access status: green
OpenAlex ID: W4409493343
FWCI: 2.186
Cites: 48
Cited by: 2
Related to: 10