Symptom Validity Testing (SVT) and Social Security Disability Claims

Abstract

Background and aims

Over 50% of adult disability claimants fail some form of SVT. While some over report psychological, affective symptoms, others may report incredible cognitive symptoms. We examined effects of different types of response bias on free recall and self-reported depression.

Participants and methods This is a single site cross-sectional study using a convenience sample (n = 224) of disability claimants in the Netherlands. The Green Word Memory Test (GWMT) was administered to all subjects. The Amsterdam Short Term Memory Test (AKTG), the Structured Inventory of Malingered. Symptomatology (SIMS), and the beck depression inventory (BDI-II) were administered in subsamples. Participant classification according to GWMT and SIMS outcomes resulted in four groups, G+/S+, G+/S−, G−/S+ and G−/S−.

Results

Average age of the participants was 46.3 years (SD 9.9), 41.5% were female, and 43% were higher educated. GWMT was positive in 48.2% of all subjects, and 27.6% scored positive on both GWMT and SIMS. Analysis of variance of GWMT Free recall and Beck depression scores showed significant group differences [F(3, 123) = 33.21, P = .000] and [F(3, 106) = 25.17, P = .000] respectively.

Conclusions

Non credible test performance was prevalent in this Dutch study of disability claimants. Insufficient effort and over reporting of psychological symptoms are associated with different score profiles on regular tests and self-rating scales.

Disclosure of interest

The author receives funding for his work as a neuropsychologist in an expertise setting.