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<p>Premorbid intellectual function estimation is essential in neuropsychological evaluation to differentiate acquired neurocognitive decline from baseline functioning. Although confounding variables may impact performance-based premorbid estimates, little is known about the impact of invalid test performance on such estimates. This cross-sectional study examined the impact of performance invalidity on performance based vs. demographics-based premorbid estimation using the Test of Premorbid Functioning (TOPF). Using four freestanding performance validity tests (PVTs), 489 adults referred for comprehensive neuropsychological evaluation were divided into valid (≤ 1 failure) or invalid (≥ 2 failures) groups. Three premorbid estimates were then calculated for each patient from the TOPF (i.e., Reading-Only, Demographics-Only, and Combined). IQ estimates from all 3 TOPF models were significantly lower in the invalid group compared to the valid, with the largest effect size for the Reading-Only model and the smallest for the Demographics-Only model. Supplementary analyses revealed negligible within-group effects in the valid group and medium effects in the invalid group. TOPF prediction models including the performance-based irregular word reading score (Reading-Only and Combined Models) were significantly impacted by invalid performance. Although considered a hold test, irregular word reading scores are susceptible to invalid performance. The Demographics-Only model should be utilized in such cases.</p>

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Performance Invalidity is Associated with Lower Test of Premorbid Functioning IQ Estimates in Performance-Based Versus Demographics-Based Prediction Models: Implications for Neuropsychological Practice and Research

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月16日

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  • Greg Shapiro,
  • Evan P. Fisher,
  • Nevin A. Orleans,
  • Malorie E. Watson,
  • Brian M. Cerny,
  • Matthew S. Phillips,
  • Jason R. Soble,
  • G. Whitman Kent

摘要

Premorbid intellectual function estimation is essential in neuropsychological evaluation to differentiate acquired neurocognitive decline from baseline functioning. Although confounding variables may impact performance-based premorbid estimates, little is known about the impact of invalid test performance on such estimates. This cross-sectional study examined the impact of performance invalidity on performance based vs. demographics-based premorbid estimation using the Test of Premorbid Functioning (TOPF). Using four freestanding performance validity tests (PVTs), 489 adults referred for comprehensive neuropsychological evaluation were divided into valid (≤ 1 failure) or invalid (≥ 2 failures) groups. Three premorbid estimates were then calculated for each patient from the TOPF (i.e., Reading-Only, Demographics-Only, and Combined). IQ estimates from all 3 TOPF models were significantly lower in the invalid group compared to the valid, with the largest effect size for the Reading-Only model and the smallest for the Demographics-Only model. Supplementary analyses revealed negligible within-group effects in the valid group and medium effects in the invalid group. TOPF prediction models including the performance-based irregular word reading score (Reading-Only and Combined Models) were significantly impacted by invalid performance. Although considered a hold test, irregular word reading scores are susceptible to invalid performance. The Demographics-Only model should be utilized in such cases.