Rates of Embedded Effort Test Failure Among Hospitalized Patients with Schizophrenia and Other Psychiatric Disorders

Date of Award


Document Type

Doctoral Research Paper

Degree Name



Graduate School of Professional Psychology

First Advisor

Kimberly Gorgens, Ph.D., ABPP

Second Committee Member

Laura Meyer, Ph.D.

Third Committee Member

Lauri L. Korinek, Ph.D.


Schizophrenia, Psychiatric disorder, Effort test, Psychological testing, Neuropsychology, Performance validity testing

Publication Statement

Copyright is held by the author. Permanently suppressed.


Schizophrenia spectrum disorders (SSD) are characterized by heterogeneous symptoms that can include cognitive and other psychosocial deficits. Neuropsychological evaluations are often requested to assess these deficits, but variable effort can make assessment difficult so the use of performance validity tests (PVT) is important. The Repeatable Battery for the Assessment of Neuropsychological Status Effort Index (RBANS EI) and the California Verbal Learning Test- II Forced Choice Recognition (CVLT-II FCR) are common PVTs used in the assessment of effort. The purpose of the present study was to establish base rates of effort test failure on these two PVTs for the inpatient psychiatric population and determine if there are statistically significant differences between the SSD population and other psychiatric populations. Records from 198 patients were reviewed. Results indicated that the effort test failure rates for the SSD group ranged from 65.5% to 73.3% on the RBANS EI, and from 2.9% to 11.7% on the CVL T-II FCR. For the other psychiatric populations, effort test failure rates ranged from 0% to 26.7% on the CVLT-II FCR, and from 26.7% to 100% on the RBANS EI. There were no statistically significant differences for effort test failure rates between psychiatric diagnoses. Given the wide range of failure rates across the two PVTs, the usage of multiple PVTs and usage of clinical judgment is recommended for clinical practice, and further research on effort measures is crucial.


27 pages

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