Cross-validation of picture completion effort indices in personal injury litigants and disability claimants

Picture Completion (PC) indices from the Wechsler Adult Intelligence Scale, Third Edition, were investigated as performance validity indicators (PVIs) in a sample referred for independent neuropsychological examination. Participants from an archival database were included in the study if they were between the ages of 18 and 65 and were administered at least two PVIs. Effort measure performance yielded groups that passed all or failed one measure (Pass; n = 95) and failed two or more PVIs (Fail-2; n = 61). The Pass group performed better on PC than the Fail-2 group. PC cut scores were compared in differentiating Pass and Fail-2 groups. PC raw score of ≤12 showed the best classification accuracy in this sample correctly classifying 91% of Pass and 41% of Fail-2 cases. Overall, PC indices show good specificity and low sensitivity for exclusive use as PVIs, demonstrating promise for use as adjunctive embedded measures.