An Examination of the Relationship between Validity and Memory Measures in Retired NFL Players

Neuropsychologists have increasingly become involved in assessing sports-related concussions; however, an important concern is the validity of the evaluations. This study examined the relationship between Performance Validity Tests (PVTs) and memory measures in a comprehensive standardized battery administered to retired NFL players, with the purpose of exploring how predictive PVTs are for memory performance in this population. Hierarchical multiple regression analyses were used to evaluate the relationship between four PVTs (TOMM, MSVT, RDS, and Word Choice) and six memory tasks (WMS-IV LM I and LM II, VPA I and VPA II, VR I and VR II). A regression analysis was conducted for each memory test, for a total of six regression analyses. For each model, years played in the NFL, as well as MMPI-2-RF RCd, RC2, and RC7 scales were entered into the first block and the four PVTs were entered into the second block. Each memory subtest was entered as a dependent variable. Results yielded significant findings for each of the regression models, demonstrating that PVTs accounted for a significant amount of the variance of memory performance beyond the effects of emotional functioning, and years in the NFL. MSVT FR was found to be a significant predictor for each of the memory scales. Reliable Digit Span was a significant predictor for immediate memory subtests. Word Choice was a significant predictor for VPA II, and TOMM was a significant predictor of VR I and II. While the results demonstrated significant relationships between PVTs and memory performance, these relationships may be impacted by cognitive abilities, rather than true effort put forth on performance. This is particularly true for MSVT Free Recall, RDS, and the TOMM. Emotional functioning also appeared to impact memory performance. These results have important implications, including that PVTs may not be valid for individuals with severe cognitive impairment and that alternatives to validity testing may be necessary. Additionally, mood difficulties may exacerbate poor performance on neuropsychological testing. Overall, caution must be taken when evaluating performance on PVTs and cognitive tests in order to differentiate between genuine cognitive impairment, emotional distress, and suboptimal effort