INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #78 The Relationship Between Performance Validity Test Failure and Psychological Functioning in Long COVID Greta Minor, University of Minnesota, Minneapolis, United States Laura Fry, University of Minnesota, Minneapolis, United States Michael Basso, Mayo Clinic, Rochester, United States Nicole Thayer, University of St. Thomas, Saint Paul, United States Savana Naini, University of Virginia, Charlottesville, United States Eric Waldron, University of Minnesota, Minneapolis, United States Erin Holker, University of Minnesota, Minneapolis, United States James Porter, University of Minnesota, Minneapolis, United States Courtney Eskridge, University of Minnesota, Minneapolis, United States Allison Logemann, University of Minnesota, Minneapolis, United States Chen Shen, University of Minnesota, Minneapolis, United States Douglas Whiteside, University of Minnesota, Minneapolis, United States Category: Infectious Disease (HIV/COVID/Hepatitis/Viruses) Keyword 1: performance validity Keyword 2: infectious disease Keyword 3: personality Objective: Persistent cognitive complaints following recovery from acute COVID-19 infection, a phenomenon widely referred to as “Long COVID,” has emerged as a salient clinical concern. Cognitive dysfunction associated with Long COVID is now recognized as a disability under ADA guidelines. Consequently, some examinees may be motivated to manifest non-credible performances or embellish complaints of emotional distress during neuropsychological evaluations. Tests of performance validity (PVTs) and symptom validity (SVTs) have been established as essential elements of neuropsychological evaluations, but such measurements have rarely been utilized with Long COVID patients. The current study examined whether subjective symptom complaints on the Personality Assessment Inventory varied according to PVT responses in Long COVID patients. Participants and Methods: 247 patients diagnosed with Long COVID (WHO, 2022) were referred by medical providers for neuropsychological evaluation as part of a clinical workup in an adult post-COVID clinic. All patients had a positive polymerase chain reaction (PCR) test, at-home antigen test, or antibody test for COVID-19 noted in their record. 175 of the 247 total patients completed the Personality Assessment Inventory (PAI). In addition to the PAI, all participants completed a standardized neuropsychological test battery (including measures of pre-morbid intellectual functioning, attention, processing speed, visuospatial abilities, language, learning/memory, and executive functioning), four PVTs (Test of Memory Malingering, Dot Counting Test, Reliable Digit Span, and the Discrimination Index from the Hopkins Verbal Learning Test-Revised), and two mood/anxiety questionnaires. Electronic medical records were reviewed for possible evidence of external incentives (e.g., disability or worker’s compensation claims). Among the 175 patients who completed the PAI, 66.3% were female, 88.6% were white, the mean age was 54 years, and the mean education was 15 years. 25.7% of these patients had external incentives. Based on PVT performances during the neuropsychological evaluation, patients were assigned to one of three groups: a Pass group (no PVT failures), an Intermediate group (1 PVT failure), or a Fail group (2+ PVT failures). Results: Of the patients who completed the PAI, 86.3% passed PVTs, 6.3% failed one PVT, and 7.4% failed 2+ PVTs. Between the three groups (Pass, Intermediate, and Fail), there were no significant differences in age, education, ethnicity, gender, or external incentive frequency. There was one significant difference (η² = 0.11) between groups on the somatization subscale (SOM-S) of the PAI, with marginally greater somatization symptoms reported in the Fail group relative to the Pass group and no significant differences between either the Fail or Pass groups and the Intermediate group. There were no significant differences observed between groups on any other PAI scale or subscale. Conclusions: These findings suggest that individuals with Long COVID who fail PVTs endorse more somatization symptoms, but they do not endorse heightened emotional distress. Thus, other aspects of psychological functioning, as measured by the PAI, may not be related to PVT failure in Long COVID samples. Future studies should attempt to replicate this finding, in addition to examining whether PAI responses vary according to SVT performances in Long COVID patients.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #78

The Relationship Between Performance Validity Test Failure and Psychological Functioning in Long COVID

Greta Minor, University of Minnesota, Minneapolis, United States
Laura Fry, University of Minnesota, Minneapolis, United States
Michael Basso, Mayo Clinic, Rochester, United States
Nicole Thayer, University of St. Thomas, Saint Paul, United States
Savana Naini, University of Virginia, Charlottesville, United States
Eric Waldron, University of Minnesota, Minneapolis, United States
Erin Holker, University of Minnesota, Minneapolis, United States
James Porter, University of Minnesota, Minneapolis, United States
Courtney Eskridge, University of Minnesota, Minneapolis, United States
Allison Logemann, University of Minnesota, Minneapolis, United States
Chen Shen, University of Minnesota, Minneapolis, United States
Douglas Whiteside, University of Minnesota, Minneapolis, United States

Category: Infectious Disease (HIV/COVID/Hepatitis/Viruses)

Keyword 1: performance validity
Keyword 2: infectious disease
Keyword 3: personality

Objective:

Persistent cognitive complaints following recovery from acute COVID-19 infection, a phenomenon widely referred to as “Long COVID,” has emerged as a salient clinical concern. Cognitive dysfunction associated with Long COVID is now recognized as a disability under ADA guidelines. Consequently, some examinees may be motivated to manifest non-credible performances or embellish complaints of emotional distress during neuropsychological evaluations. Tests of performance validity (PVTs) and symptom validity (SVTs) have been established as essential elements of neuropsychological evaluations, but such measurements have rarely been utilized with Long COVID patients. The current study examined whether subjective symptom complaints on the Personality Assessment Inventory varied according to PVT responses in Long COVID patients.

Participants and Methods:

247 patients diagnosed with Long COVID (WHO, 2022) were referred by medical providers for neuropsychological evaluation as part of a clinical workup in an adult post-COVID clinic. All patients had a positive polymerase chain reaction (PCR) test, at-home antigen test, or antibody test for COVID-19 noted in their record. 175 of the 247 total patients completed the Personality Assessment Inventory (PAI). In addition to the PAI, all participants completed a standardized neuropsychological test battery (including measures of pre-morbid intellectual functioning, attention, processing speed, visuospatial abilities, language, learning/memory, and executive functioning), four PVTs (Test of Memory Malingering, Dot Counting Test, Reliable Digit Span, and the Discrimination Index from the Hopkins Verbal Learning Test-Revised), and two mood/anxiety questionnaires. Electronic medical records were reviewed for possible evidence of external incentives (e.g., disability or worker’s compensation claims). Among the 175 patients who completed the PAI, 66.3% were female, 88.6% were white, the mean age was 54 years, and the mean education was 15 years. 25.7% of these patients had external incentives. Based on PVT performances during the neuropsychological evaluation, patients were assigned to one of three groups: a Pass group (no PVT failures), an Intermediate group (1 PVT failure), or a Fail group (2+ PVT failures).

Results:

Of the patients who completed the PAI, 86.3% passed PVTs, 6.3% failed one PVT, and 7.4% failed 2+ PVTs. Between the three groups (Pass, Intermediate, and Fail), there were no significant differences in age, education, ethnicity, gender, or external incentive frequency. There was one significant difference (η² = 0.11) between groups on the somatization subscale (SOM-S) of the PAI, with marginally greater somatization symptoms reported in the Fail group relative to the Pass group and no significant differences between either the Fail or Pass groups and the Intermediate group. There were no significant differences observed between groups on any other PAI scale or subscale.

Conclusions:

These findings suggest that individuals with Long COVID who fail PVTs endorse more somatization symptoms, but they do not endorse heightened emotional distress. Thus, other aspects of psychological functioning, as measured by the PAI, may not be related to PVT failure in Long COVID samples. Future studies should attempt to replicate this finding, in addition to examining whether PAI responses vary according to SVT performances in Long COVID patients.