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Medical Symptom Validity Test (MSVT)
Availability
Please visit this website for more information about the instrument: The Medical Symptom Validity Test (MSVT)
Classification
Supplemental: Sport-Related Concussion (SRC) Subacute (after 72 hours to 3 months) and Persistent/Chronic (3 months and greater post concussion), and Traumatic Brain Injury (TBI)
Short Description of Instrument
The Medical Symptom Validity Test (MSVT) is a shorter version of the Word Memory Test, in which patients are presented with 10 semantically-related word pairs. Four conditions are tested: Immediate Recognition, Delayed Recognition, Paired Associate, and Free Recall.
 
Can be used in adults and children, although not appropriate for individuals who have less than a 2nd grade reading level.
 
Sport-Related Concussion Specific:
 
Advantages:The MSVT appears to have good potential value as an objective measure for detecting symptom invalidity in school-age youth with mTBI and can be administered in 10 minutes. It has been examined both in SRC (two studies) and in non-SRC mTBI.
 
Limitations: There is also a non-verbal version. Computer-based.
 
Related study: Kirkwood, et al., 2014. METHODS: Using a consecutive clinical case series design, we examined 191 patients (62% SRC) aged 8 to 17 years seen for neuropsychological evaluation after mTBI. Participants were administered the MSVT and completed a graded symptom scale as part of a neuropsychological battery. RESULTS: A total of 23 participants (12%) failed the MSVT. The Fail group endorsed significantly more postconcussive symptoms than the Pass group, with a large effect size (P< .001; d = 1.1). MSVT performance remained a robust unique predictor of symptom report even after controlling for other influential factors (e.g., female gender, premorbid psychiatric problems). CONCLUSIONS: A subset of children who had persistent complaints after mTBI may be exaggerating or feigning symptoms. If such negative response bias remains undetected, errors in etiologic statements and less than optimal treatment may occur.
Psychometric Properties
Validity measures are sensitive to inadequate effort and quite insensitive to individual ability-based differences. Profile analysis can further differentiate true impairment from effort-related problems. Appears resistant to coaching.
Scoring
Raw scores and percent of answers correct scored per subtest.
References
Armistead-Jehle P. Symptom validity test performance in U.S. veterans referred for evaluation of mild TBI. Appl Neuropsychol. 2010;17(1):52–59.
 
Green, P. (2003, revised 2005) Medical Symptom Validity Test for Windows: User's manual and program, Green's Publishing, Edmonton.
 
Kirkwood MW, Peterson RL, Connery AK, Baker DA, Grubenhoff JA. Postconcussive symptom exaggeration after pediatric mild traumatic brain injury. Pediatrics. 2014;133(4):643–650.
 
Kirkwood MW, Kirk JW. The base rate of suboptimal effort in a pediatric mild TBI sample: performance on the Medical Symptom Validity Test. Clin Neuropsychol. 2010;24(5):860–872.
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