Rates and Predictors of Performance Validity Test Failure in Adults Treated for Post-COVID-19 Condition: a Brief Report

Phoebe A Clark; Samantha Horn; Natalie Wang; Constantine G Lyketsos; Ann M Parker; Esther S Oh; Tracy D Vannorsdall

doi:10.1093/arclin/acae122

Rates and Predictors of Performance Validity Test Failure in Adults Treated for Post-COVID-19 Condition: a Brief Report

Arch Clin Neuropsychol. 2025 Jan 2:acae122. doi: 10.1093/arclin/acae122. Online ahead of print.

Authors

Phoebe A Clark¹, Samantha Horn¹, Natalie Wang², Constantine G Lyketsos^{1

2}, Ann M Parker^{3

4}, Esther S Oh^{5

6}, Tracy D Vannorsdall⁷

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
² Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA.
³ Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
⁴ Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
⁵ Department of Medicine, Department of Psychiatry and Behavioral Sciences, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
⁶ Johns Hopkins University School of Nursing, Baltimore, MD 21287, USA.
⁷ Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

PMID: 39745850
DOI: 10.1093/arclin/acae122

Abstract

>objective: Cognitive dysfunction is a common symptom of post-COVID-19 condition (PCC). Few studies have examined rates and predictors of cognitive performance validity test (PVT) failure in patients seeking treatment for PCC.

>methods: We report the rates of PVT failure in 323 patients who received care in a long-COVID-19 clinic for any post-COVID-19 health concern and underwent routine telephone cognitive testing that included two embedded PVTs. Binary logistic regressions examined the demographic, illness, and psychological variables associated with PVT failure.

>results: The prevalence of single PVT failure ranged from 4.7% to 26.1% whereas failure on both PVTs occurred in just 6.3%. Illness characteristics, subjective cognitive dysfunction, and most demographic and psychological variables were unrelated to single PVT failure. Males and those with anxiety were more likely to fail both PVTs.

>conclusion: Failure across multiple PVTs was not common and was unrelated to COVID-19 severity or cognitive complaints.

Keywords: Assessment; Infectious diseases, non-HIV; Malingering/symptom validity testing.

Abstract

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