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Advanced Neurology

ORIGINAL RESEARCH ARTICLE
Specificity of multiple performance validity tests

in a mixed neurological patient sample from
Indonesia

Widhi Adhiatma 1,2 , Marc P. H. Hendriks 1,2,3 , Magdalena S. Halim 1 ,
Eugenia Emile Natasha 1 , Octavianus Darmawan 4,5 , Diatri Nari Lastri 6,7 ,
and Roy P. C. Kessels *
2,8
1 Department of Clinical Psychology, Faculty of Psychology, Atma Jaya Catholic University of
Indonesia, Jakarta, Indonesia
2 Department of Neuropsychology and Rehabilitation Psychology, Donders Institute for Brain,
Cognition, and Behavior, Radboud University, Nijmegen, Gelderland, The Netherlands
3 Academic Centre of Epileptology, Kempenhaeghe, Heeze, North Brabant, The Netherlands
4 Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University
of Indonesia, Jakarta, Indonesia
5 Department of Neurology, Atma Jaya Hospital, Jakarta, Indonesia
6 Department of Neurology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
7 Department of Neurology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
8 Korsakoff Center for Alcohol-related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry,
Venray, The Netherlands

Abstract
*Corresponding author:
Roy P. C. Kessels Performance validity testing (PVT) is crucial in contemporary neuropsychological
(roy.kessels@donders.ru.nl)
assessment. This study aimed to validate several PVTs— – the Reliable Digit
Citation: Adhiatma W, Span (RDS), the Longest Digit Forward-1 Trial, the Longest Digit Forward-2 Trials
Hendriks MPH, Halim MS, et al.
Specificity of multiple performance (LDF-2), the Tes Memori Jangka Pendek Indonesia (TMJPI), and the Non-Verbal
validity tests in a mixed neurological Medical Symptom Validity Test – in an Indonesian mixed neurological sample.
patient sample from Indonesia. Adv We recruited 141 patients through convenience sampling, divided into three
Neurol. 2025;4(2):86-99.
doi: 10.36922/an.5661 groups: Neurocognitive disorder due to possible neurodegenerative disease (ND;
n = 49), post-stroke (n = 42), and mixed etiology (n = 47). Data were collected
Received: October 29, 2024 prospectively. The PVT cut-off scores were adjusted when specificity rates fell
Revised: January 10, 2025 below 0.90. Intercorrelations between Mini-Mental State Examination (MMSE)
Accepted: February 11, 2025 scores, demographic variables, and PVT scores were computed. The cut-off scores
were modified for each group due to unacceptable specificity rates, with the
Published online: March 10, 2025 most substantial adjustment made for the TMJPI cut-off score in the ND group.
Copyright: © 2025 Author(s). Three variables (MMSE, education, and age) were significantly correlated with
This is an Open-Access article PVT scores, with the exception of RDS and LDF-2. The PVTs were also significantly
distributed under the terms of the
Creative Commons Attribution intercorrelated. We conclude that the previously developed Indonesian PVTs can
License, permitting distribution, be validly applied in neurological patients. However, clinicians should exercise
and reproduction in any medium, caution when selecting PVTs and consider the demographic backgrounds of
provided the original work is
properly cited. patients to minimize false-positive results.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Neuropsychological tests; Malingering; Cognitive dysfunction; Diagnosis;
regard to jurisdictional claims in
published maps and institutional Motivation; Sensitivity and specificity
affiliations.

Volume 4 Issue 2 (2025) 86 doi: 10.36922/an.5661