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Objective: The purpose of this study is to examine, in a mixed clinical sample, the sensitivity of the Personality Assessment Inventory (PAI; Morey, 1996) validity scales in discriminating between patients who failed two or more performance validity tests (PVT) from patients who passed all PVTs. Method: The sample included 351 consecutive clinical referrals for neuropsychological evaluation (mean Age = 46.4, SD = 15.1; mean Education = 13.5, SD = 2.6). All participants completed a comprehensive examination that included at least one free-standing PVT, at least two embedded PVTs, and the PAI. Individuals who failed a free standing PVT and at least one embedded PVT were classified into the FAIL group (n = 61), and all others were classified into the PASS group (n = 290). T-tests between the groups on the validity scales were performed. Receiver Operating Characteristic (ROC) analyses were performed and area under the curve (AUC) was calculated to evaluate overall classification accuracy. Results: The Negative Impression Management (NIM) scale and the Malingering Index (MAL) were found to significantly differentiate the PASS and FAIL group (p = 0.022 and p = 0.039). No other statistically significant findings were found for any other validity scale. The AUCs for both NIM (0.59, 95%CI = 0.51-0.67) and MAL (0.58, 95%CI = 0.50-0.65) were below acceptable levels for clinical use. Conclusion: Findings suggest the PAI validity scales have poor classification accuracy in detecting cognitive response bias, as defined by performance on PVTs. Thus, these findings suggest the need to create a new PAI validity scale designed specifically to detect cognitive response bias.
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