Use of the color trails test as an embedded measure of performance validity.

One hundred personal injury litigants and disability claimants referred for a forensic neuropsychological evaluation were administered both portions of the Color Trails Test (CTT) as part of a more comprehensive battery of standardized tests. Subjects who failed two or more free-standing tests of cognitive performance validity formed the Failed Performance Validity (FPV) group, while subjects who passed all free-standing performance validity measures were assigned to the Passed Performance Validity (PPV) group. A cutscore of ≥45 seconds to complete Color Trails 1 (CT1) was associated with a classification accuracy of 78%, good sensitivity (66%) and high specificity (90%), while a cutscore of ≥84 seconds to complete Color Trails 2 (CT2) was associated with a classification accuracy of 82%, good sensitivity (74%) and high specificity (90%). A CT1 cutscore of ≥58 seconds, and a CT2 cutscore ≥100 seconds was associated with 100% positive predictive power at base rates from 20 to 50%.