The Victoria Symptom Validity Test (VSVT) is a performance validity test (PVT) with over two decades of empirical backing, although methodological limitations within the extant literature restrict its clinical and research generalizability. Chief among these constraints includes limited consensus on the most accurate index within the VSVT and the most appropriate cut-scores within each VSVT validity index. The current systematic review synthesizes existing VSVT validation studies and provides additional cross-validation in an independent sample using a known-groups design. We completed a systematic search of the literature, identifying 17 peer-reviewed studies for synthesis (7 simulation designs, 7 differential prevalence designs, and 3 known-groups designs). The independent cross-validation sample consisted of 200 mixed clinical neuropsychiatric patients referred for outpatient neuropsychological evaluation. Across all indices, Total item accuracy produced the strongest psychometric properties at an optimal cut-score of ≤ 40 (62% sensitivity/88% specificity). However, ROC curve analyses for all VSVT indices yielded statistically significant areas under the curve (AUCs; .73–81), suggestive of moderate classification accuracy. Cut-scores derived using the independent cross-validation sample converged with some previous findings supporting cut-scores of ≤ 22 for Easy item accuracy and ≤ 40 for Total item accuracy, although divergent findings were noted for Difficult item accuracy. Overall, VSVT validity indicators have adequate diagnostic accuracy across populations, with the current study providing additional support for its use as a psychometrically sound PVT in clinical settings. However, caution is recommended among patients with certain verified clinical conditions (e.g., dementia) and those with pronounced working memory deficits due to concerns for increased risk of false positives.

Victoria Symptom Validity Test (VSVT) 是一种具有超过二十年经验支持的性能效度测试 (PVT)，尽管现有文献中的方法学局限性限制了其临床和研究的普遍性。这些限制因素中最主要的包括对 VSVT 中最准确的指数和每个 VSVT 有效性指数中最合适的分值的有限共识。当前的系统评价综合了现有的 VSVT 验证研究，并使用已知组设计在独立样本中提供了额外的交叉验证。我们完成了对文献的系统搜索，确定了 17 项经过同行评审的综合研究（7 项模拟设计、7 项差异流行设计和 3 项已知组设计）。独立交叉验证样本由 200 名混合临床神经精神病患者组成，这些患者转诊进行门诊神经心理学评估。在所有指标中，总项目准确度在 ≤ 40 的最佳分数（62% 敏感性/88% 特异性）下产生了最强的心理测量属性。然而，所有 VSVT 指数的 ROC 曲线分析产生了具有统计意义的曲线下面积（AUC；0.73-81），表明分类准确度适中。使用独立交叉验证样本得出的切割分数与之前的一些发现一致，支持简单项目准确度的切割分数≤ 22，总项目准确度的切割分数≤ 40，尽管对困难项目的准确度有不同的发现。总体而言，VSVT 有效性指标在人群中具有足够的诊断准确性，目前的研究为其在临床环境中用作心理测量学上合理的 PVT 提供了额外的支持。然而，由于担心假阳性风险增加，建议对具有某些经证实的临床状况（例如，痴呆）的患者和具有明显工作记忆缺陷的患者保持谨慎。