Validity of the Verbal Concept Attainment Test in multiple sclerosis

Ryan Mulligan, Michael R. Basso, Lily Lau, Bradley Reynolds, Douglas M. Whiteside, Dennis Combs, Robert A. Bornstein

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective. As many as 70% of people with multiple sclerosis (MS) have clinically significant cognitive impairment, and most of these individuals exhibit executive dysfunction. Most research concerning executive dysfunction in MS has focused upon nonverbal measures. The Verbal Concept Attainment Test (VCAT) has demonstrated construct validity as an executive function measure in people infected with HIV and in people with focal brain lesions, but its validity among people with MS is unknown. The current study evaluated the VCAT’s criterion, diagnostic, and ecological validity in people with MS. Method. A comprehensive neuropsychological battery was administered to 44 healthy individuals and 97 people with MS. Based on existing norms, they were classified as impaired or unimpaired, resulting in 65 people with MS categorized as unimpaired and 32 as impaired. They were administered a battery assessing neuropsychological impairment and disability status. Results. The VCAT correlated with most measures of neuropsychological function, but its largest correlations occurred with measures of executive function, working memory, and verbal memory. Regarding classification accuracy, the VCAT achieved satisfactory sensitivity and specificity in identifying neuropsychological impairment in people with MS. The VCAT achieved moderate correlations with measures of disability status. Conclusions. The data provide evidence for an optimal VCAT cutoff score for establishing neuropsychological impairment in people with MS, and they demonstrate that the VCAT possesses acceptable criterion, diagnostic, and ecological validity. As such, these data support the inclusion of the VCAT in research and clinical practice involving people with MS.

Original languageEnglish (US)
Pages (from-to)331-340
Number of pages10
JournalJournal of Clinical and Experimental Neuropsychology
Issue number4
StatePublished - Apr 21 2019
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by the National Institute of Neurological Disorders and Stroke [grant number R01 NS043362].

Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.


  • Classification accuracy
  • criterion validity
  • ecological validity
  • executive function
  • multiple sclerosis
  • verbal abstract reasoning


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