Objective: Assessment of response validity is an integral part of forensic neuropsychological evaluations. The utility of performance validity measures (PVMs) in patients with potentially impaired cognitive functioning is less studied. The purpose of the current study was to compare the three potential profiles of the Medical Symptom Validity Test (MSVT; Pass, Genuine Memory Impairment Profile [GMIP], and Fail) on other freestanding and embedded PVMs. Method: Patients referred for a neuropsychological evaluation in a metropolitan Veteran Affairs medical center were included (N = 638). Each patient was administered the MSVT as well as other freestanding and embedded PVMs. Raw scores for each task, as well as incidence of scores below cutoffs were computed. Results: The sample revealed 260 (41%) in the Pass group. Of the 378 who failed the easy subtests of the MSVT, 314 (83%) had a GMIP and 64 (17%) were classified as Fail. The Pass group failed fewer freestanding and embedded PVMs and obtained higher raw scores on all PVMs than both GMIP and Fail groups. The differences in performances of the GMIP and Fail groups were minimal. Specifically, GMIP protocols failed fewer freestanding PVMs than the Fail group; failure on embedded PVMs did not differ between GMIP and Fail. Conclusion(s): When using the MSVT with clinical patients, the GMIP may indicate less failure on freestanding PVMs than that seen in Fail protocols. However, this group difference is not seen with embedded PVMs. Future research is recommended to differentiate cognitive impairment from invalidity.