Decision rules for an abbreviated administration of the Test of Memory Malingering

Appl Neuropsychol Adult. 2024 Jul-Aug;31(4):382-391. doi: 10.1080/23279095.2022.2026948. Epub 2022 Jan 24.

Abstract

The present study investigated abbreviation methods for the Test of Memory Malingering (TOMM) in relation to traditional manual-based test cutoffs and independently derived more stringent cutoffs suggested by recent research (≤48 on Trial 2 or 3). Consecutively referred outpatient U.S. military veterans (n = 260) were seen for neuropsychological evaluation for mild traumatic brain injury or possible attention-deficit/hyperactivity disorder. Performance on TOMM Trial 1 was evaluated, including the total score and errors on the first 10 items (TOMMe10), to determine correspondence and redundancy with Trials 2 and 3. Using the traditional cutoff, valid performance on Trials 2 and 3 was predicted by zero errors on TOMMe10 and by Trial 1 scores greater than 41. Invalid performance was predicted by commission of more than three errors on TOMMe10 and by Trial 1 scores less than 34. For revised TOMM cutoffs, a Trial 1 score above 46 was predictive of a valid score, and a TOMMe10 score of three or more errors or a Trial 1 score below 36 was associated with invalid TOMM performance. Conditional abbreviation of the TOMM is feasible in a vast majority of cases without sacrificing information regarding performance validity. Decision trees are provided to facilitate administration of the three trials.

Keywords: ADHD; assessment; forensic neuropsychology; head injury; performance validity.

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Brain Concussion / diagnosis
  • Female
  • Humans
  • Male
  • Malingering* / diagnosis
  • Memory Disorders / diagnosis
  • Middle Aged
  • Neuropsychological Tests* / standards
  • Veterans*
  • Young Adult