Objective This is the first systematic review and meta-analysis of the Test of Memory Malingering (TOMM) in pediatric examinees. It adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Method A systematic literature search was conducted using PsycINFO and PubMed, reviewing articles from January 1997 to July 2019. Books providing data on pediatric validity testing were also reviewed for references to relevant articles. Eligibility criteria included publication in a peer-reviewed journal, utilizing a pediatric sample, providing sufficient data to calculate specificity and/or sensitivity, and providing a means for evaluating validity status external to the TOMM. After selection criteria were applied, 9 articles remained for meta-analysis. Samples included clinical patients and healthy children recruited for research purposes; ages ranged from 5 to 18. Fixed and random effects models were used to calculate classification accuracy statistics. Results Traditional adult-derived cutoffs for Trial 2 and Retention were highly specific (0.96–0.99) in pediatric examinees for both clinical and research samples. Sensitivity was relatively strong (0.68–0.70), although only two studies reported sensitivity rates. A supplemental review of the literature corroborated these findings, revealing that traditional adult-based TOMM cutoffs are supported in most pediatric settings. However, limited research exists on the impact of very young age, extremely low cognitive functioning, and varying clinical diagnoses. Conclusions The TOMM, at traditional adult cutoffs, has strong specificity as a performance validity test in pediatric neuropsychological evaluations. This meta-analysis found that specificity values in children are comparable to those of adults. Areas for further research are discussed.
Objective The present study, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, is the first systematic review of the Test of Memory Malingering (TOMM) to examine the specificity of traditional adult cutoffs in children ages 5-18. Data Selection Article search terms and selection criteria were identified a priori. A search of PsycINFO and PubMED in January 2018 identified 539 peer-reviewed journal articles published from 1997-2017. Studies were excluded if they did not involve a pediatric sample, did not provide a means for ensuring validity external to the TOMM, contained samples overlapping those of other included studies, or did not provide sufficient data to calculate specificity values at traditional cutoffs. Frequencies of true negatives and false positives were extracted. When not available, these counts were calculated from sample size and specificity values. Data extraction was completed independently by the first two authors with any discrepancies rectified via discussion. Data were synthesized using a fixed effects model to calculate overall specificity. Data Synthesis Application of selection criteria resulted in 9 articles comprising 13 samples for Trial 2 and 3 studies comprising 5 samples for Retention. Weighted mean specificity was 0.98 for Trial 2 (n = 662) and 0.99 for Retention (n = 173) at standard cutoffs. Conclusions TOMM Trial 2 and Retention at traditional cutoffs maintain specificity values in pediatrics comparable to those of adults. Given limited research on the potential impact of very young age and extremely low cognitive functioning, further research will be important in determining the generalizability of these results across all pediatric populations.
Objective In cognitive domains such as memory, decline can manifest in several ways. The current study investigated how different memory changes reported by family members on a behavior rating scale were related to neuropsychological test performance. The study also examined if reported memory problems reflected memory impairment specifically, versus general cognitive dysfunction. Method Patients (n = 87, mean age = 73.0, mean education = 13.1 years) minimally completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) during dementia evaluations. Information from patients’ family members was obtained via a questionnaire asking about degrees of perceived change (no change, mild change, moderate change, or severe change) in “remembering conversations,” “repeating self,” and “misplacing items.” Spearman correlations were calculated between family members’ perceptions of change and cognitive dysfunction, measured by RBANS index scores. Results Perceived changes in misplacing items significantly correlated with RBANS Immediate Memory (rs = −.291, p = .008) and Delayed Memory (rs = −.261, p = .018) indices. The only other correlations that approached statistical significance were between remembering conversations and Immediate Memory (rs = −.209, p = .052) and repeating self and Delayed Memory (rs = −.208, p = .056). No correlations with other RBANS index scores approached statistical significance at p < .05. Conclusions While not all results were statistically significant, trends among correlations between RBANS index scores and family-reported changes in patients remembering conversations, repeating themselves, and misplacing items suggest that when these terms are utilized on behavior rating scales, they possess both convergent and discriminant validity. Since misplacing items significantly correlated with both immediate and delayed memory dysfunction, changes in this area might be the most useful to assess on behavior rating scales.
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