A Comparison of the Degree of Effort Involved in the TOMM and the ACS Word Choice Test Using a Dual-Task Paradigm

Abstract

The aims of the current study were to: (a) examine the predictive validity and efficacy of the Advanced Clinical Solutions Word Choice Test (WCT) as a measure of effort relative to the Test of Memory Malingering (TOMM); (b) investigate whether performing a dual (distraction) task would undermine performance on either test; (c) assess the effect of coaching on the diagnostic accuracy of both the WCT and the TOMM; and (d) establish an optimal cut score for the WCT. The current study used a simulation design based on an analogue design in which normal participants were instructed to either apply full effort or simulate a brain injury on the tasks without being detected. Participants included 93 undergraduate university students who were randomly assigned to 1 of 4 conditions: (a) distraction, (b) uncoached traumatic brain injury (TBI) simulators, (c) coached TBI simulators, or (d) full effort. The results demonstrated that the WCT and the TOMM were effective in detecting simulated cognitive impairment. Both tests were resistant to the effects of distraction and were equally effective in detecting coached and uncoached simulators. A cut score of 42 on the WCT was found to provide optimal specificity and sensitivity on the test.

Convergent, Discriminant, and Concurrent Validity of Nonmemory-Based Performance Validity Tests

“…Recognition of the words is tested immediately following the learning trial using a forced-choice paradigm of a target item and a foil. Consistent with previous research, noncredible and valid performance were identified using the cutoffs of ⩽41 and ⩾42, respectively (Bain & Soble, 2019; Barhon, Batchelor, Meares, Chekaluk, & Shores, 2015).…”

Bridging the Gap Between Neurocognitive Processing Theory and Performance Validity Assessment among the Cognitively Impaired: A Review and Methodological Approach

“…Furthermore, the CAM’s ease of implementation in comparison to clinical known groups (e.g., Greve et al, 2008) or drug administration paradigms (Loring et al, 2011) would facilitate replication by independent research groups. Of note, in the final stages of preparing this manuscript Barhon, Batchelor, Meares, Chekaluk, and Shores (2014) reported similar success in using a dual task paradigm to simulate cognitive impairment in healthy adults, further supporting the potential utility of this approach.…”

Validation of the Advanced Clinical Solutions Word Choice Test (WCT) in a Mixed Clinical Sample: Establishing Classification Accuracy, Sensitivity/Specificity, and Cutoff Scores

“…Authors of both studies noted that their findings suggest that the WCT should not be used alone as an indicator of performance validity, but should be considered in the context of performance on multiple PVTs. In a later analogue sample study, Barhon, Batchelor, Meares, Chekaluk, and Shores (2015) compared the WCT against the Test of Memory Malingering (TOMM) in its ability to distinguish between undergraduate students instructed to provide full effort and those instructed to feign acquired brain injury (with and without coaching). Both the TOMM and WCT demonstrated good ability to discriminate between feigned CI and valid performance.…”