A Validation of the Test of Memory Malingering in a Forensic Psychiatric Setting

Abstract

The Test of Memory Malingering (TOMM) has not been adequately validated in a forensic psychiatric setting. Dissimulation of cognitive impairment, as assessed by the TOMM, was evaluated in a group of 25 forensic inpatients admitted for evaluation of Competency to Stand Trial (CST/MSO group), and hypothesized to be at higher risk for feigning cognitive impairment. A comparison group of 36 patients, who were either civilly committed or adjudicated Not Guilty by Reason of Insanity (CIVIL/NGRI group), were hypothesized to be less likely to feign cognitive impairment. Groups were comparable in age, education, premorbid intelligence, and psychiatric symptom severity. Significantly more CST/MSO patients (36%) scored below a recommended TOMM cutoff score relative to CIVIL/NGRI patients (6%). Findings indicate excellent specificity and modest sensitivity, and generally support the validity of the TOMM in a forensic psychiatric population. The utility of different cutoff scores and need for multiple indicators of effort are discussed.

Do tests of malingering concur? Concordance among malingering measures

“…These findings might reflect either the greater sensitivity of the TOMM to detecting subtle forms of malingering, or might indicate a tendency to over-classify malingering. Given that other research has not supported the latter conclusion (Rees et al, 1998;Weinborn et al, 2003), the former appears more likely, although further research using analog methods is necessary to fully understand these associations.…”

“…Scores below 45 (90% correct) on the second or retention trial suggest that respondents have not performed to the best of their abilities (Tombaugh, 1996). Normative data indicate that, unlike the FIT, the TOMM is highly accurate in differentiating malingering individuals from normal controls (Rees et al, 1998;Weinborn, Orr, Woods, Conover, & Feix, 2003). Although persons with dementia appear apt to fail the TOMM, most genuinely impaired patients perform well above cutoffs on this measure (Teichner & Wagner, 2004;Tombaugh, 1997).…”

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

“…Two studies (Batt, Shores, & Chekaluk, 2008;Loring et al, 2011) using differing methodological approaches to temporarily Batt et al (2008) found greater reduction in performance on the WMT versus the TOMM in a traumatic brain injury (TBI) sample under a cognitive distraction task condition. From a clinical groups perspective, while it is welldocumented that some individuals with significant cognitive impairment (e.g., bilateral hippocampal atrophy; GoodrichHunsaker & Hopkins, 2009) can perform well on published PVTs, there is also a growing body of literature indicating that some moderate to severely impaired clinical groups with no incentive to malinger or supply poor effort produce unacceptably low specificity rates, and this appears to vary across individual PVTs (Gorissen, Sanz, & Schmand, 2005;Greve et al, 2008;Howe & Loring, 2009;Merten, Bossink, & Schmand, 2007;Rudman, Oyebode, Jones, & Bentham, 2011;Weinborn, Orr, Woods, Conover, & Feix, 2003;but cf. Chafetz, Prentkowski, & Rao, 2011;Schroeder & Marshall, 2010).…”

“…Specifically, components that were deemed to be less likely to contribute to the overall PVT performance were (2011) 79 Batt et al (2008) 75.5 c Barhon et al (in press) 96 Bolan et al (2002) 100 Gervais et al (2004) 89 Green (2011) 93.5 Greve, Bianchini, & Doane (2006) 96 Greve, Bianchi, Black, et al (2006) 82 Merten et al (2007) 91.5 c Tan et al (2002) 80 Teichner & Wagner (2004) 24/91.7 Tombaugh (1996) 86.5 c Tombaugh (1997) 91.28 c Weinborn et al (2003) 83.3 Weinborn et al (2012) 100 c 876 A. Leighton et al…”

Performance of mentally retarded forensic patients on the test of memory malingering

“…A study by Gierok, Dickson, and Cole (2005) found that patients with pending legal charges exerted less effort on the TOMM than those with no obvious secondary gain while Weinborn, Orr, Woods, Conover, and Feix (2003) found that adjudicated forensic patients did significantly better than did patients still facing legal charges. Thus, a decision was made to include only patients who were no longer facing legal charges in an attempt to eliminate any external incentive to malinger.…”