Clinical Utility of Trial 1 of the Test of Memory Malingering (TOMM)

Abstract

The clinical utility of Trial 1 of the Test of Memory Malingering (TOMM) has recently become a topic of investigation. The current study cross-validated previous research suggesting that those participants who score 45 or greater on Trial 1 of the TOMM will continue to do so on Trial 2 and the Retention Trial and extended these findings to broader clinical and nonclinical populations. Two archival samples were included for analyses: one sample of healthy community-dwelling elders and another sample drawn from an outpatient neuropsychology clinic. As demonstrated previously, 100% of those patients that scored 45 or greater on TOMM Trial 1 scored above cut-scores on Trial 2 and the Retention Trial, supporting the utility of a possible discontinuation rule on Trial 1. When combined with previous research, the current results provide further support for the clinical utility of Trial 1 in predicting overall performance on the TOMM; however, use of any nonstandard administration of the TOMM may not satisfy Daubert criteria in forensic settings and may not be appropriate.

Influence of poor effort on self-reported symptoms and neurocognitive test performance following mild traumatic brain injury

“…Scores in the mid 30s are approximately two standard deviations below the mean for patients with aphasia (Tombaugh, 1997), temporal lobe epilepsy (Hill, Ryan, Kennedy, & Malamut, 2003), or traumatic brain injuries (Rees, Tombaugh, Gansler, & Moczynski, 1998;Tombaugh, 1997). Finally, researchers have laid the foundation for using Trial 1 as an indicator of possible poor effort (Bauer et al, 2007;Gavett, O'Bryant, Fisher, & McCaffrey, 2005;Horner, Bedwell, & Duong, 2006;O'Bryant, Engel, Kleiner, Vasterling, & Black, 2007;O'Bryant et al, 2008), which allowed us to include those MTBI patients who only received this first trial of the TOMM.…”

Neuropsychological Functioning in Veterans with Posttraumatic Stress Disorder: Associations with Performance Validity, Comorbidities, and Functional Outcomes

“…Participants were classified as demonstrating inadequate effort if they performed below established cutoffs on any PVT. Cutoff scores for adequate performance were ≥45 of TOMM Trial 1 or Trial 2 (Denning, 2012;O'Bryant et al, 2008), ≥90% correct on the DMT (Berry, Allen, & Schmitt, 1991;Woods et al, 2003), and ≥14 on CVLT Forced Choice (Delis et al, 2000). Before the assessment, participants underwent urine toxicology exams sensitive to illicit (e.g., cocaine) and licit (e.g., benzodiazepines) substances to ensure acute substance effects did not impact performances.…”

Administration Order Effects on the Test of Memory Malingering

“…However, research has shown that a TOMM-1 score <45 is sufficient as a screener for suboptimal effort and that TOMM-2 and TOMM-R offer little incremental validity for this purpose (O'Bryant, Engel, Kleiner, Vasterling, & William, 2007;O'Bryant et al, 2008). For practitioners who use the TOMM-1 with a cutoff of <45 as a screen to determine the need for a more thorough assessment of effort, our findings are informative.…”