Effects of Korsakoff Amnesia on performance and symptom validity testing

Oudman, Erik; Krooshof, Emmy; Oort, Roos Van; Lloyd, Beth; Wijnia, Jan W.; Postma, Albert

doi:10.1080/23279095.2019.1576180

Cited by 12 publications

(7 citation statements)

References 37 publications

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“…This was despite there being a much higher proportion of severely injured cases, a lower proportion of outpatient assessments, and much greater cultural diversity in the current sample, which attests to the robustness of this finding within the brain injury rehabilitation setting. It is also in line with the base rates reported in many smaller studies of other clinical groups, including stroke (Bodner et al, 2019), Korsakoff's syndrome (Oudman et al, 2020), Huntington's disease (Sieck et al, 2012), mild cognitive impairment (Walter et al, 2014), and HIV (Paul et al, 2017).…”

Section: Discussionsupporting

confidence: 89%

What are the predictors of TOMM failure in clinical TBI populations? A retrospective analysis

Gates

Metcalf

Sabaz

et al. 2022

J Int Neuropsychol Soc

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Objectives: To determine base rates of invalid performance on the Test of Memory Malingering (TOMM) in patients with traumatic brain injury (TBI) undertaking rehabilitation who were referred for clinical assessment, and the factors contributing to TOMM failure. Methods: Retrospective file review of consecutive TBI referrals for neuropsychological assessment over seven years. TOMM failure was conventionally defined as performance <45/50 on Trial 2 or Retention Trial. Demographic, injury, financial compensation, occupational, and medical variables were collected. Results: Four hundred and ninety one TBI cases (Median age = 40 years [IQR = 26–52], 79% male, 82% severe TBI) were identified. Overall, 48 cases (9.78%) failed the TOMM. Logistic regression analyses revealed that use of an interpreter during the assessment (adjusted odds ratio [aOR] = 8.25, 95%CI = 3.96–17.18), outpatient setting (aOR = 4.80, 95%CI = 1.87–12.31) and post-injury psychological distress (aOR = 2.77, 95%CI = 1.35–5.70) were significant multivariate predictors of TOMM failure. The TOMM failure rate for interpreter cases was 49% (21/43) in the outpatient setting vs. 7% (2/30) in the inpatient setting. By comparison, 9% (21/230) of non-interpreter outpatient cases failed the TOMM vs. 2% (4/188) of inpatient cases. Conclusions: TOMM failure very rarely occurs in clinical assessment of TBI patients in the inpatient rehabilitation setting. It is more common in the outpatient setting, particularly in non-English-speaking people requiring an interpreter. The findings reinforce the importance of routinely administering stand-alone performance validity tests in assessments of clinical TBI populations, particularly in outpatient settings, to ensure that neuropsychological test results can be interpreted with a high degree of confidence.

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Section: Discussionsupporting

confidence: 89%

What are the predictors of TOMM failure in clinical TBI populations? A retrospective analysis

Gates

Metcalf

Sabaz

et al. 2022

J Int Neuropsychol Soc

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“…33 34 Oudman et al reported that 2 (10%) of 20 individuals with Korsakoff Amnesia failed the second trial of the TOMM. 35…”

Section: Acquired Brain Injurymentioning

confidence: 99%

Performance validity test failure in clinical populations—a systematic review

McWhirter

Ritchie

Stone

et al. 2020

J Neurol Neurosurg Psychiatry

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Performance validity tests (PVTs) are widely used in attempts to quantify effort and/or detect negative response bias during neuropsychological testing. However, it can be challenging to interpret the meaning of poor PVT performance in a clinical context. Compensation-seeking populations predominate in the PVT literature. We aimed to establish base rates of PVT failure in clinical populations without known external motivation to underperform. We searched MEDLINE, EMBASE and PsycINFO for studies reporting PVT failure rates in adults with defined clinical diagnoses, excluding studies of active or veteran military personnel, forensic populations or studies of participants known to be litigating or seeking disability benefits. Results were summarised by diagnostic group and implications discussed. Our review identified 69 studies, and 45 different PVTs or indices, in clinical populations with intellectual disability, degenerative brain disease, brain injury, psychiatric disorders, functional disorders and epilepsy. Various pass/fail cut-off scores were described. PVT failure was common in all clinical groups described, with failure rates for some groups and tests exceeding 25%. PVT failure is common across a range of clinical conditions, even in the absence of obvious incentive to underperform. Failure rates are no higher in functional disorders than in other clinical conditions. As PVT failure indicates invalidity of other attempted neuropsychological tests, the finding of frequent and unexpected failure in a range of clinical conditions raises important questions about the degree of objectivity afforded to neuropsychological tests in clinical practice and research.

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“…Even in patients with severe (memory) impairments, such as patients suspected of KS. Oudman et al (2020) also examined the performance on PVTs in patients with KS, using the TOMM (Trial 2, cutoff <45) and VAT-E (cutoff values according to Meyer et al, 2017, i.e. Immediate Recognition ≤ 21, Delayed Recognition ≤ 20, Consistency ≤ 21 and Free Recall ≥ 7 in combination with Multiple Choice ≤ 9).…”

Section: Discussionmentioning

confidence: 99%

“…As several patient groups, such as patients with (some types of) dementia (Bortnik et al, 2013;Burton et al, 2015) or patients with moderate-to-severe acquired brain injury (Allen et al, 2007;Macciocchi et al, 2006), are associated with high levels of PVT failure (i.e., false positives), it is expected that patients with KS would show high PVT failure rates as well. Oudman et al (2020) were the first to examine the performance of a small sample of patients with KS (N = 20) on PVTs (i.e., TOMM and VAT-E). They found that PVT task performance was lower for the TOMM and VAT-E in patients with KS compared with healthy controls and did lead to 5%-45% false-positive scores on the PVT subscales.…”

mentioning

confidence: 99%

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Performance validity testing in individuals with alcohol-related cognitive impairments.

Rensen,

Vos,

Aaftink

et al. 2024

Psychology & Neuroscience

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Objective: Memory impairments may lead to false positives on performance validity tests (PVTs). This is relevant in the neuropsychological assessment of patients suspected of having alcohol-related cognitive impairments (ARCI). The aims of this study were twofold.(1) To compare the performances of patients with ARCI and Korsakoff's syndrome (KS) to that of patients with alcohol use disorder (AUD) without cognitive impairments on three PVTs: the Amsterdam Short-Term Memory Test (ASTM), the Test of Memory Malingering (TOMM), and the Visual Association Test-Extended (VAT-E). (2) To examine how many patients with ARCI, KS, and AUD perform below (different) cutoff points on these tests. Method: Eighty-five patients with mild-to-moderate alcohol-related cognitive disorders, 58 patients with KS, and 77 patients with "uncomplicated" AUD completed one or two PVTs. Established cutoff scores from the test manuals were used. If the percentage patients performing below this cutoff exceeded 10%, this was considered "unacceptable." Results: The patients groups with cognitive impairments had higher falsepositive rates compared with uncomplicated AUD. However, only the ASTM resulted in unacceptably high failure rates, whereas the TOMM and VAT-E can be validly applied in assessments of individuals suspected of ARCI. Conclusions: Failure on two PVTs (the TOMM and VAT-E) is uncommon in patients with ARCI, even in severely affected patients with KS. However, the ASTM is not recommended because of unacceptable failure rates. For neuropsychological assessments in individuals with AUD, ARCI, and KS, we thus recommend using the TOMM and VAT-E to detect credibility of the response set. Public Significance StatementThe findings in this study are relevant for the neuropsychological assessment of patients with alcohol use disorder. Professionals working with these patients need to be aware that the use of different performance validity tests might result in different outcomes. Based on the present study, both the Test of Memory Malingering and Visual Association Test-Extended can be validly interpreted, whereas the Amsterdam Short-Term Memory Test is not recommended for this patient group. This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

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Effects of Korsakoff Amnesia on performance and symptom validity testing

Cited by 12 publications

References 37 publications

What are the predictors of TOMM failure in clinical TBI populations? A retrospective analysis

What are the predictors of TOMM failure in clinical TBI populations? A retrospective analysis

Performance validity test failure in clinical populations—a systematic review

Performance validity testing in individuals with alcohol-related cognitive impairments.

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