title: The use of all three Test of Memory Malingering trials in establishing the level of effort.
abstract: Assessment of the effort level is an essential step in establishing the internal validity of any neuropsychological evaluation. The use of response bias measures as part of a core battery, however, is less common outside of forensic evaluations. The amount of time needed to administer many of these tests is often cited as a likely explanation for their exclusion from routine neuropsychological evaluations. This study examined all three trials of the Test of Memory Malingering (TOMM) in a large sample (n = 213) of inpatients on an epilepsy monitoring unit with the goal of establishing cut scores for early termination. TOMM Trial 1 demonstrated impressive diagnostic accuracy for determining both adequate and suboptimal levels of effort; various cut scores and classification statistics are presented. The optional Retention trial from the TOMM also increased the hit rate 16% in the detection of poor effort. Clinical implications, limitations, and directions for further research are discussed.
authors.affiliation: Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.
authors.forename: Nick M
authors.initials: NM
authors.lastname: Wisdom
authors.forename: Whitney L
authors.initials: WL
authors.lastname: Brown
authors.forename: David K
authors.initials: DK
authors.lastname: Chen
authors.forename: Robert L
authors.initials: RL
authors.lastname: Collins
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004192:Discrimination, Psychological / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008306:Malingering / Q000175:diagnosis* / Q000523:psychology*; D008403:Mass Screening; D008569:Memory Disorders / Q000175:diagnosis*; D008875:Middle Aged; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012153:Retention, Psychology / Q000502:physiology; D055815:Young Adult