Examining the Test of Memory Malingering Trial 1 and Word Memory Test Immediate Recognition as Screening Tools for Insufficient Effort

Abstract

Assessing effort level during neuropsychological evaluations is critical to support the accuracy of cognitive test scores. Many instruments are designed to measure effort, yet they are not routinely administered in neuropsychological assessments. The Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) are commonly administered symptom validity tests with sound psychometric properties. This study examines the use of the TOMM Trial 1 and the WMT Immediate Recognition (IR) trial scores as brief screening tools for insufficient effort through an archival analysis of a combined sample of mild head-injury litigants ( N = 105) who were assessed in forensic private practices. Results show that both demonstrate impressive diagnostic accuracy and calculations of positive and negative predictive power are presented for a range of base rates. These results support the utility of Trial 1 of the TOMM and the WMT IR trial as screening methods for the assessment of insufficient effort in neuropsychological assessments.

Posttraumatic Stress Disorder: Assessing Response Style and Malingering

“…Lastly and what truly distinguishes the WMT is its sensitivity. While many SVTs have sensitivities between 0.30 and 0.60, the WMT achieves nearly 100% sensitivity among simulator groups (Green 2005) and has generated failure rates nearly three times as high as the TOMM in populations of suspected malingerers in some disability contexts (Demakis et al 2008;Gervais et al 2004; see also Bauer et al 2007 andGreen 2007). Importantly, these failures are corroborated by failure on other effort tests, external data, or retesting with incentives to improve performance (Green 2007).…”

“…It has been the subject of fewer formal investigations in psychiatric samples than the TOMM but has been extensively researched by a number of independent researchers (Bauer et al 2007;Brockhaus and Merten 2004;Gervais et al 2004;Greve et al 2008;Morel 2008;Sullivan et al 2007). The author has presented considerable data that the effort indicators are relatively unaffected by most neurological or psychological conditions short of dementia, and even very impaired groups, such as mentally retarded adults and fetal alcohol syndrome children, are usually able to pass them (Green 2005).…”

Memory Malingering: Evaluating WMT Criteria

“…Several tests have been developed to measure effort, and among them, the Word Memory Test (WMT) has been considered one of the most sensitive, not only in North America (Bauer, O'Bryant, Lynch, McCaffrey, & Fisher, 2007;Green, Lees-Haley, & Allen, 2002) but also in the German population (Brockhaus & Merten, 2004). When applied to samples of subjects claiming disability with mild head injury or with legal processes, WMT actually explains most of the variance found on psychometric tasks (Green, 2007;Green et al, 2001;Stevens, Friedel, Mehren, & Merten, 2008;Wynkoop & Denney, 2005).…”

The effect of distraction on the Word Memory Test and Test of Memory Malingering performance in patients with a severe brain injury

“…In summary, three studies have directly compared the WMT and TOMM each employing a litigating sample (Bauer et al, 2007;Gervais et al, 2004;Green et al, 2000). The results have found an increased number of fails on the WMT ranging from 27% to 66% with an average of 42%, whereas the TOMM has fail rates ranging from 10% to 29%, with an average of 17%.…”