Classification Accuracy of the Test of Memory Malingering in Traumatic Brain Injury: Results of a Known-Groups Analysis

Abstract

This study used a known-groups design to determine the classification accuracy of the Test of Memory Malingering (Tombaugh, 1996 Tombaugh, T. 1996. Test of Memory Malingering manual, New York: MultiHealth Systems. [Google Scholar], 1997 Tombaugh, T.N. 1997. The Test of Memory Malingering (ToMM): Normative data from cognitively intact and cognitively impaired individuals. Psychological Assessment, 9: 260–68. [CROSSREF][CSA][Crossref], [Web of Science ®] , [Google Scholar]) in detecting cognitive malingering in traumatic brain injury (TBI). Forty-one of 161 TBI patients met Slick, Sherman, and Iverson (1999) Slick, D.J., Sherman, E.M.S. and Iverson, G.L. 1999. Diagnostic criteria for malingering neurocognitive dysfunction: Proposed standards for clinical practice and research. The Clinical Neuropsychologist, 13: 545–561. [INFOTRIEVE][CSA][Taylor & Francis Online], [Web of Science ®] , [Google Scholar] criteria for Malingered Neurocognitive Dysfunction. Twenty-two no-incentive memory disorder patients were also included. The original cutoffs (<45) for Trial 2 and Retention demonstrated excellent specificity (less than a 5% false positive error rate) and impressive sensitivity (greater than 45%). However, these cutoffs are actually conservative in the context of mild TBI. Over 90% of the non-MND mild TBI sample scored 48 or higher on the Retention Trial and none scored less than 46 while 60% of the MND patients claiming mild TBI were detected at those levels. Trial 1 also demonstrated excellent classification accuracy. Application of these data to clinical practice is discussed.