A-209 The Relationship Between Performance on the Test of Memory Malingering (TOMM) Trial 1 and Neurocognitive, Emotional, and Behavioral Functioning in a Pediatric Concussion Population

Abstract

Abstract Objective In concussion populations, suboptimal effort on performance validity tests (PVTs) has been associated with poorer neuropsychological scores and greater post-concussive complaints. This study examined if performance on TOMM Trial 1 was associated with increased cognitive deficits, post-concussive symptoms, and emotional concerns in a pediatric concussion population. Method This study utilized archival data from 93 patients (mean age = 14.56, SD = 2.01) with a history of concussion who were assessed at approximately 40 days post-injury. Individuals were divided into “Pass” and “Fail” groups based on their TOMM Trial 1 performance using the established cut-off. The testing battery included Auditory Consonant Trigrams, CPT-II and III, HVLT-R, WJ-III and IV, ImPACT, BASC-2, and BRIEF. Results The overall pass rate on Trial 1 was 70% (mean = 46.04, SD = 4.55). There were no significant correlations with Trial 1 and age, grade, gender, prior history of concussion, or mechanism of injury. The Fail group scored lower across domains of attention, memory, and processing speed when compared to the Pass group (p < .05), though their performances were largely average. On rating scales, more concerns were endorsed with the Fail group for attention and executive functioning relative to the Pass group (p < .05), though their scores were below clinical levels. The Fail group reported more post-concussive complaints (p < .05) but they did not significantly differ from the Pass group in terms of depressive symptoms, anxiety, or somatization. Conclusions This study highlights the importance of utilizing PVTs when evaluating concussion recovery in pediatric patients.