Cross-Validation of Supplemental Test of Memory Malingering Scores as Performance Validity Measures

Abstract

Assessment of the validity of neuropsychological test data has become an ensconced aspect of the assessment process. Among the more popular free-standing performance validity measures (PVMs) is the Test of Memory Malingering (Tombaugh 1996). Given the popularity of this measure, a number of researchers (i.e., Trial 1 (Denning, 2012); TOMMe10 (Denning, 2012); Albany Consistency Index (Gunner, Miele, Lynch, & McCaffrey, 2012)) have sought to expand its utility by increasing the number of scoring approaches associated with its administration. This paper aimed to cross-validate prior work by examining the performance of these measures in a mixed clinical sample of veterans referred for neuropsychological evaluation. All five examined measures provided good to excellent discrimination of patients determined to be putting forth poor effort based on failure of two or three alternate measures of performance validity. Traditional scoring approaches revealed high rates of specificity, with lower rates of sensitivity. The newer measures performed well for both sensitivity and specificity at higher base rates. However, predicted performance in low base rate populations (i.e., 0.10) using the newly derived scoring failed to reach predetermined cutoffs for specificity (0.90). Further examination of the cumulative performance of the scoring approaches indicated that administration of only two initial scoring indices was necessary to obtain a high rate of classification.