Can the Sensitivity and Specificity of the TOMM Be Increased with Differential Cutoff Scores?

Abstract

Accurate determination of performance validity is paramount in any neuropsychological assessment. Numerous freestanding symptom validity tests, like the Test of Memory Malingering (TOMM), have been developed to assist in this process; however, research and clinical experiences have suggested that each may not function with the same classification accuracy. In an effort to increase the TOMM's ability to accurately classify performance validity, recent research has investigated the use of nonstandard cutoff scores. The purpose of this study was to potentially validate the use of two, nonstandard cutoff scores (<49 on Trial 2 or the Retention Trial or ≤39 on Trial 1) applied to the TOMM in a medicolegal sample of mild traumatic brain injury litigants. Both descriptive and inferential statistics found that the cutoff of <49 on Trial 2 or the Retention Trial was the most sensitive to performance validity as compared with both the standard TOMM criteria and the cutoff of ≤39. These findings support the use of nonstandard cutoffs to increase the TOMM's classification accuracy.

Key words:

• cutoff scores
• medico-legal
• performance validity
• symptom validity tests
• Test of Memory Malingering

Acknowledgments

Portions of this article were presented at the Fourth Annual Meeting of the American College of Professional Neuropsychology in Las Vegas, NV.

Notes

^a Mild traumatic brain injury.

^b Moderate-to-severe traumatic brain injury.

^c False-negative rate.

^d False-positive rate.

^a Mild traumatic brain injury.

^b Moderate-to-severe traumatic brain injury.

^c False-negative rate.

^d False-positive rate.

^a Retention Trial.