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Nonverbal Performance Validity Testing: Test of Memory Malingering (TOMM)

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Detection of Malingering during Head Injury Litigation

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Abstract

The TOMM is a widely used forced-choice performance validity test (PVT) that requires recognition of visual stimuli though may not require a verbal response. The Test of Memory Malingering (TOMM) is the most well-known measure utilizing this format. Empirical research has found patients scores to be unaffected by age, education, pain, psychiatric conditions, and all but the most severe neurocognitive conditions. It is not a measure of memory and is insensitive to cognitive ability and cognitive impairment secondary to acquired brain injury. Though the TOMM was initially designed for adults it has been cross validated for effective use with school-age children and can be used with confidence in clinical samples as young as age 5. There is a growing body of cross-cultural empirical research on the TOMM. There is general empirical support for use in Spanish-speaking populations from various countries. The TOMM has also been found to perform adequately with deaf individuals who use ASL. Moreover, in addition to being valid for use with many different groups, the TOMM also potentially provides users with multiple validity indices (Trail 1 score, Trail 2 score, Recognition Score, Albany Consistency Index). Efficient use of the TOMM and any PVTs requires the understanding of differential sensitivity/specificity at different cut scores with specific diagnostic groups. There is no optimal sensitivity/specificity ratio as the combination varies per situation and varies with each cut score. There is sufficient empirical research on the TOMM to make informed and precise opinions about performance validity for many clinical groups. This chapter is intended to thoroughly inform the reader about the use and potential limitations of the TOMM.

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Authors and Affiliations

  1. Clinical Neuropsychologist, Pate Rehabilitation, Dallas, TX, USA

    Robert Perna

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  1. Robert Perna
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Correspondence to Robert Perna .

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Editors and Affiliations

  1. Neuropsychology Section, Psych Associates of Maryland Towson and Columbia, Bethesda, MD, USA

    Arthur MacNeill Horton, Jr.

  2. Department of Educational Psychology, Texas A&M University College Station, Austin, TX, USA

    Cecil R. Reynolds

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Perna, R. (2021). Nonverbal Performance Validity Testing: Test of Memory Malingering (TOMM). In: Horton, Jr., A.M., Reynolds, C.R. (eds) Detection of Malingering during Head Injury Litigation. Springer, Cham. https://doi.org/10.1007/978-3-030-54656-4_6

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