تست حافظه تمارض (تام): داده های هنجاری بیماران شناختی دست نخورده، شناختی اختلال یافته و سالمند مبتلا به دمانس

This research adds to the psychometric validation of the Test of Memory Malingering (TOMM) by providing data for samples of elderly patients who are cognitively intact, cognitively impaired (non-dementia), and with dementia. Subjects were 78 individuals referred for evaluation of memory complaints. Significant group differences emerged between the dementia group and the two other groups (normals and cognitively impaired), although the latter two did not differ from each other. One hundred percent of normals and 92.7% of the cognitively impaired group made fewer than five errors (the suggested cut-off) on Trial 2 or the Retention trial of the TOMM, yielding an overall correct classification rate of 94.7%. However, the rate of misclassification for persons with dementia was high whether using a cut-point score of five, eight, or ten errors. This investigation extends the validity and clinical utility of this instrument. Results suggest that the TOMM is an useful index for detecting the malingering of memory deficits, even in patients with cognitive impairment, but only when dementia can be ruled out.

Patients who malinger symptoms are motivated by an external incentive. Common incentives include receiving compensation, avoidance of responsibility, threat of punishment, or retaliation. The possibility of symptom exaggeration or feigning should be objectively examined when: (1) the patient presents in a medicolegal context such as litigation or application for disability; (2) identifiable incentives for exaggeration are present; (3) symptoms do not make medical, neuropsychological, or psychological sense; (4) the claimed disability is in excess of objective findings; (5) a lack of cooperation during the evaluation occurs; (6) inconsistencies between complaints and behavior are observed; or, (7) contradictions between self-report and medical records are present. The issue of detecting exaggerated or deliberately faked cognitive impairment is paramount in many clinical, medicolegal, and forensic cases. Assessment results often determine whether a patient receives financial or personal gains, or determines the initial course of treatment.