تشخیص علائم و آزمون مربی با آزمون حافظه تمارض

The ability of the Test of Memory Malingering (TOMM; Tombaugh, 1996) to detect feigned-memory impairment was explored. The TOMM was administered to three groups: (a) a control group instructed to perform optimally, (b) a symptom-coached group instructed to feign memory problems after being educated about traumatic brain injury symptomatology, and (c) a test-coached group instructed to feign memory problems after being educated about test-taking strategies to avoid detection. The recommended cutoff scores (Tombaugh, 1996) on Trial 2 and the Retention Trial produced overall classification accuracy rates of 96%, with high levels of sensitivity and specificity. Although the symptom-coached group performed more poorly on the TOMM relative to the test-coached group, the test was equally sensitive in detecting suboptimal effort across the different coaching paradigms.

There has been an emergent body of research over the past decade focusing on the assessment and detection of poor effort within neuropsychological evaluations (Reynolds, 1998). Mild head injured patients involved in litigation have historically served as the primary target for empirical evaluation of poor effort (Binder & Rohling, 1996; Binder & Willis, 1991; Green, Iverson, & Allen, 1999; Langeluddecke & Lucas, 2003). More recent evidence indicates that a variety of other medical, litigious or psychiatric patient populations (e.g., disability claimants or chronic pain syndromes) may also exhibit compromised effort during neuropsychological evaluation (Gervais et al., 2001 and Gervais et al., 2001; Gervais et al., 2001 and Gervais et al., 2001; Mittenberg, Patton, Canyock, & Condit, 2002; Rohling, Green, Allen, & Iverson, 2002). Although base rates of symptom exaggeration for any group will vary widely due to methodological and sample characteristics (Reynolds, 1998), a recent survey of American Board of Clinical Neuropsychology members provides benchmark prevalence estimates of suboptimal effort for a variety of patient populations (Mittenberg et al., 2002).