The Test of Memory Malingering (TOMM) is a well-validated and widely used forced-choice symptom validity test. However, little is known about how TOMM performance is affected by pain. The present study evaluated the sensitivity of the TOMM to pain induced in healthy participants via the cold-presser test. Participants (n = 20 per group) were administered the TOMM under one of three conditions: (1) standard instructions; (2) instructions to simulate pain-related memory deficit in pursuit of personal injury litigation; (3) while experiencing cold-induced pain. Results indicate that TOMM performance was unaffected by laboratory-induced moderate to severe pain and support the TOMM's use in evaluating clinical patients with pain.
Clinicians have used forced-choice symptom validity tests (SVTs) for decades to detect exaggeration of cognitive and perceptual symptoms in neuropsychological evaluations (for a review, see Bianchini, Mathias, & Greve, 2001). Most SVTs are two-alternative forced-choice tests that serve ostensibly as measures of cognitive or perceptual ability. Cognitive SVTs work because they look very cognitively demanding but actually are very easy to perform. Research has demonstrated that SVTs are relatively insensitive to memory impairment caused by brain damage (e.g., Bianchini, Mathias, Greve, Houston, & Crouch, 2001; Tombaugh, 1996 and Tombaugh, 1997). Moreover, performance on several commonly used SVTs is insensitive to the effects of depression and anxiety (e.g., Test of Memory Malingering (TOMM); Ashendorf, Constantinou, & McCaffrey, 2004; Rees, Tombaugh, & Boulay, 2001). In short, SVTs are insensitive to ability and instead are considered to measure test-taking effort. The results of SVTs allow clinicians to draw inferences about the validity of test performance and can contribute to a diagnosis of malingering (e.g., Bianchini et al., 2001). Therefore, SVTs are commonly included in psychological batteries when there is potential incentive to exaggerate symptoms or level of disability, such as personal injury litigation and worker's compensation claims.
