Abstract

Objective

The Test of Memory Malingering (TOMM) Trial 1 (T1) and errors on the first 10 items of T1 (T1-e10) were developed as briefer versions of the TOMM to minimize evaluation time and burden, although the effect of genuine memory impairment on these indices is not well established. This study examined whether increasing material-specific verbal and visual memory impairment affected T1 and T1-e10 performance and accuracy for detecting invalidity. Method: Data from 155 neuropsychiatric patients administered the TOMM, Rey Auditory Verbal Learning Test (RAVLT), and Brief Visuospatial Memory Test-Revised (BVMT-R) during outpatient evaluation were examined. Valid (N = 125) and invalid (N = 30) groups were established by four independent criterion performance validity tests. Verbal/visual memory impairment was classified as ≥37 T (normal memory); 30 T-36T (mild impairment); and ≤29 T (severe impairment). Results: Overall, T1 had outstanding accuracy, with 77% sensitivity/90% specificity. T1-e10 was less accurate but had excellent discriminability, with 60% sensitivity/87% specificity. T1 maintained excellent accuracy regardless of memory impairment severity, with 77% sensitivity/≥88% specificity and a relatively invariant cut-score even among those with severe verbal/visual memory impairment. T1-e10 had excellent classification accuracy among those with normal memory and mild impairment, but accuracy and sensitivity dropped with severe impairment and the optimal cut-score had to be increased to maintain adequate specificity. Conclusion: TOMM T1 is an effective performance validity test with strong psychometric properties regardless of material-specificity and severity of memory impairment. By contrast, T1-e10 functions relatively well in the context of mild memory impairment but has reduced discriminability with severe memory impairment.

摘要

客观的

记忆损害测试 (TOMM) 试验 1 (T1) 和 T1 前 10 个项目 (T1-e10) 的错误是作为 TOMM 的简短版本开发的，以最大限度地减少评估时间和负担，尽管真正的记忆障碍对这些指数还没有很好地建立起来。本研究检查了增加特定材料的语言和视觉记忆障碍是否会影响 T1 和 T1-e10 检测无效的性能和准确性。方法：对 155 名在门诊评估期间接受 TOMM、Rey 听觉语言学习测试 (RAVLT) 和修订版简明视觉空间记忆测试 (BVMT-R) 的神经精神病患者的数据进行了检查。有效（N  = 125）和无效（N = 30) 组由四个独立的标准性能有效性测试建立。语言/视觉记忆障碍被归类为≥37 T（正常记忆）；30 T-36T（轻度损伤）；≤29 T（严重损伤）。结果：总体而言，T1 具有出色的准确性，灵敏度为 77%/特异性为 90%。T1-e10 不太准确，但具有出色的辨别力，灵敏度为 60%/特异性为 87%。无论记忆障碍的严重程度如何，T1 都保持了出色的准确性，具有 77% 的敏感性/≥88% 的特异性，即使在那些有严重的语言/视觉记忆障碍的人中，切割分数也相对不变。T1-e10 在记忆力正常和轻度损伤的人群中具有出色的分类准确性，但准确性和灵敏度随着严重损伤而下降，必须提高最佳分界线以保持足够的特异性。结论：TOMM T1 是一种有效的性能有效性测试，具有强大的心理测量特性，无论材料特异性和记忆障碍的严重程度如何。相比之下，T1-e10 在轻度记忆障碍的情况下功能相对较好，但对严重记忆障碍的辨别能力降低。