Search

Assessing effort level during neuropsychological evaluations is critical to support the accuracy of cognitive test scores. Many instruments are designed to measure effort, yet they are not routinely administered in neuropsychological assessments. The Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) are commonly administered symptom validity tests with sound psychometric properties. This study examines the use of the TOMM Trial 1 and the WMT Immediate Recognition (IR) trial scores as brief screening tools for insufficient effort through an archival analysis of a combined sample of mild head-injury litigants ( N = 105) who were assessed in forensic private practices. Results show that both demonstrate impressive diagnostic accuracy and calculations of positive and negative predictive power are presented for a range of base rates. These results support the utility of Trial 1 of the TOMM and the WMT IR trial as screening methods for the assessment of insufficient effort in neuropsychological assessments. (Contains 2 tables.)

There has been an increased recognition that validity testing is an integral component of evaluations conducted with youth. The incorporation of validity testing provides an objective basis for placing confidence in the test data as an accurate assessment of the child's or adolescent's current ability level and/or an accurate indication of the child's or adolescent's current symptoms or behavioral functioning. The use of objective performance validity and symptom validity is consistent with the current emphasis of data-driven decision-making. This paper provides a review of the literature on performance and symptom validity tests for children and adolescents. The strengths and limitations of the available validity tests are discussed, and recommendations for use in pediatric assessments are provided. [ABSTRACT FROM AUTHOR]

Introduction: The Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) are both performance validity tests (PVTs) that use a two-alternative forced-choice (2AFC) recognition memory format. Several studies have reported that these tests are susceptible to cognitive impairment and that the WMT is more susceptible than the TOMM. The current study explored components of recognition memory (i.e., conscious recollection and familiarity) underlying the TOMM and WMT to identify factors that make them susceptible and resilient to cognitive impairment.Method: Fifty-four nonclinical undergraduate research participants were administered the TOMM and WMT while providing introspective judgments about their recognition memory using the remember/know/guess procedure. In addition, half of participants were administered dual-task interference, a manipulation intended to reduce recollection, during these tests, while the other half completed these tests without interference. Standard cutoffs on the TOMM and WMT were explored, as well as alternative cutoffs based on TOMM Trial 1 scores.Results: The WMT was more impacted by dual-task interference than standard TOMM cutoff trials, while alternative TOMM cutoff trials were equally impacted by dual-task interference relative to the WMT. Dual-task interference reduced recollection on these tests, but spared familiarity. Standard TOMM trials and the WMT were relatively comparable on levels of recollection, but familiarity contributed more to the TOMM than to the WMT. Alternative TOMM trials possessed lower familiarity and recollection than standard TOMM trials and lower recollection than the WMT.Conclusions: Reduced recollection places examinees at risk of failing the TOMM and WMT, while familiarity contributes to the relative resilience of the standard TOMM. Future development of 2AFC recognition memory PVTs should attempt to maximize the contribution of familiarity to their completion. [ABSTRACT FROM AUTHOR]

Embedded performance validity tests (PVTs) have been criticized for their poor specificity and sensitivity. Aggregated models of embedded PVTs have been proposed to improve their classification accuracy; however, limitations to aggregation-based improvement of PVTs have yet to be explored. The current study evaluated the classification accuracy of 3 types of models of embedded PVTs in the Halstead-Reitan Neuropsychological Battery for Adults (HRNB): a single-, a pairwise-, and a triple-failure model. In addition, this study evaluated the impact of aggregating between 1 and 6 embedded PVTs in each of these 3 types of models. Analyzing only the 2, 4, and 6 most discriminating embedded PVTs in the single-, pairwise-, and triple-failure models maximized classification accuracy, respectively. Comparisons across these models indicated that the single-failure model including only the two most discriminating embedded PVTs had the best classification accuracy; however, classification accuracy was only minimally improved in this model relative to analyzing just Reliable Digit Span. These results suggest that aggregation of embedded PVTs from the HRNB does not substantially improve their classification accuracy and that the benefits of aggregating PVTs may only emerge when the PVTs entered into the aggregated models have sufficient classification accuracy on their own. [ABSTRACT FROM AUTHOR]

Third party observers have been found to significantly impair neuropsychological test performance on measures of attention, verbal memory, verbal fluency, and cognitive symptom validity. One measure of the importance of a research-based finding for clinical practice is effect size. Effect sizes were calculated for selected social facilitation literature and empirical studies of the impact of a third party observer on formal neuropsychological measures. The average effect size estimate found for the social facilitation research was large. Effect size estimates associated with findings from the third party observer research were, on average, medium for memory measures and small for motor and attention/executive measures. These findings indicate that the presence of an observer during a neuropsychological evaluation should be expected to have a clinically meaningful impact on an examinee's test performance, with memory measures particularly vulnerable. [ABSTRACT FROM AUTHOR]

Following a brief discussion of the emergence of third party observation as an issue in neuropsychology, this article reviews the social psychological theory of social facilitation. Social facilitation refers to the impact of another person, whether as an observer or a performer of the same activity, on an individual's performance. Both performance enhancements and impairments can be caused by this phenomenon. The article concludes with a review of the empirical studies that have demonstrated that a third party observer significantly impacts an individual's performance on some neuropsychological tests. [ABSTRACT FROM AUTHOR]

This report is a replication of a survey conducted a decade ago that examined the graduate training and postdoctoral experiences of the instructors of clinical neuropsychology within American Psychological Association-accredited doctoral programs in clinical psychology. The orginal findings indicated that the formal background and clinical experiences of most of the instructors of clinical neuropsychology fell short of the minimum level of training guidelines proposed by the International Neuropsychology Society (INS) Task Force on Education, Accreditation, and Credentialing. In the present survey, data from 61 doctoral training programs revealed that instructors are more closely approximating the minimal educational standards than they were a decade earlier. Specifically, respondents to the current survey indicated more training in both the neurosciences and clinical neuropsychology and involvement in more research activities than did respondents to the past survey. Despite the significant improvements in the background training of current instructors, many still do not report educational and clinical experiences that are consistent with the INS minimal level training guidelines. [ABSTRACT FROM PUBLISHER]

The Halstead Category Test is a popular measure of abstraction, concept formation, and logical analysis skills. Due to its large apparatus, however, ease of administration of the standard Category Test is limited. For this reason, a number of computer versions of the Category Test have been developed to facilitate its administration. The current study evaluated the equivalence of a new computer version to the standard Category Test in a sample of undergraduate students. Analyses revealed that the two versions did not differ significantly on subtest error scores, total error scores, or Neuropsychological Deficit Scale scores. Results of the current study support the equivalence of this new computer version to the standard version of the Category Test.