(PS8-B48) Utility of the Test of Memory Malingering (TOMM) in a College Sample Referred for ADHD/LD Evaluation: Implications for Cut-off Scores and Trial Administration

Neuropsychological evaluations benefit from formal evaluation of noncredible responding, particularly in circumstances where secondary gain is possible. The Test of Memory Malingering (TOMM) is a widely used performance validity test (PVT) but it has been criticized for its low sensitivity, prompting examination of performance within specific populations to reach interpretation guidelines that provide a better balance of sensitivity and specificity. We examined the TOMM scores of consecutively referred college students (N = 87) who sought evaluation for ADHD and/or LD in order to qualify for academic accommodations. The mean scores of Trial 1 (M = 46.03, SD = 5.46) and Trial 2 (M = 48.94, SD = 3.32) were higher than the established cut-off score of < 45 correct responses, although they differed significantly from each other, with Trial 1 significantly lower than Trial 2, t(86) = -7.38, p < .001, indicating significant improvement in performance from Trial 1 to Trial 2. Applying established interpretative guidelines for inconsistent TOMM performance, we found that 6.9% of the sample achieved a score of < 45 correct responses (out of 50) on Trial 2. This rate of identification was much lower than that found in studies of referred college students using the Word Memory Test, another widely used PTV: Suhr et al. (2008), χ² = 18.75, p = .001 and Sullivan et al. (2007), χ² = 12.64, p = .001, whose studies found 31% and 27% identification rates, respectively. In contrast, applying the < 45 cut off to TOMM 1 performance, we found a 24.5% rate of inconsistent performance, which did not differ significantly from the Suhr et al. and Sullivan et al. WMT rates, χ² = 0.375, p > .05 and χ² = 0.399, p > .05, respectively. We also administered the TOMM to a sample of college students (N = 26) who participated for research credit and were instructed to perform honestly. Their mean scores on Trial 1 (M = 48.46, SD = 2.50) and Trial 2 (M = 49.92, SD = 0.39) were significantly higher than those of the referred sample, t(92.45) = -3.18, p = 0.002 and t(93.51) = -2.69, p = 0.008, respectively, and only one individual obtained a score on Trial 1 that would indicate inconsistent effort. Considering our findings in light of results from other studies (e.g., Denning, 2022; Mossman et al., 2017), we advocate for further study of the utility of Trial 1 performance as the standard to use in identifying inconsistent effort in higher functioning groups, such as college students, to improve the sensitivity of the TOMM, with additional consideration to examining the utility of higher cut-off scores, given the very high scores of high functioning honest responders.