An alternative approach to TOMM cutoff scores using a large sample of military personnel.

IF 1.7 4区 心理学 Applied Neuropsychology-Adult Pub Date : 2024-11-01 Epub Date: 2022-10-13 DOI:10.1080/23279095.2022.2119391
Felicity R Doddato, Jessica Forde, Yishi Wang, Antonio E Puente
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Abstract

The accuracy of neuropsychological assessments relies on participants exhibiting their true abilities during administration. The Test of Memory Malingering (TOMM) is a popular performance validity test used to determine whether an individual is providing honest answers. While the TOMM has proven to be highly sensitive to those who are deliberately exaggerating their symptoms, there is a limited explanation regarding the significance of using 45 as a cutoff score. The present study aims to further investigate this question by examining TOMM scores obtained in a large sample of active-duty military personnel (N = 859, M = 26 years, SD = 6.14, 97.31% males, 72.44% white). Results indicated that no notable discrepancies existed between the frequency of participants who scored a 45 and those who scored slightly below a 45 on the TOMM. The sensitivity and specificity of the TOMM were derived using the forced-choice recognition (FCR) scores obtained by participants on the California Verbal Learning Test, Second Edition (CVLT-II). The sensitivity for each trial of the TOMM was 0.84, 0.55, and 0.63, respectively; the specificity for each trial of the TOMM was 0.69, 0.93, and 0.92, respectively. Because sensitivity and specificity rates are both of importance in this study, balanced accuracy scores were also reported. Results suggested that various alternative cutoff scores produced a more accurate classification compared to the traditional cutoff of 45. Further analyses using Fisher's exact test also indicated that there were no significant performance differences on the FCR of the CVLT-II between individuals who received a 44 and individuals who received a 45 on the TOMM. The current study provides evidence on why the traditional cutoff may not be the most effective score. Future research should consider employing alternative methods which do not rely on a single score.

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使用大样本军事人员的 TOMM 临界分数替代方法。
神经心理评估的准确性取决于受测者在施测过程中表现出的真实能力。记忆误导测试(TOMM)是一种常用的表现效度测试,用于确定受测者是否提供了真实的答案。虽然 TOMM 已被证明对那些故意夸大症状的人高度敏感,但关于以 45 分作为分界线的意义的解释却很有限。本研究旨在通过对大量现役军人样本(样本数=859,男=26岁,标差=6.14,97.31%为男性,72.44%为白人)的 TOMM 分数进行研究,进一步探讨这一问题。结果表明,在TOMM中得分达到45分和略低于45分的参与者之间不存在明显差异。TOMM的灵敏度和特异性是根据参加者在加州言语学习测验第二版(CVLT-II)中获得的强迫选择识别(FCR)分数得出的。TOMM每次测试的灵敏度分别为0.84、0.55和0.63;TOMM每次测试的特异度分别为0.69、0.93和0.92。由于灵敏度和特异度在本研究中都很重要,因此还报告了平衡准确度得分。结果表明,与传统的 45 分界点相比,不同的分界点能产生更准确的分类。使用费雪精确检验法进行的进一步分析还表明,在 CVLT-II 的 FCR 中,TOMM 得分为 44 分的人与得分为 45 分的人之间没有明显的表现差异。目前的研究提供了证据,说明为什么传统的分界点可能不是最有效的分数。未来的研究应考虑采用不依赖于单一分数的替代方法。
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来源期刊
Applied Neuropsychology-Adult
Applied Neuropsychology-Adult CLINICAL NEUROLOGY-PSYCHOLOGY
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11.80%
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0
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>12 weeks
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