Weinborn Michael, Orr Tamara, Woods Steven Paul, Conover Emily, Feix Jeffrey
Martinsburg VA Medical Center, Mental Health Service Line, Martinsburg, WV 25401, USA.
J Clin Exp Neuropsychol. 2003 Oct;25(7):979-90. doi: 10.1076/jcen.25.7.979.16481.
The Test of Memory Malingering (TOMM) has not been adequately validated in a forensic psychiatric setting. Dissimulation of cognitive impairment, as assessed by the TOMM, was evaluated in a group of 25 forensic inpatients admitted for evaluation of Competency to Stand Trial (CST/MSO group), and hypothesized to be at higher risk for feigning cognitive impairment. A comparison group of 36 patients, who were either civilly committed or adjudicated Not Guilty by Reason of Insanity (CIVIL/NGRI group), were hypothesized to be less likely to feign cognitive impairment. Groups were comparable in age, education, premorbid intelligence, and psychiatric symptom severity. Significantly more CST/MSO patients (36%) scored below a recommended TOMM cutoff score relative to CIVIL/NGRI patients (6%). Findings indicate excellent specificity and modest sensitivity, and generally support the validity of the TOMM in a forensic psychiatric population. The utility of different cutoff scores and need for multiple indicators of effort are discussed.
记忆伪装测验（TOMM）在法医精神病学环境中尚未得到充分验证。在一组因受审能力评估而入院的25名法医住院患者（CST/MSO组）中，对通过TOMM评估的认知功能损害伪装情况进行了评估，并假设他们伪装认知功能损害的风险更高。另一组由36名民事拘押或因精神错乱而被判定无罪的患者（民事/因精神错乱而无罪组）被假设伪装认知功能损害的可能性较小。两组在年龄、教育程度、病前智力和精神症状严重程度方面具有可比性。与民事/因精神错乱而无罪组患者（6%）相比，显著更多的CST/MSO患者（36%）得分低于推荐的TOMM临界分数。研究结果表明该测验具有出色的特异性和适度的敏感性，总体上支持TOMM在法医精神病学人群中的有效性。文中还讨论了不同临界分数的效用以及对多种努力指标的需求。
