Validation of the Test of Memory Malingering in a Dementia Population in Singapore

Abstract

The present study aims to validate the use of the Test of Memory Malingering (TOMM) in a Singaporean sample with dementia. Employing a known-groups design, individuals with dementia (n = 30) were demographically matched with individuals without dementia (n = 30). The clinical utility of the TOMM was compared with alternative performance validity testing (PVT) measures, including: Dot Counting Test (DCT), Victoria Symptom Validity Test (VSVT), Rey 15-Item Memory Test II (Rey-II), and Non-Verbal Medical Symptoms Validity Test (NV-MSVT). The Comprehensive Test of Non-verbal Intelligence, Second Edition (CTONI-2) was used to measure intelligence as a possible covariate. Results supported the hypotheses that, despite their best efforts across measures, 1) individuals with dementia significantly underperformed individuals without dementia, and 2) lower performance on the CTONI-2 was related to lower performance on all effort tests. Findings validate and extend past research on the sensitivity of effort tests to IQ and dementia. The TOMM and VSVT were recommended for use on the non-dementia population, while the TOMM with a lower cut-off score, VSVT, Rey-II and NV-MSVT were recommended for use on the dementia population. Overall, findings support the use of the VSVT if the diagnosis is uncertain in the local clinical forensic setting.