WAIS-IV Digit Span variables: are they valuable for use in predicting TOMM and MSVT failure?

The Digit Span (DS) task in the Wechsler Adult Intelligence Scale-Fourth Edition differs substantially from earlier versions of the measure, with one of the major changes being the addition of a sequencing component. In the present investigation, the usefulness of the new sequencing task and other DS variables (i.e., DS Age-Scaled Score, DS Forward Total, DS Backward Total, and Reliable DS) was investigated with regard to the ability of these variables to predict negative response bias. Negative response bias was first defined and examined using below-cutoff performance on the Test of Memory Malingering (TOMM) (N = 99). Then, for comparison purposes, negative response bias was examined using below-cutoff performance on the Medical Symptom Validity Test (MSVT; N = 95). Study participants included primarily middle-aged outpatients at a Veterans Affairs medical center. Findings from this retrospective analysis showed that, regardless of whether the TOMM or the MSVT was used as the negative response bias criterion, of all the DS variables examined, DS Sequencing Total showed the best classification accuracy. Yet, due to its relatively low positive and negative predictive power, DS Sequencing Total is not recommended for use in isolation to identify negative response bias.

Validity of the Wechsler Test of Adult Reading (WTAR): effort considered in a clinical sample of U.S. military veterans.

The current study represents an examination of the construct validity of the Wechsler Test of Adult Reading (WTAR) among a sample of U.S. military veterans referred for outpatient neuropsychological evaluation that included a measure of negative response bias, namely, the Test of Memory Malingering (TOMM). This retrospective data analysis examined the relationship between the WTAR and measures of current verbal general intellectual function and current cognitive skills. Findings showed that, among patients passing the TOMM (N = 98), WTAR scores were most highly correlated with current verbal IQ but also showed significant correlations with verbal memory and lesser, but still significant, correlations with measures of visual-spatial memory. Discriminant validity for the WTAR was also shown among the group passing the TOMM in the sense that the WTAR, which is designed to measure verbal premorbid general intellectual skill, was not as highly correlated with measures of learning and memory as was a measure of current verbal general intellectual skill. Whereas scores on most study measures did significantly differ between the groups that passed versus failed the TOMM (N = 26), scores on the WTAR did not, suggesting that the WTAR may remain robust even in the face of suboptimal effort.

Digit span age scaled score in middle-aged military veterans: is it more closely associated with TOMM failure than reliable digit span?

The relative usefulness of two digit span (DS) variables in detecting negative response bias, as defined by below cut-off performance on the Test of Memory Malingering (TOMM), was examined among primarily middle-aged military veteran outpatients who were judged clinically to be at increased risk for displaying negative response bias on cognitive testing. Digit span variables included DS Age Scaled Score (DS Age SS) and Reliable DS. Findings from this retrospective data analysis (N = 46) suggest that DS Age SS is preferable for use over Reliable DS in predicting TOMM failure. Results of the current study suggest that, particularly if the Wechsler scales are an existing part of the neuropsychological assessment, examination of DS Age SS is an efficient means of detecting negative response bias.

The Medical Symptom Validity Test in the evaluation of Operation Iraqi Freedom/Operation Enduring Freedom soldiers: a preliminary study.

The clinical utility of the Medical Symptom Validity Test (MSVT) for soldiers returning from service in Operation Iraqi Freedom or Operation Enduring Freedom was preliminarily investigated through retrospective chart review. Results showed that 17%, or 4 of 23, Operation Iraqi Freedom/Operation Enduring Freedom patients at a Polytrauma Network Site (Level 2), performed below cut-offs on the MSVT. On "easy" subtests of the MSVT, the group of individuals who failed the MSVT performed significantly worse than the group of individuals who passed. However, there were no significant group differences on the "hard" subtests of the MSVT. When the profiles of individuals who failed the MSVT were examined, none of them met the criteria for the Dementia Profile. These preliminary findings and additional test data supported the conclusion that participants who failed the MSVT were exhibiting diminished symptom validity, suggesting that the specificity of the MSVT was 100%.

Is the Rey 15-Item Memory Test II (Rey II) a valid symptom validity test?: comparison with the TOMM.

The Rey 15-Item Memory Test II (Rey II) is a revised version of the original Rey Memory Test and is used as a measure of test-taking effort. In the present study, the concurrent validity of the Rey II was examined by comparing Rey II test scores to a well-established measure of symptom validity, the Test of Memory Malingering (TOMM). Retrospective chart review was conducted using the records of 60 veterans who were referred for outpatient neuropsychological testing and suspected of possible symptom exaggeration. Results of the study suggest that when compared to the TOMM, the Qualitative, as opposed to the Quantitative, scoring method of the Rey II was more discriminative, but showed both positive and negative predictive power that was unacceptably low, falling at .62 and .64, respectively. Clinical implications are discussed.

Utility of the response bias scale (RBS) and other MMPI-2 validity scales in predicting TOMM performance.

The present study represents a replication and extension of the original Response Bias Scale (RBS) validation study. In addition to examining the relationship between the Test of Memory Malingering (TOMM), RBS, and several other well-researched Minnesota Multiphasic Personality Inventory 2 (MMPI-2) validity scales (i.e., F, Fb, Fp, and the Fake Bad Scale), the present study also included the recently developed Infrequency Post-Traumatic Stress Disorder Scale and the Henry-Heilbronner Index (HHI) of the MMPI-2. Findings from this retrospective data analysis (N=46) demonstrated the superiority of the RBS, and to a certain extent the HHI, over other MMPI-2 validity scales in predicting TOMM failure within the outpatient Veterans Affairs population. Results of the current study confirm the clinical utility of the RBS and suggest that, particularly if the MMPI-2 is an existing part of the neuropsychological assessment, examination of RBS scores is an efficient means of detecting negative response bias.