The Albany Consistency Index for the Test of Memory Malingering

The determination of examinee effort is an important component of a neuropsychological evaluation and relies heavily on the use of symptom validity tests (SVTs) such as the Test of Memory Malingering (TOMM) and the Word Memory Test (WMT). Diagnostic utility of SVTs varies. The sensitivity of traditional TOMM criteria to suboptimal effort is low. An index of response consistency across three trials of the TOMM was developed, denoted the Albany Consistency Index (ACI). This index identified a large proportion of examinees classified as optimal effort using traditional TOMM interpretive guidelines but suboptimal effort using the WMT profile analysis. In addition, previous research was extended, demonstrating a relationship between examinee performance on SVTs and neuropsychological tests. Effort classification using the ACI predicted the performance on the Global Memory Index from the Memory Assessment Scales. In conclusion, the ACI was a more sensitive indicator of suboptimal effort than traditional TOMM interpretive guidelines.