Assessing sub-optimal performance with the Test of Memory Malingering in Spanish speaking patients with TBI

To examine the clinical utility of the Test of Memory Malingering (TOMM) with US Spanish speaking patients diagnosed with traumatic brain injury (TBI).

The demographic characteristics and neuropsychological functioning of Spanish speaking patients with TBI with valid vs suboptimal performance were compared.

Demographic and neuropsychological data were retrospectively collected from charts of patients who underwent neurocognitive evaluations for clinical, med-legal and workmen's compensation purposes. Slick et al. criteria for malingered neurocognitive dysfunction were employed for clinical determination of the validity of participants' neuropsychological profiles, resulting in 16 valid and four suboptimal performers.

Valid performers obtained significantly greater scores than suboptimal performers on all trials of the TOMM and generally demonstrated less impairment across neuropsychological domains. The traditional cut-off score for the TOMM misclassified 18.8% of participants not suspected of malingering and lower levels of education appeared to reduce performance on this measure within the valid group.

The current findings generally support the use of the TOMM with US primarily Spanish speaking patients diagnosed with TBI. However, caution is recommended when utilizing this measure with individuals having minimal levels of education. Future research with a larger sample and a non-neurological age- and education-matched sample should investigate lower cut-off scores for use with such patients.