The impact of cognitive and psychiatric impairment of psychotic disorders on the Test of Memory Malingering (TOMM)

The author analyzes the scores of inpatient psychiatric patients with varying degrees of cognitive impairment who met criteria for a psychotic disorder on the following tests: the Test of Memory Malingering (TOMM), the California Verbal Learning Test-Second Edition, Conner's Continuous Performance Test-Second Edition, and the Brief Psychiatric Rating Scale-Expanded Version. Group 1 consisted of psychotic-disordered patients with significant concentration problems (concentration impersistence = 29). Group 2 consisted of psychotic disordered patients without significant concentration problems (no concentration impairment = 21). Although psychotic patients with concentration problems showed greater variability across TOMM trials, both groups obtained mean scores above 45 on Trial 2 and the retention trial on the TOMM. These findings indicate that cognitive impairment associated with psychosis generally does not negatively impair TOMM performance to such a level that would produce a false positive on the TOMM. Implications for forensic assessment, study limitations, and future directions are discussed.