PERFORMANCE ON THE TEST OF MEMORY MALINGERING IN A MIXED PEDIATRIC SAMPLE

Performance on the Test of Memory Malingering (TOMM) was evaluated in a sample of 100 consecutively referred 6 to 16–year-old children with a wide range of clinical diagnoses. In the complete sample, 97 children met actuarially defined criteria for sufficient effort on the TOMM. Two children were correctly identified as providing suboptimal effort and only one case was a possible false positive. Performance on the second trial of the TOMM did not vary with gender, ethnicity, parental occupation, performance on an independent memory test, or length of coma. Although younger children tended to be somewhat less efficient on the TOMM than older children, more than 90% of children in the 6-8 years range met criteria originally developed for adults for sufficient effort on the TOMM. It is concluded that the TOMM is a potentially useful measure of effort in the clinical neuropsychological evaluation of school-age children.     

Children and the Test of Memory Malingering: Is one trial enough?

There is a growing body of research suggesting that the first trial of the TOMM may provide an accurate screener of effort in children. During neuropsychological assessments, some circumstances result in only one completed trial of the TOMM. Research on adults reflects that passing scores on Trial 1 (based on Trial 2 cutoff) are highly predictive of passing scores on Trial 2 and the TOMM overall. Pediatric research found that 100% of children and adolescents who passed Trial 1 of the TOMM also passed Trial 2. Our research hypothesis is that children who pass Trial 1 will also pass Trial 2. Data from 75 clinically diagnosed children (ages 6–18 years) found that 64% performed above the published adult TOMM cutoff on Trial 1. All children who passed Trial 1 also passed Trial 2 suggesting support for the research hypothesis. Sensitivity was 1.0, specificity was 0.72, positive predictive value was .33, and negative predictive value was 1.0. These findings suggest that in this sample, the children who performed above the Trial 2 cutoff on Trial 1 also all passed Trial 2 (so there were no false negatives, thus a perfect sensitivity and negative predictive value). Of the 36% of children who did not pass the Trial 1 cutoff, 67% passed on Trial 2. Data clearly support that children passing Trial 1 have a high likelihood of passing Trial 2, thus drawing conclusions about performance validity after passing Trial 1. Conclusions after failing Trial 1 require further investigation.     

TOMM Performances and Self-Reported Symptoms of Depression and Anxiety

The Test of Memory Malingering (TOMM) is the most frequently used symptom validity test (SVT) by neuropsychologists and appears to be robust in the context of a number of neurological and psychiatric conditions. The current study cross-validated and extended prior research by examining the relation between scores on self-report measures of depression and anxiety, independently and combined, and scores on the TOMM in an outpatient neuropsychology clinic. A total of 262 files were reviewed, 67 of which contained complete data on the TOMM, Beck Depression Inventory-II, and the State-Trait Anxiety Inventory. Results show that scores on self-report inventories of depression and anxiety are not significantly related to scores on the TOMM, cross-validating previous research. Extending prior research, current analyses demonstrate that TOMM scores are not significantly influenced by the combined relation of self-reported symptoms of depression and anxiety. Findings support the utility of the TOMM with patients reporting affective disturbances.     

The implicit self and the specificity-matching principle: Implicit self-concept predicts domain-specific outcomes

According to the specificity-matching principle (Swann, Chang-Schneider, & McClarty, 2007), specific aspects of self-concept should predict domain specific outcomes, rather than broader outcomes. The purpose of the current study was to determine whether this principle, which has thus far been examined using explicit measures of the self, extends to the implicit self-concept. We tested this idea in the domain of math achievement. We observed that explicit math self-concept was correlated with specific outcomes (measures of math achievement), whereas explicit self-esteem was correlated with a broad outcome (satisfaction with life). Thus, we replicated the specificity-matching principle using explicit measures of self-esteem and self-concept. Moreover, we found that implicit self-concept was correlated with domain-specific outcomes, but not a global outcome, as the specificity-matching principle would predict. Furthermore, regression analyses indicated that implicit self-concept accounted for unique variance in the domain-specific outcomes, for which the other measures of the self could not account. Taken together, we conclude that the specificity-matching principle does indeed extend to the implicit self-concept.     

Presentation of Mexican Americans to a Memory Disorder Clinic

Despite the rapidly growing nature of the Mexican American population in the United States, relatively little is known regarding cognitive aging among this minority group compared to non-Hispanic, white individuals. The current study was conducted to describe the nature of cognitive and affective characteristics of Mexican American patients with dementia or other cognitive disorders on initial presentation to a Memory Disorder Clinic. Archival data were reviewed from this specialty clinic for 219 patients who were evaluated for the first time over a 2-year period. Twenty-two Mexican American patients were identified, and a sample of 22 matched non-Hispanic white patients was derived for comparison. When compared to non-Hispanic white patients, Mexican Americans were found in fewer numbers, reported higher levels of anxiety and depression, and produced lower scores on neurocognitive assessments. Results support the notion that Mexican American patients present for cognitive assessment and treatment at a greater stage of impairment severity as compared to non-Hispanic whites.     

Keeping an eye on the truth? Pupil size changes associated with recognition memory

During recognition memory tests participants' pupils dilate more when they view old items compared to novel items. We sought to replicate this “pupil old/new effect” and to determine its relationship to participants' responses. We compared changes in pupil size during recognition when participants were given standard recognition memory instructions, instructions to feign amnesia, and instructions to report all items as new. Participants' pupils dilated more to old items compared to new items under all three instruction conditions. This finding suggests that the increase in pupil size that occurs when participants encounter previously studied items is not under conscious control. Given that pupil size can be reliably and simply measured, the pupil old/new effect may have potential in clinical settings as a means for determining whether patients are feigning memory loss.     

Performance on the Test of Memory Malingering in children with neurological conditions

Despite increasing interest in the use of performance validity tests with youth, relatively little is known about how children and adolescents with neurological diagnoses perform on these measures. The purpose of this study was to examine performance on the Test of Memory Malingering (TOMM) in a general pediatric neurologic sample. Data were obtained from 266 consecutive patients (mean age = 13.0, SD = 3.7, range = 5–18) referred for a neuropsychological assessment in a tertiary care pediatric hospital. As part of a broader neuropsychological battery, patients were administered the TOMM. In this sample, 94% of children passed the TOMM. Pass rate was 87% for 5–7 year-olds but was ≥ 90% for all other ages. Children with a history of stroke had the lowest pass rate (86%), with other diagnostic groups scoring ≥ 90%, including epilepsy, traumatic brain injury, and hydrocephalus. Lower TOMM performance was related to slower processing speed and weaker memory performance. The results support using the TOMM with children and adolescents who have neurological diagnoses. Caution may still be warranted when interpreting scores in those who are younger and/or who have more significant cognitive difficulty.     

Power to the will: How exerting physical effort boosts the sense of agency

The sense of agency refers to the experience of being in control of one’s actions and their consequences. The 19th century French philosopher Maine de Biran proposed that the sensation of effort might provide an internal cue for distinguishing self-caused from other changes in the environment. The present study is the first to empirically test the philosophical idea that effort promotes self-agency. We used intentional binding, which refers to the subjective temporal attraction between an action and its sensory consequences, as an implicit measure of the sense of agency. Effort was manipulated independent of the primary task by requiring participants to pull stretch bands of varying resistance levels. We found that intentional binding was enhanced under conditions of increased effort. This suggests not only that the experience of effort directly contributes to the sense of agency, but also that the integration of effort as an agency cue is non-specific to the effort requirement of the action itself.     

身体还是认知努力的损害?抑郁症努力奖赏动机评估及计算模型应用

动机损害是抑郁症的常见特征, 患者常表现出异常的奖励评估或体验等行为。理解抑郁症患者努力奖赏动机活动中不愿意付出努力的类型——是不愿意付出身体努力还是不愿意付出认知努力, 对帮助患者恢复社会功能活动具有重要作用。然而, 当前缺少研究探讨努力类型(身体或认知努力)对研究认识的影响, 同时, 计算模型方法具有能够精细评估动机相关变量的优势, 这一方法在该领域中并未得到普及应用。通过实验方法区分评估抑郁症患者“认知努力”和“身体努力”这两种不同的努力决策, 并结合计算模型的数据分析方式, 从努力奖赏动机这一角度探索抑郁症动机损害行为, 对揭示这一损害潜在的认知神经基础具有促进作用。     

学习和考试技能训练对不同类型考试焦虑者的作用

以209名高中学生为被试,采用现场实验法考察了学习与考试技能训练(SST)对认知主导型考试焦虑(C型)、生理唤醒主导型考试焦虑(P型)和学习技能缺乏型考试焦虑(S型)的作用效果。结果表明：SST不能降低三种考试焦虑类型的状态考试焦虑,但能显著提高三种不同类型考试焦虑者的考试成绩。     

努力：成本还是奖赏?

努力(Effort)与奖赏系统关系密切。当前关于努力在奖赏加工中的作用存在两个截然相反的观点：努力是一种成本还是一种奖赏?理论模型包括：其一, 努力是一种成本, 会降低奖赏的价值, 相应的理论解释包括内部成本模型、机会成本模型及信号模型等; 其二, 努力能够提升奖赏的价值, 相应的理论解释包括认知失调和努力的合理化模型、习得性勤奋理论及认知需求理论等。这两种观点均得到了来自于动物学、行为学、电生理学以及神经影像学等证据的支持。未来研究需要对努力准确定义, 从时间进程角度对努力的理论进行整合, 进一步考察努力的相关影响因素。     

A survey of neuropsychologists’ use of validity tests with children and adolescents

A web-based survey of validity test use by North American neuropsychologists was conducted, with 282 participants meeting inclusion criteria. Respondents indicated that they use a median of one stand-alone performance validity test (PVT), one embedded PVT, and one symptom validity test (SVT) per pediatric assessment. The vast majority of respondents indicated they give at least one PVT (92%) and at least one SVT (88%) during each pediatric assessment. A meaningful difference in validity use (i.e., at least a medium effect size) was only found for those who engage in forensic work, with those clinicians giving more stand-alone PVTs than those who do not conduct forensic work. The most frequently used validity measures in pediatric assessments are presented, as are reasons participants reported for both using and not using validity tests. Limitations and qualitative comparisons to other surveys on validity test use with adults are discussed.