Decreasing the Susceptibility of Effort Measures to Coaching: The Tomm as an Exemplar

Malingering has been the focus of numerous studies in forensic psychology and neuropsychology over the last several decades; however, accurate identification of malingerers continues to be a primary concern in these fields, particularly in civil cases that come with costly consequences for erroneous identification. Many measures have been developed over the years to identify individuals attempting to malinger on neuropsychological testing; unfortunately, given the vast amount of information available on the Internet that compromises the security of these tests, they may be particularly vulnerable to attempts to coach, or inform, a potential malingerer on how to avoid being detected by these measures. A previous study showed that a commonly used measure of effort, the Test of Memory Malingering (TOMM), was susceptible to coaching based on information that was obtained from the Internet (Kovach, 2018). This finding highlighted the importance of identifying ways to either revise existing effort measures or develop new measures to be more resistant to coaching attempts. The current study sought to examine whether increasing the complexity of the TOMM led to variation in level of performance between groups providing differing levels of effort. Participants were assigned to one of four conditions: best effort (control), intermediate effort (fatigued performance), feigning (simulating symptoms of mild traumatic brain injury [mTBI]), and coached feigning (simulating mTBI while trying not to be detected as faking). The study addressed three main hypotheses: 1) Participants in the feigning group will demonstrate significantly poorer performance on the revised measure than the control group, intermediate effort group, and coached feigning group; 2) Participants in the coached feigning group will show significantly poorer performance on the revised measure than the control group; and 3) Participants providing intermediate effort will demonstrate significantly poorer performance on the revised measure than the control group. Results showed that the coached feigning group had the lowest total score on the revised measure (M = 27.36), followed by the feigning condition (M = 31.43), the intermediate effort condition (M = 36.86), and finally, the control group (M = 41.50). A one-way between subjects ANOVA was used to determine if total score on the revised TOMM across effort conditions was stasticially significant; results of post-hoc tests indicated that participants in the control condition outperformed participants in the two feigning conditions, but they did not perform significantly better than those in the intermediate effort condition. Results of this study showed that including similar distractor items and varying the number of response options increased the complexity of the TOMM and led to varying levels of performance between groups providing different levels of effort. This suggests that increasing the complexity of a measure of effort may be a useful strategy for decreasing susceptibility of these measures to coaching attempts; however, additional research is needed using various clinical groups with repeated learning and recall trials to confirm the potential utility of this strategy in reducing susceptibility to