TOMM (Test of Memory Malingering)

Author: Tom N. Tombaugh, PhD

A brief visual recognition test designed to help discriminate between individuals with true memory impairment and malingerers.

The TOMM instrument is designed to provide a reliable, economical first step as part of a full psychological battery to help assess whether an individual is falsifying symptoms of memory impairment.

How to Use This Test

Psychologists and psychiatrists can use the TOMM instrument in a variety of settings, including:

• Forensic investigations
• Personal injury lawsuits
• Civil and criminal trials
• Medical insurance examinations
• Social Security disability reviews
• Workers compensation exams

Key Features

• The presentation of 50 pictures provides the TOMM instrument with good face validity as a test of learning and memory, decreasing its transparency as an assessment of malingering. One of the limitations of most malingering tests is the patient’s ability to determine the purpose of the evaluation. In research studies, subjects did not suspect that the objective of the TOMM instrument was to detect malingering.



• Extensive data was collected to provide a norm-based criterion to detect malingering, supplementing the more traditional procedure of using below-chance performance as the criterion.



• Explicit feedback to patients on response correctness after each item has been shown to widen the gap between the scores of memory-impaired patients and malingerers. Non-malingering patients may seek to increase their response accuracy, while malingers may adjust their performance to respond more poorly on subsequent trials.



• The TOMM instrument is insensitive to a wide range of neurological impairments, i.e., cognitive impairment, aphasia, traumatic brain injury, and dementia.

Test Development

In the first phase of data collection, 405 males and females ages 16 to 84 were administered a forced-choice, no feedback version of the instrument. In the second phase, 70 males and females ages 17 to 73 were administered the two-choice version, which included feedback regarding correctness of response.

Validation data included 138 neuropsychological assessments from inpatient and outpatient settings and 23 head-injured subjects.

Quick Facts

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