Portal de Periódicos da CAPES

Assessing Feigned Cognitive Impairment in Defendants Hospitalized for Competency Restoration: Further Validation of the TOMI

2011; Taylor & Francis; Volume: 11; Issue: 4 Linguagem: Inglês

10.1080/15228932.2011.562804

1522-9092

Lori H. Colwell, Kevin Colwell,

Healthcare Decision-Making and Restraints

Abstract Valid screens for feigned cognitive impairment are a fundamental component of any forensic assessment. The TOMI is a verbally administered, two-alternative forced-choice screen for feigned cognitive impairment in competence to stand trial (CST) evaluations. The present study provided further validation for the use of this tool in a sample of 82 forensic inpatients, the second investigation of the TOMI in a real-world, psycholegal context. Using three independent external criteria—the Test of Memory Malingering (TOMM) Trial 2 score, TOMM Retention Trial score, and a clinical treatment team decision—and these combined criteria—the Legal Knowledge scale (TOMI-L) evidenced high levels of sensitivity and specificity and excellent negative predictive power (NPP). The General Knowledge scale (TOMI-G) demonstrated poor sensitivity but high specificity and NPP. The authors discuss the utility of both scales in guiding and streamlining more thorough assessments of response styles in CST evaluations. Keywords: malingeringcompetencyforensic assessmenttwo-alternative forced-choice Notes A copy of the TOMI can be obtained by contacting either author. 1 The Rey-FIT was administered for clinical purposes only and was not utilized in the present research. 2 The labels genuine and probable feigning are used here only for descriptive purposes. The authors do not suggest that treatment teams can or should diagnose an individual with malingering on the basis of a single test score or absent a comprehensive, multi-method assessment, and no implication is made here that these test scores were indicative of a diagnosis of malingering. 3 Although data were gathered regarding the team's impressions about both cognitive and psychiatric malingering, the group comparisons dealt solely with cognitive malingering, as that is what the TOMI is designed to assess.