Predictors of invalid neuropsychological test performance after traumatic brain injury

Objective: To investigate the usefulness of the Test of Memory Malingering (TOMM) and the California Verbal Learning Test-Second Edition (CVLT-II) in assessing invalid test performance after traumatic brain injury (TBI). Design: Consecutive 3-year series of rehabilitation referrals (n = 132). Methods and procedures: Percentage of participants who failed validity criteria was determined. Hierarchical logistic regression analysis and odds ratios were used to identify predictors of invalid test performance. Results: Twenty patients (15%) performed in the invalid range when held to a priori specified criteria for invalid test performance (i.e. TOMM <45/50 on Trial 2 or CVLT-II <15/16 on Forced-Choice recognition trial). Both psychiatric history and financial compensation seeking were associated with an almost 4-fold increase in likelihood of invalid responding. Conclusions: The TOMM and CVLT-II are sensitive to the potential impact of current financial compensation seeking and prior psychiatric history on neuropsychological test performance after TBI.