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Test of Memory Malingering (TOMM) Scores are not Affected by Chronic Pain or Depression in Patients with Fibromyalgia

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By GL Iverson, et al. • • April 27, 2007

Journal: The Clinical Neuropsychologist. 2007 May;21(3):532-46.

[Note: the TOMM test is designed to provide a reliable, low-cost first step in efforts to assess whether an individual is falsifying symptoms of memory impairment. But might results be skewed by FM patients' depression or pain? .]

Authors and affiliations: Iverson GL, Page JL, Koehler BE, Shojania K, Badii M. University of British Columbia & Riverview Hospital, Vancouver, British Columbia, Canada.

PMID: 17455036

Neuropsychologists routinely give effort tests, such as the Test of Memory Malingering (TOMM). When a person fails one of these tests, the clinician must try to determine whether the poor performance was due to suboptimal effort or to chronic pain, depression, or other problems.

Participants were 54 community-dwelling patients who met American College of Rheumatology criteria for Fibromyalgia (FM). In addition to the TOMM, they completed the Beck Depression Inventory-Second Edition, Multidimensional Pain Inventory-Version 1, Oswestry Disability Index-2.0, British Columbia Cognitive Complaints Inventory, and the Fibromyalgia Impact Questionnaire.

The majority endorsed at least mild levels of depressive symptoms (72%), and 22% endorsed "severe" levels of depression. The average scores on the TOMM were 48.8 (SD = 1.9, range = 40-50) for Trial 1, 49.8 (SD = 0.5, range = 48-50) for Trial 2, and 49.6 (SD = 0.9, range = 45-50) for Retention.

Despite relatively high levels of self-reported depression, chronic pain, and disability, not a single patient failed the TOMM. In this study, the TOMM was not affected by chronic pain, depression, or both.

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