This study compared the Word Memory Test (WMT) and California Verbal Learning Test-Second Edition (CVLT-II) in a sample (N = 76) of outpatient physiatry referrals who passed WMT validity indices. WMT and CVLT-II raw scores showed moderate to strong correlations. WMT scores were more likely to be below expectation than CVLT-II scores using norms from the respective test manuals. With impaired scores defined as 2 SDs below normative mean, the WMT and CVLT-II showed 67% overall agreement and kappa of 0.34. Forty percent of participants who scored within normal limits on the CVLT-II demonstrated an impaired score on the WMT. Despite evidence of utility, WMT memory subtests appear limited by current normative data.

Introduction

The Word Memory Test (WMT; Green, 2003) is a commonly used performance validity test (PVT; Sharland & Gfeller, 2007). Initial WMT studies focused on traumatic brain injury (TBI) claims among litigants (Green, Iverson, & Allen, 1999), but subsequent work examined the WMT with a variety of populations and conditions: chronic pain (Gervais, Green, Allen, & Iverson, 2001), pediatric evaluations (Green & Flaro, 2003), schizophrenia (Gorissen, Sanz, & Schmand, 2005), psychogenic nonepileptic seizures (Drane et al., 2006), attention-deficit hyperactivity disorder and learning disorder evaluations (Sullivan, May, & Galbally, 2007), posttraumatic stress disorder (Morel, 2008), severe memory impairment (Green, Montijo, & Brockhaus, 2011), and military personnel (Lange, Pancholi, Bhagwat, Anderson-Barnes, & French, 2012).

While the bulk of research on the WMT has focused on its role as a PVT, the test author refers to it as a “verbal memory test with multiple subtests and with self-contained effort measures” (Green, 2003, p. 1) and as a measure of “the ability to learn a list of 20 word pairs” (p. 6). Accordingly, the subtests are categorized by focus on validity or memory with the primary memory subtests including Multiple Choice (MC), Paired Associates (PA), and Free Recall (FR) with an optional Long Delay Free Recall subtest that may also be administered 20 min after FR. The test manual presents data in support of the proposal that MC, PA, and FR are memory measures. For example, neurologic patients who passed WMT validity subtests with normal (n = 20) and impaired (n = 20) performances on a separate verbal list learning task were reported to be significantly different on WMT memory subtests (p. 11). Effect sizes calculated from reported means and standard deviations were large for MC (d = 0.79), PA (d = 0.81), and FR (d = 1.04). Similarly, an unpublished supplement to the test manual (L. M. Allen & P. Green, 1999, unpublished manuscript) reported data from patients with history of severe TBI who passed WMT validity subtests and were grouped by performance on a separate memory test. Patients with relatively worse (n = 25) versus better (n = 26) performance on a separate memory measure demonstrated significant differences with small to medium effect sizes on MC (d = 0.38), PA (d = 0.37), and FR (d = 0.45).

Independent studies of relationships between WMT and separate memory measures are less common than studies focused on the validity subtests. Donders and Boonstra (2007) examined relationships between the WMT and California Verbal Learning Test-Second Edition (CVLT-II; Delis, Kramer, Kaplan, & Ober, 2000) in individuals with TBI. Correlations based on the entire sample (N = 87), which included 21 cases reported to meet criteria for questionable performance validity, were reported between WMT validity subtests and Forced Choice Recognition (FC) and Total Immediate Recall (TOT) on the CVLT-II. Correlations were higher between WMT validity subtests and FC (r = .50–.63) than TOT (r = .30–.37). No data were presented on MC, PA, or FR. Merten, Bossink, and Schmand (2007) reported correlations between WMT validity subtests and separate measures including learning trials on a list learning task in general neurologic patients (r = .58–.65) and patients diagnosed with probable Alzheimer's disease (r = −.07–.80). No data were presented on MC, PA, or FR.

Goodrich-Hunsaker and Hopkins (2009) reported findings from a case series of three patients with documented bilateral hippocampal atrophy subsequent to anoxia without dementia or external incentive. Both patient and demographically matched control (n = 4) participants performed above cutoff on the WMT validity subtests. General cognitive ability index scores were similar across groups. Patients performed significantly lower on all indices on a separate measure of memory. Patients also performed significantly lower on WMT validity and memory subtests. Examination of WMT profiles of the patient group revealed score patterns consistent with a genuine memory impairment profile (GMIP) as explained in the WMT manual (Green, 2003). Patient–control comparisons demonstrated large effect sizes on MC (d = 3.8), PA (d = 2.6), and FR (d = 2.8).

Rienstra, Spaan, and Schmand (2009) administered a Dutch version of the WMT to normal community dwelling participants (N = 115) and compared findings with normative data published in the test manual. Given reported similarities between their participants and the sample in the WMT manual, Rienstra and colleagues combined data with those from the test manual resulting in a normative dataset of 155 cases. They investigated relationships among demographic characteristics and WMT performance. Gender was not associated with WMT performance, but age and education showed significant correlations with WMT subtest scores. Accordingly, Rienstra and colleagues presented tabular data on WMT subtest scores by three age groupings (i.e., 20–40, 41–65, and 66–80 years) and three levels of education described as low (M = 9.5 years, SD = 0.9), average (M = 13.5 years, SD = 0.9), and high (M = 17.7 years, SD = 1.5).

Martins and Martins (2010) investigated a Portuguese version of the WMT in a sample of healthy controls (n = 29), simulators (n = 20), and patients diagnosed with mild cognitive impairment (n = 21). Participants diagnosed with mild cognitive impairment performed below expectation on WMT validity indices, but use of GMIP analysis resulted in reported specificity of 0.93 for that group. Compared with control participants, patients demonstrated lower scores on WMT memory subtests with large effect sizes observed on MC (d = 3.5), PA (d = 3.4), and FR (d = 3.3). Although the authors did not report statistical analysis of demographics, examination of reported characteristics shows a substantial difference in education between control and patient groups: 72% of control participants were reported to have college degrees; 71% of the patient participants were reported to have <6 years of education. Age also appeared different between control (M = 31.7 years, SD = 2.8) and patient (M = 71.2 years, SD = 2.0) groups, but the possibility of an older patient group would be expected given the diagnosis.

Donders and Hui (2013) examined the utility of memory subtests of the WMT in a TBI sample (N = 107). TOT on the CVLT-II showed modest correlations with MC (rs = .40), PA (rs = .44), and FR (rs = .45). Length of coma was significantly correlated with TOT (rs = −.26), but not with WMT memory subtests (rs = −.02–−.10). While groups based on TBI severity were significantly different on TOT, no significant differences were observed on WMT memory subtests. WMT memory subtests were reported to demonstrate sensitivity of 0.55 and specificity of 0.74 in differentiating patients with impaired scores on the CVLT-II (using the 10th percentile as the impairment cutoff).

Although research has provided initial support for the proposal that MC, PA, and FR may have utility as memory measures, a more recent study (Donders & Hui, 2013) has challenged the utility of WMT memory subtests in cases involving TBI. On a purely rational basis, it would appear reasonable that the subtests could be useful in the evaluation of memory, since other well-validated measures of learning and memory like the Wechsler Memory Scale-Fourth Edition (WMS-IV; Wechsler, 2009) and CVLT-II have components similar to PA and FR. It may be more challenging to find an analogous measure to MC. A limitation to clinical use of WMT memory measures appears to be lack of normative data as available norms include either the small Canadian sample (N = 40) reported by Green (2003) or data reported by Rienstra and colleagues (2009) including Green's normative cases combined with additional data from a Dutch sample.

The goal of the present study was to investigate relationships among WMT memory subtests and the CVLT-II in a clinical sample. The primary aim involved exploration of the concordance of norm-referenced scores on WMT memory subtests with the CVLT-II as criterion memory measure.

Method

Participants

Consecutive referrals to a neuropsychology clinic in an academic medical center in the western United States were considered for inclusion in the study. Inclusion criteria were aged between 20 and 65 and completion of outpatient neuropsychological evaluation with administration of WMT and CVLT-II. Exclusion criteria were English as a second language, history of grade retention or special education, and failure on the validity indices of the WMT without meeting GMIP criteria. Of 155 cases meeting the age criterion, 39 cases were not administered the WMT and 1 case was not given the CVLT-II. Five cases were excluded due to English as a second language, and 13 cases were excluded for history of grade retention or special education. In the remaining group (n = 97), 27 cases failed WMT validity indices of which 21 were excluded for not meeting GMIP criteria resulting in a final sample of 76.

The six participants identified as meeting GMIP criteria had medical histories notable for serious neurologic compromise due to intracranial hemorrhage secondary to aneurysm rupture (n = 2), anoxia (n = 2), cerebrovascular accident involving posterior cerebral artery distribution (n = 1), and severe TBI (n = 1). One individual required assistance with basic activities of daily living like personal grooming and hygiene, four individuals required assistance with medication management, five individuals required assistance with financial management, and four individuals were not driving. None of these participants had returned to their previous occupation at the time of the evaluation.

The average age of participants was 42.8 (SD = 12.6) and average educational level was 14.5 (SD = 2.3; range 10–19). Thirty-two percent of participants were female. Regarding ethnicity, participants were 92% Caucasian, 5% Hispanic/Latino, and 3% other ethnicities. Ninety-one percent of participants were right handed. The majority (74%) of participants reported a history of TBI (n = 56). History of cerebrovascular insult was observed in 16% of participants, and other presenting conditions were reported in 10% of participants. Additional information on presenting condition is shown in Table 1. For participants with a history of cerebral insult (n = 75), median time since injury was 185 days (M = 487, SD = 1137; range 20–8783). TBI was classified using standard criteria (Kay et al., 1993), and the following rates of severity levels were noted: 38% mild, 16% complicated-mild/moderate, and 46% severe. Median posttraumatic amnesia duration in participants with a history of severe TBI was 21 days (M = 24, SD = 12; range 9–64).

Table 1.

Frequency of presenting conditions

Condition Frequency 
Traumatic brain injury 
 Mild 21 28 
 Complicated-mild/moderate 12 
 Severe 26 34 
Cerebrovascular compromise 
 Stroke 
 Aneurysm 
 Cavernous hemangioma 
Other conditions 
 Anoxia, carbon monoxide exposure 
 Encephalopathy, encephalomyelitis 
 Psychiatric diagnosis 
 Electrical injury 
Condition Frequency 
Traumatic brain injury 
 Mild 21 28 
 Complicated-mild/moderate 12 
 Severe 26 34 
Cerebrovascular compromise 
 Stroke 
 Aneurysm 
 Cavernous hemangioma 
Other conditions 
 Anoxia, carbon monoxide exposure 
 Encephalopathy, encephalomyelitis 
 Psychiatric diagnosis 
 Electrical injury 

Measures

Participants underwent comprehensive neuropsychological evaluation that followed a flexible battery approach. The measures of interest to this study included the WMT (Green, 2003) and CVLT-II (Delis et al., 2000).

The WMT (Green, 2003) is a computerized measure of verbal learning and performance validity that involves presentation of 20 semantically associated word pairs followed by trials ranging from recognition to free recall. Standard administration guidelines were followed, and the optional Long Delay Free Recall trial was not administered. Profiles of participants who failed validity subtests were compared with criteria for GMIP as described in the test manual. Cases meeting GMIP criteria were included in the sample as previously noted. The primary variables of interest included MC, PA, and FR. MC, PA, and FR raw scores were converted to standard scores based on published normative references (Green 2003; Rienstra et al., 2009).

The CVLT-II (Delis et al., 2000) is a widely used supra-span verbal list learning task. It was administered according to standard instructions. The main variables of interest included raw and norm-referenced scores on TOT, Short Delay Free Recall (SDFR), Long Delay Free Recall (LDFR), and Delayed Recognition Discrimination (REC).

Procedure

Following an IRB-approved research protocol, retrospective review of consecutive cases was conducted to identify participants meeting inclusion criteria. Relevant demographic, clinical, and test data were entered into a dataset for analysis. WMT scores were converted to standard scores using available normative data from the manual (WMT-G; Green, 2003) and an independent publication (WMT-R; Rienstra et al., 2009). Given the observed distribution in MC and PA scores, standard scores for those variables were kept in z scores. FR scores were converted to T scores following convention in Rienstra and colleagues. Frequencies of below-expectation scores on CVLT-II and WMT variables were examined at three levels below normative mean (1, 1.5, and 2 SDs below the mean). Summary variables were created for each of the below-expectation score cutoffs such that a single below-expectation score out of the variables of interest was counted as a below-expectation performance on the measure. The resulting dichotomous scores were compared across measures. The proportion of participants who performed in the impaired range (defined as 2 SDs below normative mean) was compared across measures.

Results

Descriptive statistics on CVLT-II and WMT performances are shown in Table 2. Correlations among demographic characteristics and raw scores on the WMT and CVLT-II were examined. Age was correlated with REC (r = −.30, p = .008) and PA (r = −.24, p = .03). Education showed significant associations with TOT (r = .33, p = .003), SDFR (r = .29, p = .01), LDFR (r = .27, p = .02), and FR (r = .33, p = .004). Of the WMT variables, FR showed the greatest association with the CVLT-II, and its strongest relationship was observed with TOT (r = .81, p < .001). Details on correlations are shown in Table 3.

Table 2.

Raw and norm-referenced scores on CVLT-II and WMT

Variable Raw scores, M (SDNorm-referenced scores, M (SD)
 
Test manual Rienstra and colleagues (2009) 
TOT 47.2 (11.9) 48.8 (12.1) — 
SDFR 9.6 (3.9) −0.2 (1.3) — 
LDFR 9.9 (3.8) −0.4 (1.2) — 
REC 3.0 (1.0) −0.02 (1.3) — 
MC 83.2 (18.5) −1.8 (2.8) −1.8 (2.9) 
PA 80.9 (20.2) −1.2 (2.1) −1.7 (2.9) 
FR 46.1 (19.5) 35.8 (15.6) 34.5 (15.0) 
Variable Raw scores, M (SDNorm-referenced scores, M (SD)
 
Test manual Rienstra and colleagues (2009) 
TOT 47.2 (11.9) 48.8 (12.1) — 
SDFR 9.6 (3.9) −0.2 (1.3) — 
LDFR 9.9 (3.8) −0.4 (1.2) — 
REC 3.0 (1.0) −0.02 (1.3) — 
MC 83.2 (18.5) −1.8 (2.8) −1.8 (2.9) 
PA 80.9 (20.2) −1.2 (2.1) −1.7 (2.9) 
FR 46.1 (19.5) 35.8 (15.6) 34.5 (15.0) 

Notes: Norm-referenced scores are z scores except for TOT and FR, which are T scores. CVLT-II = California Verbal Learning Test-Second Edition; WMT = Word Memory Test; TOT = Total Immediate Recall (CVLT-II); SDFR = Short Delay Free Recall (CVLT-II); LDFR = Long Delay Free Recall (CVLT-II); REC = Delayed Recognition (d′; CVLT-II); MC = Multiple Choice (WMT); PA = Paired Associates (WMT); FR = Free Recall (WMT).

Table 3.

Demographic, CVLT-II, and WMT inter-correlations

 Age Ed TOT SDFR LDFR REC MC PA FR 
Age         
Ed 0.11        
TOT −0.17 0.33**       
SDFR −0.15 0.29* 0.86***      
LDFR −0.17 0.27* 0.86*** 0.91***     
REC −0.30** 0.19 0.76*** 0.83*** 0.84***    
MC −0.20 0.17 0.57*** 0.59*** 0.59*** 0.66***   
PA −0.24* 0.17 0.65*** 0.69*** 0.69*** 0.74*** 0.92***  
FR −0.16 0.33** 0.81*** 0.72*** 0.75*** 0.74*** 0.66*** 0.71*** 
 Age Ed TOT SDFR LDFR REC MC PA FR 
Age         
Ed 0.11        
TOT −0.17 0.33**       
SDFR −0.15 0.29* 0.86***      
LDFR −0.17 0.27* 0.86*** 0.91***     
REC −0.30** 0.19 0.76*** 0.83*** 0.84***    
MC −0.20 0.17 0.57*** 0.59*** 0.59*** 0.66***   
PA −0.24* 0.17 0.65*** 0.69*** 0.69*** 0.74*** 0.92***  
FR −0.16 0.33** 0.81*** 0.72*** 0.75*** 0.74*** 0.66*** 0.71*** 

Notes: CVLT-II = California Verbal Learning Test-Second Edition; WMT = Word Memory Test; Ed = education; TOT = Total Immediate Recall (CVLT-II); SDFR = Short Delay Free Recall (CVLT-II); LDFR = Long Delay Free Recall (CVLT-II); REC = Delayed Recognition (d′; CVLT-II); MC = Multiple Choice (WMT); PA = Paired Associates (WMT); FR = Free Recall (WMT).

*p < .05; **p < .01; ***p < .001.

Examination of norm-referenced scores on the CVLT-II and WMT revealed differences between measures. For example, using a one-sample t-test and expected normative mean (M = 50, SD = 10), TOT was not significantly different, t (75) = −0.86, p = .39, d = 0.11. Norm-referenced FR scores were significantly different with WMT-G, t (75) = −7.93, p < .001, d = 1.08, and WMT-R, t (75) = −9.01, p < .001, d = 1.22.

Turning to levels of below-expectation performance on CVLT-II variables, 20%–30% of participants scored 1 SD below the mean, 11%–17% scored 1.5 SDs below the mean, and 8%–11% scored 2 SDs below the mean. Using WMT-G, 43%–61% of participants scored 1 SDs below the mean, 34%–49% scored 1.5 SDs below the mean, and 24%–43% scored 2 SDs below the mean. Similar values were observed using WMT-R: 43%–68% of participants scored 1 SDs below the mean, 37%–57% scored 1.5 SDs below the mean, and 33%–38% scored 2 SDs below the mean.

Using the 1 SD cutoff, 42% of participants scored below expectation on the CVLT-II, 71% of participants scored below expectation on WMT-G, and 76% scored below expectation on WMT-R. The percentage of participants scoring below expectation on CVLT-II was significantly different from those scoring below expectation on WMT-G, χ2 (1) = 30.8, p < .001, and WMT-R, χ2 (1) = 47.9, p < .001. The percentage scoring below expectation on WMT-G was not significantly different from WMT-R, χ2 (1) = 1.0, p = .31. Using the 1.5 SDs cutoff, 24% of participants scored below expectation on the CVLT-II, 61% scored below expectation on WMT-G, and 64% scored below expectation on WMT-R. The percentage of participants scoring below expectation on CVLT-II was significantly different from those scoring below expectation on WMT-G, χ2 (1) = 44.5, p < .001, and WMT-R, χ2 (1) = 53.6, p < .001. The percentage scoring below expectation on WMT-G was not significantly different from WMT-R, χ2 (1) = 0.4, p = .53.

With impairment defined as scores falling 2 SDs or more below the mean, the relationship of norm-referenced WMT scores to impaired or normal CVLT-II scores is shown in Fig. 1. Impairment percentages on the CVLT-II components were 8% on TOT, 11% on SDFR, 11% on LDFR, and 9% on REC with 13 participants (17%) scoring in the impaired range on at least one of four CVLT-II variables. Impairment percentages on WMT-G were 34% on MC, 24% on PA, and 43% on FR with 38 participants (50%) scoring in the impaired range on at least one of three WMT variables. Impairment percentages on WMT-R were 36% on MC, 33% on PA, and 38% on FR with 40 participants (53%) scoring in the impaired range on at least one of three WMT variables. The percentage of participants scoring in the impaired range on the CVLT-II was significantly different from those scoring in the impaired range on WMT-G, χ2 (1) = 32.9, p < .001, and WMT-R, χ2 (1) = 39.3, p < .001. The percentage scoring below expectation on WMT-G was not significantly different from WMT-R, χ2 (1) = 0.3, p = .60.

Fig. 1.

California Verbal Learning Test-Second Edition (CVLT-II) and WMT norm-referenced z scores on select variables in sample groups based on normal limits (n = 63) or impaired (i.e., at least one score that was 2 SDs below normative mean; n = 13) CVLT-II performance. Error bars delineate 95% confidence intervals for the observed scores. TOT = Total Immediate Recall (CVLT-II); SDFR = Short Delay Free Recall (CVLT-II); LDFR = Long Delay Free Recall (CVLT-II); REC = Delayed Recognition (d′; CVLT-II); MC = Multiple Choice (WMT); PA = Paired Associates (WMT); FR = Free Recall (WMT); G = Green (2003) normative data; R = Rienstra and colleagues (2009) normative data.

Fig. 1.

California Verbal Learning Test-Second Edition (CVLT-II) and WMT norm-referenced z scores on select variables in sample groups based on normal limits (n = 63) or impaired (i.e., at least one score that was 2 SDs below normative mean; n = 13) CVLT-II performance. Error bars delineate 95% confidence intervals for the observed scores. TOT = Total Immediate Recall (CVLT-II); SDFR = Short Delay Free Recall (CVLT-II); LDFR = Long Delay Free Recall (CVLT-II); REC = Delayed Recognition (d′; CVLT-II); MC = Multiple Choice (WMT); PA = Paired Associates (WMT); FR = Free Recall (WMT); G = Green (2003) normative data; R = Rienstra and colleagues (2009) normative data.

Thirty-eight participants (50%) did not demonstrate an impaired score on either the CVLT-II or WMT-G, and 13 participants (17%) demonstrated an impaired score on both measures. The measures demonstrated overall agreement of 67% with kappa of 0.34, z = 3.96, p < .001. Among participants who did not perform in the impaired range on the CVLT-II (n = 63), 40% produced an impaired range score on WMT-G; among participants who did not perform in the impaired range on WMT-G (n = 38), none were impaired on the CVLT-II. Thirty-five participants (46%) did not demonstrate an impaired score on either the CVLT-II or WMT-R, and 12 participants (16%) demonstrated an impaired score on both measures. The measures demonstrated overall agreement of 62% with kappa of 0.26, z = 3.15, p < .001. Among participants who did not perform in the impaired range on the CVLT-II (n = 63), 44% produced an impaired range score on WMT-G; among participants who did not perform in the impaired range on WMT-G (n = 36), one demonstrated an impaired score on the CVLT-II.

Discussion

This study explored WMT memory subtests in a clinical sample with a goal of clarifying their relationship to the CVLT-II as a criterion verbal memory measure. Moderate-to-strong associations were observed between WMT memory subtests and CVLT-II subtests. Specifically, MC, PA, and FR showed increasing correlations with CVLT-II trials. It is not surprising that MC and PA showed relatively lower correlations since they involve distinct formats from CVLT-II trials. These findings appear consistent with research reported by the test author (L. M. Allen & P. Green, 1999, unpublished manuscript; Green, 2003) in that the observed effect sizes between reported clinical groups were larger for FR than for MC and PA. The pattern of the current findings appears complimentary to other research (Donders & Boonstra, 2007) that showed stronger correlations between WMT validity indices and CVLT-II Forced Choice Recognition than TOT. The strong correlation between FR and TOT in the current data appears in contrast to reported moderate correlations in more recent research (Donders & Hui, 2013). Given the inclusion of a wider range of presenting conditions in the present study, there may have been a corresponding increase in range of observed WMT and CVLT-II scores, which would strengthen the correlation coefficient.

Although these correlational findings appear supportive of the potential utility of WMT memory subtests, the promising results were based on raw score data. Examination of norm-referenced scores on the WMT raised concern with regard to the status of currently available norms. In contrast to the CVLT-II, the available norms on the WMT produced greater rates of below-expectation scores across levels of below-expectation performance ranging from 1 to 2 SDs below the mean. With impairment defined as scores 2 SDs below normative mean, the WMT demonstrated more than double the rate of impaired scores as the CVLT-II using WMT norms from the test manual (Green, 2003) and a separate publication (Rienstra et al., 2009). In one third of cases, discrepancy was observed between impairment on the CVLT-II and WMT. Notably, almost half of participants with normal memory performance on the CVLT-II scored in the impaired range on WMT memory subtests.

It may be possible that the different format of WMT learning trials (i.e., computer versus examiner presentation, visual versus auditory, etc.) contributes to a memory measure of much greater difficulty, but given the raw score associations, it appears more likely a normative issue. Certainly, the sample of 40 cases presented in the test manual appears insufficient for meaningful use of the memory measures. The more recent work by Rienstra and colleagues is an improvement. There may remain important demographic and cultural differences that limit widespread utility of Dutch norms for a measure administered in English in the United States.

Limitations of these findings include a sample size that may be considered small by typical standards for examination of normative issues. The majority of cases had histories of TBI, which may limit generalizability to other populations. The sample was also relatively well educated compared with the United States as a whole. It was also predominantly Caucasian. Future work might target a more diverse sample in ethnicity and educational history. These analyses were focused on the memory subtests of the WMT. It may also be important to consider a future research design with a larger sample that would afford an opportunity to examine the WMT as a whole. Such a project might also benefit from administration of additional measures of both performance validity and memory as points of comparison. Considering the nature of the WMT subtests, it may be helpful if future research included a measure with analogous trials to PA. The WMS-IV may be a candidate measure for such a project.

Despite the need for improved norms, the wealth of clinical comparison group data remains a strength of the WMT. While large-scale normative efforts are costly and time intensive, another potentially useful approach may be development of meta-norms based on group level data on normal control participants published in research on the WMT. A variant of this approach would involve contacting authors of those publications to explore the possibility of collaborative norm development. Overall, these preliminary findings are interpreted as promising with regard to the potential utility of WMT memory subtests provided that normative data can be developed.

Conflict of Interest

None declared.

References

Delis
D. C.
Kramer
J. H.
Kaplan
E.
Ober
B. A.
California verbal learning test
 
2000
2nd ed
San Antonio, TX
The Psychological Corporation
Donders
J.
Boonstra
T.
Correlates of invalid neuropsychological test performance after traumatic brain injury
Brain Injury
 
2007
21
319
326
Donders
J.
Hui
E.
Clinical utility of the WMT as a measure of memory after TBI
2013, October
Poster presented at the 33rd annual conference of the National Academy of Neuropsychology
San Diego, CA
Drane
D. L.
Williamson
D. J.
Stroup
E. S.
Holmes
M. D.
Jung
M.
Koerner
E.
et al.  
Cognitive impairment is not equal in patients with epileptic and psychogenic nonepileptic seizures
Epilepsia
 
2006
47
1879
1886
Gervais
R. O.
Green
P.
Allen
L.
Iverson
G. L.
Effects of coaching on symptom validity testing in chronic pain patients presenting for disability assessments
Journal of Forensic Neuropsychology
 
2001
2
1
19
Goodrich-Hunsaker
N. J.
Hopkins
R. O.
Word Memory Test performance in amnesic patients with hippocampal damage
Neuropsychology
 
2009
23
529
534
Gorissen
M.
Sanz
J.
Schmand
B.
Effort and cognition in schizophrenia patients
Schizophrenia Research
 
2005
78
199
208
Green
P.
Green's word memory test for windows: User's manual
 
2003
Edmonton, Canada
Green's Publishing
Green
P.
Flaro
L.
Word Memory Test performance in children
Child Neuropsychology
 
2003
9
189
207
Green
P.
Iverson
G. L.
Allen
L.
Detecting malingering in head injury litigation with the Word Memory Test
Brain Injury
 
1999
10
813
819
Green
P.
Montijo
J.
Brockhaus
R.
High specificity of the Word Memory Test and medical symptom validity test in groups with severe verbal memory impairment
Applied Neuropsychology
 
2011
18
86
94
Kay
T.
Harrington
D. E.
Adams
R.
Anderson
T.
Berrol
S.
Cicerone
K.
et al.  
Definition of mild traumatic brain injury
Journal of Head Trauma Rehabilitation
 
1993
8
86
87
Lange
R. T.
Pancholi
S.
Bhagwat
A.
Anderson-Barnes
V.
French
L. M.
Influence of poor effort on neuropsychological test performance in U. S. Military personnel following mild traumatic brain injury
Journal of Clinical and Experimental Neuropsychology
 
2012
34
453
466
Martins
M.
Martins
I. P.
Memory malingering: Evaluating WMT criteria
Applied Neuropsychology
 
2010
17
177
182
Merten
T.
Bossink
L.
Schmand
B.
On the limits of effort testing: Symptom validity tests and severity of neurocognitive symptoms in nonlitigant patients
Journal of Clinical and Experimental Neuropsychology
 
2007
29
3
308
318
Morel
K. R.
Comparison of the Morel Emotional Numbing Test for Posttraumatic Stress Disorder to the Word Memory Test in neuropsychological evaluations
The Clinical Neuropsychologist
 
2008
22
350
362
Rienstra
A. A.
Spaan
P. J.
Schmand
B. B.
Reference data for the Word Memory Test
Archives of Clinical Neuropsychology
 
2009
24
3
255
262
Sharland
M. J.
Gfeller
J. D.
A survey of neuropsychologists’ beliefs and practices with respect to the assessment of effort
Archives of Clinical Neuropsychology
 
2007
22
213
223
Sullivan
B. K.
May
K.
Galbally
L.
Symptom exaggeration by college adults in attention-deficit hyperactivity disorder and learning disorder assessments
Applied Neuropsychology
 
2007
14
189
207
Wechsler
D.
Wechsler memory scale-fourth edition manual
 
2009
San Antonio, TX
Pearson