Colorado Division of Workers’ Compensation COMPREHENSIVE PSYCHOLOGICAL TESTING Psychological Tests Commonly Used in the Assessment of Chronic Pain * TEST TEST CHARACTERISTICS STRENGTHS AND LENGTH, SCORING WEAKNESSES OPTIONS & TEST TAKING TIME Comprehensive Inventories For Medical Patients BHI™ 2 (Battery for What it Measures: Depression, anxiety and hostility; Strengths: Well-developed theoretical basis tied 217 items, 18 scales including Health Improvement – 2nd violent and suicidal ideation; borderline, emotional to a paradigm of delayed recovery in medical 3 validity measures, 40 edition ) dependency, chronic maladjustment, substance abuse, patients, and to assessing primary (“red flag”) content-based subscales, 25 history of abuse, perseverance, conflicts with and secondary (“yellow flag”) risk factors. Has critical items, 25-35 minutes, Pearson Assessments employer, family and physician, pain preoccupation, nationally normed 0-10 pain profiling. Two computerized scoring and www.pearsonassessments.c somatization, disability perceptions and others. norms groups are available, based on national report. om rehabilitation patient and community samples, Uses: Useful for identifying affective, both of which are stratified to match US census 6th grade reading level Standardization: S characterological, psychophysiological and social data. English and Spanish versions available. Scientific Review: JBG factors affecting pain and disability reports. Also Standardized audio tape administration for Intended for: M useful for assessing patients referred for intensive persons with literacy or reading problems, Research: 1-40 treatment programs such as chronic pain, functional computerized administration and progress Restrictions: H restoration, or work conditioning, for presurgical or tracking. Computerized reports also refer to a pre-treatment risk assessment, for impairment chronic pain subsample, five diagnostic determinations, or when there are indications that reference groups (head, neck, upper extremity, psychological factors are delaying the recovery back and lower extremity pain groups), and to process. Computerized progress tracking using serial groups of patients asked to fake good and fake administrations. bad. Benefits: When part of a comprehensive evaluation, Weaknesses: Assessment of psychosis is via can contribute substantially to the understanding of critical items only, no assessment of elevated psychosocial factors underlying pain reports, mood. Somewhat less able to assess coping perceived disability, somatic preoccupation, and help styles of relatively normal individuals with to design interventions. Serial administrations can medical conditions. Does not assess health track changes in a broad range of variables during the habits. course of treatment, and assess outcome. 1 Colorado Division of Workers’ Compensation COMPREHENSIVE PSYCHOLOGICAL TESTING Psychological Tests Commonly Used in the Assessment of Chronic Pain * TEST TEST CHARACTERISTICS STRENGTHS AND LENGTH, SCORING WEAKNESSES OPTIONS & TEST TAKING TIME MBMD™ (Millon What it Measures: Provides information on coping Strengths: Assesses a number of factors 165 Items, 38 scales, 3 validity Behavioral Medical styles (introversive, inhibited, dejected, cooperative, relevant to medical patients, with a well- measures, 20-30 minutes, Diagnostic) sociable, etc.), health habits (smoking, drinking, developed theoretical basis pertaining to coping computerized scoring eating, etc.), psychiatric indications (anxiety, strategies. Designed to assess how a patient who Pearson Assessments depression, etc.), stress moderators (Illness is more or less psychologically normal may 6th grade reading level www.pearsonassessments.c Apprehension vs. Illness Tolerance, etc.), treatment react to or cope with a serious medical om prognostics (Interventional Fragility vs. condition. Normed on three different groups of Interventional Resilience, Medication Abuse vs. medical patients, including a group of patients Standardization: S Medication Competence, etc.) and more. with chronic pain. English and Spanish versions Scientific Review: JBG available. Standardized audio tape Intended for: M Uses: Useful for assessment of basic personality administration for persons with literacy or Research: 41-50 types and how they cope with illness. Also useful for reading problems, computerized administration. Restrictions: H patients being referred for intensive treatment programs such as chronic pain, functional restoration, Weaknesses: Test focus is assessing coping in or work conditioning, for presurgical risk assessment, psychologically normal patients, and is less able for impairment determinations, or when there are to identify psychopathology. No community strong indications that psychological factors are norms. Has pain norms, but the chronic pain delaying the recovery process. report uses general medical patient norms instead. High level of item overlap on scales, Benefits: When used as a part of a comprehensive uses base rate scores which is an unfamiliar evaluation, can contribute substantially to the metric to most. No published research on understanding of psychosocial factors affecting patients with chronic pain. medical patients. Understanding risk factors and patient personality type can help to optimize treatment protocols for a particular patient. 2 Colorado Division of Workers’ Compensation COMPREHENSIVE PSYCHOLOGICAL TESTING Psychological Tests Commonly Used in the Assessment of Chronic Pain * TEST TEST CHARACTERISTICS STRENGTHS AND LENGTH, SCORING WEAKNESSES OPTIONS & TEST TAKING TIME Comprehensive Psychological Inventories These tests are designed for detecting various psychiatric syndromes, but in general are more prone to false positive findings when administered to medical patients. MCMI-III™ (Millon What it Measures: Has scales based on DSM-IV Strengths: Strong research and theoretical base, 175 items, 25 scales, 3 validity Clinical Multiaxial diagnostic criteria for affective disorders, personality scales are keyed to DSM-IV diagnostic criteria. measures, critical items, 25-30 Inventory, 3rd edition) disorders, psychotic disorders, somatization and Strength is the differential diagnosis of minutes, computerized scoring others. personality disorders. English and Spanish Pearson Assessments versions available. Standardized audio tape 8th grade reading level www.pearsonassessments. Uses: Useful for patients undergoing a more administration for persons with literacy or com comprehensive psychological assessment. reading problems, computerized administration. Especially useful for the differential diagnosis of Standardization: S personality disorders. Designed for the assessment Weaknesses: Designed for and normed on Scientific Review: JBG of psychiatric patients, not pain patients, which can psychiatric patients, not pain patients. May Intended for: P bias results, and this should be a consideration when over-pathologize medical patients. Unusually Research: 51-59 using. high item overlap results in highly interrelated Restrictions: Psy, MD scales, uses base rate scores which cannot Benefits: When used as a part of a part of a generate percentile ranks. Scales will be less comprehensive evaluation, can screen for a broad relevant when DSM-5 is published in 2013. range of DSM-IV diagnoses. MMPI-2™ (Minnesota What it Measures: Original scale constructs, such as Strengths: Extremely strong research basis, with 567 items, 100+ scales and Multiphasic Personality hysteria and psychesthenia are archaic but continue both strengths and weaknesses in pain indices, critical items, 60-90 Inventory- 2nd edition ™) to be useful. Newer content scales include assessment being well documented. Strength is Minutes, computerized scoring depression, anxiety, health concerns, bizarre the assessment of faking or biased responding. and report, hand scoring. Pearson Assessments mentation, social discomfort, low self-esteem and English and Spanish versions available. www.pearsonassessments. about 100 others. Standardized audio tape administration for 6th grade reading level com persons with literacy or reading problems, Uses: Useful for patients undergoing a more computerized administration. Standardization: S comprehensive psychological assessment. Designed Scientific Review: JBG for assessment of psychiatric patients, not pain Weaknesses: Originally designed for assessing Intended for: P patients, but commonly used in chronic pain and psychiatric patients, not medical patients. Scales Research: 60-115 presurgical assessment. Especially useful for the may over-pathologize pain or rehabilitation Restrictions: Psy, MD assessment of exaggerating or minimizing patients. Normed on community sample but 3 Colorado Division of Workers’ Compensation COMPREHENSIVE PSYCHOLOGICAL TESTING Psychological Tests Commonly Used in the Assessment of Chronic Pain * TEST TEST CHARACTERISTICS STRENGTHS AND LENGTH, SCORING WEAKNESSES OPTIONS & TEST TAKING TIME symptoms. contains some chronic pain data in the interpretive report. Length can be prohibitive, Benefits: When used as a part of a part of a full computerized report is complicated, yet comprehensive evaluation, measures a number of many pain patients receive similar profiles. It factors that have been associated with poor treatment takes considerable experience to interpret outcome. correctly. MMPI-2-RF™ (Minnesota What it Measures: The MMPI-2-RF has been Strengths: Relatively new test, which is the 338 items, 50 scales Multiphasic Personality revised so extensively