7 Colo. Code Regs. § 1101-3 R17 Ex 09, app DESCRIPTION OF TESTS OF PSYCHOLOGICAL FUNCTIONING
Refer to Section F.2.c, Tests of Psychological Functioning, for more information. Examples of frequently used psychometric tests performed include, but are not limited to, the following:
What it measures - Depression, anxiety, and hostility; violent and suicidal ideation; borderline, dependency, chronic maladjustment, substance abuse, conflicts with work, family and physician, pain preoccupation, somatization, perception of functioning, catastrophizing and kinesiophobia, and risk assessment for surgery, physical rehabilitation, and abuse of prescription medication.
Benefits - When used as a part of a comprehensive evaluation, can contribute substantially to the design of interventions and to the understanding of psychosocial factors underlying pain reports, perceived disability, and somatic preoccupation. Serial administrations can track changes in a broad range of variables during the course of treatment and assess outcome.
Characteristics - Standardized test normalized on patients with chronic pain or injury and on community members, with reference groups for six other subcategories of injured patients.
What it measures - Updated version of the Millon Behavioral Health Inventory (MBHI). Provides information on coping styles (introversive, inhibited, dejected, cooperative, sociable, etc.), health habits (smoking, drinking, eating, etc.), psychiatric indications (anxiety, depression, etc.), stress moderators (illness apprehension vs. illness tolerance, etc.), treatment prognostics (interventional fragility vs. interventional resilience, medication abuse vs. medication competence, etc.), and other factors.
Benefits - When used as a part of a comprehensive evaluation, can contribute substantially to the understanding of psychosocial factors affecting medical patients. Understanding risk factors and patient personality type can help to optimize treatment protocols for a particular patient.
Characteristics - Standardized test normalized on medical patients with various diseases, and bariatric population. Chronic pain/presurgical analysis cites a chronic pain reference group but the analysis is based on a general medical population.
These tests are designed for detecting various psychiatric syndromes but in general are more prone to false positive findings when administered to medical patients.
What it measures - Has scales to assess 15 types of maladaptive personality types, and 10 clinical syndromes including bipolar spectrum, depression, anxiety, drug/alcohol abuse, somatic symptom, post-traumatic stress and psychosis.
Benefits - When used as a part of a comprehensive evaluation, can screen for a broad range of ICD psychiatric diagnoses.
Characteristics - Standardized test normalized on psychiatric patients.
What it measures - Original scale constructs, such as hysteria and psychasthenia are archaic but continue to be useful. Newer content scales include depression, anxiety, health concerns, bizarre mentation, social discomfort, low self-esteem, and almost 100 others.
Benefits - When used as a part of a comprehensive evaluation, measure a number of factors that have been associated with poor treatment outcome.
Characteristics - Standardized test normalized on community members
What it measures - 50 scales assess a wide range of psychiatric disorders and personality traits, plus 8 validity scales, critical items.
Benefits - new version of MMPI-2 has undergone extensive revision to correct perceived MMPI-2 deficiencies. Has advantages over the original MMPI-2 in psychiatric assessment, but may be less capable when assessing patients with chronic pain.
Characteristics - Standardized test normalized on community members, with multiple other reference groups including chronic pain and spine surgery candidate.
What it measures - A measure of general psychopathology that assesses depression, anxiety, somatic complaints, stress, alcohol and drug use reports, mania, paranoia, schizophrenia, borderline, antisocial, suicidal ideation, and more than 30 others.
Benefits - When used as a part of a comprehensive evaluation, can contribute substantially to the identification of a wide variety of risk factors that could potentially affect the medical patient.
Characteristics - Standardized test normalized on community members.
Treating providers may use brief instruments to assess a variety of psychological and medical conditions, including depression, pain, disability, and others. These instruments may also be employed as repeated measures to track progress in treatment or as one test in a more comprehensive evaluation. Brief instruments are valuable in that the test may be administered in the office setting and hand scored by the physician. Results of these tests should help providers distinguish which patients should be referred for a specific type of comprehensive evaluation.
What it measures - Depression, anxiety, somatization, pain, function, and defensiveness.
Benefits - Can identify patients needing treatment for depression and anxiety and identify patients prone to somatization, pain magnification, and self-perception of disability. Can compare the level of factors above to other pain patients and community members. Serial administrations can track changes in measured variables during the course of treatment and assess outcome.
Characteristics - Standardized test normalized on patients with chronic pain or injury and on community members, with reference groups for six subcategories of injured patients.
What it measures - Assesses depression, anxiety, and somatization.
Benefits - Can identify patients needing treatment for depression and anxiety and patients prone to somatization. Can compare the level of depression, anxiety, and somatization to other pain patients and community members. Serial administrations can track changes in measured variables during the course of treatment and assess outcome.
Characteristics - Standardized test normalized on patients with chronic pain and on community members.
What it measures - A survey of general health, well-being, and functional states.
Benefits - Assesses a broad spectrum of patient disability reports. Serial administrations could be used to track patient perceived functional changes during the course of treatment and assess outcome.
Characteristics - Non-standardized test without norms.
What it measures - Perceived disability in the areas of sleep, eating, home management, recreation, mobility, body care, social interaction, emotional behavior, and communication.
Benefits - Assesses a broad spectrum of patient disability reports. Serial administrations could be used to track patient perceived functional changes during the course of treatment and assess outcome.
Characteristics - Non-standardized test without norms.
What it measures - Cognitive, emotional, and sensory aspects of pain.
Benefits - Can identify patients prone to pain magnification. Repeated administrations can track progress in treatment for pain.
Characteristics - Non-standardized test without norms.
What it measures - Emotional and sensory aspects of pain.
Benefits - Can identify patients prone to pain magnification. Repeated administrations can track progress in treatment for pain.
Characteristics - Non-standardized test without norms.
What it measures - Disability secondary to low back pain.
Benefits - Can measure patient's self-perceptions of disability. Serial administrations could be used to track changes in self-perceptions of functional ability during the course of treatment and assess outcome.
Characteristics - Non-standardized test without norms.
What it measures - Graphical measure of patient's pain report, in which the patient makes a mark on a line to represent pain level.
Benefits - Quantifies the patient's pain report, most-commonly using a 10 centimeter horizontal line. Serial administrations could be used to track changes in pain reports during the course of treatment and assess outcome.
Characteristics - Non-standardized test without norms. Some patients may have difficulty with this conceptual test format, depending on perceptual, visuomotor, cultural orientation, or other factors.
What it measures - Numerical report of patient's pain.
Benefits - Quantifies the patient's pain report, typically on a 0-10 scale. Serial administrations could be used to track changes in pain reports during the course of treatment and assess outcome.
Characteristics - Recommended by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Non-standardized test without norms. May be more easily understood than the VAS.
What it measures - The CPGS is a multidimensional measure that assesses two dimensions of overall chronic pain severity: pain intensity and pain-related disability.
Benefits - Among patients with moderate to severe chronic musculoskeletal pain, the CPGS has been shown to be modestly responsive to change.
Characteristics - Non-standardized test without norms.
These tests are designed for detecting various psychiatric syndromes but in general are more prone to false positive findings when administered to medical patients.
What it measures: Somatization, obsessive-compulsive, depression, anxiety, phobic anxiety, hostility, paranoia, psychoticism, and interpersonal sensitivity.
Benefits: Can identify patients needing treatment for depression and anxiety and patients prone to somatization. Can compare the level of depression, anxiety, and somatization to community members. Serial administrations could be used to track changes in measured variables during the course of treatment and assess outcome.
Characteristics - Standardized test normalized on community members.
What it Measures: Depression, anxiety, and somatization.
Benefits: Can identify patients needing treatment for depression and anxiety and patients prone to somatization. Can compare the level of depression, anxiety, and somatization to community members. Serial administrations could be used to track patient perceived functional changes during the course of treatment and assess outcome.
Characteristics - Standardized test normalized on patients with chronic pain associated with cancer.
What it measures: Somatization, obsessive-compulsive, depression, anxiety, phobic anxiety, hostility, paranoia, psychoticism, and interpersonal sensitivity.
Benefits: Can identify patients needing treatment for depression and anxiety and patients prone to somatization. Can compare the level of depression, anxiety, and somatization to community members. Serial administrations could be used to track changes in measured variables during the course of treatment and assess outcome.
Characteristics - Standardized test normalized on community members.
What it measures: Depression.
Benefits: Can identify patients needing referral for further assessment and treatment for depression and anxiety and identify patients prone to somatization. Repeated administrations can track progress in treatment for depression, anxiety, and somatic preoccupation. Requires a professional evaluation to verify diagnosis.
Characteristics - Standardized test without norms, uses cutoff scores.
What it measures: Depression.
Benefits: Brief self-administered screening test. Requires a professional evaluation to verify diagnosis.
Characteristics - Non-standardized test without norms.
Note: Designed for assessment of psychiatric patients, not pain patients, which can bias results, and this should be a consideration when using.
What it measures: Depression, panic disorder.
Benefits: Brief self-administered screening test. Requires a professional evaluation to verify diagnosis.
Characteristics - Non-standardized test without norms, keyed to diagnostic criteria, uses cutoff scores.
What it measures: Depression.
Benefits: Brief self-administered screening test. Requires a professional evaluation to verify diagnosis.
Characteristics - Non-standardized test without norms.
Note: The Zung Depression Scale must be distinguished from the Modified Zung Depression scale used by the DRAM (a QPOP measure). The Zung Depression Scale has different items and a different scoring system than the Modified Zung Depression scale, making the cutoff scores markedly different. The cutoff scores for one measure cannot be used for the other.
7 CCR 1101-3 R17 Ex 09, app DESCRIPTION OF TESTS OF PSYCHOLOGICAL FUNCTIONING
7 CCR 1101-3 has been divided into smaller sections for ease of use. Versions prior to 01/01/2011 and rule history are located in the first section, 7 CCR 1101-3. Prior versions can be accessed from the All Versions list on the rule's current version page. To view versions effective after 01/01/2011, select the desired part of the rule, for example 7 CCR 1101-3 Rules 1-17, or 7 CCR 1101-3 Rule 18: Exhibit 1.