Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Diagnostic Testing

The Paper Trail”

The purpose of psychological testing in worker_s compensation is to determine what, if any, disorder is giving rise to the patient’s behavior following injury.

A disorder is a combination of symptoms that often occur together and define a behavior as a departure from normal functioning. A disorder interferes with a person_s usual process of adaptation to stress. It interferes with occupational and social functioning. The process of defining or classifying that disorder, and separating it from other disorders, is called “differential diagnosis.”

For example, being sad or frightened after injury is not a disorder. However, a combination of problems with sleep, eating, energy, irritability, memory, and concentration, may well be symptoms of a mood disorder such as major depressive disorder.

You can verbally ask a patient a range of questions in an organized fashion and make a reasonable diagnosis, but many patients will respond more openly to questions presented to them in written form, especially those questions which they feel are embarrassing.

It is also quite difficult to insure that you ask every patient, every question, in a form to which they will respond. It is difficult to insure that all questions are asked in such a way as to not offend, threaten or frighten a patient when they are presented in verbal form.

Written questions can insure that the same questions are asked in the same way of all patients. This removes a source of bias (error).

The responses are then correlated with the information obtained in a clinical interview, and the two response sets are compared for consistency. The combination of the two produces greater validity than either as a stand-alone form of evaluation. If a patient responds differently when the questions are asked verbally versus when they are presented in written form, this can provide us with additional information.

Putting together the right combination of psychological tests can provide critical data in determining how best to help mobilize a particular patient.

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