Presented at the 2012 AAPM Annual Meeting « Back

Standardized Norms for Block’s Criteria for Psychosocial Risk in Patients Being Treated for Pain and Injury

John Mark Disorbio, EdD, jmdisorbio@healthpsych.com¹, Daniel Bruns, PsyD², Alexander Bruns, Student³, (1) Independent Practice, Evergreen, Colorado, (2) Independent Practice, Greeley, Colorado, (3) Health Psychology Associates, Greeley, Colorado

Introduction: Research has determined that the outcome of invasive treatments for pain is influenced by psychosocial variables. Block and colleagues1 developed one well-known method of presurgical psychological evaluation. However, this method has lacked standardized psychometric norms. Methods: Battery for Health Improvement-2 (BHI-2)2 profiles and other information was gathered from 527 patients in treatment for pain or injury from 90 sites in 30 U.S. states. Using these data a standardized method was developed to calculate Block’s criteria for presurgical risk. Block’s five-level risk score was calculated using BHI-2 scale cutoffs of one standard deviation above the mean using the patient norms. Posters were used to recruit patients, and this method was IRB approved. Results: The mean, standard deviation, median and mode of the Block scores were as follows for patients: Psychosocial (6.64, 5.81, 5.0, 4), Medical (3.20, 2.63, 3.0, 0), Adverse Signs (0.16, 0.55, 0.0, 0) and the Overall Rating (2.26, 1.17, 2.0, 2), with frequencies of 30.9%, 33.8%, 19.5%, 9.9% and 5.9% in risk groups 1 (low) through 5 (high) respectively. Conclusions: Standardization is an important part of clinical assessment. A limitation of this study is that these means and norms would not apply when using other methods of assessing Block’s criteria. Further research is needed to develop standardized methods for the assessment of patients with chronic pain. References: 1)Block, A. R., R. J. Gatchel, et al. (2003). The psychology of spine surgery. Washington DC, American Psychological Association. 2)Bruns, D. and J. M. Disorbio (2003). Battery for Health Improvement 2 Manual. Minneapolis, Pearson.

Funding: None