Presented at the 2012 AAPM Annual Meeting « Back

The Reliability of a Standardized Method for Assessing 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: The outcome of invasive treatments for pain is known to be influenced by psychosocial variables. Block and colleagues1 developed one well-known method of presurgical psychological evaluation, which categorizes patients into five risk levels. However, this method has never been standardized, and there has been no prior research on its reliability. Materials and Methods: The Battery for Health Improvement 2 (BHI-2)2 was administered twice with a one-week interval to 86 patients in treatment for pain or injury. A standardized method to calculate Block’s criteria for presurgical risk was used, where Block’s risk score was calculated by employing BHI-2 scale cutoffs of one standard deviation above the mean using the patient norms. Subjects were recruited by poster, and this method was IRB approved. Results: The test-retest reliability of the Block scores were as follows: Psychosocial risks (.924), medical risks (.881), adverse signs (.812), and the overall risk score (.905). Conclusions: Reliable methods are a prerequisite for clinical assessment. The method employed by this study to assess Block’s criteria produced scores that were highly reliable over a one-week interval. Limitations of this study include that 1) the reliabilities observed using this method would not apply to other methods of assessing Block’s criteria, and 2) the log-term reliability of this method remains unknown. Further research is needed to develop standardized methods for the psychological assessment of patients undergoing treatment for 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