By Joshua Willson, Certified Psychometrist
The physicians in the OSC Interventional Pain Management Department recognize that chronic pain is a reality involving both physiological and psychological factors. Pain does not exist in a social vacuum, and non-physiological factors such as personality, cognitions, beliefs, socio-cultural variables, learning and emotional reactivity all significantly affect a patient’s perception of pain. In our Pain-Management department, psychometric testing may be requested when a doctor requires more information to make informed decisions about a patient’s care or course of treatment. For example, we do short screening sessions with candidates for Spinal Cord Stimulator implantation, to help predict the patient’s recovery outcome after the procedure and prognosis for success with the device. OSC also uses psychological assessment to determine risk factors before prescribing certain federally and state-regulated medications. Plus, as laws regarding opioid pain medications become stricter, OSC seeks to provide patients alternative strategies for coping with the realities of chronic pain and postsurgical recovery. OSC even receives referrals from agencies such as Worker’s Compensation for psychometric testing as part of the claims process.
Thus, psychological assessment is often a standard part of the comprehensive pain management workup, as well as part of the pre-surgical process. OSC’s resident Medical Psychologist, Dr. Cal Robinson, interprets the results of these tests to help focus and direct the patient’s care, analogous to the way an Orthopedist interprets the results of an x-ray or MRI scan. Just as an x-ray image can help identify a bone that needs healing, so psychological assessment helps to identify a patient’s emotional and behavioral tendencies that may either help or hinder their ability to cope and recover.
In medical science, ‘Psychometry’ (literally, ‘mind-measurement’), focuses on the quantifiable relationships between a patient’s brain-functions and the brain’s visible product: behavior. Behavior in this sense is whatever a person says or does that is externally observable, and therefore measureable. Psychometry examines various neuropsychological domains, which may include, but are not limited to: Memory and Learning, Attention, Language, Visuospatial, Executive Functioning, Motor Functioning, and Socio-Emotional Functioning. Neuroscience tells us that different parts of the brain are responsible for different sensory inputs and behavioral outputs; psychometric tests are simple, useful tools to collect data about these important functional relationships.
Two of the immediate benefits of psychometric testing are that it is physiologically non-invasive (no brain-surgery nor use of electric probes required!), and it is much more economical than using f-MRI to directly observe neural activity. The assessments are mostly paper-and-pencil questionnaires and tasks resembling games and puzzles, with select tests occasionally administered via computer. Patients often find similarity to activities they did in their school classrooms.