The Psychology of Disability Assessments

By Jonathan Evan Siegel and Chendur Gandhidoss

The book is a compilation of articles written by Jonathan Evan Siegel, Psychologist and Chendur Gandhidoss, Statistician, as well as in collaboration with others over the past 15 years. The majority of the articles have been previously published in a trade journal (Without Prejudice) for Ontario (Canada) Insurance Adjustors. The articl

• Language: English
• Publisher: Authors' Tranquility Press
• Release date: Oct 30, 2023
• ISBN: 9781962492461

Book preview

INTRODUCTION

This self-published book consists of 11 chapters, 10 of which have already been published in a trade journal, Without Prejudice (WP), the official trade journal for Ontario, Canada, insurance adjustors. The 11th chapter is in the process of being submitted for publication. We are grateful to the executive committee of WP for providing verbal and written permission to republish these articles, the first of which was written in 2005. While each article addresses ideas and distinctions relevant to the field of psychological disability assessments, this book is neither a how-to method for conducting psychological disability assessments nor an exhaustive or comprehensive review of the principles, techniques, or methodology for writing psychological reports. Far from it. WP magazine is not a refereed journal. The articles were primarily written to provide insurance adjustors with ideas highlighting the importance of psychological variables that may shape an individual’s reactions and responses to both the physical injuries and emotional trauma associated with car accidents. Since psychological factors can play a very significant role in mediating impairment and disability, and since psychological factors can significantly impact an individual’s perception of pain, as well as the maintenance, intensification, and perpetuation of pain, psychological disability assessments are often requested by adjustors when assessing an individual’s requirements for treatment and assessing an individual’s readiness to return to their pre-accident activities of daily living and work.

Since a comprehensive psychological assessment involves psychological testing, and since the determination of a test’s value is based on the reliability and validity of the tests, the authors chose to write several articles on the statistics of psychological testing. Statistics is the scientific method for determining the strengths and limitations of psychological test results, assigning probability values to qualitative statements, and providing confidence intervals to psychological opinions. Our focus has been to address those fundamental statistical principles and methods that are required for understanding the benefits of psychological testing in general, and more specifically their application to validity testing. Validity testing is particularly important to evaluate whether or not an individual is providing full effort relative to actual abilities.

This book will be a useful reference for psychologists, insurance adjustors, and lawyers interested in the field of disability assessments following motor vehicle accidents.

The following provides a brief overview of each of the chapters.

• Chapter 1 provides a very broad overview of the components of a psychological assessment and some criteria for insurance adjustors to consider when deciding if a psychological assessment will be of benefit.

• Chapter 2 discusses the fundamental properties of psychological testing: reliability and validity. There are slides that provide both the definitions and mathematical formulas for the following: sensitivity, specificity, positive and negative predictive values.

• Chapter 3 addresses the controversial issue of malingering or lying about the nature and/ or severity of one’s psychological symptoms. In an attempt to identify scientific methods for correctly discriminating feigners from non-feigners, psychologists have developed tests of both symptom validity and performance validity.

• Chapter 4 provides an overview of psychosocial factors that shape and influence a person’s perception of pain, impairment, and disability. We discuss the biomedical and biopsychosocial model of pain and psychological vulnerability factors that may predispose an individual to experiencing chronic pain.

• Chapter 5 provides definitions of reliability and validity, different types of reliability and validity, and the clinical utility of testing.

• Chapter 6 represents somewhat of a departure from the particular focus on psychological testing and addresses the broad topic of ‘emotional intelligence’. Five components are discussed which can be of value to both the psychologist and adjustor to assist in better communication with claimants.

• Chapter 7 offers a deeper dive into understanding both the concepts and statistical methods for determining confidence intervals. Since there is no psychological test that is 100% accurate, psychologists apply statistical procedures to arrive at ranges of values that can be associated with psychological opinions and conclusions.

• Chapter 8 provides a critical review of the psychological tests that are used by psychologists in Ontario (as required by law) for making a determination of whether or not an individual has both physical and psychological symptoms (when combined with ratings) that reach a threshold for determination of a ‘catastrophic impairment’.

• Chapter 9 was written by Dr. Luciano, Giromini, Dr. Donald Viglione, Dr. Laszlo Erdodi and Jonathan Siegel, psychologist. The first three authors created a new symptom validity test (Inventory of Problems-29). The article discusses various studies demonstrating the value of the test in classifying individuals who are providing valid versus invalid efforts on testing.

• Chapter 10 provides an overview of each of the 52 scales on the Minnesota Multiphasic Personality-3 (MMPI-3). This article is meant to provide an overview for adjustors to understand the various dimensions of personality and psychopathology.

• Chapter 11 discusses the significant limitation of using T scores (linear transformation of raw scores to T scores with a mean of 50 and a standard deviation of 10) with personality measures, given that the distribution of scores on personality measures is positively skewed. We provide a critical review of the method that the authors of the MMPI-3 used for creating T scores.

While each chapter addresses a relevant idea or principle that has application to the psychological assessment process, there is no specific progression of ideas from one chapter to the next. We wish to emphasize that each chapter can be read on its own without any prerequisite or reference to the ideas in any of the other articles. Articles were written over the last 19 years based on the authors’ goal to introduce concepts relevant to the field of psychological disability assessments. We hope that this book will provide insurance adjustors with a fundamental overview of the ideas, concepts, and methods that psychologists employ when conducting psychological disability assessments.

1

The Psychology of Disability Assessment

Car accidents will cause disruption to a person’s life. The disruption may be minor or major, a temporary inconvenience or a tragedy. You, the adjustor, are called upon to make decisions regarding whether or not an individual requires treatment and/or disability benefits. Psychological assessments provide information regarding the nature and severity of psychological impairments and their impact on functioning.

What Is Psychology?

The word psychology is a combination of two terms, derived from Latin, meaning study (-ology) and soul or mind (psyche). While the subject of soul and mind has occupied poets, philosophers, and theologians from time immemorial, it is only in the last 100 or so years that psychology has emerged as a distinct discipline.

While the subject is broad and detailed, and in many ways complex, there is value in distilling a few simple ideas that can assist in directing attention to the reason the discipline is so fascinating.

Think of the soul as an invisible entity or principle that occupies, interacts with and directs the physical body. Think of the mind as that part of you that is aware of your thoughts, and the means by which you navigate the world both within and without.

You will quickly notice that you cannot detect either soul or mind through the five senses. You cannot touch, taste, smell, hear or see the soul or mind. And yet our thoughts are as real to us as any of our five senses. This means that the mind is indivisible and cannot be understood in its essence by referring either to the senses only or to the physical world from which it emanates.

The remarkable fact of being human is that we do not experience ourselves as simply a collection of billions of cells. The mind is the by-product of innumerable and unimaginably complex electrochemical processes. The field of psychology largely deals with looking at means and methods to study and evaluate the by-products of the mind. More specifically, as it relates to conducting psychological assessments, the field of psychology helps to explain how and why we think, act, and behave.

What Is a Psychological Assessment?

A psychological assessment is a process that helps to gather information about a person’s feelings, thoughts, and behaviours. Even though only a very small percentage of the population is trained in the discipline of psychology or in conducting psychological assessments, everyone is, to some extent, forming opinions and judgments about the environment and the people around us. Being human, we are hard-wired to draw inferences about the world around us and make evaluations about what we think is good or bad, healthy or unhealthy.

When the question of disability is raised, psychologists conduct a psychological assessment that typically involves four components:

• The structured clinical interview. This process involves gathering information about a person’s