Effects of Coaching on Symptom Validity Testing in Chronic Pain Patients Presenting for Disability Assessments

Assessment of cognitive impairment in people with chronic pain can be complicated by response bias or suboptimal effort. A total of 118 chronic pain patients seen for disability-related psychological evaluations were administered the CARB and the WMT. Failure rates of over 40% were observed on both tests. When subsequent patients were informed that the CARB is unaffected by pain or emotional distress, the CARB failure rate dropped to 6%. Coaching on the WMT, however, did not alter the failure rate on this test. This study illustrates the importance of assessing for biased responding in disability-related pain evaluations. It also shows that coaching is likely to influence performance on some SVTs more than others.