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6 Selected Instruments for Assessment of Mental Functional Abilities Relevant to Work Requirements
Pages 235-294

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From page 235...
... adult Listing of Impairments for mental disorders includes neurocognitive disorders such as dementia; schizophrenia spectrum and other psychotic disorders; depressive, ­ bipolar, and related disorders; intellectual disorders; anxiety and obsessivecompulsive disorders; somatic symptom and related disorders; personality and impulse-control disorders; autism spectrum disorder; neurodevelopmental disorders; eating disorders; and trauma- and stressor-related dis­ orders.1 Community functioning and mental illness are closely associated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) definition of mental illness, in which "clinically significant distress or disability" is a key diagnostic criterion for all mental disorders.
From page 236...
... MENTAL FUNCTIONAL ABILITIES RELEVANT TO WORK REQUIREMENTS Annex Table 6-1 links mental functional domains identified by the committee (defined in Annex Table 6-2) to specific work demands.
From page 237...
... . Annex Table 6-1 links these eight mental functional domains to mental abilities listed in three SSA forms used to collect functional information when making a disability determination: the Psychiatric Review Technique Form (PRTF)
From page 238...
... . Thus, Annex Table 6-1 shows that a limitation in the functional domain of language and communication can limit specific job demands related to interacting with others, processing information, and completing tasks.
From page 239...
... Again, SSA does not require documentation for all of these examples. INSTRUMENTS USED TO ASSESS MENTAL FUNCTIONAL ABILITIES RELEVANT TO WORK REQUIREMENTS The committee applied the following criteria in deciding which instruments to describe in this chapter: (1)
From page 240...
... simulations were conducted to examine the instrument's psychometric properties. Results of confirmatory factor analysis revealed acceptable fit statistics across all mental health subdomains in both samples and for all scales (root mean square error of approximation ≤ 0.08, comparative fit index and TuckerLewis index ≥ 0.9)
From page 241...
... Ratings of functional capacity are of increasing interest in studies of people with mental illness because they are highly correlated with cognition and some aspects of community functioning. In particular, the UPSA has shown some promise in being able to predict real-world functioning in m ­ iddle-aged and older adults with schizophrenia (Mausbach et al., 2011)
From page 242...
... Social and Occupational Functioning Assessment Scale (SOFAS) SOFAS is derived from the GAF (DSM Axis V)
From page 243...
... Specific Level of Functioning Scale (SLOF) The SLOF, a multidimensional behavioral rating scale developed in the early 1980s (Schneider and Struening, 1983)
From page 244...
... . In addition, the SLOF was significantly correlated with cognitive functioning as measured by tests of problem solving, inhibition, information processing speed, object recognition, attention, and praxis, as follows: interpersonal skills, r = 0.23, p < 0.05; community activities, r = 0.50, p < 0.01; and work skills, r = 0.41, p < 0.01 (Bowie et al., 2006)
From page 245...
... Neuropsychologists interpret results relative to population norms and in terms of the test taker's pattern of relative strengths and weaknesses across cognitive domains. Neuropsychological testing allows SSA to evaluate the severity of cognitive impairments and claimants' residual functional capacity.
From page 246...
... , is easy to score, requires no third-party input or special equipment or training, and has high sensitivity and specificity in persons with mild cognitive impairments and dementia. Its disadvantages reflect (1)
From page 247...
... . These cognitive domains often are impaired in individuals with schizophrenia and other severe mental illnesses and are correlated highly with community functioning (Keefe et al., 2006)
From page 248...
... Highlighted below are tests relevant to SSA's mental functional domains. NIH Toolbox: Picture Vocabulary  This test measures receptive vocabulary (Gershon et al., 2014)
From page 249...
... . NIH Toolbox: Picture Sequence Memory Test  This test measures episodic memory (Dikmen et al., 2014; Loring et al., 2019)
From page 250...
... . NIH Toolbox: Pattern Comparison Processing Speed Test  This test measures speed of processing (Carlozzi et al., 2015)
From page 251...
... . Measures of Disorder Severity and Work-Related Functional Impairment Psychiatric disorders are generally defined by the presence of specific symptoms.
From page 252...
... identified 83 articles examining the relationship between common anxiety-related disorders and functional impairment, including occupational impairment. Of these articles, 40 consider PTSD, 17 OCD, 13 social anxiety disorder, 9 GAD, 6 panic disorder, and 7 agoraphobia.
From page 253...
... Posttraumatic Stress Disorder PTSD can reduce work functioning through limitations in the ability to sustain attention on tasks, get along with peers, and leave the safety of one's home. These effects can be worse if the trauma occurred in the workplace.
From page 254...
... Autism Spectrum Disorder With respect to ASD, its distinguishing diagnostic features include impairments in social communication and social interaction across multiple contexts, coupled with restricted, repetitive patterns of behavior, interests, or activities that result in significant difficulties with current social, occupational, or community functioning (APA, 2013)
From page 255...
... 6-2. When assessing mental functional abilities relevant to work require ments, it is important to assess the following domains: general cogni tive/intellectual ability, language and communication, learning and memory, attention and vigilance, processing speed, executive func tioning, adaptability, and work-related personal interactions.
From page 256...
... 6-2. Understanding the relationship between mental illness and function ing is important because some major mental illnesses are episodic in nature, with severity of symptoms and functional impairments varying over time, and with periods of greater severity ranging from weeks to months.
From page 257...
... 2015. The NIH Toolbox Pattern Comparison Processing Speed Test: Normative data.
From page 258...
... 2014. Language measures of the NIH Toolbox Cognition Battery.
From page 259...
... 2019. NIH Toolbox Picture Sequence Memory Test for assessing clinical memory function: Diagnostic relationship to the Rey Auditory Verbal Learning Test.
From page 260...
... 2013a. Conceptual foun dation for measures of physical function and behavioral health function for Social Security work disability evaluation.
From page 261...
... 2005. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment.
From page 262...
... 2013. NIH Toolbox Cognition Battery (CB)
From page 263...
... II. NIH Toolbox Cognition Battery (CB)
From page 264...
... B Criteria Survey Abilities Work Activities General   Decision Inductive Analyzing data or Cognitive/ making (DOL, reasoning information Intellectual 2017) ; Ability Problem solving (DOL, Judging the qualities 2018)
From page 265...
... F4-SUP) Executive function Completing tasks Understand, remember, or apply information Language Getting along with others Social interaction Understand, remember, or Understanding apply informationa Understanding and memory Interact with others Completing tasks Learning and memory Memory Understanding and memory Understand, remember, or Understanding apply information continued
From page 266...
... B Criteria Survey Abilities Work Activities Attention and Concentrate, Adaptability Problem Evaluating Vigilance persist, or (DOL, 2017) sensitivity information maintain to determine pace compliance with standards Analyzing data or information Organizing, planning, and prioritizing work Updating and using relevant knowledge Selective attention Scheduling work and activities Making decisions and solving problems Developing objectives and strategies
From page 267...
... F4-SUP) Complex attention Concentration Sustained concentration and persistence Concentrate, persist, or maintain pace continued
From page 268...
... B Criteria Survey Abilities Work Activities Processing Concentrate, Adaptability Perceptual Evaluating Speed persist, or (DOL, 2017) speed information maintain to determine pace compliance with standards Fluency of ideas Organizing, planning, and prioritizing work Pace (DOL, 2017, 2018)
From page 269...
... F4-SUP) Perceptual-motor Understanding Understanding and memory Following instructions Completing tasks continued
From page 270...
... B Criteria Survey Abilities Work Activities Executive   Decision Category Analyzing data or Functioning making (DOL, flexibility information 2017) ; Problem solving (DOL, 2018)
From page 271...
... F4-SUP) Executive function Completing tasks Adaptation Understand, remember, or apply information Complex attention Following instructions Adapt or manage oneself continued
From page 272...
... ; Personal contacts: verbal interactions and people skills (DOL, 2018) bThe domains of "adaptability" and "work-related personal interactions" are included in the cognitive demand elements in the July 2017 version of the Occupation Requirements Survey (ORS)
From page 273...
... F4-SUP) Adapt or manage oneself Completing tasks Adaptation Following instructions Getting along with others Interact with others Getting along with others Social interaction
From page 274...
... Interactions aThe domains of "adaptability" and "work-related personal interactions" are included in the cognitive demand elements in the July 2017 version of the Occupation Requirements Survey (ORS) Collection Manual.
From page 276...
... Global Assessment of Functioning (GAF) Social and Occupational Functioning Scales Specific Level of Schneider and Trained rater 43-item scale; Functioning Scale Struening, 5-point rating (SLOF)
From page 277...
... criterion validity. aging, dementia; cognitive and functional impairments related to medical disorders   Interrater reliability     English and criterion validity.
From page 278...
... and Memory; Attention and Vigilance Learning National NU, 2018a "Approval is Performance tests and Memory; Institutes of granted to Attention and Health (NIH) researchers Vigilance Toolbox and clinicians Cognition with knowledge Battery: of how to use episodic neuropsychological memory, tests" executive function and attention, working memory, language, processing speed, immediate recall
From page 279...
... 30 minutes Valid and reliable For purchase for mental illness; from healthy controls; Neurocog aging. Trials Established Public reliability and domain validity.
From page 280...
... 280 FUNCTIONAL ASSESSMENT FOR ADULTS WITH DISABILITIES ANNEX TABLE 6-4 Continued Mental Functional Functional Assessment Qualifications to How It Is Domain Tool References Administer Administered Adaptability; WD-FAB Marfeo et al., None Self-report Work-Related Behavioral 2013b Personal Health: selfInteractions efficacy, mood and emotions, behavioral control, social interactions Personal Morosini Mental health Record review and Social et al., 2000 worker (minimum Performance qualifications) Scale
From page 281...
... ASSESSMENT OF MENTAL ABILITIES RELEVANT TO WORK REQUIREMENTS 281 Psychometric Properties Population Time to (reliability, to Which It Administer validity) Proprietary Applies Comments ~15 minutes Excellent; No Generic;   developed with individuals large sample of with self Social Security reported Disability Insurance mental (SSDI)
From page 282...
... 282 FUNCTIONAL ASSESSMENT FOR ADULTS WITH DISABILITIES ANNEX TABLE 6-5 Selected Measures of Disorder Severity and Work-Related Functional Impairment Mental Functional Functional Assessment Qualifications to How It Is Domain Tool References Administer Administered Obsessive-Compulsive Disorder Attention and Yale-Brown Goodman Advanced Clinician Vigilance Obsessive et al., 1989 graduate-level administered Compulsive training in Scale (Y-BOCS) administration and interpretation of psychodiagnostic assessment instruments
From page 283...
... Good convergent validity: total severity score correlates with clinician-rated measures of obsessive compulsive disorder (OCD) severity (r = 0.75–0.79)
From page 284...
... 284 FUNCTIONAL ASSESSMENT FOR ADULTS WITH DISABILITIES ANNEX TABLE 6-5 Continued Mental Functional Functional Assessment Qualifications to How It Is Domain Tool References Administer Administered Attention and Obsessive- Huppert None Self-report Vigilance Compulsive et al., 2007 (18 items) (continued)
From page 285...
... . Good to fair convergent validity: total score correlates with clinician-rated measures of OCD severity (r = 0.41–0.66)
From page 286...
... interpreted by a needs to be clinician administered with a brief assessment of Criterion A for posttraumatic stress disorder (PTSD) (trauma exposure)
From page 287...
... ASSESSMENT OF MENTAL ABILITIES RELEVANT TO WORK REQUIREMENTS 287 Psychometric Properties Population Time to (reliability, to Which It Administer validity) Proprietary Applies Comments 5–10 From Bovin Public domain Any 20-item minutes et al.
From page 288...
... 288 FUNCTIONAL ASSESSMENT FOR ADULTS WITH DISABILITIES ANNEX TABLE 6-5 Continued Mental Functional Functional Assessment Qualifications to How It Is Domain Tool References Administer Administered Depression and Anxiety Disorders Attention and Patient Health Kroenke Self-report, Self-report Vigilance Questionnaire-9 et al., 2001; but should be (9 items)
From page 289...
... html (accessed April 11, 2019) continued
From page 290...
... 290 FUNCTIONAL ASSESSMENT FOR ADULTS WITH DISABILITIES ANNEX TABLE 6-5 Continued Mental Functional Functional Assessment Qualifications to How It Is Domain Tool References Administer Administered Attention and Hamilton Hamilton, Must be ClinicianVigilance Depression 1960 administered by a administered (continued) Rating Scale clinician (17 items)
From page 291...
... 10–20 Summary from Can be obtained from Research minutes the American the publisher, Mind and clinical Psychological Garden, 855 Oak populations Association: Grove Avenue, Suite "Internal 215, Menlo Park, CA consistency 94025 (http://www. coefficients for mindgarden.com/ the scale have index.htm ranged from .86 [accessed April 11, to .95; test- 2019]
From page 292...
... 292 FUNCTIONAL ASSESSMENT FOR ADULTS WITH DISABILITIES ANNEX TABLE 6-5 Continued Mental Functional Functional Assessment Qualifications to How It Is Domain Tool References Administer Administered Attention and Beck Anxiety Beck None for self- Self-administered Vigilance Inventory (BAI) et al., 1988 administration; or verbally (continued)
From page 293...
... . Validity: moderate convergent validity (0.51)


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