B-200: Comparing Dot Counting Test Cutoffs to Traditional and Adjusted Word Memory Test Classifications in a Chronic Pain Sample

Abstract

Objective: To evaluate the agreement between Dot Counting Test (DCT) and Word Memory Test (WMT) classifications in a chronic pain sample. Method/Data Selection: Sample included archived data from 109 individuals (Mage=54.45, SD=13.34; Medu=12.49, SD=2.89; 78.9% White; 56.9% female) who presented for a chronic pain presurgical evaluation. Participants were classified into three groups based on WMT Immediate and Delayed Recall percentages: Genuine (≥82.5%, n=43), Indeterminate (77.6% to 82.4%, n=23), and Feigning (≤77.5%, n=43). The Indeterminate group was created to examine individuals whose scores fell between traditional (≥82.5%) and adjusted WMT cutoffs (≤77.5%) proposed by Rohling and colleagues (2024). A random sample was selected from the Genuine group to match group sizes. Percent agreement between DCT and WMT classifications were calculated using Cohen’s kappa, comparing DCT manual cutoffs for Normal Effort (Normal Effort ≥14) and Normal-Effort Groups Combined (≥19) with both traditional and adjusted WMT cutoffs. Results/Data Synthesis: Mean DCT performance was 9.88 (SD=2.54) for the Genuine group, 11.96 (SD=2.99) for the Indeterminate group, and 19.60 (SD=12.93) for the Feigning group. DCT Normal Effort had significant fair agreement with both traditional WMT (k=.286, p<.001) with 43.9% failure agreement, and adjusted WMT (k=.323, p<.001) with 48.9% failure agreement. DCT Normal-Effort Combined had significant fair agreement with both traditional WMT (k =.215, p<.001) with 25.8% failure agreement, and adjusted WMT (k=.392, p<.001) with 36.2% failure agreement. Conclusions: While both DCT cutoffs demonstrated fair agreement with WMT classifications, the Normal Effort cutoff captured more individuals who failed the WMT suggesting greater sensitivity of DCT Normal cutoff in identifying suboptimal effort.