Development of an interpersonal interactions computer adaptive test (CAT) for work disability determination

The Social Security Administration (SSA) is challenged with determining work disability for escalating numbers of applicants. Determining work capacity for people who demonstrate maladaptive interpersonal behaviors is difficult since the relationship between symptoms and work performance is not always clear. Through an interagency agreement with the SSA, the National Institutes of Health (NIH) has collaborated with Boston University to apply Item Response Theory (IRT) and Computer Adaptive Testing (CAT) to develop functional assessment instruments that SSA may use during the disability evaluation process. The overall goal of this project is to enhance functional and behavioral assessment methods to improve precision and efficiency in assessing interpersonal interactions relevant to work. The aims of this project are to: 1) determine the feasibility of using IRT/CAT techniques in measuring Interpersonal Interactions in the context of work, 2) develop a comprehensive content-model for the Interpersonal Interactions sub-domains, and 3) develop item pools that could be used to measure the identified sub-domains. Through the use of focus groups, comprehensive literature review, cognitive interviews, and expert panels, we developed a 165 item pool for SSA claimants and a 90 item pool for claimants' health-care providers. Next steps include administering the item pools to a sample of 1,000 SSA work disability applicants and a matched sample of 500 primary care providers. IRT analysis will calibrate item banks and create CAT instruments. The CAT instruments developed in this project may help the SSA disability application process to be more efficient and accurate from claimant, provider, and SSA perspectives.