229 - 'Brain Fog': The Role of Validity Testing and Mental Health Intervention for Work-related Cognitive Complaints

This panel discussion will offer evidence-based clinical tools when working with injured workers presenting with 'brain fog.' When recovery takes longer than expected, patients may believe that they are not ready to re-engage in daily function. This can subsequently impact the clinician's decision regarding return to activity, with or without restrictions. Given consistent evidence demonstrating that cognitive symptoms and impairment normally resolve over time, it is easy to lose sight of expected recovery timelines if the typical approach is to 'wait' for recovery. A 'hope for the best' approach often results in misdiagnosis of postconcussional syndrome and other cognitive conditions, and failing to consider symptom and performance validity can contribute to increased medical utilization and poor treatment outcomes. Instead, we recommend carefully considering the complex interplay of mental and physical factors and a referral for behavioral assessment that includes validity testing. The panel will describe the specifics of such assessment in order to help occupational health clinicians formulate effective treatment plans.