Date of Award

1992

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Wm. Drew Gouvier

Abstract

This study evaluated the relationship of age to various aspects of the chronic pain syndrome before and after participation in a multidisciplinary 21-day inpatient treatment program for chronic pain at the Veterans Affairs Medical Center in Long Beach, California. Subjects were 135 male servicemen and veterans, ranging in age from 23 to 71 years. Age was significantly related to number of medical problems and duration of pain, but not number of pain sites, surgeries, or medications. While age was negatively, but weakly associated with cognitive aspects of depression on admission, it was not significantly related to either total score on the Beck Depression Inventory, nor to the cognitive or somatic aspects of depression on discharge. Age was not significantly related to self-efficacy beliefs about ability to manage pain, measured by the Pain Confidence Inventory, at either admission or discharge. Analysis of the Multidimensional Pain Inventory (MPI) pain profiles revealed that older patients had more adaptive pain coping beliefs and behaviors than younger patients at admission, but not at discharge. Analysis of the MPI scales revealed a significant negative, but moderately low association between age and pain interference, life control, and affective distress at admission, but not at discharge. All patients decreased significantly in level of depression, pain severity, affective distress, and pain interference, and increased significantly in activity level, perceived life control, and self-efficacy beliefs about pain at discharge. On a post-treatment questionnaire, age was not related to self-ratings of success in learning to manage pain, but was positively correlated with ratings of helpfulness of the overall treatment program, the psychological, and the medical elements of the program. Overall, these findings suggest that older chronic pain patients are not more depressed, do not have less self-confidence in their ability to manage pain, are not more distressed or disabled by pain, and may actually be coping better with pain than younger chronic pain patients, and that older chronic pain patients can benefit substantially from treatment in a multidisciplinary inpatient program.

Pages

115

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