Thesis (M. Nurs.)--University of Hong Kong, 2006.

Thesis (DClinPsychol)--Salomons Centre. BLDSC no. DXN049064.

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2004. / Includes bibliographical references.

Thesis (Ph. D.)--Washington State University, December 2009. / Title from PDF title page (viewed on Dec. 9, 2009). "Department of Educational Leadership and Counseling Psychology." Includes bibliographical references (p. 81-86).

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The studies in this dissertation asses age differences in the experience of pain in humans and animals and the appropriateness of pain assessment tools across the adult life-span. Chapter I reviews age differences in experimental, acute and chronic pain in humans. Chapter 2 reviews age differences in the outcome of psychological treatments for chronic pain. It is concluded do there are age differences in each type of pain and that the elderly appear to benefit from psychological treatments as much as younger groups. Several experiments were conducted to examine the concepts that the elderly believe that pain is an inevitable part of aging and are not distressed by it, and that they experience less interim pain than younger patients. However, Chapter 3 presents two studies which find no age differences in pain beliefs. Furthermore, the studies described in Chapters 4 and 5 suggest that there may be age differences in the perceived qualities of chronic pain, measured with the short and full form of the McGill Pain Questionnaire (MPQ), but no age differences in pain intensity measured with single-item scales The data from Chapters 3, 4 and 5 suggest that the affective and cognitive components of chronic pain do not differ among age groups. Analysis of the psychometric properties of the pain measures suggests that verbal descriptor scales of pain intensity and both forms of the MPQ may be appropriate for use across the adult life-span. However, visual analog scales may not be appropriate for use with the elderly. To further elucidate the effects of aging on pain, Chapter 6 reviews age differences in nociceptive responsivity and pain behaviours in the rat. This review suggests that reflexive responses to nociceptive stimuli may not be age dependent although sensitivity on tests of more highly organized behaviours may decrease with age. Chapter 7 presents studies of age differences in the formalin test, a model of tonic pain, which suggest a curvilinear relationship be

The numerous pain rating scales using faces depicting varying degrees of distress to elicit reports of pain from children fall into two categories; those with a neutral face as the 'no pain' anchor, and those with a smiling face as the 'no pain' anchor. This study examined the potentially biasing impact of these anchor types on children's self-reports of pain in response to a series of vignettes. Participants were 100 children stratified by age (5-6 years, 7-8 years, 9-12 years) and randomly assigned to one of three groups: 1) neutral scale/sensory instructions; 2) smiling scale/sensory instructions; 3) smiling scale/affective instructions. Children completed a faces scale, a visual analogue scale (VAS), and emotions ratings in response to four scenarios depicting: 1) no pain/negative emotions; 2) pain/negative emotions; 3) no pain/positive emotions; 4) pain/positive emotions. Results showed that children who used the smiling scale had significantly higher pain scores for no pain and pain/negative emotions vignettes, and significantly lower faces scale scores for pain/positive vignettes, than children who used the neutral faces scale. Instructions varying in focus on sensory or affective qualities of pain had no effect on children's pain ratings. Group differences in children's ratings with the VAS and emotions measure suggested that rating pain with a smiling faces scale may alter a child's concept of pain. Age differences indicated the younger children rated the negative emotion vignettes as more painful than the older children. These findings suggest that children's pain ratings vary depending on the types of faces scale used, and that faces scales with smiling anchors may confound affective states with pain ratings.

Pain catastrophizing is a robust predictor of heightened pain report. However, theoretical models addressing mechanisms of catastrophizing are lacking. The purpose of this study was to examine whether high and low catastrophizers manifest differential psychophysiological arousal patterns in an experimental laboratory pain setting. Gender differences and covariates were also examined. Participants were 102 undergraduate students (56 female, 46 male) at Queen’s University recruited from the Psychology 100 subject pool aged 17-28 years (M = 18.44, SD = 1.40). After deleting participants with missing data, n = 95 for pain report/psychological variables, and n = 93 for psychophysiological measures. Participants were pre-screened using the Pain Catastrophizing Scale (PCS) from which individuals were selected from the top third (i.e., PCS score ≥ 24) and the bottom third (i.e., PCS score ≤ 13) of the distribution to represent high and low catastrophizers respectively. Participants completed measures of depression and anxiety before participating in a cold pressor task. Participants’ heart rate (HR) and galvanic skin response (GSR) were recorded during periods of baseline (3 minutes), pain induction (1 minute), and pain recovery (10 minutes). The Short-Form McGill Pain Questionnaire (SF-MPQ) was completed following the recovery period. Results showed that catastrophizing was related to greater pain intensity during pain induction and during pain recovery, as well as greater retrospective sensory and affective reports of pain. Women reported greater pain intensity during pain induction, during pain recovery, and greater retrospective reports of sensory pain. These effects were significant even when controlling for depression and anxiety. With regard to psychophysiological arousal, catastrophizing was related to higher HR during pain induction. There also appeared to be trends suggesting that catastrophizing may also be associated with HR before and after pain induction. Results provide partial support for an appraisal model of catastrophizing and may be useful in informing future models implicating catastrophizing in the development and maintenance of chronic pain. / Thesis (Master, Psychology) -- Queen's University, 2008-07-04 16:02:48.514

While ethnicity is often regarded as a factor in pain experience and expression, ethnic pain research has almost exclusively focused on the intrapersonal dimension of the pain experience and failed to recognize the complex interpersonal nature of the pain experience. The Sociocommunications Model of Pain (Craig, 2009; Hadjistavropoulos & Craig, 2002; Hadjistavropoulos, Craig, & Fuchs-Lacelle, 2004) states that pain behaviours serve as both expressions of the inner experience and communications to other people, and the observer must take into account the social contexts in which the pain expression and report occur. Research in the recent decade has documented reliable evidence that ethnic minorities suffer disproportionately from undertreatment of pain compared to nonminority, but studies examining factors that contribute to such disparities have seldom directly considered the sociocultural context in which the pain experience and assessment take place. This dissertation has two studies. The primary objective of Study 1 is to compare pain report and behaviours in an ethnically concordant versus discordant environment. The primary objective of Study 2 is to investigate the impact of ethnic concordance on the accuracy of observer’s assessment of pain. The Chinese ethnic group was chosen as the focus of the present research because it is the largest ethnic group in Canada and also this group has received little attention in ethnic pain research. Overall, results indicate that ethnic concordance between the person in pain and the observer would influence the sufferer’s pain expression and the observer’s pain assessment. The findings support the Sociocommunications Models of Pain and suggest the importance of considering the interpersonal dimension of the pain experience. / Thesis (Ph.D, Psychology) -- Queen's University, 2011-05-30 01:16:40.34

Background: The “gold standard” in chronic pain treatment is multidisciplinary care. With long wait times to receive appropriate care, there is a need for improved access to non-pharmacological treatments in the time gap between primary and specialist care. The Internet is emerging as a tool for delivery of healthcare information and intervention. Using this format to offer access to chronic pain therapies prior to specialist intervention may improve outcomes. Objective: To develop and test a guided Internet-based intervention for individuals with chronic pain waiting for specialty care. Method: A novel, Internet-based chronic pain intervention (ICPI) was developed, using evidence-based concepts proven effective in face-to-face interventions. This study was designed to assess feasibility of conducting larger-scale research and usability of the ICPI, and to collect preliminary data on effectiveness of the intervention. Data were collected at baseline, after each of the six intervention modules and 12 weeks after completion of the intervention. Results: Participants with chronic pain (n=41) reported satisfaction with the structure of the intervention, and ease of use at and away from their computers. Use of the Internet as a recruitment strategy aided in accrual of participants, making further large-scale study of the ICPI feasible. Preliminary data showed that the ICPI was effective in improving emotional function, had no demonstrable effect on physical function and produced a small but significant decrease in average and current pain intensity and pain interference. Most participants felt they benefited at least minimally overall as a result of using the ICPI. Conclusion: The newly-developed ICPI was well-received by participants and demonstrated some positive outcomes in this preliminary study. Further research with more participants is feasible and necessary, to fully assess the effect of this intervention. / Thesis (Ph.D, Nursing) -- Queen's University, 2014-01-31 11:54:25.7