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

Thesis (Ph.D.)--University of Melbourne, Dept. of Medicine, 2001. / Typescript (photocopy). Includes bibliographical references (leaves: 260-304).

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Typescript (photocopy) Includes bibliographical references (leaves: 260-304)

Despite the expansion of research into chronic nonmalignant pain, a majority of reported studies are based on patient populations of specialised pain management clinics, which may not adequately represent older people with chronic nonmalignant pain in the general community. Therefore, the overall aim of the present thesis was to fill some gaps in this knowledge base. / The findings of the present thesis support the notion that older people who attend multidisciplinary pain management centres are probably not representative of those with pain who live in the general community but do not attend specialised treatment centres. Indeed a conceptual framework developed from the findings suggest that less than 3 percent of a random community sample of older people with chronic pain share the profile of those who attend a multidisciplinary pain management centre. The majority (86 percent) of the community sample were found to have mild chronic pain that can be adequately managed in the community. However, about 11 percent of the community sample have moderate chronic pain, and it is probable that additional community-based pain management services can improve the management of pain. / Development of instruments to measure the perceived helpfulness and use of pain management strategies by community-dwelling older people with chronic pain is another area that has not received adequate attention. A preliminary survey questionnaire was developed to measure the use and perceived helpfulness of pain management strategies in community dwelling older people. The findings have provided new insight from the user’s perspective regarding the relative effectiveness of different pain management strategies, and highlighted the potential clinical application of strategies that are less commonly used, such as TENS (transcutaneous electrical nerve stimulation), and relaxation techniques that are beneficial for specific subgroups of older people with chronic pain. / The evaluation of the efficacy of a community-based intervention program that provides free choice of intervention for improving outcomes for older people with chronic pain showed that the program was successful in reducing pain and improving level of physical activity for those who completed the program when they were compared with matched subjects who did not participate. The findings also suggest that an educational seminar can have a positive impact that empower participants to make a more informed choice regarding interventions for managing pain. However, the long-term effect of the program has not been established. Therefore, further research will be needed to evaluate whether this approach is a viable alternative clinical option for effective, accessible, and low cost pain management for the general community of older people with chronic pain. / The pain management service model was developed based on a synthesis of the findings. The model was based on a targeted approach that focuses on community-based interventions designed to improve access and outcomes for the majority of community-dwelling older people with chronic non-malignant pain who do not use specialised pain management services. / Overall, the findings of the present thesis have enhanced our understanding of the management of chronic non-malignant pain in community-dwelling older people, which has important implications for the development of services, and has generated hypothesis for future research that may contribute to improve outcomes for older people with chronic non-malignant pain.

Thesis (Psy.D.)--Wheaton College, 2006. / The purpose of this study was to evaluate the effectiveness of a cognitive behavioral group therapy intervention for chronic pain with an economically disadvantaged community sample of older adults. Specifically, the study was designed to assess the impact of the intervention on mood, general well-being, and the use of learned coping skills to manage pain. The program was a modified version of Ersek's "Managing Chronic Pain" which incorporated coping skills training in the areas of exercise, relaxation, and cognitive restructuring. The intervention consisted of a six week "class" with a one month follow-up booster session, each session lasting 90 minutes. Twenty-two participants with an average age of 77 living in government subsidized housing completed the program. The program was found to be moderately effective. Participants' pain intensity and interference did not significantly decrease, however scores trended in the predicted direction. Scores in the areas of mood, physical well-being, and coping skills all changed in the predicted directions, however the changes were not statistically significant. Mental health well-being increased significantly following program participation, but returned to initial levels at the one month follow-up booster session assessment. Clinical implications as well as limitations of the study are discussed. Includes bibliographical references (l. 87-96).

Thesis (Psy.D.)--Wheaton College, 2006. / Abstract. The purpose of this study was to evaluate the effectiveness of a cognitive behavioral group therapy intervention for chronic pain with an economically disadvantaged community sample of older adults. Specifically, the study was designed to assess the impact of the intervention on mood, general well-being, and the use of learned coping skills to manage pain. The program was a modified version of Ersek's "Managing Chronic Pain" which incorporated coping skills training in the areas of exercise, relaxation, and cognitive restructuring. The intervention consisted of a six week "class" with a one month follow-up booster session, each session lasting 90 minutes. Twenty-two participants with an average age of 77 living in government subsidized housing completed the program. The program was found to be moderately effective. Participants' pain intensity and interference did not significantly decrease, however scores trended in the predicted direction. Scores in the areas of mood, physical well-being, and coping skills all changed in the predicted directions, however the changes were not statistically significant. Mental health well-being increased significantly following program participation, but returned to initial levels at the one month follow-up booster session assessment. Clinical implications as well as limitations of the study are discussed. Includes bibliographical references (leaves 87-96).

Thesis (Ph.D.)--University of Melbourne, Centre for Neuroscience and Howard Florey Institute, 2009. / Typescript. Includes bibliographical references.

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