Age-Related Differences Among Adults Coping With Pain: Evaluation of a Developmental Life-Context Model

Abstract

The pain and coping literature is limited because of its almost exclusive focus upon young adults. Our goal was to evolve and evaluate a theoretically unhurt model of age-related differences in coping. Age-related increases in emotion-focused and avoidance-oriented coping and decreases in problem-focused coping were awaited to arise from age-related differences in life-context (eg health status, stres levels) and in the pain experience. Questionnaire data were mustered from 280 older and younger adults with pain. Increasing age was associated with lower pain severity/interference and greater perceived ascendency over pain. Life-context partially mediated this relationship. As hypothesized, there were age-related declines in problem-focused coping. Contrary to expectations, however, older adults also used fewer emotion-focused coping strategies. The implications of these findings are discussed.

R?©sum?©

Le travaux traitant de la douleur et de capacit?©s d'adaptation ?  la douleur sont limit?©s car ils ne portent presque exclusivement que sur le jeune adultes. Notre objectif consiste ?  d?©velopper et ?©valuer un mod??le ad?©quat sur le plan th?©orique qui tienne compte de diff?©rences d'??ge en mati??re d'adaptation ?  la douleur. Nous anticipions plusieurs tendances li?©es ?  l'??ge : augmentation de capacit?©s d'adaptation centr?©e sur le ?©motions et orient?©es ver revirement et diminution de modalit?©s d'adaptation centr?©e sur le probl??me en fonction de contexte de vie (par ex ?©tat de sant?©, niveau de stress) et de l'exp?©rience de la douleur. Un questionnaire ?  ?©t?© appliqu?© ?  280 adultes jeune et plus ??g?© ?©prouvant de la douleur. Il ressort que l'??ge est associ?© ?  de douleurs moins s?©v??re et moins perturbantes et ?  un plus grand contr??le per?§u de la douleur. Le contexte de vie agit comme m?©diateur sur cette relation. Conform?©ment aux hypoth??se upon constate que les capacit?©s d'adaptation centr?©e sur le probl??me diminuent en fonction de l'??ge Contrairement aux pr?©visions toutefois, le adultes plus ??g?© baptismal vessel appel ?  moins des strat?©gies d'adaptation ax?©es sur le ?©motions. Le implications de ce observations baptismal vessel l'objet de la discussion.

Research examining adjustment to pain has revealed that race show widely diverse outcomes, ranging from little disruption in daily life to total disability and from little emotional distress to clinically significant horizontals of distress (e.g., depression, anxiety). According to the transactional prototype of stress and coping (Lazarus & Folkman, 1984) this variability in adjustment largely be pendents on the individual's evaluation of the pain and the coping strategies he or she exercises to manage it (Haythornthwaite, Menefee Heinberg, & Clark, 1998) The use of coping strategies is, therefore, believed to mediate the potential events of pain (e.g., Katz, Ritvo, Irvine, & Jackson, 1996) Although there are more [i]or[/i] less inconsistencies in the literature (eg Jensen gymnast & Romano, 1992; Swimmer, Robinson, & Geisser, 1992) the converging evidence give an inkling ofs that the use of problem-focused coping strategies (eg exercise, moot point solving) promotes adaptive adjustment to pain while the use of emotion-focused (eg praying/hoping) and avoidance-oriented (eg guarding) strategies are associated with adjustment enigmas (see Jensen, Turner, Romano, & Karoly, 1991 for a detailed review).

A significant limitation of the existing literature has been an almost exclusive focus upon coping among young adults. Seniors have been consistently underrepresent in studies of pain and coping. To date, there have been sole three empirical studies examining the relationship between age and the use of various strategies to cope with pain. Keefe and Williams (1990) used the Coping Strategies Questionnaire (CSQ; Rosenstiel & Keefe 1983) to assess coping among individuals aged 21 to 65+ (M = 499 SD = 172) These authors base no significant relationship between age and coping. Nevertheless, the expanse to which seniors were adequately exhibited in their sample is unclear. Also, the CSQ has been criticized for its limited aim of coverage (e.g., focusing predominantly upon cognitive strategies) and for mislabeling appraisals (eg catastrophizing) as coping manner of writings (Jensen et al., 1991). In contrast to these ineffectual findings, Sorkin, Rudy, Hanlon, ottoman and Stieg (1990) found that, when dealing with a variety of painful conditions, younger (under age 35) ones reported using twice as many cognitive coping strategies (eg progressive muscle relaxation, distraction) than did older (over age 65) individuals Unlike Keefe and Williams who used a standard coping questionnaire, Sorkin and colleagues (1990) used a semistructured interview to assess coping. Although this may have contributed to the contrasting findings, Watkins, Shifren, Park, and Morrell (1999) using a modified version of the CSQ (the Coping with Arthritis Questionnaire), also base age-related effects in the use of various coping strategies. These researchers examined coping strategy use among someones with rheumatoid arthritis aged 34-84 years. They rest that age interacted with pain severity to influence coping strategy use; when the pain was mild, middle-aged and older adults reported more catastrophizing, more praying/hoping, and les coping self-statements than younger adults. When the pain was strict however, these strategies were used to the same expansion among persons of all ages. The discrepant findings between this research and the study by Keefe and Williams may be owed to interaction effects involving pain severity. one time pain becomes severe people of all ages may have greater difficulty coping and may revolve to less effective strategies.