Pain and Psychological Function in Late Life

  • Patricia A. Parmelee
Part of the The Springer Series in Adult Development and Aging book series (SSAD)

Abstract

Perhaps the most creative of ongoing attempts to resolve the conundrum of objectively defining an internal event is McCaffrey’s (1979) often-cited statement that “pain is whatever the experiencing person says it is and exists whenever he says it does” (p. 8). This delightfully obtuse definition is an especially appropriate introduction to this chapter because it telegraphs the inherently phenomenological nature of pain. Psychological processes are inextricable from pain experience across the life span, but they may be especially crucial to understanding pain in late life. Aging almost inevitably brings with it some aches and pains, but the experience and effects of pain vary markedly across individuals. Of course, some sources of this diversity are quite obvious; the most notable is health status. But as we shall soon see, objective factors account for only a small portion of variability in pain and its effects. Psychological factors play an equal and perhaps even greater role in shaping the experience, expression, and effects of pain among older adults.

Keywords

Chronic Pain Anxiety Disorder Pain Behavior Late Life Chronic Pain Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Affleck, G., Tennen, H., Urrows, S., & Higgins, P. (1992). Neuroticism and the pain-mood relation in rheumatoid arthritis: insights from a respective daily study. Journal of Consulting and Clinical Psychology, 60, 119–126.PubMedGoogle Scholar
  2. Akiskal, H. S. (1985). Anxiety: Definition, relationship to depression, and proposal for an integrative model. In A. H. Tuma & J. D. Maser (Eds.), Anxiety and the anxiety disorders (pp. 787–797). Hillsdale, NJ: Erlbaum.Google Scholar
  3. Alexopoulos, G. S. (1991). Anxiety and depression in the elderly. In C. Salzman & B. D. Lebowitz (Eds.), Anxiety in the elderly: Treatment and research (pp. 63–77). New York: Springer.Google Scholar
  4. American Psychiatric Association. (1994). Diagnostic and statistical manual (4th ed.). Washington, DC: Author.Google Scholar
  5. Asplund, K. Norberg, A., Adolfsson, R., & Waxman, H. M. (1991). Facial expressions in severely demented patients: A stimulus-response study of four patients with dementia of the Alzheimer type. International Journal of Geriatric Psychiatry, 6, 599–606.Google Scholar
  6. Baldwin, R. C., & Jolley, D. J. (1986). The prognosis of depression in old age. British Journal of Psychiatry, 149, 574–583.PubMedGoogle Scholar
  7. Berkman, L. F., Berkman, C. S., Kasl, S., Freeman, D. H., Leo, L., Ostfield, A. M., Cornoni-Huntley, J., & Brody, J. A. (1986). Depressive symptoms in relation to physical health and functioning in the elderly. American Journal of Epidemiology, 124 372–388.PubMedGoogle Scholar
  8. Birdwell, B. G., Herbers, J. E., & Kroenke, K. (1993). Evaluating chest pain: The patient’s presentation style alters the physician’s diagnostic approach. Archives of Internal Medicine, 153, 1991–1995.PubMedGoogle Scholar
  9. Blalock, S. J., De Vellis, R. E., Brown, G. K., & Wallston, K. A. (1989). Validity of the Center for Epidemiological Studies Depression Scale in arthritis populations. Arthritis and Rheumatism, 38, 991–997.Google Scholar
  10. Blazer, D. G., George, L. K., & Hughes, D. (1990). The epidemiology of anxiety disorders: An age comparison. In C. Salzman & B. D. Lebowitz (Eds.), Anxiety in the elderly: Treatment and research (pp. 17–30). New York: Springer.Google Scholar
  11. Blazer, D., Hughes, D. C., & Fowler, N. (1989). Anxiety as an outcome symptom of depression in elderly and middle-aged adults. International Journal of Geriatric Psychiatry, 4, 273–278.Google Scholar
  12. Blazer, D., Hughes, D. C., & George, L. K. (1987). The epidemiology of depression in an elderly community population. Gerontologist, 27, 281–287.PubMedGoogle Scholar
  13. Blazer, D., & Williams, C. D. (1988). Epidemiology of depression and dysphoria in an elderly population. American Journal of Psychiatry, 137, 434–443.Google Scholar
  14. Block, A. R., Kremer, E. F., & Gaylor, M. (1980). Behavioral treatment of chronic pain: The spouse as a discriminative cue for pain behavior. Pain, 9, 243–252.PubMedGoogle Scholar
  15. Blumer, D., & Heilbronn, M. (1982). Chronic pain as a variant of depressive illness: The pain-prone disorder. Journal of Nervous and Mental Disease, 170, 381–406.PubMedGoogle Scholar
  16. Bruce, M. L., Seeman, T. E., Merrill, S. S., & Blazer, D. G. (1994). The impact of depressive symptomatology on physical disability: MacArthur studies of successful aging. American Journal of Public Health, 84, 1796–1799.PubMedGoogle Scholar
  17. Callahan, L. F., Kaplan, M. R., & Pincus, T. (1991). The Beck Depression Inventory, Center for Epidemiological Studies Depression Scale, and General Weil-Being Schedule Depression Subscale in rheumatoid arthritis. Arthritis Care and Research, 4, 3–11.PubMedGoogle Scholar
  18. Cariaga, J., Burgio, L., Flynn, W, & Martin, D. (1991). A controlled study of disruptive vocalizations among geriatric residents in nursing homes. Journal of the American Geriatrics Society, 39, 501–507.PubMedGoogle Scholar
  19. Casten, R. J., Parmelee, P. A., Kleban, M. H., Lawton, M. P., & Katz, I. R. (1995). The relationships among anxiety, depression, and pain in a geriatric institutionalized sample. Pain, 61, 271–276.PubMedGoogle Scholar
  20. Clarke, M., Jagger, C., Anderson, J., Battcock, T., Kelly, F., & Stern, M. C. (1991). The prevalence of dementia in a total population: A comparison of two screening instruments. Age and Ageing, 20, 396–403.PubMedGoogle Scholar
  21. Clinton, P., & Eland, J. (1990). Pain. In M. Maas & K. Buckwalter (Eds.), Nursing diagnoses and intervention for the elderly (pp. 348–368). Reading, MA: Addison-Wesley.Google Scholar
  22. Coccaro, E. F., & Miles, A. M. (1984). The attitudinal impact of training in gerontology/geriatrics in medical school: A review of the literature and perspective. Journal of the American Geriatrics Society, 32, 762–768.PubMedGoogle Scholar
  23. Cohen-Mansfield, J., Billig, N., Lipson, S., Rosenthal, A. S., & Pawlson, L. G. (1990). Medical correlates of agitation in nursing home residents. Gerontology, 36, 150–158.PubMedGoogle Scholar
  24. Cohen-Mansfield, J., & Marx, M. S. (1993). Pain and depression in the nursing home: Corroborating results. Journal of Gerontology: Psychological Sciences, 48, P96–P97.Google Scholar
  25. Colenda, C. C., & Smith, S. L. (1993). Multivariate modeling of anxiety and depression in community-dwelling elderly persons. American Journal of Geriatric Psychiatry, 1, 327–338.Google Scholar
  26. Cornwall, A., & Donderi, D. C. (1988). The effect of experimentally induced anxiety on the experience of pressure pain. Pain, 35, 105–113.PubMedGoogle Scholar
  27. Costa, P. T, Jr., & McCrae, R. R. (1980). Still stable after all these years: Personality as a key to some issues in adulthood and old age. In P. B. Baltes & O. G. Brim, Jr. (Eds.), Life span edevelopment and behavior (Vol. 4, pp. 65–102). New York: Academic Press.Google Scholar
  28. Craig, K. D., Prkachin, K. M., & Grünau, R. V. (1992). The facial expression of pain. In D. C. Turk & R. Melzack (Eds.), Handbook of pain assessment (pp. 257–274). New York: Guilford Press.Google Scholar
  29. Crook, J., Rideout, E., & Browne, G. (1984). The revalence of pain complaints in a general population. Pain, 18, 199–214.Google Scholar
  30. Dar, R., Beach, C. M., Barden, P. L., & Cleeland, C. S. (1992). Cancer pain in the marital system: A study of patients and their spouses. Journal of Pain and Symptom Management, 7, 87–93.PubMedGoogle Scholar
  31. Davidson, J., Feldman, P. H., & Crawford, S. (1994). Measuring depressive symptoms in the frail elderly. Journal of Gerontology: Psychological Sciences, 49, P159–P164.Google Scholar
  32. DeGood, D. E., Buckelew, S. P., & Tait, R. C. (1985). Cognitive-somatic anxiety response patterning in chronic pain patients and nonpatients. Journal of Consulting and Clinical Psychology, 53, 137–138.PubMedGoogle Scholar
  33. Evans, D. A., Funkenstein, H. H., Albert, M. S., Scherr, P. A., Cook, N. R., Chown, M. J., Hebert, L. E., Hennekens, C. H., & Taylor, J. O. (1989). Prevalence of Alzheimer’s disease in a community population of older persons: Higher than previously reported. Journal of the American Medical Association, 262, 2551–2556.PubMedGoogle Scholar
  34. Faherty, B. S., & Grier, M. R. (1984). Analgesic medication for elderly people postsurgery. Nursing Research, 33, 369–372.PubMedGoogle Scholar
  35. Fenton, F. R., Cole, M. G., Engelsmann, F., & Mansouri, I. (1994). Depression in older medical inpatients. International Journal of Geriatric Psychiatry, 9, 279–284.Google Scholar
  36. Fernandez, E., & Turk, D. C. (1992). Sensory and affective components of pain: Separation and synthesis. Psychological Bulletin, 112, 205–217.PubMedGoogle Scholar
  37. Ferrell, B. A., Ferrell, B. R., & Osterweil, D. A. (1990). Pain in the nursing home. Journal of the American Geriatrics Society, 38, 409–414.PubMedGoogle Scholar
  38. Ferrell, B. A., Ferrell, B. R., & Rivera, L. (1996). Pain in cognitively impaired nursing home patients. Journal of Pain and Symptom Management, 10, 591–598.Google Scholar
  39. Ferrell, B. R., Rhiner, M., Cohen, M. Z., & Grant, M. (1991). Pain as a metaphor for illness: 1. Impact of cancer pain on family caregivers. Oncology Nursing Forum, 18, 1303–1309.PubMedGoogle Scholar
  40. Flor, H., Miltner, W., & Birbaumer, N. (1992). Psychophysiological recording methods. In D. C. Turk & R. Melzack (Eds.), Handbook of pain assessment (pp. 169–190). New York: Guilford Press.Google Scholar
  41. Folstein, M., Anthony, J. C., & Parhad, I. (1985). The meaning of cognitive impairment in the elderly. Journal of the American Geriatrics Society, 33, 228–235.PubMedGoogle Scholar
  42. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-Mental State”: A practical method for grading the cognitive status of patients for the clinician. Journal of Psychiatric Research, 17, 189–198.Google Scholar
  43. Fordyce, W. E. (1976). Behavioral methods in chronic pain and illness. St. Louis: Mosby.Google Scholar
  44. Fordyce, W. E. (1978). Evaluating and managing chronic pain. Geriatrics, 33, 59–62.PubMedGoogle Scholar
  45. Garron, D. C., & Leavitt, F. (1979). Demographic and affective covariates of pain. Psychosomatic Medicine, 41, 525–534.PubMedGoogle Scholar
  46. Gaskin, M. E., Greene, A. F., Robinson, M. E., & Geisser, M. E. (1992). Negative affect and the experience of chronic pain. Journal of Psychosomatic Research, 36, 707–713.PubMedGoogle Scholar
  47. Gil, K. M., Keefe, F. J., Crisson, J. E., & Van Dalfsen, P. J. (1987). Social support and pain behavior. Pain, 29, 209–217.PubMedGoogle Scholar
  48. Greenlee, K. K. (1991). Pain and analgesia: Considerations for the elderly in critical care. AACN Clinical Issues in Critical Care Nursing, 2, 720–728.PubMedGoogle Scholar
  49. Greenwald, H. B., Bonica, J. J., & Bergner, M. (1987). The prevalence of pain in four cancers. Cancer, 60, 2563–2569.PubMedGoogle Scholar
  50. Grossman, S. A., Sheidler, V. R., Swedeen, K., Mucenski, J., & Piantadosi, S. (1991). Correlation of patient and caregiver ratings of cancer pain. Journal of Pain and Symptom Management, 6(2), 53–57.PubMedGoogle Scholar
  51. Hagglund, K. J., Haley, W. E., Reville, J. D., & Alarcon, G. S. (1989). Predicting individual differences in pain and functional impairment among patients with rheumatoid arthritis. Arthritis and Rheumatism, 32, 851–858.PubMedGoogle Scholar
  52. Hannan, M. T., Anderson, J. J., Pincus, T., & Felson, D. T. (1992). Educational attainment and osteoarthritis: Differential associations with radiographic changes and symptom reporting. Journal of Clinical Epidemiology, 45, 139–147.PubMedGoogle Scholar
  53. Harkins, S. W., Price, D. D., & Braith, J. (1989). Effects of extraversion and neuroticism on experimental pain, clinical pain, and illness behavior. Pain, 36, 209–218.PubMedGoogle Scholar
  54. Himmelfarb, S., & Murrell, S. A. (1984). The prevalence and correlates of anxiety symptoms in older adults. Journal of Psychology, 116, 139–167.Google Scholar
  55. Hnatiuk, S. H. (1991). Experience sampling with elderly persons: An exploration of the method. International Journal of Aging and Human Development, 33, 45–64.PubMedGoogle Scholar
  56. Hurley, A. C., Volicer, B. J., Hanrahan, P. A., Houde, S., & Volicer, L. (1992). Assessment of discomfort in advanced Alzheimer patients. Research in Nursing and Health, 15, 369–377.PubMedGoogle Scholar
  57. Jamison, R. N., & Virts, K. L. (1990). The influence of family support on chronic pain. Behavior Research and Therapy, 28, 283–287.Google Scholar
  58. Jensen, M. P., Karoly, P., & Harris, P. (1991). Assessing the affective component of chronic pain: Development of the Pain Discomfort Scale. Journal of Psychiatric Research, 35, 149–154.Google Scholar
  59. Jorm, A. F., Korten, A. E., & Henderson, A. S. (1987). The prevalence of dementia: A quantitative integration of the literature. Acta Psychiatrica Scandinavica, 76, 465–479.PubMedGoogle Scholar
  60. Kasniak, A. (1995, August). Aging and the neuropsychology of emotion: Research and clinical implications. Presented at the annual meeting of the American Psychological Association, New York.Google Scholar
  61. Keefe, F. J., & Block, A. R. (1982). Development of an observational method for assessing pain behavior in chronic low back pain patients. Behavior Therapy, 13, 363–375.Google Scholar
  62. Keefe, F. J., Caldwell, D. S., Queen, K. T., Gil, K. M., Martinez, S., Crisson, J. E., Ogden, W., & Nunley, J. (1987). Pain coping strategies in osteoarthritis patients. Journal of Consulting and Clinical Psychology, 55, 208–212.PubMedGoogle Scholar
  63. Kendler, K. S., Heath, A. C., Martin, N. G., & Eaves, L. J. (1987). Symptoms of anxiety and symptoms of depression: Same genes, different environment? Archives of General Psychiatry, 44, 451–457.PubMedGoogle Scholar
  64. Kennedy, G. J., Kelman, H. R., & Thomas, C. (1990). The emergence of depressive symptoms in late life: The importance of declining health and increasing disability. Journal of Community Health, 15, 93–104.PubMedGoogle Scholar
  65. Kerns, R. D., Haythornthwaite, J., Southwick, S., & Giller, E. L., Jr. (1990). The role of marital interaction in chronic pain and depressive symptom severity. Journal of Psychiatric Research, 34, 401–408.Google Scholar
  66. Koenig, H. G., O’Connor, C. M., Guarisco, S. A., Zabel, K. M., & Ford, S. M. (1993). Depressive disorder in older medical inpatients on general medicine and cardiology services at a university teaching hospital. American Journal of Geriatric Psychiatry, 1, 197–210.Google Scholar
  67. Krishnan, K. R. R., France, R. D., Pelton, S., McCann, U. D., Davidson, J., & Urban, B. J. (1985). Chronic pain and depression: 1. Classification of depression in chronic low back pain patients. Pain, 22, 279–287.PubMedGoogle Scholar
  68. Kukull, W. A., Koepsell, T. C., Inui, T. S., Borson, S., Okimoto, J., Raskind, M. A., & Gale, J. L. (1986). Depression and physical illness among elderly general medical clients. Journal of Affective Disorders, 10, 153–162.PubMedGoogle Scholar
  69. Lawton, M. P., Van Haitsma, K., & Klapper, J. (1996). Observed affect in nursing home residents with Alzheimers disease. Journal of Gerontology: Psychological Sciences, 51, 3–14.Google Scholar
  70. Leventhal, E. A., & Prohaska, T. R. (1986). Age, symptom interpretation and health behavior. Journal of the American Geriatrics Society, 34, 185–191.PubMedGoogle Scholar
  71. Lichtenberg, P. A., Skehan, M. W., & Swensen, C. H. (1984). The role of personality, recent life stress and arthritic severity in predicting pain. Journal of Psychosomatic Research, 28, 231–236.PubMedGoogle Scholar
  72. Lichtenberg, P. A., Swensen, C. H., & Skehan, M. W. (1986). Further investigation of the role of personality, lifestyle and arthritic severity in predicting pain. Journal of Psychosomatic Research, 30, 327–337.PubMedGoogle Scholar
  73. Lindesay, J. (1990). The Guy’s Age Concern Survey: Physical health and psychiatric disorder in an urban elderly community. International Journal of Geriatric Psychiatry, 5, 272-278. Lousberg, R., Schmidt, A. J. M., & Groenman, N. A. (1992). The relationship between spouse solicitousness and pain behavior: Searching for more experimental evidence. Pain, 51, 75–79.Google Scholar
  74. Magni, J., Schifano, F., & DeLeo, D. (1985). Pain as a symptom in elderly depressed patients: Relationship to diagnostic subgroups. European Archives of Psychiatry and Neurological Sciences, 235, 143–145.PubMedGoogle Scholar
  75. Marzinski, L. R. (1991). The tragedy of dementia: Clinically assessing pain the confused, nonverbal elderly. Journal of Gerontological Nursing, 17, 25–28.PubMedGoogle Scholar
  76. McCaffrey, M. (1979). Nursing management of the patient with pain (2nd ed.). Philadelphia: Lippincott.Google Scholar
  77. McIntosh, I. B. (1990). Psychological aspects influence the threshold of pain. Geriatric Medicine, 20, 37–41.Google Scholar
  78. Melding, P. (1991). Is there such a thing as geriatric pain? Pain, 46, 119–121.PubMedGoogle Scholar
  79. Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1, 277–299.PubMedGoogle Scholar
  80. Merskey, H., & Bogduk, N. (1994). Classification of chronic pain: Description of chronic pain syndromes and definition of pain terms (2nd ed.). Seattle: International Association for the Study of Pain.Google Scholar
  81. Merskey, J. (1968). Psychological aspects of pain. Postgraduate Medical Journal, 44, 297–306.PubMedGoogle Scholar
  82. Moosbrugger, H., & Schermelleh-Engel, K. (1991). Determinants of pain experience, perceived competence, trait anxiety, trait depression and moderator effects. Personality and Individual Differences, 12, 1261–1266.Google Scholar
  83. Murphy, E. (1983). The prognosis of depression in old age. British Journal of Psychiatry, 142, 111–119.PubMedGoogle Scholar
  84. Myers, J. K., Weissman, M. M., Tischler, G. L., Holzer, C. E., III, Leaf, P. J., Orvaschel, H., Anthony, J. C., Boyd, J. H., Burke, J. D., Kramer, M., & Stoltzman, R. (1984). Prevalence of psychiatric disorders in three communities. Archives of General Psychiatry, 41, 959–967.PubMedGoogle Scholar
  85. Nicassio, P. M., Wallston, K. A., Callahan, L. F., Herbert, M., & Pincus, T. (1985). The measurement of helplessness in rheumatoid arthritis: The development of the Arthritis Helplessness Index. Journal of Rheumatology, 12, 462–467.PubMedGoogle Scholar
  86. Oberle, K., Paul, P., Wry, J., & Grace, M. (1990). Pain, anxiety and analgesics: A comparative study of elderly and younger surgical patients. Canadian Journal on Aging, 9, 13–22.Google Scholar
  87. O’Brien, J., & Francis, A. (1988). The use of next-of-kin to estimate ain in cancer patients. Pain, 35, 171–178.PubMedGoogle Scholar
  88. O’Riordan, T. G., Hayes, J. P., Shelley, R., O’Neill, D., Walsh, J. B., & Coakley, D. (1989). The prevalence of depression in an acute geriatric medical assessment unit. International Journal of Geriatric Psychiatry, 4, 17–21.Google Scholar
  89. Ouslander, J. G. (1982). Physical illness and depression in the elderly. Journal of the American Geriatrics Society, 30, 593–599.PubMedGoogle Scholar
  90. Parmelee, P. A. (1996). Pain among cognitively impaired older persons. Clinics in Geriatric Medicine, 12(3), 473–487.PubMedGoogle Scholar
  91. Parmelee, P. A., Katz, I. R., & Lawton, M. P. (1989). Depression among institutionalized aged: Assessment and prevalence estimation. Journal of Gerontology: Medical Sciences, 41, M22–M29.Google Scholar
  92. Parmelee, P. A., Katz, I. R., & Lawton, M. P. (1991). The relation of pain to depression among institutionalized aged. Journal of Gerontology: Psychological Sciences, 46, P15–P21.Google Scholar
  93. Parmelee, P. A., Katz, I. R., & Lawton, M. P. (1992). Incidence of depression in long-term care settings. Journal of Gerontology: Medical Sciences, 46, M189–M196.Google Scholar
  94. Parmelee, P. A., Katz, I. R., & Lawton, M. P. (1993). Anxiety and its association with depression among institutionalized elderly. American Journal of Geriatric Psychiatry, 1, 65–78.Google Scholar
  95. Parmelee, P. A., Kleban, M. H., & Katz, I. R. Pain, anxiety and depression among institutional elderly: The role of somatic symptoms. Advances in Medical Psychotherapy (in press).Google Scholar
  96. Parmelee, P. A., Smith, B. D., & Katz, I. R. (1993). Pain complaints and cognitive status among elderly institution residents. Journal of the American Geriatrics Society, 41, 517–522.PubMedGoogle Scholar
  97. Pincus, T., Callahan, L. F., Bradley, L. A., Vaughn, W. K., & Wolfe, F. (1986). Elevated MMPI scores for hypochondriasis, depression, and hysteria in patients with rheumatoid arthritis reflect disease rather than psychological status. Arthritis and Rheumatism, 29, 1456–1466.PubMedGoogle Scholar
  98. Radecki, S. E., Kane, R. L., Solomon, D. H., Mendenhall, R. C., & Beck, J. C. (1988a). Do physicians spend less time with older patients? Journal of the American Geriatrics Society, 36, 713–718.PubMedGoogle Scholar
  99. Radecki, S. E., Kane, R. L., Solomon, D. H., Mendenhall, R. C., & Beck, J. C. (1988b). Are physicians sensitive to the special needs of older patients? Journal of the American Geriatrics Society, 36, 719–725.PubMedGoogle Scholar
  100. Radloff, L. S., & Teri, L. (1986). Use of the Center for Epidemiological Studies Depression Scale with older adults. Clinical Gerontology, 5, 119–136.Google Scholar
  101. Richards, J. S., Nepomuceno, C., Riles, M., & Suer, Z. (1982). Assessing pain behavior: The UAB Pain Behavior Scale. Pain, 14, 393–398.PubMedGoogle Scholar
  102. Romano, J. M, & Turner, J. A. (1985). Chronic pain and depression: Does the evidence support a relationship? Psychological Bulletin, 97, 18–34.PubMedGoogle Scholar
  103. Rovner, B. W., German, P. S., Broadhead, J., Morriss, R. K., Brant, L. J., Blaustein, J., & Folstein, M. F. (1990). The prevalence and management of dementia and other psychiatric disorders in nursing homes. International Psychogeriatrics, 2, 13–24.PubMedGoogle Scholar
  104. Roy, R., & Thomas, M. R. (1986). A survey of chronic pain in an elderly population. Canadian Family Physician, 32, 513–516.PubMedGoogle Scholar
  105. Sengstaken, E. A., & King, S. A. (1993). The problem of pain and its detection among geriatric nursing home residents. Journal of the American Geriatrics Society, 41, 541–544.PubMedGoogle Scholar
  106. Sofaer, B., & Walker, J. (1994). Mood assessment in chronic pain patients. Disability and Rehabilitation, 16, 35–38.PubMedGoogle Scholar
  107. Spear, F. G. (1967). Pain in psychiatric patients. Journal of Psychosomatic Research, 11, 187–193.PubMedGoogle Scholar
  108. Stewart, R. B., Blashfield, R., Hale, W. E., Moore, M. T., May, F. E., & Marks, R. G. (1991). Correlates of Beck Depression Inventory scores in an ambulatory elderly population: Symptoms, diseases, laboratory values, and medications. Journal of Family Practice, 32, 497–502.PubMedGoogle Scholar
  109. Strang, P., & Qvarner, H. (1990). Cancer-related pain and its influence on quality of life. Anticancer Research, 19, 109–112.Google Scholar
  110. Sulkava, R., Wikstrom, J., Aromaa, A., Raitasalo, R., Lehtinen, V., Lahtela, K., & Palo, J. (1985). Prevalence of severe dementia in Finland. Neurology, 35, 1025–1029.PubMedGoogle Scholar
  111. Summers, J. D., Rapoff, M. A., Varghese, G., Porter, K., & Palmer, R. E. (1991). Psychosocial factors in chronic spinal cord injury ain. Pain, 47, 183–189.PubMedGoogle Scholar
  112. Teske, K., Daut, R. L., & Cleeland, C. S. (1983). Relationships between nurses’ observations and patients’ self-reports of pain. Pain, 16, 289–296.PubMedGoogle Scholar
  113. Tief, P. M., Elliott, D. J., Stein, N., & Frederickson, B. E. (1987). Functional vs. organic pain: A meaningful distinction? Journal of Clinical Psychology, 43, 219–226.Google Scholar
  114. Turk, D. C., & Okifuji, A. (1994). Detecting depression in chronic pain patients: Adequacy of self-reports. Behavior Research and Therapy, 32, 9–16.Google Scholar
  115. von Knorring, L., Perris, C., Eisemann, M., Eriksson, U., & Perris, H. (1983). Pain as a symptom in depressive disorders: 2. Relationship to personality traits as assessed by means of KSP. Pain, 17, 377–384.Google Scholar
  116. Weisenberg, M., Aviram, O., Wolf, Y., & Raphaeli, N. (1984). Relevant and irrelevant anxiety in the reaction to pain. Pain, 20, 371–383.PubMedGoogle Scholar
  117. Williamson, G. M., & Schulz, R. (1992). Pain and depression among community-residing elderly. Journal of Gerontology: Psychological Sciences, 46, P367–P372.Google Scholar
  118. Williamson, G. M., & Schulz, R. (1995). Activity restriction mediates the association between pain and depressed affect: A study of younger and older adult cancer patients. Psychology and Aging, 10, 369–378.PubMedGoogle Scholar
  119. Williamson, J. (1978). Depression in the elderly. Age and Aging, 7(Suppl.), 35–40.Google Scholar
  120. Wolff, B. B. (1983). Laboratory methods of pain measurement. In R. Melzack (Ed.), Pain measurement and assessment (pp. 7–13). New York: Raven Press.Google Scholar

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© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Patricia A. Parmelee
    • 1
  1. 1.Polish Research InstitutePhiladelphia Geriatric CenterPhiladelphiaUSA

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