Pain program admission policies do not exclude older patients by age but frequently include age-related criteria that disproportionately exclude the elderly. There is also evidence of an age bias in which age per se reduces perceived suitability for pain program admission.

Sixty-six high hypnotizable individuals received a baseline exposure to pain and 2 counterbalanced hypnotic analgesia conditions. Standard analgesia invoked counterpain imagery, whereas imageless analgesia proscribed imagery. The mean level of pain reduction in these 2 conditions was virtually identical and significantly less than the pain rated in the baseline condition. Furthermore, cognitions experienced as active efforts to cope with the pain occurred far less often and were associated with less pain reduction than cognitions experienced as passive concomitants of pain reduction. The results cast considerable doubt on the widespread assumption that imaginative involvement mediates hypnotic responding.

OBJECTIVE:To examine the utility of the Basic Personality Inventory (BPI) as a complementary tool to the Multidimensional Pain Inventory (MPI) for the evaluation of patients with chronic pain. It was hypothesized that patients labelled 'dysfunctional' on the MPI would exhibit the highest levels of psychological distress as indicated by scores on BPI, followed in order by those labelled 'interpersonally distressed', and those described as 'adaptive copers'. It was anticipated that this pattern would be independent of sex. In addition, validity of the BPI as a measure of psychological distress among patients with pain was examined using psychiatric diagnostic ratings as independent criteria.METHODS:Three hundred and twenty-six patients with non-malignant chronic pain seeking admission to a private pain clinic, an inpatient treatment program or a short term, multidisciplinary outpatient chronic pain program completed both the MPI and the BPI at a single sitting as part of a routine assessment procedure. The majority of patients underwent psychiatric assessment which specified Diagnostic and Statistical Manual of Mental Disorders-III-R (DSM-III-R) or DSM-IV diagnosis. Psychiatric diagnosis was determined for a subsample of 110 patients in the present investigation by conducting a random chart review.RESULTS:The MPI patients classified as 'dysfunctional' manifested significantly higher levels of BPI measured psychopathology than both 'interpersonally distressed' and 'adaptive coper' groups. 'Adaptive copers' reported the lowest levels of psychological dysfunction while those labelled 'interpersonally distressed' exhibited intermediate levels of dysfunction. Individuals with high levels of emotional distress as determined from the BPI were more likely to have an axis 1 disorder.CONCLUSIONS:The BPI is an accepted valid and reliable generic measure of emotional well-being and may be used as a complementary index to the disease-specific MPI in assessing chronic pain patients. A psychometric assessment battery consisting of the MPI and BPI can assist both clinicians and researchers in identifying problem areas that may impede treatment of patients with chronic pain and in assessing treatment outcomes.

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