Does age affect how you cope with chronic pain?

The study I shared previously on coping with chronic pain points out that those who use active coping techniques tend to have a better outcome than those who use passive coping techniques. Basically, if you take action and responsibility for how your outcomes, your outcomes tend to be better. However, If you wait around expecting others (doctors or God) to fix your situation you typically have worse outcomes.

Unfortunately, most literature focuses on young adults. The few studies that did compare older with younger adults had mixed results, either seeing no difference in age, or finding that younger adults (under 35) used more coping mechanisms (active breathing, etc) than seniors.

Another study found that the coping strategies used depended on a combination of age and pain severity. More passive coping was reported among seniors when they were in less pain. However, with increased pain both younger and older adults reported these passive types of coping at the same level.

Coping Theories

There are two primary categories that coping theories fall into when looking at these differences in coping with age.

1. Developmental Theories –  There are two theories here, Regression theory suggests that we use different coping mechanisms at different stages in life (regardless of what else is going on). Regression theory also suggests that older people return to less effective coping strategies as they age.Alternatively, Growth theory suggests that as we age we become more knowledgeable and experienced and use more effective coping strategies.
2. Contextual Theories – Contextual theories suggest that age has nothing to do with coping style,that it’s all about the type of stressor we are dealing with. According to these theories the way we cope only changes across age because the type of stressors we encounter changes.

As you can see these two categories are pretty much opposites. If you go with the latter then there would be no difference in coping techniques between older and younger people in pain, because the stressor is the same.

So, what did LaChapelle & Hadjistavropoulos find when they examined both older and younger adults coping strategies when dealing with pain?

280 people with chronic pain replied to an anonymous survey. Participants were recruited from support groups and pain treatment centers.

Daily stress was measured by asking participants to respond to how much of a hassle they found a variety of daily tasks. This determined their perceived daily stress level. They then answered a 65-item questionnaire regarding their coping mechanisms.

The chronic pain coping inventory measures cognitive and behavioral coping strategies that people use when they are in pain.

The Ways of Coping questionnaire measured how often in the last week these coping strategies were used.

How does coping differ with age?

• Increasing age was directly related to lower pain severity. But, co-morbid conditions and pain diagnosis were related to higher levels of pain severity, off-setting the lower levels of pain severity found with increased age alone.In other words, the older you are the more likely you are to have co-morbid conditions which can result in increased levels of pain severity.

• Increasing age was directly related to an increased feeling of control over pain.
• Increased age was associated with decreased use of some passive/ emotion or avoidance-focused coping strategies.
• Increased age was not associated with increased use of problem-focused (active) coping strategies.

Basically, the results they found don’t support either of the coping theories discussed above. Therefore they suggest an integrated approach – the developmental life-context model.

The developmental life-context model suggests that age can restrict the available coping tools (eg. an older person may not be able to do some of the physical activities that can be used for coping).

Additionally, age and experience affect how a person perceives a stressor and how they choose to cope with it.

Helme and Gibson(1999), for example, note that seniors may de-emphasize pain due to other significant life events and high levels of comorbidity” – (Lachapelle & Hadjistavropoulos, 2005)

Finally, older people may have lower levels of work and family stress, allowing them to feel that they are more in control of their lives and their pain, changing the way that they perceive and cope with pain.

the life-context in which pain is experienced differs significantly between seniors and young adults. ” (Lachapelle & Hadjistavropoulos, 2005)

Seniors have more co-morbid illnesses than younger adults. Younger adults have more daily hassles and general life stressors than the elderly. Seniors are also more likely to have a specific pain diagnosis (whereas the younger people are often still waiting for their diagnosis).

There are a lot of differences between younger and older adults in pain, and these differences matter and determine how we cope. Overall, though, we choose how we cope with our pain. Young or old we have tools at our disposal that we can choose to use.

Related Posts:

• 6 Steps for coping with stress & improving fibromyalgia symptoms
• How are you coping with chronic pain?
• 10 Ways to distract yourself from chronic pain
• 3Ms of coping with chronic pain and fatigue

References:

Lachapelle, D. L., & Hadjistavropoulos, T. (2005). Age-Related Differences Among Adults Coping With Pain: Evaluation of a Developmental Life-Context Model. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 37(2), 123.