Age-cohort differences for seven tests from the Halstead-Reitan Neuropsychological Battery, for overall performance on the Impairment Index, and for a multivariate composite of the seven scores, were examined for 427 subjects falling into six age groups (15-24, 25-34, 35-44, 45-54, 55-64, and 65 years and over). Univariate and multivariate-discriminant analyses were performed. Poorer performance was observed across age-cohorts (linear trend) for all tests and the Impairment Index. A very modest Age-Cohort (linear trend) x Gender interaction was observed only for the Category Test. Decline in Category Test performance across age-cohorts was more pronounced for women than for men. For women, the best discrimination among age groups was observed for the Category Test. For men, Tactile Performance Localization Test discriminated best. The poorest discrimination among age groups was seen for Finger-Tapping for men and Tactile Performance Test--Total (time score) for women. Results were consistent with a model of specific nested within general decline. Although linear-trend across age groups was observed for all tests, the strongest discriminations were associated with neuropsychological tests of abstraction and complex problem-solving performance.
Seventy-nine patients with chronic headaches of diverse causes, recruited from a headache clinic's biofeedback facility, were administered the Multidimensional Pain Inventory (MPI) for measuring the cognitive, behavioral, and affective dimensions of pain. Using the statistical technique of cluster analysis to organize the results, three clusters emerged, and were similar in their characteristics to those named "Dysfunctional", "Interpersonally Distressed", and "Adaptive Coper" by other authors who had applied the Inventory and the cluster analysis technique to other populations (one population containing heterogenous groups of chronic pain patients, and another population of patients suffering from "temporomandibular joint disorders". Additional analyses of our results confirmed that the three groups were distinct from one another; and that age, sex, duration of complaint, and diagnosis, were not factors in the formation of the groups. Our results suggest that the MPI is a valid measure of the cognitive, behavioral and affective aspects of pain. Rather than apply a similar intervention program to all headache patients, it might be more effective to tailor treatment to the variations in these aspects exhibited by patients in the three different clusters.
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