Date of Award

2008

Degree Type

Thesis

Department

Psychology

First Advisor

Rakos, Richard

Subject Headings

Pain -- Treatment, Pain medicine, Chronic pain rehabilitation, Opioid, Benzodiazepine, Digit Span, Digit symbol substitution coding

Abstract

Pain is a component of many disease processes however in some cases, when pain becomes a chronic condition it can become the problem itself. It can be a debilitating condition which is emotionally and economically costly to the individual, his or her family, and societies as a whole. Theories of pain have evolved over the last several decades to incorporate a Biopsychosocial Model of Pain. The biological portion of the model relies on The Gate Control Theory of Pain, although some emerging research points to a Neuromatrix model. As is suggested by the term, Biopsychosocial Model of Pain, the biologic basis of pain is only a part of the overall phenomenon. The experience of pain relies on many subjective, individual and environmental factors. Similarly the treatment of pain has evolved to encompass multiple dimensions of the phenomena of pain. The predominant model of Interdisciplinary Treatment encompasses seven areas: Medication Education Psychophysiologic Pain and Stress Management Individual and Group Psychotherapy Physical and Occupational Therapy Behavior Modification and Family Therapy. While classically medication with opioid analgesics and benzodiazepines has been a mainstay of treatment, they have recently been the source of considerable debate. Some research and practitioners suggest that these medications may hinder a patient's progress in treatment and reduce or inhibit their functioning overall and contribute to their pain. The exact nature of the relationship to neurocognitive functioning is still the source of considerable debate. This paper examines the relationship of two classes of medication: opioids and benzodiazepines to neurocognitive functioning as measured by two subtests of the WAIS-R (Digit Span and Digit-Symbol Substitution Test) in a Cleveland, OH pain rehabilitation clinic population

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