scholarly journals Parent pain catastrophizing predicts child depressive symptoms in youth with sickle cell disease

2018 ◽  
Vol 65 (7) ◽  
pp. e27027 ◽  
Author(s):  
Alana Goldstein-Leever ◽  
Lindsey L. Cohen ◽  
Carlton Dampier ◽  
Soumitri Sil
2020 ◽  
Vol 7 (1) ◽  
pp. 205510292091725
Author(s):  
Nadine Matthie ◽  
Coretta Jenerette ◽  
Ashley Gibson ◽  
Sudeshna Paul ◽  
Melinda Higgins ◽  
...  

Among 170 adults with sickle cell disease, we evaluated chronic pain impact and disability prevalence, assessed age and gender differences, and identified psychosocial predictors of chronic pain intensity and disability. Most participants had a high level of disability. Chronic pain intensity and disability were significantly associated with pain catastrophizing and chronic pain self-efficacy, and worsened with age. Further research is needed to confirm study findings and develop interventions, including palliative care approaches that address catastrophizing and disability, particularly for young women and middle-aged adults with sickle cell disease. Moreover, consistent clinical assessment of chronic pain and psychosocial health should be implemented.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5577-5577 ◽  
Author(s):  
Carlton Haywood ◽  
Sophie Lanzkron ◽  
C. Patrick Carroll ◽  
John J. Strouse ◽  
Shawn M Bediako ◽  
...  

Abstract Introduction Perceived discrimination due to race or ethnicity has been associated with a greater burden of pain among minority groups.  Patients with sickle cell disease (SCD), who in the U.S. are comprised primarily of individuals from racial and ethnic minority groups, are known to experience behaviors from others that may be construed as discriminatory.  Nevertheless, the association of these problematic interpersonal experiences with the burden of chronic pain in SCD is unknown. Methods We conducted a cross-sectional analysis of data collected at baseline of the Improving Patient Outcomes with Respect and Trust Study (IMPORT), which is a federally funded prospective cohort study of SCD patient (age 15+) experiences of care (n = 291).  We sought to examine the association between patient perceptions of discrimination and their reports of chronic SCD pain.  Perceived discrimination from healthcare providers thought to be due to the patient's race/ethnicity (i.e., race-based), or status as having SCD (i.e, disease-based) was measured using subscales adapted from the Interpersonal Processes of Care Survey.  Using descriptive, bivariate, and multivariable analytic techniques, discrimination scores were examined for their association with self-reported chronic pain both unadjusted, and adjusted for the following potential confounders: patient age, sex, type of SCD, self-reported ED utilization for vaso-occlusive crisis, depression symptoms, the patient's perceived severity of their SCD, and the presence or absence of avascular necrosis. Results Patients in the cohort reported higher levels of race-based discrimination compared to other reports of African Americans using the same instrument.  The cohort reported an even higher level of perceived disease-based discrimination than race-based discrimination.  Race-based discrimination exhibited significant, positive associations with disease-based discrimination (r = 0.51, p<0.001), age, and depressive symptoms.  Disease-based discrimination exhibited significant, positive associations with depressive symptoms, ED utilization (see Figure 1), and perceived disease severity.  Fifty-four percent (54%) of the respondents reported having daily chronic SCD pain.  Perceived disease-based, but not race-based, discrimination from healthcare providers was independently associated with a greater likelihood of reporting daily chronic SCD pain (adjusted OR = 1.34, 95%CI [1.01, 1.78]) after adjustment for all potential confounders under study. Conclusions While perceptions of race and disease-based discrimination were correlated with each other, they exhibited different relationships with clinical factors like ED utilization and chronic pain.  Perceived disease-based, but not race-based, discrimination was found to be associated with a greater burden of chronic pain among patients with SCD independent of potential confounders like ED utilization. While the true causal directionality of this relationship is currently unclear, our findings do support greater use of a biopsychosocial approach to mitigating the burden of SCD pain.  Efforts to identify the various mechanisms through which perceived discrimination is associated with the burden of pain are essential in order to develop targeted interventions that could improve the pain experience of persons with SCD. * Test for trend significant at p <0.001 Disclosures: Haywood: NIH: Research Funding. Lanzkron:GlycoMimetics, Inc: Research Funding; NIH: Research Funding. Strouse:NIH: Research Funding; Doris Duke Charitable Foundation: Research Funding; Masimo Corporation: Membership on an entity’s Board of Directors or advisory committees, Research Funding. Bediako:NIH: Research Funding. Haythornthwaite:NIH: Research Funding. Beach:NIH: Research Funding.


2016 ◽  
Vol 63 (12) ◽  
pp. 2159-2166 ◽  
Author(s):  
Komal Bhatt-Poulose ◽  
Kenneth James ◽  
Marvin Reid ◽  
Abigail Harrison ◽  
Monika Asnani

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1397-1397
Author(s):  
Jennifer J Macdonald ◽  
Jennifer Rees ◽  
Gene H. Brody ◽  
Man-Kit Lei ◽  
Yi-fu Chen ◽  
...  

Abstract Abstract 1397 Poster Board I-419 Background: Caregivers of children with sickle cell disease (SCD) have high levels of stress and depression. Students with SCD have a higher prevalence of behavioral and cognitive deficits compared to healthy students. Adaptive skills are particularly important for children with chronic disease because they are the skills needed to transition into independent adulthood. We hypothesize that (1) Maternal depressive symptoms are associated with decreased adaptive skills in children with SCD, and (2) This association will be mediated by the association between maternal depression and the provision of lower levels of competence promoting parenting. Methods: We completed a cross-sectional analysis of a single center prospective cohort study. Adaptive skills of children with SCD were assessed by parent report of the Behavior Assessment System for Children (BASC). The BASC reflects the child's adaptive skills by 5 key adaptive scales: adaptability, activities of daily living, functional communication, social skills, and leadership. Maternal risk for depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). We completed structured interviews of the mothers to assess parenting quality. Effective parenting was characterized by high levels of support, involvement, monitoring, and low levels of ongoing conflict. A path analysis using ordinary least squares was used for statistical analysis. Results: 48 children with SCD and their mothers were evaluated. 52% of the children were male; mean age was 12 yrs (Range 6-16). 25% of the children repeated a grade level in school. The mothers' mean age was 38 yrs (Range 27-59) and the average yearly household income per capita was $7,133 (Range 708- 22,800). 60% of the children received healthcare via Medicaid. 20% of the mothers were at risk for depression.12.5% of the children had clinically significant deficits in adaptive skills and18.8% of the children were considered “at risk.” There was a moderate correlation between maternal depression and child adaptive skills (r = .481, p=.01). A path analysis revealed that in the presence of parenting, the association between maternal depression and child adaptive skills is no longer significant. The effect of maternal depression is mediated by depression induced decrements in competence promoting parenting practices (Fig. 1). Medicaid was associated with higher maternal depressive symptoms. Conclusions: Our preliminary data provide direct evidence that maternal depression is associated with proximal parenting practices that are associated with child adaptive skills. Parenting practices can be modified through education and family support and serve as a potential intervention target for moderating the effects of maternal depression on child adaptive skills in this vulnerable population. Maternal depressive symptoms have a negative association with proximal parenting processes that are linked to adaptive skills in children with SCD. Stronger parenting indices are associated with better adaptive skills. In the presence of parenting, the direct association between maternal depression and adaptive skills is no longer significant. Disclosures: Brody: NIH: Research Funding. White: NIH: Research Funding. King: NIH-NHLBI: Research Funding; Doris Duke Charitable Foundation: Research Funding.


2017 ◽  
Vol 43 (5) ◽  
pp. 543-551 ◽  
Author(s):  
Kemar V Prussien ◽  
Michael R DeBaun ◽  
Janet Yarboi ◽  
Heather Bemis ◽  
Colleen McNally ◽  
...  

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