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Depression and Anxiety as Moderators of the Pain-Social Functioning Relationship in Youth with Sickle Cell Disease

Authors Valrie C, Floyd A, Sisler I, Redding-Lallinger R, Fuh B

Received 11 November 2019

Accepted for publication 19 March 2020

Published 8 April 2020 Volume 2020:13 Pages 729—736

DOI https://doi.org/10.2147/JPR.S238115

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr E Alfonso Romero-Sandoval


Cecelia Valrie,1,2 Alfonso Floyd,1 India Sisler,3 Rupa Redding-Lallinger,4 Beng Fuh5

1Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; 2Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, USA; 3Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA; 4Departments of Pediatrics and Internal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 5Department of Pediatrics, East Carolina University, Greenville, NC, USA

Correspondence: Cecelia Valrie
Department of Psychology, Virginia Commonwealth University, 806 W Franklin St, Richmond, VA 23284 Tel +1 804 827 1562
Fax +1 804 828 2237
Email cvalrie@vcu.edu

Purpose: Youth with sickle cell disease (SCD), a genetic disorder of red blood cells, may experience acute pain episodes lasting 2 to 3 days on average. While existing research has demonstrated associations between SCD pain and poor social functioning in youth with SCD, there are no data on whether symptoms of depression and anxiety modify the relationship between pain and functional outcomes in pediatric pain populations. It was hypothesized that more symptoms of depression and anxiety would exacerbate the relationship between high pain and poor social functioning in youth with SCD.
Patients and Methods: We conducted a cross-sectional study of 114 youth with SCD and their guardians assessing the youth’s pain, social functioning, and symptoms of depression and anxiety.
Results: Analyses indicated that elevated levels of depressive symptoms were related to poorer self-reported interpersonal skills. More anxiety symptoms were related to better guardian-reported social skills and weakened the relationship between high pain frequency and poor self-reported interpersonal skills.
Conclusion: Findings build on previous work supporting the need for multidisciplinary approaches to care for youth with SCD who experience pain, and provide rationale for future studies to investigate the direct and possible moderating effects of depression and anxiety symptoms on other functional outcomes in youth with SCD and other pediatric pain populations.

Keywords: sickle cell, pain, children, adolescents, mental health, functional outcomes

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