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Negative Affect Differentiation and Adherence During Treatment for Thalassemia

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Abstract

Background

Although research has demonstrated the detrimental effects of excessive negative affect on treatment adherence and morbidity in chronic illness, rarely have researchers investigated the benefits of awareness of negative emotional experiences during treatment.

Purpose

In this investigation, we examined the association of negative affect differentiation (the ability to report negative emotional experiences as separate and distinct from each other,) to treatment adherence in adult patients with the congenital blood disorder thalassemia.

Method

Negative affect differentiation was assessed during a 12–16-week treatment-based diary and adherence was operationalized as attendance at routine screenings over 12 months. Participants were adult patients (n = 32; age M = 31.63, SD = 7.72; 72 % female) with transfusion-dependent thalassemia in treatment in a large metropolitan hospital in the Northeastern USA.

Results

The results indicate that negative affect differentiation is significantly associated with greater adherence to treatment, even when controlling for disease burden and level of psychological distress.

Conclusion

Although preliminary, this investigation suggests that differentiated processing of negative emotional experiences during illness can lead to adaptive treatment-related behavior. As such, it may present a new avenue for research and intervention targeting the improvement of adherence during treatment for chronic illness.

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Notes

  1. This includes patients with β-thalassemia major, β-thalassemia intermedia, and Diamond–Blackfan anemia, an erythroid hypoplasia.

  2. Two participants did not complete the diary correctly, one participant moved prior to the end of the diary, and three participants completed less than six diary entries. There were no significant demographic or disease-related differences between those individuals included in this investigation and those recruited for the larger study.

  3. We also initially considered including age and educational attainment as controls because prior evidence has suggested developmental factors can influence affective processing [70]. However, these variables had no meaningful effect on the results and were dropped.

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Correspondence to Karin G. Coifman.

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Coifman, K.G., Ross, G.S., Kleinert, D. et al. Negative Affect Differentiation and Adherence During Treatment for Thalassemia. Int.J. Behav. Med. 21, 160–168 (2014). https://doi.org/10.1007/s12529-012-9277-7

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