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Autonomic reactivity and clinical severity in children with sickle cell disease

  • RESEARCH ARTICLE
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Abstract

Individual differences in autonomic nervous system reactivity have been studied in relation to physical and mental health outcomes, but rarely among children with chronic disease. The purpose of this study was to examine the associations among autonomic reactivity, clinical severity, family stressors, and mental health symptoms in children with homozygous sickle cell disease. Nineteen children with homozygous sickle cell disease participated in a cross-sectional study involving parent-completed measures, medical record reviews and laboratory-based measures of autonomic nervous system responses to social, cognitive, physical and emotional challenges. Autonomic reactivity was significantly associated with both clinical severity and externalizing behavior symptoms. Children with greater parasympathetic withdrawal during challenges compared to rest had significantly more severe disease (r=–0.45, p<0.05); greater sympathetic activation during challenges compared to rest was associated with more externalizing behavior symptoms (r=0.44, p<0.05). Children experiencing major family stressors had internalizing behavior symptoms but no difference in autonomic reactivity or clinical severity compared to children experiencing fewer family stressors. Individual differences in autonomic reactivity may offer a new, biologically plausible account for observed variation in painful episodes, other physical complications and behavioral symptoms among children with sickle cell disease.

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Authors and Affiliations

  1. School of Public Health, University of California, 570 University Hall, Berkeley (CA) 94720-1190, USA

    Sarah R. Pearson MD, Brian Wolff BA & W. Thomas Boyce MD

  2. Institute for Human Development, University of California, Berkeley (CA), USA

    Sarah R. Pearson MD, Abbey Alkon PhD, Brian Wolff BA & W. Thomas Boyce MD

  3. School of Nursing, University of California, San Francisco (CA), USA

    Abbey Alkon PhD

  4. Sickle Cell Center, Dept. of Hematology, Children’s Hospital and Research Center, Oakland (CA), USA

    Marsha Treadwell PhD & Keith Quirolo MD

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  1. Sarah R. Pearson MD
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  2. Abbey Alkon PhD
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  3. Marsha Treadwell PhD
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  4. Brian Wolff BA
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  5. Keith Quirolo MD
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  6. W. Thomas Boyce MD
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Correspondence to W. Thomas Boyce MD.

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Pearson, S.R., Alkon, A., Treadwell, M. et al. Autonomic reactivity and clinical severity in children with sickle cell disease. Clin Auton Res 15, 400–407 (2005). https://doi.org/10.1007/s10286-005-0300-9

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  • DOI: https://doi.org/10.1007/s10286-005-0300-9

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