Skip to main content

Advertisement

SpringerLink
Log in

Negative Thinking as a Coping Strategy Mediator of Pain and Internalizing Symptoms in Adolescents with Sickle Cell Disease

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

The objective of this study was to examine the role of coping strategies, specifically negative thinking, in mediating the association of pain with symptoms of anxiety and depression in adolescents with sickle cell disease. Fifty-two 12–18-year-old adolescents with sickle cell disease completed a daily pain diary and paper-and-pencil measures of pain, pain coping, depression and anxiety. Symptoms of depression and anxiety were within the non-clinical range. Preliminary analyses indicated that lower family income was associated with higher reports of pain and negative thinking. Mediation regression analyses supported negative thinking as mediating the association of: (1) pain intensity with depression, and (2) pain interference with daily activities with anxiety. Findings highlight negative thinking as a factor compromising adolescents’ adaptation to sickle cell pain; however, further investigation is required to determine the mediating influence of pain coping. Associations for lower income emphasize the multiple risk factors experienced by many of these adolescents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. Because pain was associated with negative thinking and with internalizing symptoms, mediation was considered more likely than moderation in terms of describing the nature of the associations among target variables in this study. It should be noted, however, that we tested the alternative hypothesis of moderation of the association of pain and depression and pain and anxiety by negative thinking (using a strategy outlined by Baron and Kenny 1986). We did not find statistical support for this alternative hypothesis.

References

  • Band, E. B., & Weisz, J. R. (1988). How to feel better when it feels bad: Children’s perspectives on coping with everyday stress. Developmental Psychology, 24, 247–253.

    Article  Google Scholar 

  • Barakat, L. P., Kunin-Batson, A., & Kazak, A. E. (2003). Child health psychology. In I.B. Weiner (Ed.) with A. Nezu, C. Nezu, & P. Geller (Vol. Eds.), Handbook of Psychology: Health Psychology (vol. 9). New York: Wiley.

  • Barakat, L. P., Lash, L., Lutz, M. J., & Nicolaou, D. C. (2006). Psychosocial adaptation of children and adolescents with sickle cell disease. In R.T. Brown (Ed.), Pediatric Hematology/Oncology: A Biopsychosocial Approach. New York: Oxford.

    Google Scholar 

  • Barbarin, O. A., Whitten, C. F., Bond, S., & Conner-Warren, R. (1999). The social and cultural context of coping with sickle cell disease: II. The role of financial hardship in the adjustment to sickle cell disease. Journal of Black Psychology, 25(3), 294–315.

    Article  Google Scholar 

  • Barlow, J. H., & Ellard, D. R. (2006). The psychosocial well-being of children with chronic disease, their parents and siblings: An overview of the research evidence base. Child Health, Care & Development, 32(1), 19–31.

    Article  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  PubMed  Google Scholar 

  • Brown, R. T., Doepke, K. J., & Kaslow, N. J. (1993). Risk-resistance adaptation model for pediatric chronic illness: Sickle cell syndrome as an example. Clinical Psychology Review, 13, 119–132.

    Article  Google Scholar 

  • Brown, R. T., Lambert, R., Devine, D., Baldwin, K., Casey, R., Doepke, K., Ievers, C. E., Hsu, L., Buchanan, I., & Eckman, J. (2000). Risk-resistance adaptation model for caregivers and their children with sickle cell syndromes. Annals of Behavioral Medicine, 22, 158–169.

    PubMed  Google Scholar 

  • Burlew, K., Telfair, J., Colangelo, L, & Wright, E. C. (2000). Factors that influence adolescent adaptation to sickle cell disease. Journal of Pediatric Psychology, 25(5), 287–299.

    Article  PubMed  Google Scholar 

  • Casey, R. L., & Brown, R. T. (2003). Psychological aspects of hematologic diseases. Children and Adolescent Psychiatric Clinics of North America, 12, 567–584.

    Article  Google Scholar 

  • Casey, R. L., Brown, R. T., & Bakeman, R. (2000). Predicting adjustment in children and adolescents with sickle cell disease: A test of the risk-resistance—adaptation model. Rehabilitation Psychology, 45(2), 155–178.

    Article  Google Scholar 

  • Chen, E. (2004). Why socioeconomic status affects the health of children: A psychosocial perspective. Current Directions in Psychological Science, 13, 112–115.

    Article  Google Scholar 

  • Cooley, M. R., & Boyce, C. A. (2004). An introduction to assessing anxiety in child and adolescent multiethnic populations: Challenges and opportunities for enhancing knowledge and practice. Journal of Clinical Child and Adolescent Psychology, 33(2), 210–215.

    Article  PubMed  Google Scholar 

  • Dahlquist, L. M., & Switkin, M. C. (2003). Chronic and recurrent pain. In M.C. Roberts (Ed.), Handbook of Pediatric Psychology (3rd ed.). New York: Guilford.

    Google Scholar 

  • Dampier, C., Ely, B., Brodecki, D., & O’Neal, P. (2002). Characteristics of pain managed at home in children and adolescents with sickle cell disease by using diary self- reports. The Journal of Pain, 3(6), 461–470.

    Article  PubMed  Google Scholar 

  • Devine, D., Brown, R. T., Lambert, R., Donegan, J. E., & Eckman, J. (1998). Predictors of psychosocial and cognitive adaptation in children with sickle cell syndromes. Journal of Clinical Psychology in Medical Settings, 5(3), 295–313.

    Article  Google Scholar 

  • Garber, J., Weiss, B., & Shanley, N. (1993). Cognitions, depressive symptoms, and development in adolescents. Journal of Abnormal Psychology, 102, 47–57.

    Article  PubMed  Google Scholar 

  • Gil, K. M. (1994). Behavioral assessment of sickle cell disease pain. Journal of Health and Social Policy, 5, 19–38.

    Article  PubMed  Google Scholar 

  • Gil, K. M., Abrams, M. R., Phillips, G., & Keefe, F. J. (1989). Sickle cell disease pain: Relation of coping strategies to adjustment. Journal of Consulting and Clinical Psychology, 57, 725–731.

    Article  PubMed  Google Scholar 

  • Gil, K. M., Carson, J. W., Porter, L. S., Ready, J., Valrie, C., Redding-Lallinger et al. (2003). Daily stress and mood and their association with pain, health-care use, and school activity in adolescents with sickle cell disease. Journal of Pediatric Psychology, 28, 363–373.

    Article  PubMed  Google Scholar 

  • Gil, K. M., Edens, J. L., Wilson, J. J., Raezer, L. B., Kinney, T. R., Schultz, W. H., & Daeschner, C. (1997a). Coping strategies and laboratory pain in children with sickle cell disease. Annals of Behavioral Medicine, 19, 22–29.

    Article  PubMed  Google Scholar 

  • Gil, K. M., Porter, L., Ready, J., Workman, E., Sedway, J., & Anthony, K. K. (2000). Pain in children and adolescents with sickle cell disease: An analysis of daily pain diaries. Children’s Health Care, 29, 225–241.

    Article  Google Scholar 

  • Gil, K. M., Williams, D. A., Thompson, R. J. Jr., & Kinney, T. R. (1991). Sickle cell disease in children and adolescents: The relation of child and parent pain coping strategies to adjustment. Journal of Pediatric Psychology, 16(5), 643–663.

    Article  PubMed  Google Scholar 

  • Gil, K. M., Wilson, J. J., Edens, J. L., Workman, E., Ready, J., Sedway, J. et al. (1997b). Cognitive coping skills training in children with sickle cell disease pain. International Journal of Behavioral Medicine, 4, 364–377.

    Article  PubMed  Google Scholar 

  • Goldberg, M. A., & Remy-St. Louis, G. (1998). Understanding and treating pain in ethnically diverse patients. Journal of Clinical Psychology in Medical Settings, 5, 343–356.

    Article  Google Scholar 

  • Goodman, J. E., & McGrath, P. J. (1991). The epidemiology of pain in children and adolescents: A review. Pain, 46, 247–264.

    Article  PubMed  Google Scholar 

  • Hasan, S. P., Hashmi, S., Alhassen, M., Lawson, W., & Castro, O. (2003). Depression in sickle cell disease. Journal of the National Medical Association, 95(7), 533–537.

    PubMed  Google Scholar 

  • Helps, S., Fuggle, P., Udwin, O., & Dick, M. (2003). Psychosocial and neurocognitive aspects of sickle cell disease. Child and Adolescent Mental Health, 8(1), 11–17.

    Article  Google Scholar 

  • Hoff, A. L., Palermo, T. M., Schluchter, M., Zebracki, K., & Drotar, D. (2006). Longitudinal relationships of depressive symptoms to pain intensity and functional disability among children with disease-related pain. Journal of Pediatric Psychology, Advanced Access published September 8, 2005.

  • Holmbeck, G. N. (2002). Post-hoc probing of significant moderational and mediational effects in studies of pediatric populations. Journal of Pediatric Psychology, 27, 87–96.

    Article  PubMed  Google Scholar 

  • Hurtig, A. L., & White, L. (1986). Psychosocial adjustment in children and adolescents with sickle cell disease. Journal of Pediatric Psychology, 11, 411–427.

    Article  PubMed  Google Scholar 

  • Kashikar-Zuck, S., Vaught, M. H., Goldschneider, K. R., Graham, T. B., & Miller, J. C. (2002). Depression, coping, and functional disability in juvenile primary fibromyalgia syndrome. The Journal of Pain, 3, 412–419.

    Article  PubMed  Google Scholar 

  • Kaufman, N. K., Rohde, P., Seeley, J. R., Clarke, G. N., & Stice, E. (2005). Potential mediators of cognitive-behavioral therapy for adolescents with comorbid major depression and conduct disorder. Journal of Consulting and Clinical Psychology, 73, 38.46.

    Article  PubMed  Google Scholar 

  • Kell, R. S., Kliewer, W., Erickson, M. T., & Ohene-Frempong, K. (1998). Psychological adaptation of adolescents with sickle cell disease: Relations with demographic, medical, and family competence variables. Journal of Pediatric Psychology, 23, 301–312.

    Article  PubMed  Google Scholar 

  • Key, J. D., Brown, R. T., Marsh, L. D., Spratt, E. G., & Recknor, J. C. (2001). Depressive symptoms in adolescents with a chronic illness. Children’s Health Care, 30(4), 283–292.

    Article  Google Scholar 

  • Kovacs, M. (1985). The Children’s Depression Inventory (CDI). Psychopharmacology Bulletin, 21, 995–998.

    PubMed  Google Scholar 

  • La Greca, A. M. (1992). Peer influences in pediatric chronic illness: An update. Journal of Pediatric Psychology, 17, 775–784.

    Article  PubMed  Google Scholar 

  • Lemanek, K. L., Ranalli, M. A., Green, K., Biega, C., & Lupia, C. (2003). Diseases of the blood: Sickle cell disease and hemophilia. In M. C. Roberts (Ed.), Handbook of Pediatric Psychology (3rd ed.) (pp. 321–341). New York: Guilford.

    Google Scholar 

  • Livneh, H., & Wilson, L. M. (2003). Coping strategies as predictors and mediators of disability-related variables and psychosocial adaptation: An exploratory investigation. Rehabilitation Counseling Bulletin, 46(4), 194–208.

    Google Scholar 

  • Lutz, M. J., Barakat, L. P., Smith-Whitley, K., & Ohene-Frempong, K. (2004). Psychological adjustment of children with sickle cell disease: Family functioning and coping. Rehabilitation Psychology, 49(3), 224–232.

    Article  Google Scholar 

  • Morgan, S. A., & Jackson, J. (1986). Psychological and social concomitants of sickle cell anemia in adolescents. Journal of Pediatric Psychology, 11, 429–440.

    Article  PubMed  Google Scholar 

  • National Institutes of Health. (2002). The Management of Sickle Cell Disease. NIH Publication No. 02–2117.

  • Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response styles and the duration of episodes of depressed mood. Journal of Abnormal Psychology, 102, 20–28.

    Article  PubMed  Google Scholar 

  • Noll, R. B., Vannatta, K., Koontz, K., Kalinyak, K., Bukowski, W. M., & Davies, W. H. (1996). Peer relationships and emotional well-being of youngsters with sickle cell disease. Child Development, 67, 423–436.

    PubMed  Google Scholar 

  • Palermo, T. M. (2000). Impact of recurrent and chronic pain on child and family daily functioning: A critical review of the literature. Journal of Developmental and Behavioral Pediatrics, 21, 58–69.

    Article  PubMed  Google Scholar 

  • Palermo, T. M., Valenzuela, D., & Stork, P. P. (2003). A randomized trial of electronic versus paper pain diaries in children: Impact on compliance, accuracy, and acceptability. Pain, 107, 213–219.

    Article  Google Scholar 

  • Perrin, E. C., Stein, R. E. K., & Drotar, D. (1991). Cautions in using the Child Behavior Checklist: Observations based on research about children with a chronic illness. Journal of Pediatric Psychology, 16(4), 411–421.

    Article  PubMed  Google Scholar 

  • Platt, O. S., Thorington, B. D., Brambilla, D. J., Milner, P. F., Rosse, W. F., Vichinsky, E. et al. (1991). Pain in sickle cell disease: Rates and risk factors. New England Journal of Medicine, 325, 11–16.

    Article  PubMed  Google Scholar 

  • Radcliffe, J., Barakat, L. P., & Boyd, R. (2006). Family issues. In R. T. Brown (Ed.), Pediatric hematology/oncology: A biopsychosocial approach. New York: Oxford.

    Google Scholar 

  • Reynolds, C., & Richmond, B. O. (1985). Revised Children’s Manifest Anxiety Scale. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Roberts, R. E., Roberts, C. R., & Chen, Y. R. (1997). Ethnocultural differences in prevalence of adolescent depression. American Journal of Community Psychology, 24(1), 95–110.

    Article  Google Scholar 

  • Shapiro, B. S., Dinges, D. F., Orne, E. C., Bauer, N., Reilly, L. B., Whitehouse, W. G., Ohene-Frempong, K., & Orne, M. T. (1995). Home management of sickle cell-related pain in children and adolescents: natural history and impact on school attendance. Pain, 61, 139–144.

    Article  PubMed  Google Scholar 

  • Sharpe, J. N., Brown, R. T., Thompson, N. J., & Eckman, J. (1994). Predictors of coping with pain in mothers and their children with sickle cell syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 1246–1256.

    Article  PubMed  Google Scholar 

  • Thompson, R. J. Jr., Gil, K. M., Burbach, D. J., Keith, B. R., & Kinney, T. R. (1993). Role of child and maternal processes in the psychological adjustment of children with sickle cell disease. Journal of Consulting and Clinical Psychology, 61, 468–474.

    Article  PubMed  Google Scholar 

  • Thompson, R. J. Jr., Gil, K. M., Keith, B. R., Gustafson, K., George, L, & Kinney, T. R. (1994). Psychological adjustment of children with sickle cell disease: Stability and change over a 10-month period. Journal of Consulting and Clinical Psychology, 62, 856–860.

    Article  PubMed  Google Scholar 

  • Vaalamo, I., Pulkkinen, L., Kinnunen, T., Kaprio, J., & Rose, R. J. (2002). Interactive effects of internalizing and externalizing problem behaviors on recurrent pain in children. Journal of Pediatric Psychology, 27, 245–257.

    Article  PubMed  Google Scholar 

  • Varni, J. W., Thompson, K. L., & Hanson, V. (1987). The Varni/Thompson Pediatric Pain Questionnaire: I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis. Pain, 28, 27–38.

    Article  PubMed  Google Scholar 

  • Vervoort, T., Goubert, L., Eccleston, C., Bijttebier, P., & Crombez, G. (2006). Catastrophic thinking about pain is independently associated with pain severity, disability, and somatic complaints in school children and children with chronic pain. Journal of Pediatric Psychology, 31, 674–683.

    Article  PubMed  Google Scholar 

  • Wagner, J. L., Connelly, M., Brown, R. T., Taylor, L. C., Rittle, C., & Wall-Cloues, B. (2004). Predictors of social anxiety in children and adolescents with sickle cell disease. Journal of Clinical Psychology in Medical Settings, 11(4), 243–252.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Drexel University, 3141 Chestnut Street, Bdg. 47-108, Philadelphia, PA, 19104, USA

    Lamia P. Barakat & Katherine Simon

  2. Children’s Hospital of Philadelphia, 3400 Civic Center Blvd., CHOP North, Philadelphia, PA, 19104, USA

    Lisa A. Schwartz

  3. Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine, 3400 Civic Center Blvd., CHOP North, Philadelphia, PA, 19104, USA

    Jerilynn Radcliffe

Authors
  1. Lamia P. Barakat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa A. Schwartz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katherine Simon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jerilynn Radcliffe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lamia P. Barakat.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Barakat, L.P., Schwartz, L.A., Simon, K. et al. Negative Thinking as a Coping Strategy Mediator of Pain and Internalizing Symptoms in Adolescents with Sickle Cell Disease. J Behav Med 30, 199–208 (2007). https://doi.org/10.1007/s10865-007-9103-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-007-9103-x

Keywords

Search

Navigation