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Brief Screening Measures Identify Risk for Psychological Difficulties Among Children with Sickle Cell Disease

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Abstract

Children with sickle cell disease (SCD) experience disproportionately high rates of psychological problems. Our goal was to examine the clinical utility of psychological screening measures to identify children with such problems in medical settings. Caregivers completed screening measures assessing social–emotional problems, ADHD symptoms, executive dysfunction, and health-related quality of life for children with SCD (receiving either chronic blood transfusion or hydroxyurea) and their siblings. Our findings demonstrated that screening measures identified clinically elevated symptoms in children with SCD that had not been previously reported. Scores for siblings were for the most part in the normal range. The number of days hospitalized (but not cerebral infarct status) predicted higher scores, emphasizing the challenges associated with SCD complications. Overall, our findings support the notion that screening measures reduce the need for reliance on medical provider judgment for psychological referrals and increase equitability in access to services. Early identification resulting in early intervention has contributed substantially to improved psychological functioning in many contexts, and it is thus likely that such improvements would also be achieved in this uniquely vulnerable population.

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Acknowledgements

We would like to thank the participants and families who participated in our research for their contributions. We would like to acknowledge Maggie Clapp, Amanda Namchuk, and Neeti Shenoy for their contributions to data collection and study management, as well as the physicians and staff of St. Louis Children’s Hospital who generously contributed to the study through recruitment. This research was supported in part by the National Heart, Lung, and Blood Institute (1F31HL134314, and 1U01HL133994). Research was also supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number U54 HD087011 to the Intellectual and Developmental Disabilities Research Center at Washington University.

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Authors and Affiliations

  1. Department of Psychological & Brain Sciences, Washington University, Campus Box 1125, St. Louis, MO, USA

    Anna M. Hood & Desiree A. White

  2. Children’s Neuropsychological Services, Andover, MA, USA

    Ilana Reife

  3. Program in Occupational Therapy and Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine and St. Louis Children’s Hospital, St. Louis, MO, USA

    Allison A. King

  4. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH, 45229, USA

    Anna M. Hood

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  1. Anna M. Hood
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Correspondence to Anna M. Hood.

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Anna M. Hood, Ilana Reife, Allison A. King, and Desiree A. White declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

The procedures followed for this study were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national). All persons gave their informed consent prior to their inclusion in the study.

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Hood, A.M., Reife, I., King, A.A. et al. Brief Screening Measures Identify Risk for Psychological Difficulties Among Children with Sickle Cell Disease. J Clin Psychol Med Settings 27, 651–661 (2020). https://doi.org/10.1007/s10880-019-09654-y

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