Division of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, Ohio.
Department of Pediatrics, The Ohio State University, Columbus, Ohio.
Pediatr Blood Cancer. 2018 Jul;65(7):e27027. doi: 10.1002/pbc.27027. Epub 2018 Mar 7.
Youth with sickle cell disease (SCD) are at risk for recurrent pain and depressive symptoms, both of which contribute to poorer health outcomes. Furthermore, youth and family coping with child pain, including pain catastrophizing, is known to be associated with poorer psychosocial adjustment and greater functional disability among youth with SCD. In particular, child catastrophizing about pain and parent catastrophizing about their child's pain have been linked to increased pain and depressive symptoms in youth with chronic pain conditions. Despite this, the impact of child and parent pain catastrophizing on depressive symptoms remains unexplored in pediatric SCD.
The current study evaluated the predictive value of child and parent pain catastrophizing on child depressive symptoms in a sample of 100 youth with SCD. Differences in child and parent pain catastrophizing across youth with and without clinically elevated depressive symptoms were also examined.
Pain frequency and parent and child pain catastrophizing accounted for 35.9% of variance in child depressive symptoms, with only pain frequency and parent pain catastrophizing emerging as unique predictors of clinically elevated depressive symptoms. Additionally, parents of youth with clinically elevated depressive symptoms showed increased helplessness relative to parents of youth with minimal to mild depressive symptoms.
Findings support the value of depression screening and interventions to promote parent self-efficacy in managing childhood SCD pain.
镰状细胞病(SCD)患儿易出现反复发作的疼痛和抑郁症状,这两者都会导致更差的健康结局。此外,儿童及其家庭应对儿童疼痛的方式,包括疼痛灾难化,已知与 SCD 患儿的心理社会适应不良和功能障碍更严重有关。特别是,儿童对疼痛的灾难化和父母对孩子疼痛的灾难化与慢性疼痛儿童的疼痛和抑郁症状增加有关。尽管如此,儿童和父母的疼痛灾难化对 SCD 患儿抑郁症状的影响仍有待探讨。
本研究评估了儿童和父母的疼痛灾难化对 100 名 SCD 患儿的儿童抑郁症状的预测价值。还检查了具有和不具有临床显著抑郁症状的患儿的儿童和父母的疼痛灾难化之间的差异。
疼痛频率以及父母和儿童的疼痛灾难化解释了儿童抑郁症状的 35.9%的变异,只有疼痛频率和父母的疼痛灾难化是临床显著抑郁症状的唯一预测因子。此外,与抑郁症状轻微或轻度的患儿的父母相比,具有临床显著抑郁症状的患儿的父母表现出更多的无助感。
研究结果支持抑郁筛查和干预措施的价值,以提高父母在管理儿童 SCD 疼痛方面的自我效能。