(157) The association of sickle cell-related stigma with physical and emotional symptoms in patients with sickle cell pain

Abstract

interplay between these factors remains unclear. This study examined the role of catastrophizing in moderating the relationship between sleep (insomnia symptoms & objective measures of sleep continuity) and clinical and laboratory pain. 127 women with TMD were recruited as part of a larger study evaluating interventions for sleep and catastrophizing on pain. Participants underwent baseline testing, including self-report measures (clinical pain, depression, anxiety, catastrophizing, insomnia-severity), laboratory pain testing measuring central sensitization (CS), actigraphy (14 days) and a one-night polysomnography (PSG). While objective measures of sleep continuity were not significantly correlated with self-report insomnia-severity, both were associated with clinical pain and CS, suggesting that they represent distinct but important contributors to pain. Catastrophizing was associated with clinical pain and CS. Self-report insomnia-severity interacted with catastrophizing in predicting both clinical pain and CS (p's<.05). Objective measures of sleep continuity: total sleep time (actigraphy; PSG), sleep-efficiency (actigraphy; PSG) and wake after sleep onset (WASO; actigraphy) interacted with catastrophizing in predicting CS (p's<.001), but not clinical pain. The same pattern of moderation emerged from all interactions: patients with more severe self-reported insomnia symptoms, shorter sleep time, low sleep-efficiency and greater WASO who also reported high catastrophizing demonstrated increased levels of CS. Depression, anxiety and age were controlled in all analyses. These findings suggest that among women with TMD the combination of high catastrophizing and poor sleep continuity is particularly important in understanding CS and clinical pain and emphasizes the need to target this group and provide interventions for both sleep and catastrophizing.

A Survey-Based Needs Assessment of Barriers to Optimal Sickle Cell Disease Care in the Emergency Department

“…Patients with self-perceived higher levels of stigma noted increased levels of fatigue, anger, anxiety, and depression. 12 The findings of this study were confirmed with our survey, which showed that some of the barriers to patient care were that patients were in pain, tired, fearful, and angry or frustrated. This is further exacerbated by the well-documented racial and ethnic bias in the treatment of pain, with minority groups receiving less and delayed pain medication compared with their white counterparts.…”

Stigma of Sickle Cell Disease: A Systematic Review

“…Depressive symptoms, including feeling hopeless and loss of interest in daily activities, have been positively associated with internalized stigma in people with SCD (Holloway et al, 2016). Additionally, individuals who experience high rates of stigma are more likely to report anxiety, depressive symptomatology, stress, and anger in comparison to those reporting low rates of stigma (M. Ezenwa et al, 2016; Mathur et al, 2016).…”

The influence of perceived racial bias and health-related stigma on quality of life among children with sickle cell disease

“…Similarly, one study found that patients who report high levels of health-related stigma are more likely to report increased fatigue, anger, anxiety, and depression compared to patients who report lower levels of stigma. However, the patient groups in the study did not differ in terms of pain intensity (Ezenwa et al, 2016).…”