Sickle Cell Disease, More Than Just Pain: The Mediating Role of Psychological Symptoms.

Objectives: Perceived stress is associated with sickle cell disease (SCD) pain; however, little is known about psychological mechanisms that may clarify this link among adult patients. This study explored whether anxiety and depression symptoms explained the relation between perceived stress and SCD pain episode frequency among 70 African-American adults (51.4% women, mean age 35.6 years). Methods: Participants completed measures of perceived stress, pain, and psychological symptoms in an outpatient clinical setting. Results: A serial multiple mediation model showed that psychological symptoms collectively reduced the association between perceived stress and SCD pain frequency (b = 0.116, P = 0.141). However, only the indirect effect of stress on pain frequency through anxiety symptoms was significant (b = 0.089). Conclusions: Anxiety but not depression symptoms best explain the association between stress and SCD pain. Further research is needed to identify the specific components of negative affect that drive the experience of SCD pain.