Sickle cell disease pain in children and adolescents: change in pain frequency and coping strategies over time

Examined 9-month follow-up data obtained from children and adolescents with sickle cell disease (SCD) and their parents participating in a longitudinal study of pain coping strategies. Of 87 subjects completing the baseline assessment of pain coping strategies, 70 (80%) of their parents completed a structured pain interview assessing their child's health care use and activity reduction during painful episodes over the follow-up period. Regression analyses controlling for age and pain frequency revealed that baseline Coping Attempts were associated with higher levels of school, household, and social activity during painful episodes. Baseline Passive Adherence was associated with more frequent health care contacts during the subsequent 9 months. Increases in Negative Thinking over time were associated with further increases in health care contacts during the follow-up period. Comparing pain coping strategies assessed at baseline to pain coping strategies measured at follow-up revealed that pain coping strategies were relatively stable over time for younger children but changed more for adolescents.     

Relation between coping strategies and distress, stress, and marital adjustment of multiple-role women.

This study examined time-management and self-care coping techinques that multiple-role women use and their relation to self-reported levels of distress, stress, and marital adjustment. The subjects (N?=?69) were married, had at least one child under the age of 12, and were employed outside the home for more than 20 hr per week. Subjects completed a demographic questionnaire, the Brief Symptom Inventory, the Derogatis Stress Profile, and the Locke-Wallace Marital Adjustment Test. In addition, subjects participated in a 15-min structured interview designed to assess number, type, and frequency of use of time-management and self-care coping strategies. Results of the study indicated that the number, type, and frequency of use of coping strategies were significantly related to self-reported levels of distress, stress, and particularly marital adjustment. Further analysis of high and low scorers on the marital-adjustment test revealed significant differences between the groups on measures of distress and coping. Subjects in the high-marital-adjustment group had significantly lower levels of distress, employed a greater number of coping strategies, and reported greater frequency of use of coping strategies than subjects in the low-marital-adjustment group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cognitive coping skills training on coping strategies and experimental pain sensitivity in African American adults with sickle cell disease.

The present study examined whether training in cognitive coping skills would enhance pain coping strategies and alter pain perception in adults with sickle cell disease (SCD). Sixty-four African Americans with SCD were randomly assigned to either a cognitive coping skills condition (three 45-min sessions in which patients were trained to use 6 cognitive coping strategies) or a disease-education control condition (three 45-min didactic-discussion sessions about SCD). Pain sensitivity to calibrated noxious stimulation was measured at pre- and posttesting, as were cognitive coping strategies, clinical pain, and health behaviors. Results indicated that, compared with the randomly assigned control condition, brief training in cognitive coping skills resulted in increased coping attempts, decreased negative thinking, and lower tendency to report pain during laboratory-induced noxious stimulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing cognitive coping strategies for acute postsurgical pain.

The Cognitive Coping Strategy Inventory (CCSI), developed from a theoretical taxonomy of coping strategies, allows for the assessment of coping strategies in acute pain settings. The initial instrument was administered to 83 postsurgical patients, and acceptable internal consistency was obtained for the subscales. After minor revisions it was administered to 100 postsurgical patients, a concurrent validity study was conducted, and its factor structure was investigated. The final version of the inventory was administered to 81 postsurgical patients. A sum index derived from the CCSI was significantly related to both self-perception of pain tolerance and independent ratings of subjects' pain coping ability. Concurrent validity studies indicated that a small portion of pain coping variance was accounted for by the CCSI, and cautions are raised regarding its use as an isolated measure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, coping, and psychological adjustment of adults with sickle cell disease.

Examined a transactional model of psychological adjustment to chronic illness with 109 African-American adults with sickle cell disease (SCD). Good psychological adjustment was associated with lower levels of perceived daily stress and stress regarding SCD illness tasks, higher efficacy expectations, less use of palliative coping methods, less use of negative thinking/passive adherence pain-coping strategies, and family functioning characterized by high levels of support and low levels of conflict and control. Overall, the underlying stress and coping conceptual model accounted for 44–50% of the variance in psychological adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Follow-up of coping skills training in adults with sickle cell disease: Analysis of daily pain and coping practice diaries.

This study examined the 3-month follow-up effects of a pain coping skills intervention in African American adults with sickle cell disease. Sixty-seven participants were randomly assigned to either a coping skills condition or a disease-eduction control condition. Multivariate analyses applied to summary measures of coping, laboratory pain perception, and clinical measures indicated that participants in the coping intervention reported significantly lower laboratory pain and significantly higher coping attempts at 3-month follow-up in comparison with the control condition. Multilevel random effects models applied to prospective daily diaries of daily pain, health care contacts, and coping practice indicated that on pain days when participants practiced their strategies, they had less major health care contacts in comparison with days when they did not use strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sickle cell disease pain: II. Predicting health care use and activity level at 9-month follow-up.

Examined 9-mo follow-up data obtained from adults with sickle cell disease (SCD) participating in a longitudinal study of pain-coping strategies. Of 99 Ss completing the baseline assessment of pain-coping strategies, 89 (90%) completed a structured pain interview assessing health care use and activity reduction during painful episodes over the follow-up period. Regression analyses controlling for demographics and disease severity revealed that baseline Negative Thinking and Passive Adherence was associated with greater activity reduction and more frequent health care contacts during the subsequent 9 mo. Additional correlational analyses revealed that if levels of Negative Thinking and Passive Adherence increased from baseline to follow-up, this increase was associated with even further reductions in activity level during painful episodes. Changes in disease severity were not associated with any of the follow-up measures. Comparing pain-coping strategies assessed at baseline to pain-coping strategies measured at follow-up revealed that, without intervention, pain-coping strategies were relatively stable over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sickle cell disease: imaging of cerebrovascular complications

This case is reported because of the unusual blood findings, no duplicate of which I have ever seen described. Whether the blood picture represents merely a freakish poikilocytosis or is dependent on some peculiar physical or chemical condition of the blood, or is characteristic of some particular disease, I cannot at present answer. I report some details that may seem non-essential, thinking that if a similar blood condition is found in some other case a comparison of clinical conditions may help in solving the problem.     

Children's spontaneous strategies for coping with pain: A review of the literature.

Reviews the literature on strategies children use for coping with pain before professional intervention. The development of direct methods of assessing children's behavioral and cognitive coping strategies is traced; and evidence for developmental differences in the types of strategies children employ is presented. Initial evidence regarding the effectiveness of spontaneous coping strategies is presented. Future research directions to be taken may include extension to pediatric chronic pain populations, outcome studies, and investigation of parents' roles in children's development and application of coping strategies. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fathers' cognitive appraisals, coping strategies, and support resources as correlates of adjustment to parenthood.

Adjustment to parenthood was explored among fathers by applying R. S. Lazarus's (1993) theoretical model of stress and coping. Within a longitudinal framework, the assessment of 90 primiparous fathers and 90 primiparous mothers included measures of cognitive appraisals of parenting, coping strategies used to deal with parenting issues, and support resources at 1 month postpartum. Adjustment to parenthood in terms of well-being and involvement with the infant was assessed at 12 months postpartum by means of measures of parental burnout as well as observed caregiving and affiliative behaviors. Patterns of appraisals, coping strategies, and support resources related to parenting were both found to differ substantially between fathers and mothers and to be differentially associated with adjustment to parenthood. The results are discussed in light of the socialization theory and the role constraint theory explaining gender differences in the coping processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dysphoria: Relations to appraisals, coping, and adjustment.

Previous research has shown that individual differences in dysphoria are linked to adjustment, but the potential mediating influence of appraisals and coping has not been studied until now (R. Lazarus & S. Folkman, 1984). This study examined the direct and indirect influences of dysphoria on primary and secondary appraisal, coping, and psychological and physical adjustment in 361 college students. Results from conducting path analyses indicated that the link between dysphoria and adjustment was mediated by appraisals and coping. These results also suggest that dysphoria has both direct and indirect influences on adjustment. Implications for future research and development of appropriate interventions for working with dysphorics are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postoperative pain in children: Developmental and family influences on spontaneous coping strategies.

Examined children's and parents' reactions to postoperative pain, including stress appraisal and cognitive-behavioral coping processes from a developmental perspective. 30 younger children (aged 7–9 yrs) and 30 older children (aged 10–16 yrs) and their parents provided interview and psychometric data about pain and coping on the day following surgery. Observational data also was provided by nurses. All children described a variety of self-control strategies found to be helpful in managing postoperative pain. Older children were more likely to report using cognitive coping strategies, yet they reported lower overall self-efficacy. Coping strategy use, perceived self-efficacy, and frequency of catastrophizing thoughts were significantly predictive of children's pain, affective distress, and physical recovery. Parental anxiety was positively related to child anxiety, and inversely related to child self-efficacy and frequency of cognitive coping. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential effects of avoidant and attentional coping strategies on adaptation to chronic and recent-onset pain.

Examined the effectiveness of attentional (AT) and avoidant (AV) coping strategies for somatic, behavioral, and psychological adaptation to clinical pain among 30 chronic (CP) and 30 recent-onset pain (RP) patients. It was hypothesized that RP Ss would demonstrate greater adaptation (lower anxiety, depression, pain severity, and somatization ratings and higher levels of social activity) when employing AV rather than AT strategies. CP Ss using AT strategies were predicted to demonstrate greater adaptation than CP Ss using AV strategies. Ss completed the Coping Scale (A. G. Billings and R. H. Moos, 1981) as well as parts of the SCL-90 (Revised) and the West Haven-Yale Multidimensional Pain Inventory (R. D. Kerns et al, 1985). Results support the hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive strategies, expectancy, and coping style in the control of pain.

Measures of tolerance, self-reported pain threshold, and overall discomfort of cold-pressor pain were obtained from 114 male undergraduates in a pretest–training–posttest experiment. Training consisted of brief practice in 1 of 4 cognitive strategies: rational thinking, compatible imagery, incompatible imagery, and task-irrelevant cognition. Analyses of covariance indicated that (a) cognitive-imaginal strategies facilitated endurance of pain and raised self-reported threshold, (b) rational thinking and compatible imagery were generally the most effective treatments, (c) expectancy alone was not a significant pain-attenuating factor, (d) treatments did not affect discomfort ratings, and (e) individual differences in imaginal ability and coping style did not correlate with changes in any of the dependent measures. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and coping strategies as mediators of adult adjustment following childhood maltreatment

Structural equation modelling (SEM) was used to examine whether coping efforts and social support mediate the long-term sequelae of child maltreatment. The hypothesized SEM fit the data well and indicated that the association between previous childhood sexual and physical maltreatment and current psychological adjustment appeared to be strongly mediated by social support and coping strategies. In this sample of 302 female and male university students, most of whom reported at least one episode of childhood maltreatment, perceived social support and ways of coping with earlier maltreatment appeared essential to an understanding of the relationship between childhood maltreatment and later adjustment.