Date of Award


Document Type

Campus Access Thesis




Clinical-Community Psychology

First Advisor

Jeffrey C Schatz


Biological, psychological, and social (biopsychosocial) risk factors for children diagnosed with Sickle Cell Disease (SCD) have been found to impact their cognitive functioning; however few studies have investigated the possible interactions of these risk factors. SCD is a chronic, hereditary, hemoglobinopathy which is most commonly found in individuals of African descent. Research has shown that many children with SCD have been found to have deficits in their executive functioning, as a result of the defects in hemoglobin. Children with SCD often exhibit deficits in verbal, working memory, and attention switching. This study examined the relationships between SCD, biopsychosocial risk factors, and cognitive outcomes to investigate biopsychosocial risk factors as a potential mediator for neurocognitive risk status.

The authors assessed a sample of children, ages 4 to 9 years old, which consisted of 158 children: 49 children diagnosed with high risk SCD (HbSS or HBSâ0), 27 with low risk SCD (HbSC or HBSâ+), and 82 without SCD. Socioeconomic status and cognitive data was collected for both groups, and SCD disease status was obtained from medical record review. Results indicated that high risk SCD status predicted lower scores on all cognitive measures compared with low risk SCD status and controls. Hierarchical Regression analysis revealed that the psychosocial variables, maternal education and income, moderated the relationship between SCD status and performance on syntactic language and applied math problems. Exploratory analyses revealed that family

involvement moderated the relationship between SCD severity and both syntactic language ability and applied math problems. It was also found that caregiver perceived stress was a moderator for the relationship of SCD severity and applied problems. Taken together, results provided evidence that the psychosocial risk factors maternal education and income are related in young children with SCD to cognitive development. Future studies should continue to investigate the relationship between disease effects, environmental risk factors, and cognition in children with SCD. Understanding the possible association between these risk factors may impact biomedical interventions for this population of young children.