Date of Award

Summer 2024

Document Type

Open Access Dissertation

Department

Psychology

First Advisor

Jeffrey Schatz

Abstract

Introduction: Youth with sickle cell disease (SCD) experience recurrent pain and increased risk for chronic pain. Neuropathic pain, characterized by alterations to the central and/or peripheral nervous systems, is not well understood among youth with SCD. Based on our current understanding of pain systems and existing literature on pain in SCD, this study aimed to elucidate psychosocial correlates of altered sensory processing (ASP) and neuropathic pain, determine biomedical risk factors contributing to the development of ASP among youth with SCD, and identify how sensory processing and biopsychosocial factors collectively influence pain experiences by assessing two plausible models. Methods: Thirty-five youth between 12 and 21 years old with a clinical diagnosis of SCD (M age = 17.0; 63% female) completed self-report measures characterizing pain history, pain interference, pain catastrophizing, mood, neuropathic pain and engaged in thermal and mechanical quantitative sensory testing (QST). Specifically, youths’ sensitivity to mechanical pain, pinprick pain, and cool temperatures were assessed with von Frey filaments, pinpricks, and a Peltier device. Results: The hypothesized associations with psychosocial factors were partially supported. Youth with increased sensitivity to mechanical pain reported significantly more symptoms of neuropathic pain (r = -.37), negative mood (r = -.38), and greater pain interference (r = -.50). Biomedical predictors of sensory processing indicated that youth with a history of more frequent pain reported greater sensitivity to pinprick stimuli (B = .69) while controlling for oral morphine equivalents. Of the biopsychosocial models, ASP characterized by reduced mechanical pain thresholds significantly predicted greater pain interference (F = 4.50, p = .04, r2 = .14); however, negative mood did not moderate this relationship (β = -.82, p = .34). Parent pain catastrophizing did not predict increased health care utilization. Discussion: This study revealed altered sensory processing was significantly associated with symptoms of neuropathic pain and poor psychosocial functioning. More research exploring sensory processing and neuropathic pain in youth with SCD is needed to inform better screening and treatment for neuropathic pain.

Rights

© 2024, Julia Johnston

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