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

Abstract

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.

The Role of Stress and Mood in Sickle Cell Disease Pain

“…Health care providers should be sensitive to the mood and stress level of patients with SCD, and may consider referring patients who frequently experience high levels of stress and/or negative mood for psychological evaluation. In addition, stress and mood management components, such as problem solving, time management, and cognitive restructuring, may be important additions to cognitive-behavioral pain management programs for patients with SCD (Gil et al, 1996). Improved interventions might actually help patients to prevent pain, as well as use health care more efficiently and otherwise improve the quality of their lives.…”

An Evaluation of Central Sensitization in Patients With Sickle Cell Disease

“…For example, in non-SCD chronic pain conditions, lower pain tolerance [20;24] and higher levels of temporal summation [2] are associated with more frequent, intense, and disabling episodes of recent pain. The few studies that have examined QST in adults with sickle cell disease generally find enhanced sensitivity of thermal detection and reduced pain thresholds in patients with SCD [5;26;27]. A recent report found evidence of central sensitization in 60% of patients with SCD tested and a combination of central and peripheral sensitization in an additional 32% [23].…”

Editorial: New Psychological Interventions in Chronic Illness: Towards Examining Mechanisms of Action and Improved Targeting

“…Initially, psychological therapies were borrowed directly from treatments developed for psychiatric patient groups. For example, cognitive behavioural therapies originally designed for treating depression have been successfully adapted to improve adjustment in chronic illnesses such as sickle cell disease (Gil et al, 1996) osteoarthritis (Keefe et al, 1990) and chronic fatigue syndrome (Sharpe et al, 1996).…”