Abstract
The aim of this study was to examine the potential moderating effect of age on the child-reported pain–social anxiety relationship in children and adolescents with sickle cell disease (SCD). Participants were children and adolescents (ages 8–17; 33 girls, 25 boys) diagnosed with SCD who completed measures of social anxiety and severity of usual pain. Caregivers provided demographic information, and mean hemoglobin levels were computed as a measure of objective disease severity. Ratings of more severe pain were associated with greater social anxiety, including fear of negative evaluation, for older children and adolescents only, revealing a moderating effect of age. Increased relevancy of peer relationships in adolescence, limited social contacts due to SCD complications, and misreading of social cues (e.g., maladaptive coping response to pain) may explain why older children and adolescents reported greater social anxiety in the presence of a stressor such as pain.
Similar content being viewed by others
REFERENCES
Adams, C. D., Stresand, R. M., Zawacki, T., & Joseph, K. E. (2002). Living with a chronic illness: A measure of social functioning for children and adolescents. Journal of Pediatric Psychology, 27, 593–605.
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.
Barbarian, O. A., Whitten, C. F., & Bonds, S. M. (1994). Estimating rates of psychosocial problems in urban poor chil-dren with sickle cell anemia. Health and Social Work, 19, 112–119.
Brown, R. T., Buchanan, I., Doepke, K., Eckman, J. R., Baldwin, K., Goonan, B., et al. (1993). Cognitive and academic functioning in children with sickle cell disease. Journal of Clinical Child Psychology, 22, 207–218.
Brown, R. T., Lambert, R., Devine, D., Baldwin, K., Casey, R., Doepke, K., et al. (2000). Risk-resistance adaptation model for caregivers and their children with sickle cell syndromes. Annals of Behavioral Medicine, 22, 158–169.
Chambers, C. T., Craig, K. D., & Bennett, S. M. (2002). The im-pact of maternal behavior on children's pain experiences: An experimental analysis. Journal of Pediatric Psychology, 3, 293–301.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.
Conner-Warren, R. L. (1996). Pain intensity and home pain man-agement of children with sickle cell disease. Issues in Compre-hensive Pediatric Nursing, 19, 183–195.
Dampier, C. D., Ely, E., Brodecki, D., & O'Neal, P. (2002). Home management of pain in sickle cell disease: A daily diary study in children and adolescents. Journal of Pediatric Hematology/ Oncology, 24, 643–647.
Devine, D., Brown, R. T., Lambert, R., Donegan, J. E., & Eckman, J. (1998). Predictors of psychosocial and cognitive adaptation in children with sickle cell syndromes. Journal of Clinical Psy-chology in Medical Settings, 5(3): 295–313.
Fuggle, P., Shand, P. A., Gill, L. J., & Davies, S. C. (1996). Pain, quality of life, and coping in sickle cell disease. Archives of Disease in Childhood, 75, 199–203.
Gil, K. M., Carson, J. W., Porter, L. S., Ready, J., Valrie, C., Redding-Lallinger, R., et al. (2003). Daily stress and mood and their association with pain, health-care use, and school activity in adolescents with sickle cell disease. Journal of Pediatric Psychology, 28(5), 363–373.
Gil, K. M., Porter, L., Ready, L., Workman, E., Sedway, J., & Anthony, K. K. (2000). Pain in children and adolescents with sickle cell disease: An analysis of daily pain diaries. Children's Health Care, 29(4), 225–241.
Gil, K. M., Williams, D. A., Thompson, R. J., & Kinney, T. R. (1991). Sickle cell disease in children and adolescents: The relation of child and parent pain coping strategies to adjustment. Journal of Pediatric Psychology, 16, 643–663.
Gil, K. M., Wilson, J., & Edens, J. (1997). The stability of pain coping strategies in young children, adolescents, and adults with sickle cell disease over an 18-month period. Clinical Journal of Pain, 13, 110–115.
Gil, K. M., Wilson, J. J., Edens, J. L., Workman, E., Ready, J., Sedway, J., et al. (1997). Cognitive coping skills training in children with sickle-cell disease pain. International Journal of Behavioral Medicine, 4, 364–377.
Goodenough, B., Thomas, W., Champion, G. D., Perrott, D., Taplin, J. E., von Baeyer, C. L., et al. (1999). Unraveling age effects and sex differences in needle pain: Ratings of sensory intensity and unpleasantness of venipuncture pain by children and their parents. Pain, 80(1-2), 179–190.
Graumlich, S. E., Powers, S. W., Byars, K. C., Schwarber, L. A., Mitchell, M. J., & Kalinyak, K. A. (2001). Multidimensional assessment of pain in pediatric sickle cell disease. Journal of Pediatric Psychology, 26, 203–214.
Hartup, W. W. (1996). The company they keep: Friendships and their developmental significance. Child Development, 67, 1–13.
Holmbeck, G. N. (2002). Post-hoc probing of significant moderational and mediational effects in studies of pediatric popula-tions. Journal of Pediatric Psychology, 27(1), 87–96.
Hummel, T. J., & Sligo, J. (1971). Empirical comparison of univari-ate and multivariate analysis of variance procedures. Psycho-logical Bulletin, 76, 49–57.
Hurtig, A. L., & White, L. S. (1986). Psychosocial adjustment in children and adolescents with sickle cell disease. Journal of Pediatric Psychology, 11, 411–427.
Ivers-Landis, C. E., Brown, R. T., Drotar, D., Bunke, V., Lamber, R. G., & Walker, A. A. (2001). Situational analysis of parenting problems for caregivers of children with sickle cell syndromes. Journal of Developmental and Behavioral Pediatrics, 22, 169–178.
La Greca, A. M. (1999a). Manual and instructions for the SASC, SASC-R, and SAS-A, and parent versions of the scales.
La Greca, A. M. (1999b). The Social Anxiety Scales for Children and Adolescents. The Behavior Therapist, summer, 133–136.
La Greca, A. M., Dandes, S. K., Wick, P., Shaw, K., & Stone, W. L. (1988). The development of the Social Anxiety Scale for Chil-dren (SASC): Reliability and concurrent validity. Journal of Clinical Child Psychology, 17, 84–91.
La Greca, A. M., & Lopez, N. (1998). Social anxiety among adoles-cents: Linkages with peer relations and friendships. Journal of Abnormal Child Psychology, 26, 83–94.
La Greca, A. M., & Shiloff, N. (1998, February). Social anxiety in adolescents: Agreement between parent and teen. San Diego, CA: Society for Research in Adolescence.
La Greca, A. M., & Stone, W. L. (1993). The Social Anxiety Scale for Children-Revised: Factor structure and concurrent validity. Journal of Clinical Child Psychology, 22, 17–27.
La Greca, A. M. (1992). Peer influences in pediatric chronic illness: An update. Journal of Pediatric Psychology, 17, 775–784.
Lemanek, K., Ranalli, M. A., Green, K., Biega, C., & Lupia, C. (2003). Diseases of the blood. In M. C. Roberts(Ed.), Hand-book of pediatric psychology (3rd ed., pp. 321–341). New York: Guilford Press.
Lemanek, K. L., Buckloh, L. M., Woods, G., & Butler, R. (1995). Diseases of the circulatory system: Sickle cell disease and hemophilia. In M. C. Roberts (Ed.), Handbook of pediatric psychology (2nd ed., pp. 286–309). New York: Guilford Press.
Lemanek, K. L., Horwitz, W., & Ohene-Frempong, K. (1994). A multiperspective investigation of social competence in chil-dren with sickle cell disease. Journal of Pediatric Psychology, 19(4), 443–456.
Meijer, S. A., Sinnema, G., Bijstra, J. O., Mellenbergh, G. J., & Wolters, W. H. G. (2000). Social functioning in children with a chronic illness. Journal of Child Psychology and Psychiatry, 41(3), 309–317.
Midence, K., Fuggle, P., & Davies, S. (1993). Psychosocial aspects of sickle cell disease in childhood and adolescence: A review. British Journal of Clinical Psychology, 32, 271–280.
Myers, C. D., Riley, J. L., & Robinson, M. E. (2003). Psychoso-cial contributions to sex-correlated differences in pain. Clinical Journal of Pain, 19(4), 225–232.
National Heart, Lung, and Blood Institute. (1996). Sickle cell ane-mia (NIH Publication No. 96-4057). Washington, DC: U.S. Government Printing Office.
Noll, R. B., Vannatta, K., Koontz, K., Kalinyak, K., Bukowski, W. M., & Davies, W. H. (1996). Peer relationships and emo-tional well-being of youngsters with sickle cell disease. Child Development, 67, 423–436.
Pallister, C. J. (1992). A'crisis' that can be overcome: Management of sickle cell disease. Professional Nurse, 7, 509–513.
Pendley, J. S., Dahlquist, L. M., & Dreyer, Z. (1997). Body image and psychosocial adjustment in adolescent cancer survivors. Journal of Pediatric Psychology, 22, 29–43.
Pope, A., & Ward, J. (1997). Self-perceived facial appearance and psychosocial adjustment in preadolescents with cranio-facial anomalies. Cleft Palate-Craniofacial Journal, 34, 396–401.
Powers, S. W., Mitchell, M. J., Graumlich, S. E., Byars, K. C., & Kalinyak, K. A. (2002). Longitudinal assessment of pain, cop-ing, and daily functioning in children with sickle cell disease receiving pain management skills training. Journal of Clinical Psychology in Medical Settings, 9, 109–119.
Rodrigue, J. R., Streisand, R., Banko, C., Kedar, A., & Pitel, P. (1996). Social functioning, peer relations, and internalizing and externalizing problems among youths with sickle cell disease. Children's Health Care, 25(1), 37–52.
Schuman, W., Armstrong, F., Pegelow, C., & Routh, D. (1993). En-hanced parenting knowledge and skills in mothers of preschool children with sickle cell disease. Journal of Pediatric Psychol-ogy, 18(5), 575–591.
Shapiro, B. (1993). Management of painful episodes in sickle cell disease. In N. L. Schechter, C. B. Berde, & M. Yaster (Eds.), Pain in infants, children, and adolescents (pp. 385–410). Balti-more, MD: Williams & Wilkins.
Shapiro, B. S., Dinges, D. F., Orne, E. C., Bauer, N., Reilly, L. B., Whitehouse, W. G., et al. (1995). Home-management of sickle cell-related pain in children and adolescents: Natural history and impact on school attendance. Pain, 61, 139–144.
Shelby, M. D., Nagle, R. J., Barnett-Queen, L. L., Quattlebaum, P. D., & Wuori, D. F. (1998). Parental reports of psychosocial adjustment and social competence in child survivors of acute lymphocytic leukemia. Children's Health Care, 27, 113–129.
Sullivan, M. J., Thorn, B., Haythornthwaite, J. A., Keefe, F., Martin, M., Bradley, L. A., et al. (2001). Theoretical perspectives on the relation between catastrophizing and pain. Clinical Journal of Pain, 17, 52–64.
Thompson, R. J., & Gustafson, K. E. (1996). Adaptation to chronic childhood illness. Washington, DC: American Psychological Association.
Thompson, R. J., Gustafson, K. E., & Ware, R. (1998). Hematologic disorders. In R. Ammerman & J. Campo (Eds.), Handbook of pediatric psychology and psychiatry: Vol. 2. Disease, injury, and illness (pp. 298–312). Boston, MA: Allyn & Bacon.
Tsao, J. C. I., Myers, C. D., Craske, M. G., Bursch, B., & Zeltzer, L. K. (2003). Impact of anxiety, sex, and pubertal status on adolescents' laboratory pain responses [Abstract]. Journal of Pain, 4(Suppl.), 16.
Unruh, A. M., & Campbell, M. A. (1999). Gender differences in children's pain experiences. In P. J. McGrath & G. A. Finley (Eds.), Progress in pain research and management: Vol. 13. Chronic and recurrent pain in children and adolescents (pp. 199–241). Seattle, WA: IASP Press.
Varni, J. W., Katz, E. R., Colegrove, J. J. R., & Dolgin, M. (1995). Per-ceived physical appearance and adjustment of children with newly diagnosed cancer. A path analytic model. Journal of Behavioral Medicine, 18, 261–278.
Wagner et al. (2004). Predictors of Social Anxiety in Children and Adolescents with Sickle Cell Disease. Journal of Clinical Psy-chology in Medical Settings, 11, 243–252.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wagner, J.L., Connelly, M., Brown, R.T. et al. Predictors of Social Anxiety in Children and Adolescents with Sickle Cell Disease. Journal of Clinical Psychology in Medical Settings 11, 243–252 (2004). https://doi.org/10.1023/B:JOCS.0000045344.05747.d3
Issue Date:
DOI: https://doi.org/10.1023/B:JOCS.0000045344.05747.d3