The Interaction of Pain Catastrophizing and Chronic Pain Acceptance in Sickle Cell

Chronic pain in sickle cell disease is more complex and challenging to manage than in other conditions. To better inform chronic pain assessment and management, this study evaluated the role of chronic pain acceptance in the context of pain catastrophizing and their combined association with chronic pain intensity and chronic pain disability in adults with sickle cell disease.

This was a secondary analysis of cross-sectional survey data from 170 adults with sickle cell disease (mean age of 28.05 years and 53.5% female, with moderate to severe chronic pain and high levels of chronic pain disability) who completed the Pain Catastrophizing Scale and Chronic Pain Acceptance Questionnaire.

Multiple regression was used to analyze predictors of chronic pain intensity and chronic pain disability, with pain catastrophizing and chronic pain acceptance subscales (activity engagement and pain willingness) as primary variables.

Pain catastrophizing was significantly associated with chronic pain intensity and chronic pain disability. Activity engagement, but not pain willingness, was associated with chronic pain disability. There was a significant interaction between pain catastrophizing and activity engagement on chronic pain disability. Additionally, low pain catastrophizing and high activity engagement was associated with lower chronic pain disability.

Study findings suggest that optimal chronic pain management in adults with sickle cell disease may require addressing pain catastrophizing and chronic pain acceptance sequentially.

Interventions targeting the cognitive framework in addressing pain catastrophizing before promoting functional engagement may positively influence chronic pain outcomes in this population.