Situational catastrophizing mediates laboratory pain responses in sickle cell disease patients

There are many components involved in the experience of sickle cell disease (SCD) pain, but relatively little research has explored the potential effects of psychosocial factors on SCD pain. Specifically, we have shown that situational pain catastrophizing is associated with greater temporal summation in other chronic pain populations, but these processes have not been extensively examined in SCD. In this study, African American sickle cell participants (N=62) and African American healthy controls (N=19) completed a battery of quantitative sensory tests, including thermal temporal summation procedures, and reported situational pain catastrophizing after each portion of testing. When compared to healthy controls, SCD participants reported significantly greater temporal summation responses (p=.05), and catastrophizing in response to temporal summation (p=.04), after controlling for age (mean age = 36.5, range 19-64) and sex (65% female). We tested the hypothesis that situational catastrophizing mediated the relationship between group and thermal temporal summation using a statistical bootstrapping technique including age and sex as covariates. The results indicate that a significant portion of variance in temporal summation response attributed to group was mediated by situational catastrophizing (R2 = 12%, t=-1.97, p=.05). When catastrophizing was added to the statistical model, the effect of group on temporal summation response was no longer significant (t=-1.44, p=.15). The results suggest that the greater temporal summation observed in SCD patients may be explained, at least in part, by higher catastrophizing during laboratory pain testing. These findings suggest that managing catastrophizing may be an important part of understanding, and potentially treating, pain in SCD.