Health status in sickle cell disease: examining the roles of pain coping strategies, somatic awareness, and negative affectivity.

People with sickle cell disease (SCD) vary in their pain, activity levels, and medical care. We examined how coping (Coping Strategies Questionnaire), somatic awareness, and illness worry were related to these health indices in 70 African-American adults with SCD. Negative Thinking/Passive Adherence and/or somatic awareness was positively correlated with pain episode frequency, duration, or severity, after controlling for demographics and disease severity and positively correlated with activity reduction or hospitalization frequency after also controlling for pain. Self-reported negative affectivity was correlated with both psychological and SCD measures; and controlling for negative affectivity eliminated several, but not all, relationships. Examination of the Negative Thinking/Passive Adherence factor suggested a distinction between Negative Thinking and Passive Adherence, which was partially supported by their different relationships. We conclude that negative thinking, passive coping, and somatic awareness are related to several measures of poor health in SCD but that some relationships are better accounted for by general measures of negative affectivity.