Depressive Symptoms and Sickle Cell Pain: The Moderating Role of Internalized Stigma

Author/Creator ORCID

Date

2018-11-01

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Citation of Original Publication

Holloway, B. M., McGill, L. S., & Bediako, S. M. (2017). Depressive symptoms and sickle cell pain: The moderating role of internalized stigma. Stigma and health, 2(4), 271–280. https://doi.org/10.1037/sah0000060

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©American Psychological Association, 2018. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at: https://doi.org/10.1037/sah0000060. All other rights are reserved.

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Abstract

Recent studies describe the clinical implications of sickle cell disease (SCD) stigma. However, little is known about its link to depressive symptoms or its relative influence on the association between depressive symptoms and SCD pain. We examined whether internalized stigma about SCD moderated the relation between depressive symptoms and pain among 69 adults attending a SCD clinic who reported pain episodes and healthcare use over the past three months. Unadjusted bivariate analyses showed a marginal association between depressive symptoms and SCD pain frequency (r = .21, p < .10). Further analyses adjusting for health care use indicated a moderating effect of internalized stigma (b = −.10, p < .05): a significant association between depressive symptoms and pain was observed among participants low in internalized stigma, but this relationship was attenuated at moderate and high stigma levels. These results denote counterintuitive consequences of internalized attitudes about SCD and suggest a need for further study of the psychosocial and clinical implications of SCD stigma.