Ego-resilience and Pain Catastrophizing Modulate Momentary Pain-affect Dynamics in Sickle Cell Disease: An Ecological Momentary Assessment Pilot Study

Abstract

Sickle cell disease (SCD) is a hereditary blood disorder that predominantly impacts African Americans (in the U.S.), and commonly results in chronic pain and affective distress. Research on modifiable psychosocial risk and resilience factors modulating the effect of SCD-related pain on affective functioning is limited. The present study investigated the moderating roles of daily ego-resilience (i.e., the capacity to flexibly adapt to stressors) and daily pain catastrophizing (i.e., worry, rumination and magnification of pain) on the associations between momentary pain and affect in a sample (n = 25) of SCD patients. Adult SCD patients provided momentary affect and pain intensity ratings via smartphones in response to random ecological momentary assessments over a 2-week period. Day-level ego resilience and pain catastrophizing were assessed each evening. Momentary and day-level predictors were person-mean centered. Linear mixed models allowing for random intercepts tested the associations between pain and affect, and moderation by daily ego resilience and pain catastrophizing. Daily ego resilience moderated the association between momentary pain and positive affect (p = .03), such that the inverse momentary association of pain and positive affect was attenuated on days when ego resilience was high. Daily pain catastrophizing moderated the association between pain and negative affect (p = .005) such that days of elevated pain catastrophizing were characterized by stronger momentary associations between pain and negative affect. Ego resilience and pain catastrophizing may be meaningful intervention targets in the context of SCD due to their capacity to modulate the dynamic associations between pain and affect. Grant support from NIH U54EB020404 NINDS T32NS070201 NIDA T32DA007209