title: Daily stress and mood and their association with pain, health-care use, and school activity in adolescents with sickle cell disease.
abstract: OBJECTIVE
  To determine the extent to which daily stress and mood are associated with pain, health-care use, and school activity in adolescents with sickle cell disease (SCD).
  
  
  METHODS
  Adolescents with SCD (n = 37; aged 13 to 17 years) completed daily diaries assessing pain, stress, mood, activity, and health-care use for up to 6 months. Multilevel modeling was used to analyze the data.
  
  
  RESULTS
  Daily increases in stress and negative mood were associated with increases in same-day pain, health-care use, and reductions in school and social activity. Increases in positive mood were associated with decreases in pain, less health-care use, and more activity participation. Notably, pain was predictive of higher stress and lower positive mood on subsequent days.
  
  
  CONCLUSIONS
  Pain in adolescents with SCD is stressful and may lead to alterations in mood states. Understanding the way in which these variables relate to health-care use and activity may lead to improved pain management approaches.
authors.affiliation: Department of Psychology, Davie Hall, CB# 3270, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina 27599-3270, USA. kgil@email.unc.edu
authors.forename: Karen M
authors.initials: KM
authors.lastname: Gil
authors.forename: James W
authors.initials: JW
authors.lastname: Carson
authors.forename: Laura S
authors.initials: LS
authors.lastname: Porter
authors.forename: Jawana
authors.initials: J
authors.lastname: Ready
authors.forename: Cecelia
authors.initials: C
authors.lastname: Valrie
authors.forename: Rupa
authors.initials: R
authors.lastname: Redding-Lallinger
authors.forename: Charles
authors.initials: C
authors.lastname: Daeschner
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000209:etiology*; D010146:Pain / Q000209:etiology* / Q000523:psychology*; D012574:Schools; D013315:Stress, Psychological / Q000209:etiology*