Fear of movement (kinesiophobia), pain, and psychopathology in patients with sickle cell disease.
OBJECTIVE
Fear of movement (ie, kinesiophobia) has emerged as a significant predictor of pain-related outcomes including disability and psychologic distress across various types of pain (eg, back pain, headache, fibromyalgia, complex regional pain syndrome). However, no research has examined the prevalence of kinesiophobia in adults with sickle cell disease (SCD). The purpose of this study was to assess the degree of kinesiophobia reported by African American men and women with SCD and to determine whether kinesiophobia is related to pain and psychologic distress in this population.


METHODS
Sixty-seven men and women with SCD recruited from a comprehensive sickle cell treatment program in a large academic medical center completed questionnaires that assess fear of movement, pain and pain interference, and psychologic distress.


RESULTS
Participants reported levels of kinesiophobia (M=30.48, SD=7.55) that were comparable to those obtained for patients with low back pain and fibromyalgia. Although pain levels did not differ by sex, men reported greater kinesiophobia than women (P=0.02). As hypothesized, higher levels of kinesiophobia were associated with greater psychologic distress, particularly Phobic Anxiety (r=0.35), Psychoticism (r=0.29), Somatization (r=0.45), Anxiety (r=0.35), Obsessive-compulsive (r=0.34), Interpersonal Sensitivity (r=0.25), Depression (r=0.29), and all 3 summary indices of the SCL-90-R (all Ps<0.05).


CONCLUSIONS
Although and historically, pain associated with SCD has not been considered in the context of fear of movement, findings suggest that both kinesiophobia and sex are relevant constructs for consideration in understanding pain-related outcomes in SCD. Though our results require replication, this study suggests that greater kinesiophobia is associated with greater pain and psychologic distress.
Pells
Jennifer
J
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.
Edwards
Christopher L
CL
McDougald
Camela S
CS
Wood
Mary
M
Barksdale
Crystal
C
Jonassaint
Jude
J
Leach-Beale
Brittani
B
Byrd
Goldie
G
Mathis
Markece
M
Harrison
Myleme O
MO
Feliu
Miriam
M
Edwards
Lekisha Y
LY
Whitfield
Keith E
KE
Rogers
Lesco
L
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D015992:Body Mass Index; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007182:Income; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D008875:Middle Aged; D009068:Movement; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D010147:Pain Measurement; D010698:Phobic Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires