Pain-Related Injustice Appraisals in Youth with Sickle Cell Disease: A Preliminary Investigation

Megan M Miller, Deanna D Rumble, Adam T Hirsh, Tine Vervoort, Lori E Crosby, Avi Madan-Swain, Jeffrey Lebensburger, Anna M Hood, Zina Trost

Research output: Contribution to journalArticlepeer-review


Sickle cell disease (SCD) is a genetic disorder that affects approximately 100,000 Americans, the majority of whom are African American. SCD-related pain often has deleterious effects on functioning and quality of life. The inherited nature of SCD, SCD-related stigma, and serious physical and functional impact of SCD-related pain create a situation ripe for individuals to appraise their SCD-related pain as unfair or unjust. The aim of this preliminary investigation is to explore the extent to which pediatric patients with SCD appraise their pain as unjust and how these appraisals relate to functioning.Participants were youth with SCD (N = 30, mean age = 11.3, 57% boys) who attended a hematology clinic visit. Patients were invited to complete paper-based questionnaires assessing pain-related injustice appraisals, pain catastrophizing, pain and hurt, functional disability, depression, anxiety, and peer relationships.Results of hierarchical regressions indicate that pain-related injustice significantly predicted functional disability, depression, and anxiety after controlling for patient pain and catastrophizing.These findings suggest that pain-related injustice appraisals are an important contributor to the pain experience of youth with SCD. Early identification and remediation of pain-related injustice appraisals could have long-term functional benefits for youth with SCD.
Original languageEnglish
Pages (from-to)2207-2217
Number of pages11
JournalPain Medicine
Issue number10
Early online date16 Mar 2021
Publication statusPublished - 1 Oct 2021


  • Adolescent
  • Anemia, Sickle Cell/complications
  • Catastrophization
  • Child
  • Female
  • Humans
  • Male
  • Pain
  • Pain Measurement
  • Quality of Life


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