Cecelia R. Valrie

Background: Children with sickle cell disease (SCD) face multiple acute and chronic medical complications that may impact their quality of life as reported by patients themselves. Health‐related social needs (HRSNs), such as food and housing insecurity, are common in people with SCD, but the association between HRSNs and patient‐reported quality‐of‐life outcomes in pediatric SCD patients has not been examined. Methods: In this cross‐sectional study, parents/guardians of children 5–18 completed a demographic questionnaire, an HRSN screener, and the PROMIS Pediatric Parent‐Proxy 25 Profile v2.0, while children 8 and older completed the PROMIS Pediatric‐25 Profile v2.0 during routine SCD clinical appointments. To examine the association of HRSN and the six PROMIS domains reported by both parents/guardians and children, we looked at unadjusted descriptive statistics as well as fit‐nested linear regression models that adjusted for clinical and demographic characteristics. Results: Respondents included 81 parents/guardians and 64 children. Generally, across multiple domains, children with at least one parentally reported HRSN evidenced worse clinically significant quality of life, with guardians reporting greater differences than children. These differences persisted even when accounting for the child's age, gender, SCD genotype, and acute care utilization in the past 12 months. Conclusions: HRSNs are associated with worse patient‐reported quality‐of‐life outcomes in a pediatric SCD population, even after accounting for patient and demographic factors. These findings underscore the need for routine HRSN screening in clinics and support the development of systematic referral pathways to community resources to address identified needs.

Emerging adults of color face significant sleep disparities, yet we know less about underlying mechanisms. The goal of the current study was to investigate whether racial discrimination was associated with hours of sleep and sleep dissatisfaction. Further, we tested whether social media and television/digital media use moderated these associations. Participants included 464 emerging adult students of color (i.e., students who identified as Black/African American, Asian, Latine, Native Hawaiian/Other Pacific Islander and/or American Indian/Native Alaskan) in college. The results indicated that television/digital media use was associated with more hours of sleep, and social media use was not significantly associated with either sleep outcome. The relation between racial discrimination and hours of sleep was moderated by television/digital media use. Simple slopes analysis indicated that when individuals had low television/digital media use or average television/digital media use, racial discrimination was associated with fewer hours of sleep, but this relation was not significant at high levels of television/digital media use. Further, the relation between racial discrimination and sleep dissatisfaction was significantly moderated by social media use. Simple slopes analysis indicated that racial discrimination was associated with more sleep dissatisfaction at low or average levels of social media use, but this relation was not significant at high levels of social media use. Findings suggest that social media and television/digital media use may serve as coping tools for college students of color navigating the negative effects of racial discrimination on sleep.

Black Americans are at higher risk of exposure to racial discrimination, which is linked to poor pain outcomes. This study addresses gaps in understanding the racial discrimination-pain relationship in Black families by investigating sleep disturbance and fatigue as mediators of the relationship in Black adolescent-caregiver dyads. Data were from 179 Black adolescent-caregiver dyads collected from August 2019 to March 2020. We used actor-partner interdependence mediation models (APIMeMs) to test the dyadic associations of racial discrimination, sleep disturbance, fatigue, and pain outcomes. The APIMeMs predicting pain intensity via sleep disturbance and fatigue were significant, R2s = .24-.26, p < .01 for adolescents and R2s = .33-.36, p < .01 for caregivers. The APIMeMs predicting pain interference via sleep disturbance were significant, R2s = .26-.30, p < .01 for adolescents and R2s = .28-.31, p < .01 for caregivers. For actor effects, adolescents' and caregivers' own sleep disturbance and fatigue mediated the relationships between their racial discrimination experiences and their worse pain outcomes. For partner effects, greater adolescent-reported racial discrimination was associated with worse caregiver pain outcomes via higher caregiver fatigue, but not via sleep disturbance. Lastly, caregiver-reported racial discrimination was not associated with adolescent-reported pain outcomes directly or via fatigue or sleep disturbance. Findings support sleep disturbance and fatigue as mechanisms linking racial discrimination and pain, highlighting the importance of family influences in pain outcomes. Findings suggest the need to address sleep, fatigue, and family influences in interventions to reduce the influence of racial discrimination on pain outcomes for Black families. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Adverse childhood experiences (ACES) negatively impact mental, physical, and behavioral health of adults. To develop empirically supported interventions to reduce the impact of ACES, we need to have a strong empirical base of research on modifiable protective factors that reduce the link between ACES and health outcomes. The current review is focused on assessing the state of the literature on modifiable protective factors on the ACE-health outcome relationship in adults. We conducted a scoping review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A systematic search for peer-reviewed literature published in English was conducted in Medline, Embase, PsycINFO, CINAHL, and Web of Science from inception of the databases to January 5, 2023. We then constructed an evidence gap map to provide an innovative, visual approach to guide research prioritization. Seventy-seven articles met inclusion criteria. Findings indicated that the majority focused on mental health outcomes (59%), and investigated individual (52%) and general social support (23%) protective factors. Also, the majority of the work was done in North America (65%) with predominantly female samples. Future studies should focus on addressing gaps in our understanding of what factors may buffer the influence of ACES on physical health outcomes and risky health behaviors and our understanding of family and nonfamily relationships and community and cultural protective factors on the ACE-health outcome relationship in adults. Additionally, research is needed that focuses on samples that are more gender diverse and from countries outside of North America. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

SCD is a family of genetic blood disorders that affects over 20 million people worldwide. SCD complications include pain, anemia, and early death. The hallmark cause of medical visits for people with SCD is pain, initially in the form of acute, severe, vaso-occlusive crises stemming from obstructed blood vessels and a plethora of underlying disordered biological mechanisms. Vaso-occlusive crises are unpredictable and are often associated with acute disability and/or hospitalization. Both vaso-occlusive crises and longer-term, chronic sickle cell pain can contribute to multi-system organ damage and eventually early death. Many of the disordered biological mechanisms of SCD, and how they relate to painful outcomes, are not well understood. Mathematical modeling can be a useful tool to study and analyze such disordered SCD biological phenomena: biodynamics, vaso-occlusion, and responses to SCD drug and gene therapy. In this review, we summarize the variety of mathematical modeling methods used to study SCD and provide specific examples of how mathematical modeling contributes new understandings of SCD.

Background: Social determinants of health (SDoH) are socioeconomic factors that influence health and well‐being, though when unmet can greatly contribute to health disparities. Individuals with sickle cell disease (SCD) are at increased risk of mortality, disability, and healthcare utilization. However, there are limited data linking specific social needs with disease outcomes in this population. Therefore, we sought to identify the unmet needs in one institution and their association with healthcare utilization.Methods: Children with SCD and their guardians answered demographic and SDoH questionnaires during routine Sickle Cell Clinic appointments. We defined an unmet social need as any positive answer to the SDoH questionnaire. Disease outcome variables were electronic health record (EHR)‐documented emergency department (ED) visits, hospitalizations, clinic appointment attendance, and guardian‐reported acute SCD events in the previous year.Results: A total of 114 parent–guardian dyads participated, with 103 having complete data to analyze. In all, 52% of subjects reported at least one unmet social need with food insecurity (36%), trouble paying utility bills (28%), and unemployment (16%) being the most prevalent. Subjects with at least one unmet need had two times the rate of ED visits and/or hospitalizations and were 1.15 times more likely to have an SCD event in the past year. However, only the association with ED visits was statistically significant (p = 0.03).Conclusion: Over half of subjects reported at least one unmet need; the most common being reliable access to food, which has the potential to impact health outcomes of sickle cell patients. Furthermore, unmet social needs are linked to healthcare utilization and SCD‐related complications, supporting routine screening for SDoH in this population.

Objectives: Chronic pain in SCD has been defined as pain on most days over 6 months. In the landmark Pain in Sickle Cell Epidemiology Study, 60% of patients submitted 5 months of diaries (153) and >49% of diaries during all months from 1 to 4. Using the same dataset, we tested daily diary assessment over shorter intervals: 2 weeks, 1 month, 2 months, 3 months, and 4 months. We defined chronic pain as intensity rated as >0 on >50% of diary days, regardless of interval. We then calculated the sensitivity and specificity of each diary interval. Results: Among the gold-standard sample, 51.3% of patients had diary-defined chronic pain. Collection intervals of 2 months or more yielded similar chronic pain prevalences with identically high sensitivity (98.3%) and specificity (93%). Intervals of 1 month and 2 weeks yielded increasingly lower specificity (80.7%, 73.7%, respectively), but preserved sensitivity (≥96.6%). Conclusion: In the Pain in Sickle Cell Epidemiology Study, intervals of 2 months or more of daily diary collection yielded high sensitivity and specificity, compared to an interval of 5-6 months. One may reasonably diagnose chronic SCD pain using 2 months of daily diaries.

Background: Opioids are a common and essential treatment for acute sickle cell disease (SCD) pain. However, opioids carry well‐known adverse side effects, including potential development of hyperalgesia and nociplastic pain. We characterized opioid use in youth with SCD using ecological momentary assessment (EMA) data, and investigated the relationships between home‐based opioid use, pain, and a range of biopsychosocial factors. Method: Eighty‐eight youth with SCD (aged 8–17 years) completed EMAs assessing home‐based opioid use, pain, and related factors. Analyses consisted of descriptive and multilevel logistic regression to predict daily home opioid use. Results: Youth averaged 3.64 weeks of EMAs. Approximately 35% of the sample ( n = 31) took an opioid during the EMA period, and used them on only 24% of reported pain days. Youth who took opioids reported a higher percentage of pain days ( t = −2.67, p < .05) and mean pain severity scores ( t = −2.30, p < .05) than youth who did not take opioids. Multilevel logistic regression analyses indicated that high daily pain severity (odds ratio [OR] = 1.02, p < .01), older age (OR = 1.324, p < .01), and low positive affect (OR = 0.91, p < .01) were each related to an increased likelihood of opioid use. Conclusion: Youth with SCD take opioids appropriately in response to their pain, based on daily self‐report. Beyond daily pain severity, age, and daily variation in positive affect were related to home‐based opioid use. This suggests that behavioral interventions that enhance positive affect may promote reduced opioid use among youth with SCD.

In 2023, the incoming Editors of the Journal of Pediatric Psychology (JPP) and Clinical Practice in Pediatric Psychology (CPPP), Drs. Avani Modi and Christina Duncan, respectively, both identified enhancing reporting practices for diversity, equity, and inclusion (DEI) in pediatric psychology as a top priority ( Duncan, 2023; Modi, 2023). These efforts build upon a 2021 JPP editorial led by Dr Tonya Palermo and a team of Associate/Assistant Editors declaring a public commitment to being an anti-racist journal and providing guidance for reporting on race and ethnicity in JPP articles ( Palermo et al., 2021). The rationale for these efforts stems from the likelihood that (a) terminology used in previous articles published in our journals resulted in harm to people with marginalized identities, (b) past research lacks generalizability of results because study samples lacked representativeness, and (c) past articles published in our journals likely perpetuated white supremacy culture by using white culture as the norm and comparing other cultures/identities to the white norm. Moreover, our current efforts strive to address a broader set of diversity dimensions, using the ADDRESSING Framework ( Hays, 2016) as guidance, with the goal of enhancing the rigor and inclusiveness of pediatric psychology science. Thus, the Editors convened a working group of current and past JPP and CPPP Associate Editors and Editorial Board members, as well as DEI content experts. The aims were to generate consistent reporting guidelines for diversity dimensions across the journals and to inform best practices for future research in pediatric psychology. The working group found many detailed, existing checklists and guidelines on inclusive language and transparent reporting relating to DEI ( American Psychological Association, 2023b; Buchanan et al., 2021; Letzen et al., 2022; Matsui et al., 2020; Miller et al., 2019; Williford et al., 2023b). However, no comprehensive guidelines were available that captured the specific context of pediatric psychology (e.g., developmental/family considerations), while also being broadly applicable across the field (e.g., not focused on a specific condition or symptom).