The Association of Social-Environmental Factors with Cognitive Function in Children with Sickle Cell Disease

Abstract

Sickle cell disease is a chronic, life-threatening condition that affects more than one in every 400 African-American newborns. In addition to being at greater risk for cognitive impairment, children with sickle cell disease are also more likely to come from low-income, chaotic homes. The present study examined the relationship between cognitive function in pediatric sickle cell disease patients and their mothers’ reports of social-environmental stress, psychological distress, and parenting. Sixty-five children with sickle cell disease completed a comprehensive neuropsychological testing battery while their mothers completed questionnaires included in a parent interview at baseline and at follow-up 12-24 months later. The results showed partial support for the hypothesis that greater maternal social-environmental stress and psychological distress and less positive parenting would be associated with poorer cognitive function in children with sickle cell disease. Additionally, a series of linear regression analyses showed that maternal financial stress was the strongest and most consistent predictor across all domains of cognitive function. The rationale and implications of these findings are discussed.