Examining kinesiophobia as a predictor of somatization, anxiety, and phobia in patients with sickle cell disease

Meredythe Q. Galliher; John J. Sollers III; Ashley Membreno Lopez; Bayan Haseem; Danielle May; Margaret J. Fryman; Janeishka Torres Rivera; Camrynn Cutchin; John Sollers IV; Mary Wood; Camela S. Barker; Cara Green; Jonathan Livingston; Christopher L. Edwards

doi:10.59400/apr3932

Examining kinesiophobia as a predictor of somatization, anxiety, and phobia in patients with sickle cell disease

Meredythe Q. Galliher
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Sollers Psychophysiology & Health Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
John J. Sollers III
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Sollers Psychophysiology & Health Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
Ashley Membreno Lopez
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
Bayan Haseem
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Sollers Psychophysiology & Health Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
Danielle May
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Sollers Psychophysiology & Health Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
Margaret J. Fryman
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Sollers Psychophysiology & Health Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Community and Health Laboratory, North Carolina Central University, Durham, NC 27707, USA
Janeishka Torres Rivera
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
Camrynn Cutchin
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Community and Health Laboratory, North Carolina Central University, Durham, NC 27707, USA
John Sollers IV
Department of Psychology, NCCU Sollers Psychophysiology & Health Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, Thomas More University, Crestview Hills, KY 41017, USA
Mary Wood
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
Camela S. Barker
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
Cara Green
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA
Jonathan Livingston
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Sollers Psychophysiology & Health Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Community and Health Laboratory, North Carolina Central University, Durham, NC 27707, USA
Christopher L. Edwards
Department of Psychology, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Sollers Psychophysiology & Health Laboratory, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Debra O. Parker Research Incubator, North Carolina Central University, Durham, NC 27707, USA

Department of Psychology, NCCU Psychoneuroendocrine and Rare Diseases Laboratory, North Carolina Central University, Durham, NC 27707, USA

Article ID: 3932

DOI: https://doi.org/10.59400/apr3932

Keywords: chronic pain, kinesiophobia, somatization, hemoglobinopathies, anxiety, specific phobias

Abstract

Sickle cell disease (SCD) is a chronic hematologic condition characterized by recurrent pain crises that contribute to psychological distress and activity avoidance. The fear of movement due to anticipated pain (Kinesiophobia) has been identified as an important factor within chronic pain literature, yet it is an underexplored factor within chronic pain conditions like SCD, particularly in relation to psychological symptom expression. The present study examined whether age and kinesiophobia are associated with symptom dimensions of somatization, anxiety, and specific phobia in adults with SCD. Participants (N = 100–102) were recruited from a medical center in North Carolina, where they completed the Tampa Scale of Kinesiophobia (TSK) and the Symptom Checklist-90-R (SCL-90-R). Hierarchical linear regression analyses were utilized to assess the predictive value of age and kinesiophobia across symptom domains. In any model, age did not emerge as a significant predictor. The inclusion of kinesiophobia significantly improved the somatization model, accounting for an additional 7.3% of variance, and emerged as a statistically significant predictor, β = 0.255, p = 0.011. Conversely, neither age nor kinesiophobia emerged as significant predictors of anxiety or specific phobia in this sample. The findings suggest that kinesiophobia may be more specifically associated with somatic symptom expression rather than broader domains of psychological distress in individuals with SCD. Further research is needed to examine the mechanisms that underlie this relationship and to determine if targeting kinesiophobia in this population may improve clinical outcomes.

Published

2026-04-30

How to Cite

Galliher, M. Q., III, J. J. S., Lopez, A. M., Haseem, B., May, D., Fryman, M. J., Rivera, J. T., Cutchin, C., IV, J. S., Wood, M., Barker, C. S., Green, C., Livingston, J., & Edwards, C. L. (2026). Examining kinesiophobia as a predictor of somatization, anxiety, and phobia in patients with sickle cell disease. Applied Psychology Research, 5(1). https://doi.org/10.59400/apr3932

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Vol. 5 No. 1 (2026)

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Article

Copyright (c) 2026 Meredythe Q. Galliher, John J. Sollers III, Ashley Membreno Lopez, Bayan Haseem, Danielle May, Margaret J. Fryman, Janeishka Torres Rivera, Camrynn Cutchin, John Sollers IV, Mary Wood, Camela S. Barker, Cara Green, Jonathan Livingston, Christopher L. Edwards

This work is licensed under a Creative Commons Attribution 4.0 International License.

References

[1]Aily, J. B., De Almeida, A. C., Ramírez, P. C., et al. (2021). Lower education is an associated factor with the combination of pain catastrophizing and kinesiophobia in patients with knee osteoarthritis? Clinical Rheumatology, 40(6), 2361–2367. https://doi.org/10.1007/s10067-020-05518-1

[2]Allen, L. B., Tsao, J. C. I., Seidman, L. C., et al. (2012). A unified, transdiagnostic treatment for adolescents with chronic pain and comorbid anxiety and depression. Cognitive and Behavioral Practice, 19(1), 56–67. https://doi.org/10.1016/j.cbpra.2011.04.007

[3]Balaram, K., & Marwaha, R. (2024). Agoraphobia. In: StatPearls. StatPearls Publishing.

[4]Bränström, H., & Fahlström, M. (2008). Kinesiophobia in patients with chronic musculoskeletal pain: Differences between men and women. Journal of Rehabilitation Medicine, 40(5), 375–380. https://doi.org/10.2340/16501977-0186

[5]Crombez, G., Vlaeyen, J. W. S., Heuts, P. H. T. G., et al. (1999). Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability. Pain, 80(1), 329–339. https://doi.org/10.1016/S0304-3959(98)00229-2

[6]DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized anxiety disorder. Annals of Internal Medicine, 170(7), ITC49–ITC64. https://doi.org/10.7326/AITC201904020

[7]Derogatis, L. R., Rickels, K., & Rock, A. F. (1976). The SCL-90 and the MMPI: A step in the validation of a new self-report scale. British Journal of Psychiatry, 128(3), 280–289. https://doi.org/10.1192/bjp.128.3.280

[8]Edwards, C. L., Whitfield, K., Sudhakar, S., et al. (2006). Parental substance abuse, reports of chronic pain and coping in adult patients with sickle cell disease. Journal of the National Medical Association, 98(3), 420–428.

[9]Harrison, M. O., Edwards, C. L., Koenig, H. G., et al. (2005). Religiosity/spirituality and pain in patients with sickle cell disease. Journal of Nervous & Mental Disease, 193(4), 250–257. https://doi.org/10.1097/01.nmd.0000158375.73779.50

[10]IBM. (2023). IBM SPSS Statistics for Windows (Version 29.0.2.0). Armonk, NY: IBM Corp.

[11]Javaid, S. F., Hashim, I. J., Hashim, M. J., et al. (2023). Epidemiology of anxiety disorders: Global burden and sociodemographic associations. Middle East Current Psychiatry, 30(1), 44. https://doi.org/10.1186/s43045-023-00315-3

[12]Kang, J.-W., Zhang, Y.-H., Yuk, Y.-S., et al. (2025). The effects of psychologically informed physical therapy on kinesiophobia, pain, disability, depression, and anxiety in patients with chronic low back pain: An intervention study focusing on graded exposure. Journal of Physical Therapy Science, 37(11), 556–560. https://doi.org/10.1589/jpts.37.556

[13]Keefe, F. J., Brown, G. K., Wallston, K. A., & Caldwell, D. S. (1989). Coping with rheumatoid arthritis pain: Catastrophizing as a maladaptive strategy. Pain, 37(1), 51–56. https://doi.org/10.1016/0304-3959(89)90152-8

[14]Kori, S. H. (1990). Kinesiophobia: A new view of chronic pain behavior. Pain Manage, 3, 35–43.

[15]Kramer, J., Yinusa-Nyahkoon, L., Olafsson, S., et al. (2021). Black men’s experiences with health care: Individuals’ accounts of challenges, suggestions for change, and the potential utility of virtual agent technology to assist Black men with health management. Qualitative Health Research, 31(10), 1772–1785. https://doi.org/10.1177/10497323211013323

[16]Li, L., Sun, Y., Qin, H., et al. (2023). A scientometric analysis and visualization of kinesiophobia research from 2002 to 2022: A review. Medicine, 102(44), e35872. https://doi.org/10.1097/MD.0000000000035872

[17]Lucchetti, G., Oliveira, A. B., Mercante, J. P. P., et al. (2012). Anxiety and fear-avoidance in musculoskeletal pain. Current Pain and Headache Reports, 16(5), 399–406. https://doi.org/10.1007/s11916-012-0286-7

[18]Pells, J., Edwards, C. L., McDougald, C. S., et al. (2007). Fear of movement (kinesiophobia), pain, and psychopathology in patients with sickle cell disease. The Clinical Journal of Pain, 23(8), 707–713. https://doi.org/10.1097/AJP.0b013e31814da3eb

[19]Perrot, S., Trouvin, A.-P., Rondeau, V., et al. (2018). Kinesiophobia and physical therapy-related pain in musculoskeletal pain: A national multicenter cohort study on patients and their general physicians. Joint Bone Spine, 85(1), 101–107. https://doi.org/10.1016/j.jbspin.2016.12.014

[20]Quartana, P. J., Campbell, C. M., & Edwards, R. R. (2009). Pain catastrophizing: A critical review. Expert Review of Neurotherapeutics, 9(5), 745–758. https://doi.org/10.1586/ern.09.34

[21]Reid, B. R. (2024). Religiosity as a Predictor of Kinesiophobia in Sickle Cell Disease Patients [Master’s thesis]. North Carolina Central University. Available online: https://www.proquest.com/docview/3158995431

[22]Rowa, K., Waechter, S., Hood, H. K., et al. (2017). Generalized anxiety disorder. In: Craighead, W. E., Miklowitz, D. J., Craighead, L. W. (editors). Psychopathology. Wiley. pp. 149–186. https://doi.org/10.1002/9781394258949.ch4

[23]Sánchez-Robalino, A., Sinchi-Sinchi, H., & Ramírez, A. (2025). Effectiveness of pain neuroscience education in physical therapy: A systematic review and meta-analysis. Brain Sciences, 15(6), 658. https://doi.org/10.3390/brainsci15060658

[24]Sil, S., Dampier, C., & Cohen, L. L. (2016). Pediatric sickle cell disease and parent and child catastrophizing. The Journal of Pain, 17(9), 963–971. https://doi.org/10.1016/j.jpain.2016.05.008

[25]Snell, L. (2025). Dataset Supporting the Thesis: An Investigation into Interoception as a Transdiagnostic Mechanism Underpinning Anxiety-Related Disorders [PhD thesis]. University of Southampton. https://doi.org/10.5258/SOTON/D3750

[26]Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: Development and validation. Psychological Assessment, 7(4), 524–532. https://doi.org/10.1037/1040-3590.7.4.524

[27]Swathi, M., Manjusha, S., Vadakkiniath, I. J., et al. (2023). Prevalence and correlates of stress, anxiety, and depression in patients with chronic diseases: A cross-sectional study. Middle East Current Psychiatry, 30(1), 66. https://doi.org/10.1186/s43045-023-00340-2

[28]Van Denburg, A. N., Shelby, R. A., Caldwell, D. S., et al. (2018). Self-efficacy for pain communication moderates the relation between ambivalence over emotional expression and pain catastrophizing among patients with osteoarthritis. The Journal of Pain, 19(9), 1006–1014. https://doi.org/10.1016/j.jpain.2018.04.001

[29]Van Middendorp, H., Lumley, M. A., Jacobs, J. W. G., et al. (2010). The effects of anger and sadness on clinical pain reports and experimentally induced pain thresholds in women with and without fibromyalgia. Arthritis Care & Research, 62(10), 1370–1376. https://doi.org/10.1002/acr.20230

[30]Vlaeyen, J. W. S., Kole-Snijders, A. M. J., Boeren, R. G. B., et al. (1995a). Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain, 62(3), 363–372. https://doi.org/10.1016/0304-3959(94)00279-N

[31]Vlaeyen, J. W. S., Kole-Snijders, A. M. J., Rotteveel, A. M., et al. (1995b). The role of fear of movement/(re)injury in pain disability. Journal of Occupational Rehabilitation, 5(4), 235–252. https://doi.org/10.1007/BF02109988

[32]Wolters, C., Gerlach, A. L., & Pohl, A. (2022). Interoceptive accuracy and bias in somatic symptom disorder, illness anxiety disorder, and functional syndromes: A systematic review and meta-analysis. PLoS One, 17(8), e0271717. https://doi.org/10.1371/journal.pone.0271717

[33]Wood, L., Bejarano, G., Csiernik, B., et al. (2023). Pain catastrophising and kinesiophobia mediate pain and physical function improvements with Pilates exercise in chronic low back pain: A mediation analysis of a randomised controlled trial. Journal of Physiotherapy, 69(3), 168–174. https://doi.org/10.1016/j.jphys.2023.05.008

[34]Wu, Y., Li, X., Ji, X., et al. (2025). Trends in the epidemiology of anxiety disorders from 1990 to 2021: A global, regional, and national analysis with a focus on the sociodemographic index. Journal of Affective Disorders, 373, 166–174. https://doi.org/10.1016/j.jad.2024.12.086

[35]Yang, X., Fang, Y., Chen, H., et al. (2021). Global, regional and national burden of anxiety disorders from 1990 to 2019: Results from the Global Burden of Disease Study 2019. Epidemiology and Psychiatric Sciences, 30, e36. https://doi.org/10.1017/S2045796021000275

[36]Yoshihara, K., Tanabe, H. C., Kawamichi, H., et al. (2016). Neural correlates of fear-induced sympathetic response associated with the peripheral temperature change rate. NeuroImage, 134, 522–531. https://doi.org/10.1016/j.neuroimage.2016.04.040

[37]Zale, E. L., & Ditre, J. W. (2015). Pain-related fear, disability, and the fear-avoidance model of chronic pain. Current Opinion in Psychology, 5, 24–30. https://doi.org/10.1016/j.copsyc.2015.03.014

[38]Zhuo, M. (2016). Neural mechanisms underlying anxiety–chronic pain interactions. Trends in Neurosciences, 39(3), 136–145. https://doi.org/10.1016/j.tins.2016.01.006

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