This study investigated the relationship between stress and pain crisis incidence in pediatric Sickle Cell Anemia (SCA). It was hypothesized that SCA children were exposed to higher levels of stress than healthy children. It was also hypothesized that a significant positive correlation existed between level of stress and pain crisis incidence both within and between years. The sample consisted of 20 Black elementary school children with SCA. There were 12 female and 8 male children. The period of investigation included the calendar years 1983 and 1984. Pain crisis incidence was determined through parent interviews and verified by a review of medical records.

One hundred persons applying for services with the Texas Rehabilitation Commission with reported disabilities of alcohol/substance abuse or back injury/pain were selected for study. Subjects were assigned to two groups (alcohol or back) according to their reported disability. They were tested within one week of application and after 60 days were checked to see what rehabilitation status they were in to determine success or failure. Alcohol clients were administered the Health Attribution Test (HAT), 16PF, and an Alcohol Imagery questionnaire developed for this study. Back clients were administered the HAT, 16PF, and Pain Drawings. Statistical procedures including Pearson correlation, stepwise discriminant analysis, and discriminant analysis were performed. The HAT Internal Factor showed a significant relationship to rehabilitation success or failure and the 16PF motivation indices approached significance. The discriminant analysis demonstrated that success or failure could be predicted at a significant level using these measures. Issues of practicality in using these instruments (particularly imagery measures) in a rehabilitation counseling practice were noted.