1. Emotional Intelligence and Health Related Quality of Life Outcomes in Children
with Sickle Cell Anemia
Leeza Ali, Principal Investigator
Dr. Pashankar and Dr. Kristi Lockhart: Primary Advisers
Yale University

2. Road Map
 Background:
 Defining Emotional Intelligence
 How EI mediates mental and physical health
 Methods
 Results
 Data Analysis: A Visual Representation
 Future Directions

3. Background – Defining Emotional Intelligence
 Emotional Intelligence:
 How individuals recognize, and regulate emotions in the self in others – coined by Peter Salovey
Trait vs. Ability EI – Self-reported perception of EI vs. ability based tests
 Problems with EI: situational and cultural factors, real EI or ability to conform to social norms?

4. Emotional Intelligence and Health
Strong Empirical Evidence
 Analyses – 105 effect sizes and 20,000
Participants – EI is associated with mental,
Physical, and psycosomatic health
(Martins, 2010; Schutte, 2007).
Problem: Correlation vs. Causation
 Ill children never have the opportunity
to develop intepersonal skills and emotion
Related abilities? (Taylor, 2011)

5. Theoretical Frameworks Explaining EI’s
Impact on Health
1. Adolescent human brains are especially sensitive to
the effects of elevated levels of glucocorticoids
and the heightening of the HPA reactivity induced
by high stress levels (2009). Thus, managing stress
Effectively is crucial and EI may mediate this process.
2. Changes in physiological responses to stress:
Higher EI  attenuated cortisol secretion in
response to repeated stressors (Salovey).
3. Higher EI leads to higher levels of positive affect –
can better repair negative mood states, can better maximize impact of positive environmental cues. Broad-
and-build theory: high PA broadens thought-action repertoire and builds personal, social, and psychological
resources (Fredrickson, 2001).
4. Excess corticotrophin-releasing hormone and increased anxiety in anticipation for a stressful event
contribute to “allostatic load”: the wear on tissues and an acceleration of pathophysiology arising from the
body’s attempts to adapt to stress (Schulkin, 1998)

6. The Role of EI in Children with Chronic
Illness
 Cognitive decline with cranial irradiation targeted chemotherapy (Kreitler & Arush, 2004).
 higher EI contributes to better health outcomes in cancer patients (Smith et al., 2012). However, the role of EI in sickle cell
patients has never, to our knowledge, been explored.
 Unlike pediatric cancer patients that display psychological hardiness and emotional resillience (Noll et al., 1999), sickle cell
patients show poor psychosocial adjustment in response to the stress of their chronic illness (Hurtig & White, 1986).
 sickle cell disease is associated with high incidence of neurological events and poor neuropsychological outcomes, including
deficits in cognitive ability and academic performance (Berkelhammer et al., 2007).
 Children growing up in a chronically stressful family environment may actually develop exaggerated sympathetic reactivity to
stressors and amplified cortosol response to stressors (Taylor, 2011).
 Exposure to chronic stress early in may cause developing stress systems to become dysregulated, such that neuroendocrine
stress responses become dysfunctional (Taylor, 2011), producing problematic physical and psychosocial outcomes.

7. Method
Participants: 30 patients ages 8-20 diagnosed with SCD. Each patient takes 1 EI survey, the
PedsQL4.0, and the PedsQL Sickle Cell module
The survey will be linked the MRN of participants, used to record:
 Number of pain admissions in past two years
 Total number of hospital days due to pain
 Number of ER visits due to pain
 Type of sickle cell disease,
 history of ACS, stroke, social worker survey info

8. Preliminary Findings
 Higher EQ scores have been highly correlated to:
 better physical functioning scale scores
 higher emotional functioning scale scores
 better core psychosocial health summary scores
 better school functioning scale scores.
 higher communication scores (perceived ability to communicate and express pain
accurately with doctors/caregivers)
 less pain intensity, pain interference and impact, and less worry.

9. Future Directions
EI and Empathy Study – Summer 2015
 Same patient cohort, designed with Dr. David Rand (New Yale Psychology Faculty member)
 Dr. Rand’s specialty is cooperation and empathy – what makes some patients “cooperators” who always listen to
doctors orders and what makes some patients “non-cooperators” who refuse to take medications regularly and show
up to appointments?
 We believe one mediating factor is empathy – one of the 5 core areas of EI
 The ability to recognize and understand (empathize) with one’s doctor may motivate
patients to cooperate with their orders
EI In Patients with Other Chronic Illnesses:
 Continuation of this study with larger patient cohort
 (Cancers, other life threatening diseases)
 Also incorporate a control group of HEALTHY children
for comparison data