Self-Evaluation, Coping, and Depressive Affect in African American Adults with Sickle Cell Disease

Selective evaluation theory suggests that when individuals are faced with a threat such as a chronic illness they may compare themselves to less fortunate others, worse times, or hypothetical worse worlds to help cope with the threat. Research testing this model has demonstrated that these downward comparisons are associated with better psychological functioning. Although the assumption that upward comparisons are associated with poorer psychological functioning is implicitly stated in the selective evaluation theory, systematic research has not been conducted to test this hypothesis. To examine this question and to extend the generalizability of the selective evaluation theory, patients with sickle cell disease were asked to rate the frequency of use of both downward and upward comparisons when they have sickle cell disease pain and to rate their level of depressive affect. The results demonstrated that self-evaluation style accounts for a significant amount of variance in patients' level of depressive affect over and above demographic, pain, and disease-related variables. Moreover, as predicted, upward comparison was associated with higher levels of depressive affect and downward comparison was associated with lower levels of depressive affect.