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Journal of Pediatric Psychology Advance Access originally published online on November 22, 2006
Journal of Pediatric Psychology 2007 32(5):542-551; doi:10.1093/jpepsy/jsl044
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Family Emotional Climate, Depression, Emotional Triggering of Asthma, and Disease Severity in Pediatric Asthma: Examination of Pathways of Effect

Beatrice L. Wood, PhD, JungHa Lim, PhD, Bruce D. Miller, MD, Po Ann Cheah, BA, Samuel Simmens, PhD, Trudy Stern, RN, MSPN, James Waxmonsky, MD and Mark Ballow, MD

Departments of Psychiatry and Pediatrics, School of Medicine and Biomedical Sciences

All correspondence concerning this article should be addressed to Beatrice L. Wood, PhD, ABPP, Woman and Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY 14222. E-mail: bwood{at}buffalo.edu.


  Abstract

Objectives (a) To assess emotional triggering of pediatric asthma and ascertain its contribution to disease morbidity and functional status; (b) to test whether negative family emotional climate (NFEQ) is associated with depressive and/or anxious symptoms and emotional triggering of asthma attacks in the child. Method Children with asthma (N = 272, 56% male, age 7–17) and their primary caregivers answered together an Asthma Trigger Inventory (Ritz, Steptoe, Bobb, Harris, & Edwards, 2006). Children reported on anxious (STAIC) and depressive (CDI) symptoms and on asthma-related quality of life (PAQLQ). Parent(s) reported on their child's internalizing (CBCL-I) and depressive symptoms (CDI-P). A clinician also rated the child's depression using the structured CDRS-R. Asthma diagnosis was confirmed and disease severity rated according to NHLBI guidelines by an asthma clinician. Results Path analyses indicated that NFEQ was associated with depressive symptoms, which in turn were associated both directly and indirectly (by way of emotional triggering) with disease severity. Comparison of nested models indicated the possibility of differential roles and pathways for anxious versus depressive symptoms. Conclusion Findings elucidate possible pathways of effect by which family emotional climate and child depressive symptoms may influence pediatric asthma disease severity by way of potentiating emotional triggering of asthma.

Key words: anxiety; depression; family; pediatric asthma; stress.

Received March 22, 2006; revision received July 27, 2006; revision received October 1, 2006; accepted October 20, 2006


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