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Journal of Pediatric Psychology Advance Access published online on May 22, 2006
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsj112
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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
Received September 2, 2005
Revised January 8, 2006
Accepted March 7, 2006

Article

Pediatric Asthma Morbidity: The Importance of Symptom Perception and Family Response to Symptoms

Elizabeth L. McQuaid PhD 1 *, Daphne Koinis Mitchell PhD 1, Natalie Walders PhD 2, Jack H. Nassau PhD 1, Sheryl J. Kopel MSC 1, Robert B. Klein MD 1, Marianne Z. Wamboldt MD 2, and Gregory K. Fritz MD 3

1 Brown Medical School
2 University of Colorado Health Sciences Center
3 Brown Medical School; University of Colorado Health Sciences Center

* To whom correspondence should be addressed.
Elizabeth L. McQuaid, E-mail: emcquaid{at}lifespan.org


  Abstract

Objective To determine whether family response to asthma symptoms mediates the relationship between child symptom perception and morbidity. Methods A total of 122 children with asthma, aged between 7 and 17 years (47% females; 25% ethnic minorities), were recruited from three sites. Participants completed a family asthma management interview and 5-6 weeks of symptom perception assessment. Results Family response to symptoms mediated the relationship between child underestimation of symptoms and asthma morbidity and partially mediated the relationship between accurate symptom perception and morbidity. In contrast, although child overestimation of symptoms and family response to symptoms were independently related to asthma morbidity, a mediational model was not supported. Conclusions Our study found support for the role of family response to symptoms in mediating the relationship between child symptom perception and morbidity, particularly with regard to underestimation of symptoms, underscoring the need for behavioral tools to accurately recognize and optimally respond to exacerbations.

Keywords: asthma; family; morbidity.
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