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Childhood asthma, behavior problems, and family functioning.
Calam R, Gregg L, Simpson B, Morris J, Woodcock AA, Custovic A
J Allergy Clin Immunol. 2003;112( 3):499-504.
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Abstract
BACKGROUND: Studies of families of asthmatic children indicate associations between psychological factors and asthma symptoms.OBJECTIVE: We investigated relations between psychosocial factors and thedevelopment of respiratory symptoms within a large prospective cohortstudy. METHODS: The children were prenatally assigned to high, medium, orlow risk for asthma development on the basis of parental atopy and familyhistory of allergic disease. When the children were 3 years of age,parents completed the Eyberg Child Behavior Inventory (ECBI), FamilyRelationships Index (FRI), Hospital Anxiety and Depression Scale (HAD),and General Health Questionnaire (GHQ). RESULTS: Data from 663participants were analyzed. ECBI intensity scores were significantlyhigher for children with parentally reported respiratory symptoms.Symptomatic low-risk children (both parents nonatopic, no family historyof allergic disease) were particularly likely to have elevated behaviorproblem ratings. None of the other family psychosocial variables showedthis pattern. Child behavior problems were, however, significantlypositively correlated with the other family psychosocial variables.Logistic regression indicated that behavior problem scores were associatedwith 3 or more attacks of wheeze (P =.03, OR = 1.023), irrespective ofrisk group. CONCLUSIONS: Children at 3 years of age with symptomssuggestive of asthma are at elevated risk of behavior problems. Childrenfrom families without a history of asthma and allergic diseases may beparticularly vulnerable to behavioral disturbance. Families may benefitfrom additional advice on management of their child's behavior,particularly if parents do not have the experience of having the illnessthemselves.
Keyword(s)
Child Behavior; Child, Preschool; Cohort Studies; Family Relations; Female; Humans; Male; Prospective Studies; Psychology; Questionnaires; Research Support, Non-U.S. Gov't; Risk Factors; physiopathology: Asthma; physiopathology: Respiratory Sounds