Asthma and internalizing behavior problems in adolescence: a longitudinal study.
OBJECTIVE
Clinical studies of asthmatic children have found an association between lung disease and internalizing behavior problems. The causal direction of this association is, however, unclear. This article examines the nature of the relationship between behavior and asthma problems in childhood and adolescence.


METHODS
Data were analyzed on 5135 children from the Mater University Study of Pregnancy and its outcomes (MUSP), a large birth cohort of mothers and children started in Brisbane, Australia, in 1981. Lung disease was measured from maternal reports of asthma/bronchitis when the children were aged 5 and maternal reports of asthma symptoms when the children were aged 14. Symptoms of internalizing behaviors were obtained by maternal reports (Child Behavior Checklist) at 5 years and by maternal and children's reports at 14 years (Child Behavior Checklist and Youth Self Report).


RESULTS
Although there was no association between prevalence of asthma and externalizing symptoms, asthma and internalizing symptoms were significantly associated in cross-sectional analyses at 5 and 14 years. In prospective analyses, after excluding children with asthma at 5 years, internalizing symptoms at age 5 were not associated with the development of asthma symptoms at age 14. After excluding children with internalizing symptoms at 5 years, those who had asthma at 5 years had greater odds of developing internalizing symptoms at age 14.


CONCLUSIONS
Children who have asthma/bronchitis by the age of 5 are at greater risk of having internalizing behavior problems in adolescence.
Alati
Rosa
R
School of Population Health, University of Queensland, Queensland 4101, Australia. r.alati@sph.edu.au
O'Callaghan
Michael
M
Najman
Jake M
JM
Williams
Gail M
GM
Bor
William
W
Lawlor
Debbie A
DA
D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000150:complications / Q000523:psychology*; D001991:Bronchitis / Q000150:complications / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012917:Social Adjustment