Family emotional climate, depression, emotional triggering of asthma, and disease severity in pediatric asthma: examination of pathways of effect.
OBJECTIVE
(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.


METHODS
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.


CONCLUSIONS
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.
Wood
Beatrice L
BL
Woman and Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY 14222, USA. bwood@buffalo.edu
Lim
JungHa
J
Miller
Bruce D
BD
Cheah
Po Ann
PA
Simmens
Samuel
S
Stern
Trudy
T
Waxmonsky
James
J
Ballow
Mark
M
D000293:Adolescent; D000339:Affect; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D012720:Severity of Illness Index; D013315:Stress, Psychological; D011795:Surveys and Questionnaires