title: Family emotional climate, depression, emotional triggering of asthma, and disease severity in pediatric asthma: examination of pathways of effect.
abstract: 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.
authors.affiliation: Woman and Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY 14222, USA. bwood@buffalo.edu
authors.forename: Beatrice L
authors.initials: BL
authors.lastname: Wood
authors.forename: JungHa
authors.initials: J
authors.lastname: Lim
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Miller
authors.forename: Po Ann
authors.initials: PA
authors.lastname: Cheah
authors.forename: Samuel
authors.initials: S
authors.lastname: Simmens
authors.forename: Trudy
authors.initials: T
authors.lastname: Stern
authors.forename: James
authors.initials: J
authors.lastname: Waxmonsky
authors.forename: Mark
authors.initials: M
authors.lastname: Ballow
mesh_terms: 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