Symptom perception in children with asthma: cognitive and psychological factors.
OBJECTIVE
This study tested the differential effects of several cognitive and psychological variables on children's perception of asthma symptoms by use of an Asthma Risk Grid. Children's subjective and objective assessments of PEFR (peak expiratory flow rate) were characterized as representing perceptual accuracy, symptom magnification, and/or underestimation of asthma symptoms.


METHODS
The study included 270 children with asthma (ages 7-17) and their primary caregivers who completed measures assessing cognitive and psychological factors and a 5 to 6 week symptom perception assessment.


METHODS
Children's symptom perception scores by use of the Asthma Risk Grid.


RESULTS
Children's attentional abilities had more of a bearing on their symptom monitoring abilities than their IQ estimates and psychological symptoms. The more time children took on Trails and Cancellation Tasks and the fewer errors they made on these tasks, the more likely they were to perceive their asthma symptoms accurately. More time on these tasks was associated with more symptom magnification scores, and fewer errors were related to fewer symptom magnification scores. More errors and higher total scores on the Continuous Performance Task were associated with a greater proportion of scores in the danger zone.


CONCLUSIONS
Statistical support was provided for the utility of attentional-based instruments for identifying children who may have problems with perceptual accuracy, and who are at risk for asthma morbidity.
Koinis-Mitchell
Daphne
D
Bradley/Hasbro Children's Research Center, Brown Medical School, Providence, RI 02903, USA. Daphne_Koinis-Mitchell@Brown.edu
McQuaid
Elizabeth L
EL
Seifer
Ronald
R
Kopel
Sheryl J
SJ
Nassau
Jack H
JH
Klein
Robert B
RB
Feldman
Jonathan
J
Wamboldt
Marianne Z
MZ
Fritz
Gregory K
GK
D000293:Adolescent; D001249:Asthma / Q000523:psychology*; D001288:Attention; D001364:Awareness; D002648:Child; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D008960:Models, Psychological; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011594:Psychometrics; D012648:Self Care / Q000523:psychology; D012803:Sick Role; D011795:Surveys and Questionnaires