title: Do family mealtime interactions mediate the association between asthma symptoms and separation anxiety?
abstract: BACKGROUND
  Respiratory problems have been shown to be associated with the development of panic anxiety. Family members play an essential role for children to emotionally manage their symptoms. This study aimed to examine the relation between severity of respiratory symptoms in children with asthma and separation anxiety. Relying on direct observation of family interactions during a mealtime, a model is tested whereby family interactions mediate the relation between asthma severity and separation anxiety symptoms.
  
  
  METHODS
  Sixty-three children (ages 9-12 years) with persistent asthma were interviewed via the Diagnostic Interview Schedule for Children IV; family interactions were assessed via direct observation of a mealtime; primary caregivers completed the Childhood Asthma Severity Scale; youth pulmonary function was ascertained with pre- and post-bronchodilator spirometry; adherence to asthma medications was objectively tracked for six weeks.
  
  
  RESULTS
  Poorer pulmonary function and higher functional asthma severity were related to higher numbers of separation anxiety symptoms. Controlling for medication adherence, family interaction patterns mediated the relationship between poorer pulmonary function and child separation anxiety symptoms.
  
  
  CONCLUSIONS
  Family mealtime interactions may be a mechanism by which respiratory disorders are associated with separation anxiety symptoms in children, potentially through increasing the child's capacity to cognitively frame asthma symptoms as less threatening, or through increasing the child's sense of security within their family relationships.
authors.affiliation: University of Illinois at Urbana-Champaign, USA.
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Fiese
authors.forename: Marcia A
authors.initials: MA
authors.lastname: Winter
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Wamboldt
authors.forename: Ran D
authors.initials: RD
authors.lastname: Anbar
authors.forename: Marianne Z
authors.initials: MZ
authors.lastname: Wamboldt
mesh_terms: D001010:Anxiety, Separation / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D003299:Cooperative Behavior; D005190:Family / Q000523:psychology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008168:Lung / Q000503:physiopathology; D008297:Male; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D012919:Social Behavior