title: Are children and adolescents with food allergies at increased risk for psychopathology?
abstract: OBJECTIVE
  Living with food allergy is a unique and potentially life-threatening stressor that requires constant vigilance to food-related stimuli, but little is known about whether adolescents with food allergies are at increased risk for psychopathology-concurrently and over time.
  
  
  METHODS
  Data came from the prospective-longitudinal Great Smoky Mountains Study. Adolescents (N=1420) were recruited from the community, and interviewed up to six times between ages 10 and 16 for the purpose of the present analyses. At each assessment, adolescents and one parent were interviewed using the Child and Adolescent Psychiatric Assessment, resulting in N=5165 pairs of interviews.
  
  
  RESULTS
  Cross-sectionally, food allergies were associated with more symptoms of separation and generalized anxiety, disorder, attention deficit and hyperactivity disorder, and anorexia nervosa. Longitudinally, adolescents with food allergy experienced increases in symptoms of generalized anxiety disorder and depression from one assessment to the next. Food allergies were not, however, associated with a higher likelihood of meeting diagnostic criteria for a psychiatric disorder.
  
  
  CONCLUSIONS
  The unique constellation of adolescents' increased symptoms of psychopathology in the context of food allergy likely reflects an adaptive increase in vigilance rather than cohesive syndromes of psychopathology. Support and guidance from health care providers is needed to help adolescents with food allergies and their caregivers achieve an optimal balance between necessary vigilance and hypervigilance and unnecessary restriction.
authors.affiliation: University of North Carolina at Chapel Hill, United States. Electronic address: lilly_shanahan@unc.edu.
authors.forename: Lilly
authors.initials: L
authors.lastname: Shanahan
authors.affiliation: Developmental Epidemiology Program, Duke University Medical Center, United States; Duke Center for Eating Disorders, United States.
authors.forename: Nancy
authors.initials: N
authors.lastname: Zucker
authors.affiliation: Developmental Epidemiology Program, Duke University Medical Center, United States.
authors.forename: William E
authors.initials: WE
authors.lastname: Copeland
authors.affiliation: Developmental Epidemiology Program, Duke University Medical Center, United States.
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Costello
authors.affiliation: Developmental Epidemiology Program, Duke University Medical Center, United States.
authors.forename: Adrian
authors.initials: A
authors.lastname: Angold
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology; D002648:Child; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D011446:Prospective Studies; D011599:Psychopathology; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies
keywords: Adolescence; Anxiety; Depression; Eating disorders; Food allergy; Psychopathology; Stressors