title: Patterns of adaptation to children's food allergies.
abstract: BACKGROUND
  Families with food allergy (FA) are at risk of reduced quality of life and elevated anxiety. A moderate level of anxiety may be beneficial to sustain vigilance for food avoidance; however, excessive anxiety may increase risk for burden and maladjustment. The current study presents a framework for understanding the patterns of adaptation to FA across families and to identify typologies of families that would benefit from intervention.
  
  
  METHODS
  Participants included 57 children, 6-12 years old with documented FA, and their mothers. Families were assessed using the Food Allergy Management and Adaptation Scale. Families also completed measures of quality of life, anxiety, FA management, and psychosocial impairment.
  
  
  RESULTS
  A hierarchical cluster analysis revealed that 56 of the 57 families of food-allergic children were categorized into four groups that differed on their adequacy of family FA management, levels of anxiety, and balanced psychosocial functioning: balanced responders (n = 23; 41%), high responders (n = 25; 45%), and low responders (n = 3; 5%). The fourth group, anxious high responders (n = 5; 9%), was characterized by extremely high maternal FA anxiety scores and low scores for balanced integration of FA management and psychosocial functioning. Families in clusters differed across illness and psychosocial outcome variables.
  
  
  CONCLUSIONS
  Families with FA were characterized by patterns of FA management, anxiety, and ability to integrate FA demands into daily life. Identified adaptation patterns correspond with clinical impressions and provide a framework for identifying families in need of intervention.
authors.affiliation: University of Florida, Gainesville, FL, USA.
authors.forename: D A
authors.identifier: http://orcid.org/0000-0003-0896-910X
authors.initials: DA
authors.lastname: Fedele
authors.affiliation: Bradley/Hasbro Children's Research Center, Brown University, Providence, RI, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: McQuaid
authors.affiliation: National Jewish Health, Denver, CO, USA.
authors.forename: A
authors.initials: A
authors.lastname: Faino
authors.affiliation: National Jewish Health, Denver, CO, USA.
authors.forename: M
authors.initials: M
authors.lastname: Strand
authors.affiliation: National Jewish Health, Denver, CO, USA.
authors.forename: S
authors.initials: S
authors.lastname: Cohen
authors.affiliation: National Jewish Health, Denver, CO, USA.|University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: J
authors.initials: J
authors.lastname: Robinson
authors.affiliation: National Jewish Health, Denver, CO, USA.|University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: D
authors.initials: D
authors.lastname: Atkins
authors.affiliation: University College Cork, Ireland.
authors.forename: J O'B
authors.initials: JO
authors.lastname: Hourihane
authors.affiliation: National Jewish Health, Denver, CO, USA.|University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Klinnert
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety; D002648:Child; D016000:Cluster Analysis; D019468:Disease Management; D005190:Family / Q000523:psychology*; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D008297:Male; D011159:Population Surveillance; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: adaptation; anxiety; family; food allergy management; pediatric food allergy