This pilot study investigates the effects of specific family processes on the psychosocial adjustment and medical treatment response of 60 adolescents hospitalized with severe asthma. A cross-sectional, multiple agent, multiple method, within subjects research strategy with carefully chosen state-of-the-art measures will be used to accomplish four specific aims. First, data gathered will help to clarify important measurement issues concerning adolescent psychosocial adjustment, family processes and medical treatment outcome in severely ill asthmatics. Second, the established prior findings of high rates of psychosocial problems in severely ill asthmatics and of poorer response to standard medical treatment in those adolescents with greater psychosocial problems will be replicated and extended, particularly through the gathering of reliable and valid DSM-III/R psychiatric diagnoses. Third, this study will capitalize on recent advances in the conceptualization and measurement of family processes to examine the extent to which and the mechanism whereby specific family process variables, identified through a thorough review of the existing literature, can be shown to directly and indirectly (through influences on adolescent psychosocial adjustment) determine the adolescent asthmatic's medical treatment response. Fourth, the multivariate data collected will permit an examination of whether different family factors appear to influence medical and psychosocial outcome in different subgroups of asthmatic adolescents. This study is the initial effort of a research program being developed to identify specific family processes that influence the health care practices, medical outcomes, and psychosocial adjustment of children and adolescents with chronic medical illnesses. The long term goal of this research program is to develop novel, empirically-based individual and family interventions that improve the medical treatment response and prevent psychosocial impairments in young people afflicted with serious medical problems.
