This proposal is for an ADAMHA Research Scientist Development Award - Level I to study the process of emotional regulation in a sample of young children who have experienced severe early life stress. The RSDA would provide me the opportunity to obtain specific research training that is critical for the implementation of the described systematic research program to study serious emotional disturbances in chronically ill children. The specific stressful stimuli that will be studied are severe asthma (an illness characterized by repeated reversible frightening attacks of the inability to breathe) and early multiple hospitalizations. The initial goal is to document specific problems in emotional regulation in young severely asthmatic children (36 to 72 months of age) who have experienced repeated hospitalizations. An experimental paradigm will be used to elicit parent-child interactions that are coded using a sequential scoring system that highlights the affective content of parent and child responses. A severely asthmatic outpatient sample will be studied to examine the effects of severe asthmatic symptoms without the confound of early hospitalization. A sample of children with corrected congenital cardiac abnormalities will also be studied to examine the effects of early hospitalizations without chronic disability or sudden severe respiratory attacks. A third sample of healthy children matched for age, sex, and socioeconomic status will be studied to better understand the processes of early emotional regulation in normal children and to provide a contrast to the clinical samples. Finally, a prospective study is planned to examine the relative effects of genetic, physiologic, allergic, and emotional influences on children at risk for asthma and will investigate the relationship between emotional regulation and prognosis in children who develop the illness.
