The overall goal of this study is to further our understanding of the manner in which emotional processes contribute to asthmatic symptoms in subgroups of asthmatics. The first purpose is to define the psychological characteristics of young children with asthma in relation to the severity of the illness and the presence versus absence of allergy. Evidence suggests that psychopathology may play a greater role for nonallergic asthmatics than for those who have allergies. The second purpose of this study is to define certain autonomic characteristics of these asthmatic children. Disregulation of the autonomic nervous system has been proposed as a mechanism involved in nonallergic asthma. The end result should be an increased understanding of the differences between subgroups of asthmatics leading to more differentiated intervention. When emotional contributions are identified, treatment would address the psychological component with a clearer idea of what factors are involved and how they impact the asthma. The study will identify a group of 96 6-year-old children with asthma ranging in severity from extremely mild to severe, and a control group of 24 nonasthmatic children. Study groups will be formed by categorizing the children along the two dimensions of severity of asthma and presence of allergies. The children will undergo bronchial inhalation tests to determine their level of bronchial reactivity, and skin testing to determine whether or not they are allergic. An assessment will be made of the children's emotional adjustment. A semi-structured child interview will be used to evaluate emotional and behavioral adjustment. Maternal report of child disturbance will be assessed using a behavior problem checklist. Mothers will also complete temperament questionnaires. In addition, affect regulation and tone will be assessed since empirical data and clinical experience indicate that young asthmatic children with emotional triggering are affectively negative and emotionally disregulated. The affective scales to be used were developed in this laboratory and utilized in piloting this project. Finally, a parameter of the autonomic nervous system, cardiac vagal tone, will be assessed to determine whether autonomic disregulation is associated with nonallergic asthma and with emotional contributions to asthma.
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| Mrazek, D A; Mrazek, P; Klinnert, M (1995) Clinical assessment of parenting. J Am Acad Child Adolesc Psychiatry 34:272-82 |
| Klinnert, M D; Mrazek, P J; Mrazek, D A (1994) Early asthma onset: the interaction between family stressors and adaptive parenting. Psychiatry 57:51-61 |
