Psychopathology and Asthma in Urban Children

University Of Massachusetts Boston, Dorchester MA

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Linked publications & trials

Abstract

Asthma is the most common chronic illness among children in the United States, and it disproportionately affects poor and minority children living in inner-city environments. There is considerable evidence that children with asthma are at greater risks for problems in psychosocial development when compared to their healthy peers, population norms, and/or children with some other chronic illness. Specifically, studies have revealed elevated levels of depression, functional impairment (e.g., frequent school absences, activity restrictions). The proposed Children's Health in Context (CHIC) Project will examine co-morbid psychopathology and asthma in a sample consisting of minority children from low socioeconomic backgrounds. Participants will be recruited from urban community health centers. Interview assessments will be conducted of 110-8-10 year-old children who have been diagnosed with asthma, as well as their primary and secondary care givers. Questionnaire data will also be collected from children's teachers and health care providers. Participants will be assessed at two points separated by approximately one year. The study will utilize hierarchical multiple regression analyses and structural equation modeling to test a hypothetical model that incorporates several dimensions of children's ecological contexts, including family stresses, family resources, and the quality of connections between the family and child, between the secondary family/child, between the family and health care provider, and between the family and teacher. It is proposed that these aspects of children's social contexts influence their ability to successfully manage asthma symptoms. Successful symptom management is crucial in order for children to participate in developmentally important activities and enjoy healthy psychosocial adjustment. Ineffective asthma symptom management directly and indirectly increases children's risk for psychopathology, with indirect effects occurring through greater functional impairment (e.g., activity restriction, school absences). The results of the proposed study will inform the design of developmentally-and socioculturally-sensitive clinical interventions to optimize urban children's adaptive asthma symptom management and psychosocial well being.