The increase in food allergies among US children has led to greater awareness of the psychological impact on their families. A variety of negative effects can result from both the daily strain of food-allergy management and the constant vigilance and fear that this condition engenders. Most of these effects are normal and expected responses to having a child with a demanding condition filled with uncertainties. However, a small but substantial proportion of families living with childhood food allergy experience significant psychological distress and/or maladaptive coping responses that interfere with the child's psychological and social development and family members' optimal functioning. Health care providers must be aware of the psychological challenges these families face, understand their role in helping families to achieve positive adaptation, and know when to encourage families to seek psychoeducational guidance.

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 patterns of adaptation to FA across families and to identify typologies of families that would benefit from intervention. Methods Participants included 57 children, 6 to 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. Conclusion 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.

Preliminary analyses support Food Allergy Management and Adaptation Scale validity as a measure of family adaptation to pediatric FA.

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