Severely negative life events increase the risk of children's asthma attacks over the coming few weeks. This risk is magnified and brought forward in time if the child's life situation is also characterised by multiple chronic stressors.

Background: A recent prospective study of children with asthma employing a within subject, over time analysis using dynamic logistic regression showed that severely negative life events significantly increased the risk of an acute exacerbation during the subsequent 6 week period. The timing of the maximum risk depended on the degree of chronic psychosocial stress also present. A hierarchical Cox regression analysis was undertaken to examine whether there were any immediate effects of negative life events in children without a background of high chronic stress. Methods: Sixty children with verified chronic asthma were followed prospectively for 18 months with continuous monitoring of asthma by daily symptom diaries and peak flow measurements, accompanied by repeated interview assessments of life events. The key outcome measures were asthma exacerbations and severely negative life events. Results: An immediate effect evident within the first 2 days following a severely negative life event increased the risk of a new asthma attack by a factor of 4.69 (p = 0.00). In the period 3-10 days after a severe event there was no increased risk of an asthma attack (p = 0.5). In addition to the immediate effect, an increased risk of 1.81 was found 5-7 weeks after a severe event (p = 0.002). This is consistent with earlier findings. There was a statistically significant variation due to unobserved factors in the incidence of asthma attacks between the children. Conclusion: The use of statistical methods capable of investigating short time lags showed that stressful life events significantly increase the risk of a new asthma attack immediately after the event; a more delayed increase in risk was also evident 5-7 weeks later.

and Adolescent P y h i a try, Institirte of P{ychiatry, I/nhersi/_y of LondonConcern has often been expressed over the possibility of ethnic o r racial bias in teachers' assessment of children's behaviour problems. In this paper we present t w o studies that address this issue directly b y looking at the relationship between teachers' subjective ratings of hyperactivity and more objective measures of activity and inattention in groups of 'Asian" and 'Ilnglish' primary schoolchildren. In Study 1, teachers' questionnaire and interview ratings of hyperacti\ 'it ' 1 7 werc compared with mechanical and observational measures of activity and inattention taken during a testing session for groups of 'Asian' persistently hyperactive bovs and nonhyperactive controls and their 'English' classmates. Although '.Asian' hyperactives were rated by teachers as being as deviant as 'English' hyperactives, in actuality they were no more active and inattentive than the 'English' control children o n the majority of objective measures. In Study 2, groups of 'Asian' and 'Rnglish' boys, matched o n a number of variables, including ratings of hyperactivity, were observed in a classroom situation. .A standard observational measure of classroom hyperactivity was used. As in Study 1, 'Asian' and 'English' children who were rated equally hyperactive differed in terms of actual hyperactivc behaviour. 'jlsian' children displayed fewer hyperactive behaviours than their 'linglish' classmates. h number o f possible explanations for these results are suggested and their implications for the use of rating scales in a multicultural context arc discussed.