A Preliminary Comparison of Rapidly Remitting and Persistently “Steroid-Dependent” Asthmatic Children

Five symptom categories have previously been identified which described the subjective symptoms experienced during asthma attacks: These include 2 mood symptom categories, panic-fear and irritability, describing affective states concomitant with asthma; 2 somatic symptom categories, hyperventilation-hypocapnia and airway obstruction, describing reports of more specific bodily symptoms; and fatigue, describing the reduced energy level accompanying asthma attacks. In this study, 15 patterns of asthma symptomatology based on reported frequency of the 5 symptom categories during asthma attacks were identified within a group of 100 inpatients with asthma. The relationships between scores on the individual symptom categories within patterns showed that hyperventilation-hypocapnia symptoms were associated with generally high levels of the mood symptom categories, but not clearly related to the reported frequency of airway obstruction symptoms; high fatigue symptom scores accompanied both high mood symptom and airway obstruction symptom category scores; and high airway obstruction scores were not necessarily associated with high scores on the mood symptom categories. Patients who showed patterns with high mood symptom scores were prescribed higher steroid regimens upon discharge. Alternative explanations for the latter finding are discussed in some detail.

Section: Sementioning

confidence: 58%

Observations on Patterns of Subjective Symptomatology of Acute Asthma

Kinsman

Spector

Shucard

et al. 1974

“…In our view, such complex patterning of subjective symptomatology during asthma is highly probable. Considering the importance of the work of Purcell (21,22) and Block and Jennings (23,24) in defining subgroups within the asthma population, more specific delineation of subjective symptom typologies in asthma may provide important information concerning such aspects as the role of emotions in asthma and response to treatment.…”

Section: Subjective Symptomatology Of Asthmamentioning

confidence: 99%

Multidimensional Analysis of the Subjective Symptomatology of Asthma

Kinsman

Luparello

O'Banion

et al. 1973

212

107

Characteristics of the subjective symptomatology of asthma were explored within a group of 100 asthma inpatients. Patients rated the relative frequency with which 77 symptom adjectives were associated with asthma attacks. Key cluster analysis of the full set of 77 adjectives identified 5 symptom clusters: Two Mood clusters, Panic-Fear and Irritability, describe affective states concomitant with asthma, while two Somatic clusters, Hyperventilation-Hypocapnia and Bronchoconstriction, describe reports of more specific bodily symptoms. The fifth symptom cluster, Fatigue, describes the reduced energy level accompanying acute asthma. For the Mood symptom clusters, an increase in Panic-Fear and Irritability was reported to occur frequently by 42% and 34% of the patients respectively. For the Somatic symptom clusters, 9% and 91% of the patients reported the frequent occurrence of Hyperventilation-Hypocapnia and Bronchoconstriction symptoms. Seventy-eight percent (78%) reported the frequent occurrence of Fatigue. Reports of Bronchoconstriction were almost independent of the Mood clusters, Panic-Fear (r = 0.20) and Irritability (r = 0.18), although associated with increased reports of Fatigue (r = 0.43). In contrast, Hyperventilation-Hypocapnia was more highly related to both reports of Panic-Fear (r = 0.38) and Irritability (r = 0.39) during acute asthma episodes. This study suggests that complex patterning of subjective symptomatology is common in asthma. Symptom patterns described across each of the 5 symptom clusters may help to define coping styles related to the role of emotions in asthma and the course of illness.Clinical descriptions of asthma only occasionally describe the subjective symptomatology associated •with episodes of bronchoconstriction, although dyspnea, syncope, fear, depression, and fatigue have been reported (1-4). While the importance of subjective symptoms for

“…The hypothesis about the role and importance of some kind of intervening somatic variable such as immunological sensitivity or allergic potential is reinforced by a study by Purcell et al, 9 who compared asthmatic children whose symptoms showed relatively rapid remission after admission to a hospital for asthmatic children with children whose symptoms showed little abatement following hospitalization and who continued to be dependent upon steroid treatment. These results have been interpreted by the authors, using independent psychological measures, as supportive of the hypothesis that "the asthmatic syndrome functions as a psychogenic symptom more often among the rapidly remitting than among the steroid dependent children."…”

mentioning

confidence: 99%

Interaction Between Allergic Potential and Psychopathology in Childhood Asthma

Block

Jennings

Harvey

et al. 1964

A sample of 62 asthmatic children was divided into two subgroups on the basis of scores on the Allergic Potential Scale (APS)-an index of somatic or constitutional predisposition to allergy. The subgroups were compared, together with the associated mothers, on a variety of independent psychological tests and standardized interactional situations. The hypothesis that psychopathological factors would be observed significantly more often in the children identified by low APS scores, and their mothers, was supported. It was shown that the two groups were comparable with respect to the degree of severity of asthma and socioeconomic level. The results attest to the fruitfulness of seeking subgroups and suggest that a differentiated approach to asthma reconciles some findings in the literature which otherwise appear to be contradictory. The APS may prove useful, not only in other research, but as a guide for differential treatment of asthmatic children.I H E SUPPOSITION of homogeneity within subject samples is pervasive in psychology. It influences methodological decisions and it underlies many statistical techniques on which the researcher is dependent in the analysis of his data.