Family Chaos and Asthma Control

Abstract

OBJECTIVES: Asthma is a highly prevalent childhood chronic disease, with particularly high rates among poor and minority youth. Psychosocial factors have been linked to asthma severity but remain poorly understood. This study examined (1) relationships between parent and child depression and posttraumatic stress disorder (PTSD) symptoms, family functioning, and child asthma control in a sample of urban minority youth with uncontrolled asthma and (2) family functioning as a pathway linking parent depression and asthma outcomes. METHODS: Data were drawn from the baseline cohort of a randomized trial testing community interventions for children aged 5 to 16 with uncontrolled asthma (N 5 223; mean age 5 9.37, SD 5 3.02; 85.2% Hispanic). Asthma control was defined by using the Asthma Control Test and Childhood Asthma Control Test, activity limitation, and previous-12-month asthma severity. Psychosocial measures included parent and child depression and PTSD symptoms, family chaos, and parent social support. RESULTS: Parent and child depression symptoms, but not PTSD, were associated with worse asthma control (b 5 2.20 [SE 5 0.06] and b 5 2.12 [SE 5 2.03]; P , .001). Family chaos corresponded to worse asthma control, even when controlling for parent and child depression (b 5 2.33; [SE 5 0.15]; P , .05), and was a mediator of the parent depression-asthma path. Emotional triggers of asthma also mediated the parent depression-asthma relationship. CONCLUSIONS: Findings highlight family chaos as a mechanism underlying the relationship between parent depression and child asthma control. Addressing parent and child depression, family routines, and predictability may optimize asthma outcomes.

PTSD in parents of children with severe diseases: a systematic review to face Covid-19 impact

“…In line with the previous DSM-IV indications, studies on this issue were mainly on cancer diseases and, to a lesser extent, on traumatic accidents. It has only been in the last few years that other diseases have emerged [24][25][26][27][28][29].…”

Chronic stress and asthma in adolescents

“…43,44 In a cross-sectional study of 223 primarily Hispanic children and adolescents with uncontrolled asthma, depressive symptoms in the parent and her or his child were associated with worse asthma severity or control, activity limitations, and emotional triggers of asthma. 45 Moreover, family chaos (measured by assessing commotion, disorganization, and routine in the household 46 ) was associated with worse asthma control (even after adjusting for depressive symptoms in both parent and child) and identified as a mediator of the association between parent-child depressive symptoms and worse asthma outcomes. 45 Adverse experiences in an individual's household can be highly stressful and have a long-lasting impact on an adolescent.…”

“…45 Moreover, family chaos (measured by assessing commotion, disorganization, and routine in the household 46 ) was associated with worse asthma control (even after adjusting for depressive symptoms in both parent and child) and identified as a mediator of the association between parent-child depressive symptoms and worse asthma outcomes. 45 Adverse experiences in an individual's household can be highly stressful and have a long-lasting impact on an adolescent. A crosssectional study of 6 home adverse childhood experiences (ACE) and lifetime asthma prevalence in 92,472 children and adolescents (aged 0-17 years) in the United States revealed that home ACE were significantly associated with increased odds of lifetime asthma, with a dose-response relationship going from 1 ACE (OR ¼ 1.28, 95% CI ¼ 1.12-1.43) to 4 ACE (OR ¼ 1.73, 95% CI ¼ 1.27-2.36).…”

Household chaos: a risk factor for adverse child outcomes gains attention in public health

“…Attention is more recently being given to the importance of household chaos on child health outcomes traditionally associated with health behavior research and public health. For example, greater household chaos has been independently related to poor asthma control among children and adolescents [5] and poor glycemic control among adolescents with type 1 diabetes [6]. Household chaos has also been identified as a potential obesity risk factor during infancy [7] and childhood [8].…”