Integrated behavioral health care for management of stress in allergic diseases

Oland, Alyssa A.; Booster, Genery D.; Bender, Bruce G.

doi:10.1016/j.anai.2018.05.002

Cited by 11 publications

(5 citation statements)

References 55 publications

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“…There is a great body evidence of stress/stress events on onset or aggravation allergic diseases [ 9 , 26 ], so management interventions are focused on individual, family, school, medical provider, et al [ 46 , 47 ]. However, few studies explore the relationship between stress management skills and allergic diseases.…”

Section: Discussionmentioning

confidence: 99%

Association of stress management skills and stressful life events with allergy risk: a case-control study in southern China

Cheng

Lai

et al. 2021

BMC Public Health

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Background Psychosocial stress and stressful life events are known to aggravate allergic diseases. Less is known about the impact of stress management skills on allergies. Here we sought to determine whether stress management skills are associated with the allergies and to assess the combined effects of stress management skills and stressful events on allergy risk. Methods A survey on risk factors for self-reported allergic diseases was carried out among 28,144 southern Chinese people; 14 stressful life events and 8 stress management skills were retrospectively recorded in a case-control setting with multivariate logistic regression analysis. Multiplicative and additive interactions between stressful events and stress management skills were evaluated. Results Stressful events significantly increased allergy risk. The odds ratio (OR) for allergies was 1.65 (95% confidence interval CI, 1.41–1.93) for those reporting one or two stressful events and 3.10 (95% CI, 2.55–3.79) for those reporting more than three stressful events compared to participants without stressful events. Stress management skills were adversely associated with allergic risk for people experiencing stressful events (OR, 0.71; 95% CI, 0.53–0.97) when adjusted demographically, particularly “concentrate on pleasant thoughts at bedtime” (OR, 0.67; 95% CI, 0.51–0.89), “pace myself to prevent tiredness” (OR, 0.67; 95% CI, 0.54–0.83), “get enough sleep” (OR, 0.48; 95% CI, 0.32–0.72) and “take some time for relaxation each day” (OR, 0.55; 95% CI, 0.37–0.80). But in people without stressful events, no association was observed. There was a significant linear trend for allergy risk from good stress management skills with no stressful events to poor stress management skills with stressful events (P < 0.001), with significant interaction in additive models (P = 0.006). Conclusions There are independent and antagonistic combined associations of stressful life events and stress management skills with allergy risk. The data supports the use of stress management skills in managing allergic disease among people with stressful life events.

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Section: Discussionmentioning

confidence: 99%

Association of stress management skills and stressful life events with allergy risk: a case-control study in southern China

Cheng

Lai

et al. 2021

BMC Public Health

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“…If a future clinical validation study establishes an association between low WAFA scores and clinical characteristics that suggest poor allergy management, the WAFA may demonstrate clinical utility as a screener for poor adherence to an allergy management plan. As FA healthcare providers are calling for integrated behavioral health services in allergy clinics (Oland, Booster, & Bender, 2018), there is a concomitant increasing call for allergy-specific measures (Birdi, Cooke, & Knibb, 2016;Lieberman & Sicherer, 2011) to improve detection of relevant targets for treatment.…”

Section: Discussionmentioning

confidence: 99%

Assessing Parental Anxiety in Pediatric Food Allergy: Development of the Worry About Food Allergy Questionnaire

Poehacker

McLaughlin

Humiston

et al. 2020

J Clin Psychol Med Settings

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Food allergies (FAs) in children are increasingly common, and strict allergen avoidance and safety concerns place parents at risk for anxiety (Lau et al. in Pediatr Allergy Immunol 25:236-242, 2014). Assessing parental anxiety with generic instruments may not capture the unique experience of parents managing children's FAs. This study developed and preliminarily validated the 13-item Worry About Food Allergy (WAFA) questionnaire, a measure of FA-specific parental anxiety, in an online sample of 265 parents aged 22-66 (M = 40.25) of children with FAs. The WAFA showed good internal reliability (Cronbach's α = .89) and moderate convergent validity with other anxiety measures, indicating support for a reliable measure of a discrete, specific construct. Exploratory factor analysis indicated a single factor structure. Criterion validity was established through significant, small, positive correlations with relevant allergy variables. A coherent single factor measure, the WAFA, shows promise as a screening tool for parental anxiety in pediatric practice and FA management. Keywords Parental anxiety • Pediatric food allergy • Assessment • Measure developmentRecent prevalence rates for pediatric food allergy (FA) are estimated to be approximately 9% (Gupta et al., 2017), with 38.7% of children having a history of severe reactions (Gupta et al., 2011). Food allergy reactions can be life-threatening: In the US, every three minutes someone is sent to the emergency room due to a food allergy reaction (Clark, Espinola, Rudders, Banerji, & Camargo, 2011). The current management strategy for childhood food allergy is strict avoidance of the allergen, monitoring for cross contamination, carrying an epinephrine auto-injector, and yearly visits to the child's physician (Longo, Berti, Burks, Krauss, & Barbi, 2013). Although there is increasing focus on development of novel therapies such as allergen immunotherapy, which involves repeated exposure to increasing doses of the antigen (Burks, Laubach, & Jones, 2008), a recent analysis indicated risk for adverse reactions (Nurmatov et al., 2017), and long-term effects remain uncertain. As such, current practice in FA management generally remains focused on strict avoidance and preparation for a reaction.

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“…Psychologic disturbances are associated with greater abdominal pain severity and predict worse outcomes and persistence into adulthood [ 48 , 49 , 50 ]. In addition, asthma, allergic rhinitis, atopic dermatitis, and food allergy are associated with increased stress, changes in mood, and emotional dysfunction [ 51 , 52 ]. Psychologic functioning interacts with biologic functioning (in a bi-directional fashion) particularly with the immunologic system; anxiety and depression have been associated with increased mast cell and/or eosinophil density in youth and adults with FAPDs [ 41 , 53 , 54 , 55 ].…”

Section: Inflammation and The Biopsychosocial Modelmentioning

confidence: 99%

“…Anxiety/stress and depression may be important therapeutic targets as both FAPDs and allergies are associated with psychologic dysfunction, triggering symptoms. Treatment of stress has been shown to benefit allergic conditions and in children with FD in association with duodenal eosinophilia [ 52 , 115 ].…”

Section: Managementmentioning

confidence: 99%

Update on the Role of Allergy in Pediatric Functional Abdominal Pain Disorders: A Clinical Perspective

2021

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Both functional abdominal pain disorders (FAPDs) and food allergies are relatively common in children and adolescents, and most studies report an association between FAPDs and allergic conditions. FAPDs share pathophysiologic processes with allergies, including both immune and psychological processes interacting with the microbiome. No conclusive data are implicating IgE-mediated reactions to foods in FAPDs; however, there may be patients who have IgE reactions localized to the gastrointestinal mucosa without systemic symptoms that are not identified by common tests. In FAPDs, the data appears stronger for aeroallergens than for foods. It also remains possible that food antigens initiate an IgG reaction that promotes mast cell activation. If a food allergen is identified, the management involves eliminating the specific food from the diet. In the absence of systemic allergic symptoms or oral allergy syndrome, it appears unlikely that allergic triggers for FAPDs can be reliably identified by standard testing. Medications used to blunt allergic reactions or symptomatically treat allergic reactions may be useful in FAPDs. The purpose of the current manuscript is to review the current literature regarding the role of allergy in FAPDs from a clinical perspective, including how allergy may fit in the current model of FAPDs.

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Integrated behavioral health care for management of stress in allergic diseases

Cited by 11 publications

References 55 publications

Association of stress management skills and stressful life events with allergy risk: a case-control study in southern China

Association of stress management skills and stressful life events with allergy risk: a case-control study in southern China

Assessing Parental Anxiety in Pediatric Food Allergy: Development of the Worry About Food Allergy Questionnaire

Update on the Role of Allergy in Pediatric Functional Abdominal Pain Disorders: A Clinical Perspective

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