Psychosocial stress and asthma morbidity

Abstract

Purpose of review The objective of this review is to provide an overview and discussion of recent epidemiologic and mechanistic studies of stress in relation to asthma incidence and morbidity. Recent findings Recent findings suggest that stress, whether at the individual- (i.e., epigenetics, perceived stress), family- (i.e., prenatal maternal stress, early life exposure or intimate partner violence) or community- (i.e.., neighborhood violence; neighborhood disadvantage) level influences asthma and asthma morbidity. Key recent findings regarding how psychosocial stress may influence asthma through Post Traumatic Stress Disorder (PTSD), pre-and post-natal maternal/caregiver stress, and community violence and deprivation are highlighted. Summary New research illustrates the need to further examine, characterize and address the influence of social and environmental factors (i.e., psychological stress) on asthma. Further research and innovative methodologies are needed to characterize the relationship and pathways associated with stress at multiple levels to more fully understand and address asthma morbidity, and to design potential interventions, especially to address persistent disparities in asthma in ethnic minorities and economically disadvantaged communities.

The Influence of Community Violence and Protective Factors on Asthma Morbidity and Healthcare Utilization in High-Risk Children

“…9 Research consistently suggests a complex interplay between individual (e.g., genetic predisposition), family (e.g., parental smoking, socioeconomic status, and maternal stress), and environmental risk factors (e.g., allergen exposure), which undermine asthma management and exacerbate vulnerability to poor outcomes. [10][11][12][13][14][15][16] Community violence, which may range from perceived threats to direct victimization, is one stressor that has an especially robust connection to asthma morbidity, as it is proposed to precipitate asthma exacerbations and result in increased healthcare utilization. 17,18 In a prospective study, adults with asthma who were exposed to violence had 92 times more asthma-related ED visits and 92 times more hospitalizations compared with adults without community violence exposure.…”

ADCYAP1R1 and Asthma in Puerto Rican Children

“…For example, Puerto Ricans were more likely to report symptoms of post-traumatic stress disorder (PTSD) or to have a perievent panic attack after the attacks of September 11, 2001 than members of other ethnic groups (9). PTSD and psychosocial stress have been associated with increased asthma morbidity (11), and we previously showed that physical or sexual abuse (a traumatic event) is associated with increased asthma morbidity in Puerto Rican children of school age living in San Juan, Puerto Rico (4). The biologic mechanisms linking exposure to violence or psychosocial stress and asthma are largely unknown (11).…”

“…PTSD and psychosocial stress have been associated with increased asthma morbidity (11), and we previously showed that physical or sexual abuse (a traumatic event) is associated with increased asthma morbidity in Puerto Rican children of school age living in San Juan, Puerto Rico (4). The biologic mechanisms linking exposure to violence or psychosocial stress and asthma are largely unknown (11).…”

Paediatrics in Barcelona

“…In recent years, several studies have provided valuable insights into the relationship between psychosocial factors and asthma morbidity [150]. HAVLAND et al [151] investigated the association between maternal anxiety and offspring asthma in a ''children of twin''-design study.…”