Stress, upper respiratory symptoms and the 'common cold' in children with asthma

McCann, Donna (1997) Stress, upper respiratory symptoms and the 'common cold' in children with asthma. PhD thesis, University of Glasgow.

Abstract

This study examined the relationship between life events and experiences, psychological adjustment and upper respiratory illness in 78 children, age 7-14 years, with moderate to severe asthma attending a specialist children's asthma clinic. Longterm experiences (LTEs) and acute life events (LEs), both positive and negative, were evaluated at baseline and after 9 months using an interview-based measure of psychological stress: PACE (Psychosocial Assessment of Childhood Experiences). Psychological adjustment was measured using Speilberger's State-Trait Anxiety in Children questionnaire and Harter's Self-Perception questionnaire. The occurrence and severity of upper respiratory (UR) symptoms were recorded daily by the parent using a specially designed symptom diary. At times of increased UR symptoms parents contacted the researcher who arranged to collect a throat swab for subsequent viral analysis. A mean of 2 upper respiratory infections (URIs) per subject was recorded over the study period with a mean of 1.7 UR symptoms per day on 27% of study days. Girls, age 9-11 years, were at increased risk of reporting higher levels of URI (p<0.05). Children in lower social class groups were at increased risk of reporting higher levels of high negative LTEs (p<0.05) and lower levels of positive LTEs (p<0.001) compared to those in higher groups. High threat LTEs were negatively related to symptom measures in boys (r=0.37, p<0.05), with positive LTEs apparently playing a protective role. Those with high mean UR symptoms were at increased risk of reporting a higher number of high threat LTEs compared to those with low (p<0.05) or moderate UR symptoms (p<0.05) Self-perception scores were significantly higher in children with asthma compared to a normative Scottish sample of schoolchildren. Reported mean UR symptom levels were negatively correlated with self-perception scores but not anxiety measures. Boys reporting high mean UR symptoms perceived themselves as less well-behaved and had a lower sense of their own global self-worth compared to those with low UR symptom levels but after controlling for high threat LTEs (mean duration 40.9 months), this relationship disappeared. Girls, particularly those aged 9-11 years, were at increased risk of reporting acute high threat LEs in the 6-week period before the start of a URI. These findings show that high chronic stress levels are related to UR symptoms in boys with asthma, a relationship that might be moderated by self-esteem and mediated by inappropriate behaviours such as non-compliance with medication. In contrast, girls were at increased risk of URI or cold after the occurrence of an acute high threat life event.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: R Medicine > R Medicine (General); R Medicine > RJ Pediatrics
• Colleges/Schools: College of Medical Veterinary and Life Sciences
• Supervisor's Name: Paton, Prof. James and Dimigen, Dr. Gisela
• Date of Award: 1997
• Depositing User: Enlighten Team
• Unique ID: glathesis:1997-39017
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 18 Dec 2018 15:26
• Last Modified: 17 Oct 2022 10:13
• Thesis DOI: 10.5525/gla.thesis.39017
• URI: https://theses.gla.ac.uk/id/eprint/39017

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