Agreement Between Parents and Children Regarding Anxiety and Depression Diagnoses in Children With Asthma

Department of Psychiatry and Behavioral Sciences, University of Washington Seattle, Seattle, Washington, United States
The Journal of nervous and mental disease (Impact Factor: 1.69). 12/2007; 195(11):897-904. DOI: 10.1097/NMD.0b013e318159289c
Source: PubMed


This study examined parent-child agreement regarding anxiety and depressive disorders in youth with asthma and evaluated key demographic and health differences associated with parent-child agreement. Of 756 outpatient youth with asthma, 122 (16.0%) were diagnosed with a DSM-IV anxiety or depression disorder using the Diagnostic Interview Schedule for Children (C-DISC). Parents reported on internalizing symptoms using the Child Behavior Checklist (CBCL). Logistic regression analyses were used to examine factors related to parent- and child-reported symptom agreement. Low rates of agreement (48.9%) between youth and parents regarding diagnosis of a DSM-IV anxiety or depressive disorder were found among youth with asthma. Increased agreement was associated with higher externalizing behavior score on the CBCL and more anxiety and depressive symptoms on the C-DISC. Children without behavioral problems and with less severe anxiety and depression were recognized significantly less often by their parents.

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    • "This aligns with a report (Non-Hispanic Black = 75%, Hispanic = 23%) that demonstrated significant association between children's anxiety and depression and both interpersonal relationships and peer network extensiveness (Berz, 2005). Another study found that parental recognition of anxiety and depression was more frequent if children who had asthma exhibited behavioral problems (Rockhill et al., 2007). "
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    ABSTRACT: A systematic review of the literature was performed to answer the following questions (a) What factors contribute to the emotional responses of school-age children who have asthma? (b) What are the potential gaps in the literature regarding the emotional responses of school-age children (ages 6-12) who have asthma? (c) Are children with a lower socioeconomic status (SES) and those who are minorities represented in the literature proportionate to their prevalence? Two main focus areas regarding emotional responses were identified: (a) factors related to children who have asthma and (b) factors related to caregivers of children who have asthma. Internalizing disorders were reported consistently for children and caregivers of children who have asthma. Negative consequences of asthma for children included panic and asthma attacks, missed school days, and behavioral problems. Issues for caregivers included higher levels of anxiety and depressive symptoms, asthma management deficits, and lower caregiver warmth and involvement. Gaps in the literature included separated studies for children ages 6-12, a lack of a standardized method to define SES, studies that were of a more experimental nature, and a disparate number of studies of minority children and caregivers relative to their asthma prevalence.
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    • "While considerable research has documented that depression symptoms are related to high levels of negative affect and low levels of positive affect [41, 42], affect measures are theorized to measure relatively stable traits, whereas depression symptoms are more likely to fluctuate over time. The use of parallel measures would have been ideal, though some researchers have argued for using related but not parallel measures in other report discrepancy researches (e.g., [10, 43]) and some have even suggested that parallel measures may be no more ideal [44]. Additionally, much report discrepancy research focuses around difference scores, making parallel measures more essential. "
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    ABSTRACT: Anxiety disorders are among the most common psychiatric disorders in children and adolescents with estimated prevalence rates of between five and ten percent. Comorbidity rates are high--in particular for further anxiety and depressive disorders. The etiology is considered to be multifactorial, with genetic, biological and temperamental factors as well as stressful life events, parental role models and parenting all playing a part. Therapeutic programs combine psychological counseling--including the family--psychotherapy and psychopharmacotherapy, as required. As psychotherapy, cognitive-behavioral interventions have proven highly effective. In severe disorders that prevent the overcoming of complex anxiety/phobias (e.g. going to school impossible), psychopharmacotherapeutic measures can be helpful, and may support, or, in individual cases even make possible, successful psychotherapy.
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