Stressful Events Trigger Asthma Attacks in Kids

From the WebMD Archives

Sept. 18, 2000 -- Stress takes its toll on kids, too, especially asthmatic kids. According to researchers from Finland, Scotland, and the U.K., the more stress an asthmatic child is under, the more asthma attacks he or she will suffer.

"Asthma" comes from the Greek word for panting. It is a condition that affects the airways or bronchi of the lungs. When these airways are irritated, a reaction occurs, and the result is an asthma attack. Characteristics of these attacks are wheezing, coughing, and difficulty breathing. Such attacks can be caused by things the child is allergic to, irritants such as smoke or chemical fumes, exercise, illness, and even the weather.

Although pediatricians have long suspected that stress plays a role in asthma attacks, this study by Seija Sandberg and colleagues, appearing in this week's issue of the medical journal The Lancet, is the first to scientifically show that it does. Specifically, the researchers found that children with asthma are more likely to have asthma attacks when faced with highly negative life events. These attacks are even more likely in children who have a lot of chronic stress in their daily lives.

Researchers studied the incidence of severe life events and chronic stress in these children. Severe life events usually consisted of the loss of a loved one, including the death of a grandparent or the loss of either parent through separation. They also included a loss of the child's sense of security, which can be caused by the breakup of their home through divorce.

Sandberg and colleagues also detailed the incidence of chronic stress, which was considered to be any long-term psychosocial experiences with a significant negative effect on the child. These included chronic or mental illness of a close family member, marital or familial discord, inadequate living conditions, and school-related stressors (for example, being bullied daily).

When severe events occurred, children were more at risk for asthma attacks, although there was a slight delay in their occurrence. In the first two weeks that the children were faced with the stressful events, they had no increase in their risk of new attacks. But in the following two periods of two weeks, at four and six weeks following the stressful event, their risk of asthma attacks increased significantly.


Notably, in children who had a lot of chronic stress in their lives, severe events raised the risk of asthma attacks significantly and immediately.

The researchers also found that girls were more likely to have asthma attacks and that parental smoking was likely to lead to more attacks. Seasons also played a role -- attacks were more frequent during the fall and winter months, with the fewest attacks occurring in the summer.

According to Ruth A. Etzel, MD, PhD, pediatricians have intuitively accepted that specific events and stressors can trigger asthmatic attacks in children. But she tells WebMD that this study is really the first to document this, and the results are important for both pediatricians and parents.

"Although all pediatricians know that that the child's mind-set can influence the course of asthma, this study shows that when bad things happen to kids with asthma, the 'mind-upset' leads to more asthma attacks," says Etzel, who is editor of the American Academy of Pediatrics Handbook of Pediatric Environmental Health. "[The study] rings true to my experience in dealing with kids with asthma."

Parents and pediatricians should play close attention to the emotional state of children with asthma and be prepared for worse symptoms when stress occurs, Etzel concludes.

The authors concur, and close their study by stating that because most chronic stress occurs in the child's home and school, teachers, school nurses, family doctors, and pediatricians must be more sensitive to it.

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