ABSTRACT
When circumstances other than the child's asthma stress the family system, the consequences for the child, both psychologically and medically, become more severe. For instance, children with more than one physical illness (46) or physical disability (47) are more likely to develop psychopathology than children with only one such condition. In one study of 551 asthmatic children, those children with asthma and another chronic medical condition demonstrated more behavioral/psychological problems than children with asthma alone (33). Negative life events-such as frequent moves, parental job loss, or loss of a family member-increase the psychological duress for a child with a chronic illness (48,49). "Undesirable life events" were predictive of psychopathology in a study of 36 asthmatic children and played a greater role in predicting psychopathology than other factors such as illness severity (49). In another study (48), illness severity in a group of 6-to 14-year-old asthmatic children was assessed with a composite scale that included medication level, attack frequency, and missed school days. The mothers completed the CBCL, and the children reported on stressful life events they had experienced. The severely asthmatic children received significantly higher overall problem behavior scores than those with moderate asthma, and they received lower social competence scores than the rest of the children. When negative life events and illness severity were entered into a regression equation, asthma severity did not add to predictability of behavior problems over and above negative life events.
