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Association Between Asthma Symptom Scores and Increased Perceived Stress and Trait Anxiety in Asthmatic Adolescents
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Cathryn J. Luria, MD, Alexandra R. Sitarik, M.S., Suzanne Havstad, M.A., Ganesa R Wegienka, PhD, Haejin Kim, MD, Edward M. Zoratti, MD, FAAAAI, Christine L.M. Joseph, PhD, Andrea Cassidy-Bushrow, PhD
Rationale: The relationship between asthma symptoms and perceived stress and trait anxiety is not well understood.

Methods: Adolescents ages 14-17 years were recruited to examine the effect of stress on health measures. They were included in the present analysis if they reported current asthma, defined as self-reported clinician-diagnosed asthma plus one or more episodes of asthma in the past year. Asthma symptoms were assessed on a 7-point Likert scale using six asthma control questionnaire items targeting nocturnal awakening due to asthma, symptoms upon awakening, activity limitation, shortness of breath, time spent wheezing, and short-acting bronchodilator (SABA) use. Stress was measured using the perceived stress scale (PSS), and trait anxiety was measured using the State-Trait Anxiety Inventory. Linear regression was used to associate asthma symptoms with PSS and trait anxiety.

Results: Of 335 adolescents recruited, 38 (11.3%) reported current asthma. Four of the six asthma symptom assessments had significant associations with PSS: symptoms upon awakening (β=4.8, p-value<0.001), nocturnal awakening due to asthma (β=4.47, p<0.001), activity limitation (β=2.78, p=0.005), and shortness of breath (β=1.73, p=0.014). These associations remained significant after adjusting for gender, race, and BMI percentile. Time spent wheezing and SABA use were not significantly associated with PSS. Trait anxiety had significant associations with nocturnal awakening (β=9.28, p=0.002) and symptoms upon awakening (β=8.74, p=0.002).

Conclusions: Asthma symptoms are associated with increased perceived stress and trait anxiety. Asthmatic adolescents may represent a population that is particularly vulnerable to perceived stress and anxiety, highlighting the importance of considering these factors in asthma counseling.