The impact of cumulative stress on asthma outcomes among urban adolescents

Bibliographic Data

ID21443994
AuthorsSamantha A Miadich (0000-0001-8514-7869, Department of Psychology Arizona State University Tempe AZ USA, corresponding author), Robin S Everhart (0000-0002-6771-5436, Department of Psychology Virginia Commonwealth University 806 West Franklin Street Richmond 23284‐2018 VA USA), Jessica Greenlee (0000-0002-4393-5661, Waisman Center University of Wisconsin Madison WI USA), Marcia A Winter (0000-0002-2849-4263, Department of Psychology Virginia Commonwealth University 806 West Franklin Street Richmond 23284‐2018 VA USA)
Year2020
Volume80
Issue1
Pages254-263
Publication date2020-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Adolescence (JOURNAL)
Journal identifiersISSN: 0140-1971 • E-ISSN: 1095-9254
PublisherWiley (PUBLISHER • GB)
DOI10.1016/j.adolescence.2019.12.007
PMID32222611
OpenAlexW3013356725
LanguageEN
References cited44

INTRODUCTION: Many families living in low-income, urban areas experience a number of stressors (e.g., poverty, neighborhood stress, family functioning) that place adolescents at risk for worse asthma outcomes. Adolescents may face additional challenges (e.g., peer pressure, school stress) that add to their overall stress and influence their disease care and health outcomes. The current study examined the impact of a cumulative risk model of stressors including poverty, neighborhood stress, school stress, peer pressure, and caregiver-adolescent conflict on asthma outcomes (e.g., emergency department [ED] visits, asthma control, quality of life [QOL]) among urban adolescents (13-17 years). METHODS: Data were collected from 61 urban families of adolescents with asthma (54.1% female; 93.4% African American) in the United States. Caregivers and adolescents completed questionnaires assessing stressors and asthma outcomes separately during a research session. RESULTS: Cumulative risk was significantly associated with worse adolescent QOL and asthma control, and more ED visits. The cumulative risk index was also a more robust predictor of QOL and asthma control than any one individual predictor. Poverty, neighborhood stress, and school stress emerged as individual predictors of ED visits. Further, adolescents with well-controlled asthma had significantly lower neighborhood and school-related stress scores. CONCLUSIONS: Findings suggest that beyond the risk conferred by individual risk factors, an accumulation of stress can have an especially negative impact on asthma outcomes for urban adolescents. Future intervention work aimed at improving asthma outcomes should consider incorporating strategies for minimizing overlapping sources of stress in adolescents' daily lives.

Asthma · Developmental psychology · Stress (linguistics) · Asthma and respiratory diseases · Clinical Psychology · Delphi Technique in Research · Health, Environment, Cognitive Aging · Medicine · Psychology

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