aard Allergy, Asthma & Respiratory Disease Allergy Asthma Respir Dis 2288-0402 2288-0410 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma 10.4168/aard.2016.4.3.205 aard-4-205 Original Article Behavioral characteristics and parental stress in elementary school children with bronchial asthma and allergic rhinitis ChoiEunjeong 1 LeeMi Ji 2 YunHyun-Jin 1 KimJa Hyeong 3 LeeJu Suk 4 ParkJae Hong 5 JungJin-A 2 Department of Pediatrics, Ilsin Christian Hospital, Busan Department of Pediatrics, Dong-A University College of Medicine, Busan Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon Department of Psychiatry, Dong-A University College of Medicine, Busan, Korea Correspondence to: Jin-A Jung http://orcid.org/0000-0002-4243-6983 Department of Pediatrics, Dong-A University Hospital, Dong-A University College of Medicine, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea Tel: +82-51-240-5617, Fax: +82-51-242-2765, E-mail: jina1477@dau.ac.kr 05 2016 12 05 2016 4 3 205 211 13022016 03042016 17042016 Copyright © 2016 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

The aim of this study was to investigate the differences in behavioral characteristics and parental stress between allergic and nonallergic elementary school children.

 Methods

Ninety-one elementary school children who had allergic disease were enrolled (asthma, n=27; allergic rhinitis, n=35; combined, n=29). Also one hundred six nonallergic elementary school children were enrolled for the control group. The Korean Child Behavior Check List (K-CBCL) and Korean Parenting Stress Index-Short Form (K-PSI-SF) were completed by their mothers.

 Results

According to the analysis of K-CBCL, the score for Internalizing, anxious/depressed and somatic complaints were significantly higher in the combined group than in the control group. The score for Diagnostic and Statistical Manual of Mental Disorders (DSM)-affective problems in the combined group and DSM-somatic problems were significantly higher in the asthma group than in the control group. According to the analysis of K-PSI-SF, the score for parental distress was significantly higher in the allergic rhinitis group than in the control group. The scores for behavioral problems and parental stress were significantly correlated to allergic disease groups.

 Conclusion

Behavioral problems and parental stress were significantly associated with asthma and allergic rhinitis. The results of this study suggest the importance of psychosocial support for mothers and children with allergic diseases.

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Demographic characteristics

Characteristic Control (n=106) Asthma (n=27) AR (n=35) Combined (n=29) P-value
Age (yr) 9.3±1.8 10.4±2.7 8.9±2.4 9.4±2.5 0.046∗
Male sex 52 (49.1) 16 (59.3) 20 (57.1) 18 (62.1) <0.001†
Father's education level         0.158
Graduate school and above 2 (2.0) 0 (0) 1 (2.9) 2 (7.1)  
College 38 (37.3) 15 (57.7) 20 (57.1) 16 (57.1)  
High school 58 (56.9) 10 (38.5) 14 (40.0) 10 (35.7)  
Middle school and below 4 (3.9) 1 (3.8) 0 (0) 0 (0)  
Mather's education level         <0.001
Graduate school and above 1 (1.0) 0 (0) 4 (11.4) 0 (0)  
College 29 (28.7) 14 (51.9) 19 (54.3) 17 (58.6)  
High school 66 (65.3) 13 (48.1) 12 (34.3) 11 (37.9)  
Middle school and below 5 (5.0) 0 (0) 0 (0) 1 (3.4)  
Economic status         0.031
High 0 (0) 1 (4.0) 0 (0) 0 (0)  
High in the middle 3 (3.2) 3 (12.0) 4 (12.5) 1 (3.7)  
Middle in the middle 41 (43.6) 10 (40.0) 15 (46.9) 21 (77.8)  
Low in the middle 39 (41.5) 9 (36.0) 10 (31.3) 4 (14.8)  
Low 11 (10.4) 2 (8.0) 3 (9.4) 1 (3.7)  

Values are presented as mean±standard deviation or number (%). AR, allergic rhinitis; Combined, asthma and allergic rhinitis. There are missing data in parent's education level and economic status because of no answer.

AR>Asthma.

Combined>Control.

Comparison of scores of K-CBCL

Variable Control (n=106) Asthma (n=27) AR (n=35) Combined (n=29) P-value
Internalizing 50.1±8.5 53.0±11.3 53.2±9.6 55.7±11.0 0.019∗
Anxious/depressed 53.2±4.9 54.9±6.1 55.1±7.3 56.7±7.9 0.035∗
Withdrawn/depressed d 54.0±5.6 53.7±7.2 54.4±6.2 55.0±5.4 0.817
Somatic complaints 53.9±5.4 57.4±9.0 56.2±7.6 58.0±8.0 0.008*
Externalizing 51.5±9.9 52.1±10.3 50.1±8.8 54.6±7.6 0.287
Rule-breaking behavio r 54.5±5.9 55.1±6.5 54.0±5.2 55.4±5.0 0.741
Aggressive behavior 54.6±6.1 54.9±7.0 53.3±5.1 55.8±5.8 0.416
Social problem 55.3±6.6 55.0±7.2 53.4±5.9 56.9±6.5 0.198
Thought problems 54.4±5.1 55.0±6.2 55.6±6.2 57.3±7.3 0.119
Attention problems 54.5±6.1 53.8±5.9 53.3±5.0 55.2±5.6 0.572
Other problems 54.4±6.0 55.4±7.5 54.3±5.7 57.3±6.7 0.142
Total behavior problems score 50.8±10.5 52.8±9.3 51.9±8.6 56.1±9.7 0.093

Values are presented as mean±standard deviation. K-CBCL, Korean Child Behavior Check List; AR, allergic rhinitis; Combined, asthma and allergic rhinitis.

Combined>Control.

Comparison of scores of K-CBCL

Variable Control (n=106) Asthma (n=27) AR (n=35) Combined (n=29) P-value
DSM-affective problems 53.2±5.2 54.5±6.9 54.8±6.8 56.9±7.5 0.027∗
DSM-anxiety problems 53.5±5.4 55.6±6.0 54.8±8.0 56.4±7.6 0.107
DSM-somatic problems 53.2±5.4 57.6±9.4 56.3±8.0 57.0±8.6 0.003†
DSM-ADHD 54.9±7.1 54.9±10.3 52.9±5.0 55.9±6.5 0.375
DSM-oppositional defiant problems 54.7±6.4 54.7±5.6 53.6±5.3 55.4±4.9 0.656
DSM-conduct problems 54.0±5.8 54.6±7.4 52.6±5.2 54.7±5.3 0.463
Obsessive-compulsive problems 53.6±4.8 55.9±7.3 55.3±7.4 55.4±8.4 0.192
Posttraumatic stress problems 54.5±5.9 55.2±6.1 54.4±7.8 56.2±7.4 0.612
Sluggish cognitive tempo 52.7±5.9 52.1±4.8 53.5±6.2 53.6±5.4 0.700
Social competence 51.7±8.8 48.6±9.9 49.5±10.7 50.0±12.1 0.405
School competence 52.7±8.0 5.5±6.9 53.7±8.1 54.7±7.4 0.516
Total social adaptation score 52.7±9.1 51.8±10.2 52.0±10.1 53.0±12.0 0.957

Values are presented as mean±standard deviation. K-CBCL, Korean Child Behavior Check List; AR, allergic rhinitis; Combined, asthma and allergic rhinitis; DSM, Diagnostic and Statistical Manual of Mental Disorders; ADHD, attention deficit/hyperactivity disorder.

Combined>Control.

Asthma>Control.

Comparison of scores of K-PSI-SF

Variable Control (n=106) Asthma (n=27) AR (n=35) Combined (n=29) P-value
Parental distress 31.9±19.7 35.6±25.4 51.8±28.7 41.6±28.1 0.011∗
Dysfunctional interaction 41.2±23.7 47.6±26.8 48.6±28.9 50.9±27.0 0.900
Difficult child 38.2±22.5 46.5±31.2 50.4±27.5 56.0±27.5 0.459
Parenting stress total 33.7±18.3 43.0±27.8 51.5±27.3 50.3±27.3 0.017∗

Values are presented as mean±standard deviation. K-PSI-SF, Korean arenting Stress Index-Short Form; AR, allergic rhinitis; Combined, asthma and allergic rhinitis.

AR>Control.

Correlation coefficients between K-CBCL and K-PSI-SF among allergic diseases group

Variable Parental distress Dysfunctional interaction Difficult child Parenting stress total
Total behavior problems score 0.321* 0.463* 0.657* 0.617*
Internalizing 0.378* 0.390* 0.521* 0.554*
Externalizing 0.206* 0.414* 0.639* 0.539*
DSM-affective problems 0.266* 0.357* 0.461* 0.464*
DSM-anxiety problems 0.247* 0.377* 0.448* 0.457*
DSM-somatic problems 0.252* 0.164 0.369* 0.346*
DSM-ADHD 0.086 0.287* 0.509* 0.379*
DSM-oppositional defiant problems 0.233* 0.366* 0.646* 0.540*
DSM-conduct problems –0.003 0.226* 0.455* 0.293*
Obsessive-compulsive problems 0.225* 0.276* 0.395* 0.387*
Posttraumatic stress problems 0.276* 0.406* 0.644* 0.574*
Sluggish cognitive tempo 0.228* 0.326* 0.371* 0.394*
Total social adaptation score –0.146 –0.287* –0.302* –0.307*

K-CBCL, Korean Child Behavior Check List; K-PSI-SF, Korean Parenting Stress Index-Short Form; DSM, Diagnostic and Statistical Manual of Mental Disorders; ADHD, attention deficit/hyperactivity disorder.

*P<0.05.