Behavioral characteristics and parental stress in elementary school children with bronchial asthma and allergic rhinitis

Eunjeong Choi; Mi Ji Lee; Hyun-Jin Yun; Ja Hyeong Kim; Ju Suk Lee; Jae Hong Park; Jin-A Jung

doi:10.4168/aard.2016.4.3.205

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Choi, Lee, Yun, Kim, Lee, Park, and Jung: Behavioral characteristics and parental stress in elementary school children with bronchial asthma and allergic rhinitis

Original Article

Allergy Asthma Respir Dis 2016;4(3):205-211.

Published online: 12 May 2016

DOI: https://doi.org/10.4168/aard.2016.4.3.205

Behavioral characteristics and parental stress in elementary school children with bronchial asthma and allergic rhinitis

Eunjeong Choi¹, Mi Ji Lee², Hyun-Jin Yun¹, Ja Hyeong Kim³, Ju Suk Lee⁴, Jae Hong Park⁵, Jin-A Jung²

^¹Department of Pediatrics, Ilsin Christian Hospital, Busan

^²Department of Pediatrics, Dong-A University College of Medicine, Busan

^³Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan

^⁴Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon

^⁵Department 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

Received 13 February 2016 Revised 3 April 2016 Accepted 17 April 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.

Keywords: Elementary school children, Asthma, Allergic rhinitis, Behavioral characteristics, Parental stress

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Table 1.

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.

Table 2.

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.

Table 3.

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.

Table 4.

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.

Table 5.

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.

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