Understanding and treating anxiety disorders in children with asthma

Abstract

The aim of this thesis was to provide research to understand and treat anxiety in children with asthma. Specifically, the aims were to: (1) investigate the parent and cognitive factors associated with anxiety in children with asthma; and (2) evaluate a cognitive behavioural treatment (CBT) specifically developed for children in this population. The rationale behind this research was the identification of a higher prevalence of anxiety disorders in children with asthma compared to healthy children, yet very little understanding about the factors which may underlie this relationship. This poor understanding has translated into a lack of evidence-based treatments for this population. The research comprises of five empirical studies, including a meta-analysis, two cross-sectional empirical studies, a case series analysis of treatment and a qualitative study. The findings of this thesis highlight that some parenting behaviours, namely parental control, and child cognitions, namely avoidant coping, whilst understandable in the context of a chronic illness, may – in fact – also confer risk for anxiety in these children. The results also showed promise for the efficacy of a group CBT intervention for a small number of participants with asthma and a comorbid anxiety disorder, however critically a large number of eligible participants declined to take part. It appears that a number of barriers to treatment engagement exist, which relate specifically to parent beliefs and understanding about the link between asthma and anxiety. Additional research is needed with larger samples in order to further explicate the role of parent and cognitive factors in the development and maintenance of anxiety in children with asthma, and establish CBT as an evidence-based treatment for this population.