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The Psychological Adjustment of Children with Asthma: Study of Associated Variables

Published online by Cambridge University Press:  10 January 2013

Lígia Lima*
Escola Superior de Enfermagem do Porto (Portugal)
Marina Prista Guerra
Universidade do Porto (Portugal)
Marina Serra de Lemos
Universidade do Porto (Portugal)
Correspondence concerning this article should be addressed to Lígia Lima. Escola Superior de Enfermagem do Porto. Rua Dr. António Bernardino de Almeida. 4200-072 Porto. (Portugal). E-mail:


As part of a larger research project aimed to understand the impact of asthma in the psychological adjustment of children, this study focuses in the identification of factors associated with this process. The sample of this study consisted of 89 children, aged 8 to 12 with physician diagnosed asthma. To assess children's adjustment, the Portuguese versions of the following instruments were used: School-age Temperament Inventory (McClowry, 1995) Schoolagers Coping Strategies Inventory (Ryan-Wenger, 1990); Pediatric Quality of Life Inventory – PedsQL (Varni, Seid & Kurtin, 2001); The Self-perception Profile for Children (Harter, 1985), Child Behavior Checklist (Achenbach,1991); Social Skills Rating System (Gresham & Elliot, 1990). The results revealed that negative reactivity predicts the level of anxiety/depression, task persistence and perceived coping efficacy predicts social skills and that self-esteem is a significant predictor of the perceived quality of life. A significant proportion of shared variance was also found what seems to confirm the existence of multi-determination in the process of adjustment. The main conclusion is that two dimensions of temperament (negative reactivity and task persistence), as well as perceived coping efficacy and self-esteem, play a significant role in influencing the psychological adjustment of children with asthma.

Como parte de un proyecto de investigación más extenso cuyo objetivo es comprender el impacto del Asma en el ajuste psicológico de los niños, este estudio se centra en la identificación de los factores asociados a este proceso. La muestra de este estudio incluyó a 89 niños con edades comprendidas entre los 8 y 12 años y con diagnóstico médico de asma. Para medir el ajuste de los niños se utilizaron versiones en portugués de los siguientes instrumentos: School-age Temperament Inventory (McClowry, 1995) Schoolagers Coping Strategies Inventory (Ryan-Wenger, 1990); Pediatric Quality of Life Inventory – PedsQL (Varni, Seid & Kurtin, 2001; The Self-perception Profile for Children (Harter, 1985), Child Behavior Checklist (Achenbach,1991); Social Skills Rating System (Gresham & Elliot, 1990). Los resultados revelaron que la reactividad negativa predice el nivel de ansiedad/depresión, la persistencia de tarea y la eficacia de afrontamiento percibida predicen habilidades sociales y que la autoestima es un predictor significativo de la calidad de vida percibida. Se encontró también una proporción significativa de la varianza compartida lo que confirma la existencia de multi determinación en el proceso de ajuste. La conclusión principal es que dos dimensiones de temperamento (reactividad negativa y persistencia en la tarea), así como la eficacia de enfrentamiento percibida y la autoestima, juegan un papel significativo en el ajuste psicológico de los niños con asma.

Research Article
Copyright © Cambridge University Press 2010

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Achenbach, T.M. (1991). Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Burlington: University of Vermont, Department of Psychiatry.Google Scholar
Bacharier, L.B., Boner, a., Carlsen, K-H., Eigenmann, P.A., Frischer, T., Gotz, M. et al. (2008) Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy. 63, 534.CrossRefGoogle Scholar
Barros, L. (1999). Psicologia Pediátrica: Perspectiva desenvolvimentista. Lisboa: CLIMEPSI.Google Scholar
Benchell, J., & Glasgow, A. (1997). The Role of Temperament in Children with Insulin-Dependent Diabetes Mellitus. Journal of Pediatric Psychology, 22(6), 795809.CrossRefGoogle Scholar
Bender, B.G., Annet, R.D., Duttamel, T.R., Rand, C., & Strunk, R.C. (2000). Relationship between disease and psychological adaptation in children in the Childhood Asthma Management program and their Families. Archives Pediatric Adolescence Medicine, 154(7), 706713.CrossRefGoogle Scholar
Bleil, M.E., Ramesh, S., Miller, B. D., & Wood, B.L. (2000). The influence of Parent-Child Relatedness on Depressive Symptons in Children with Asthma: Tests of Moderator and Mediator Models. Journal of Pediatric Psychology, 25(7), 481491.CrossRefGoogle Scholar
Brown, R.T., Wiener, L.W., Kupst, M.J.K., Brennan, T., Behrman, R., Compas, B.E. et al. (2008). Single Parenting and Children with Chronic Illness: An Understudied Phenomenon. Journal of Pediatric Psychology, 33(4), 408421.CrossRefGoogle Scholar
Carey, W. (2004). Temperament and the Pediatrician. Reprinted from Pediatric Development and Behaviour Online. Consultado a 19 de Julho de 2004 em http.// id=18.Google Scholar
Carranza, J.A, & Salinas, C. G. (2003). Temperamento en la infancia: aspectos conceptuales básicos. Barcelona: Ariel Psicología.Google Scholar
Cichetti, D., & Toth, S. (1998). Perspectives on Research and Practice in Developmental Psychology. In Damon, William (Editor in Chief), Siegel, I., Renninger, A.. Child Psychology. Volume Four: Child Psychology in Practice. (pp. 479559). New York: Wiley.Google Scholar
Creer, T.L., & Bender, B.G. (1995). Pediatric Asthma. In Roberts, M. (Eds), Handbook of Pediatric Psychology (pp 219240). London: Guilford Press.Google Scholar
Edwards, M., & Davis, H. (1997). Counselling Children with Chronic Medical Conditions. Leicester: British Psychological Society.Google Scholar
Ferreira, H. I. M. M. (2000). A competência social no contexto escolar: um estudo na interface entre a competência social e a realização académica na criança. Dissertação de Mestrado apresentada à Faculdade de Psicologia e Ciências da Educação da Universidade do Porto.Google Scholar
Frankel, K., & Wamboldt, M. (1998). Chronic Childhood Illness and Maternal Mental Health – Why Should We Care? Journal of Asthma, 35(8), 621630.CrossRefGoogle ScholarPubMed
Global Initiative for Asthma- GINA (1995). Global strategy for asthma management and prevention. NHLBI/WHO workshop report. National Institutes of Health, National Heart, Lung and Blood Institute, NIH publication number 95-3659.Google Scholar
Gresham, F. M.& Elliot, S. N. (1990). Social Skills Rating system: Manual. Circle Pines, MN: American Guidance Service.Google Scholar
Harter, S. (1985). Adolescent Self-Perception Profile. Non-published manuscript.Google Scholar
Hérnandez, M. J. (1995). Aspectos básicos da Psicopatologia Infantil. In Hernádez, M.J. (Ed). Psicopatologia Infantil. (pp.1935). Granada: Ediciones Aljibe.Google Scholar
Isaacs, D.& Sewell, J.R. (2003). Children with chronic conditions. Medical Journal of Australia, 179(5), 235236.Google Scholar
Kaugars, A.S., Klinnert, M.D., & Bender, B.G. (2004). Family Influences on Pediatric Asthma. Journal of Pediatric Psychology, 29(7), 475491.CrossRefGoogle ScholarPubMed
Klinnert, M., McQuaid, E., McCormick, D., Adinoff, A., & Bruant, N. (2000). A Multimethod Assessement of Behavioral and Emotional Adjustment in Children with Asthma. Journal of Pediatric Psychology, 25(1), 3547.CrossRefGoogle Scholar
Lemos, M. S.& Meneses, H. I. (2002). A avaliação da competência social: Versão Portuguesa da Forma para professores do SSRS. Psicologia, Teoria e Pesquisa, 18(3), 167274.CrossRefGoogle Scholar
Lima, L., Guerra, P.M.& Lemos, M.S. (2009). Adaptação da escala genérica do Inventário Pediátrico de Qualidade de vida – Pediatric Quality of Life Inventory 4.0 - PedsQL, a uma população portuguesa. Revista Portuguesa de Saúde Pública, 8, 8395.Google Scholar
Lima, L., Lemos, M. S.& Guerra, M.P. (2002a). Examination of the validity and reliability of the Portuguese version of the school-age temperament inventory (SATI) by McClowry, 1995. Poster presented at the 16th Conference of the European Health Psychology Society (2-6 October).Google Scholar
Lima, L., Lemos, M. S. & Guerra, (2002b). Estudo das qualidades psicométricas do SCSI (Schoolagers' Coping Strategies Inventory) numa população portuguesa. Análise psicológica, 4(20), 555570.Google Scholar
Martin, R.P., Olejnik, S.& Gaddis, L. (1994). Is temperament an important contributor to schooling outcomes in elementary school? Modeling effects of temperament and scholastic ability on academic achievement. In Carey, W.B. & McDevitt, S.C. (Eds). Prevention and early intervention: Individual Differences as risk factorsfoor the mental health of children.(pp 5968). New York: Bruner/Mazel.Google Scholar
Masten, A.S., Morison, P., Pellegrini, D.& Tellegen, A. (1992). Competence under stress: risk and protective factors. In Rolf, J., Masten, A., Ciccheti, D., Nuechterlein, K & Weintraub, S.. (Eds) Risk and Protective Factors in the Development of Psychopathology (pp. 236256). Cambridge: Cambridge University Press.Google Scholar
McClowry, S.G. (1995). The Development of the School-age Temperament Inventory. Merril Palmer Quartely. 41(3), 271285.Google Scholar
McClowry, S.G. (2002). The temperament Profiles of School Age Children. Journal of Pediatric Nursing, 17(1), 310.CrossRefGoogle ScholarPubMed
McQuaid, E.L., Kopel, S.J., & Nassau, J.H. (2001). Behavioral Adjustment in children with asthma: A meta-analysis. Journal of Developmental and Behavioral Pediatrics; 22(6), 430439.CrossRefGoogle Scholar
McQuaid, E.& Walders, N. (2003). Pediatric Asthma. In Roberts, M. (Eds), Handbook of Pediatric Psychology (pp 269285). London: Guilford Press.Google Scholar
Mishoe, S., Baker, R., Poole, S., Harrel, L., Arant, C., & Rupp, N. (1998). Development of an Instrument to Assess Stress Levels and Quality of Life in children with Asthma. Journal of Asthma, 35(7), 553563.CrossRefGoogle ScholarPubMed
Moran, M. G. (2000) Doenças Pulmonares e Reumatológicas. In Stoudemire, A. (org). Fatores Psicológicos Afetando Condições Médicas. (pp. 143158). Porto Alegre: Artes Médicas Sul.Google Scholar
Pauli-Pott, U., Darui, A., & Beckman, D. (1999). Infants with Atopic Dermatitis: Maternal Hopelessness, Child-Rearing Attitudes and Perceived Infant Temperament. Psychotherapy and Psychosomatics, 68, 3945.CrossRefGoogle ScholarPubMed
Rothbart, M., & Bates, J. (1998). Temperament. In Damon, W. & Eisenberg, N. (Eds), Handbook of child psychology- Volume 3: Social, emotional and Personality development (pp. 105164). New York: Jonh Willey & Sons.Google Scholar
Ryan-Wenger, N. (1990). Development and psychometric properties of the schoolagers' coping strategies inventory. Nursing Research, 39(6), 344349.CrossRefGoogle ScholarPubMed
Ryan-Wenger, N. (1996). Children, coping and the stress of Illness: a synthesis of the research. Journal of The Society of Pediatric Nurses, 1(3) 126139.CrossRefGoogle Scholar
Ryan-Wenger, N., Sharrer, V., & Wynd, C. (2000). Stress, Coping and Health In Children. In Rice, V.H. (Ed). Handbook of Stress, Coping and Health. (pp. 265293). Thousand Oaks: Sage.Google Scholar
Schuman, W., & La Greca, A. (1999). Social Correlates of Chronic Disease. In Brown, R. T. (Eds.), Cognitive Aspects of Chronic Illness in Children. (pp. 289311). London: Guilford Press.Google Scholar
Sharp, S., & Cowie, H. (1998). Counselling and Supporting Children in Distress. London: Sage.Google Scholar
Spirito, A., Stark, L.J., Gil, K.M., & Tyc, V.L. (1995). Coping with everyday and disease-related by chronically ill children and adolescents. Journal of The American Academy of Child and Adolescent Psychiatry, 34(3), 283291.CrossRefGoogle ScholarPubMed
Thompson, R.J., & Gustafson, K. E. (1996). Adaptation to Chronic Childhood Illness. Washington: American Psychological Association.CrossRefGoogle Scholar
Thompson, R. J., Gustafson, K. E., George, L. K., & Spock, A. (1994). Change Over a 12-Month Period in the Psychological Adjustment of Children with Cystic Fibrosis. Journal of Pediatric Psychology, 19(2), 189203.CrossRefGoogle Scholar
Varni, J.W., Seid, M., & Kurtin, P.S. (2001) The PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory 4.0 version, Medical Care, 39, 800812.Google Scholar
Vinson, J.A. (2002). Children With Asthma: Initial Development of The Child Resilience Model. Pediatric Nursing, 28(2), 149158.Google Scholar
Wallander, J., & Varni, J. (1998). Effects of Pediatric Physical Disorders on Child and Family Adjustment. Journal Child Psychology Psychiatry, 39(1), 2946.CrossRefGoogle ScholarPubMed
World Health Organization (2000). Bronchial Asthma. WHO Fact Sheet n°206. Revised January 2000.Google Scholar
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