Interaction Between Allergic Potential and Psychopathology in Childhood Asthma

Abstract

A sample of 62 asthmatic children was divided into two subgroups on the basis of scores on the Allergic Potential Scale (APS)-an index of somatic or constitutional predisposition to allergy. The subgroups were compared, together with the associated mothers, on a variety of independent psychological tests and standardized interactional situations. The hypothesis that psychopathological factors would be observed significantly more often in the children identified by low APS scores, and their mothers, was supported. It was shown that the two groups were comparable with respect to the degree of severity of asthma and socioeconomic level. The results attest to the fruitfulness of seeking subgroups and suggest that a differentiated approach to asthma reconciles some findings in the literature which otherwise appear to be contradictory. The APS may prove useful, not only in other research, but as a guide for differential treatment of asthmatic children.I H E SUPPOSITION of homogeneity within subject samples is pervasive in psychology. It influences methodological decisions and it underlies many statistical techniques on which the researcher is dependent in the analysis of his data.

Heterogeneity of Bronchial Asthma

“…Twenty-seven of them were sensitive to acetylsalicylic acid, and 28 were not. The authors sub-grouped the latter group into socalled atopic (13), infectious (9), and "mixed" (6).…”

“…^ . ° Psychological aspects bronchial provocation testing one can also distinguish between different reaction types ( nality patterns have concerning asthma has There is the one type with immediate reac-been discussed in many papers (6,45,46,47). In tions and the one with slowly developing ob-this discussion a clear distinction has to be made struction.…”

“…The very core of heterogeneity and subdivision of the asthma population is regularly touched upon in scientific papers reporting that certain characteristics under investigation are found in one proportion of the patients under study, but not in others. Clinical aspects of this have been discussed in several papers (6,9,11,17,21,38,44,46,48,54,58). Laros, using different combinations of clinical and laboratory data (31), classified 36 different sub-groups among patients with chronic lung disorders of different kinds, including several sub-groups of asthma.…”

Significance of Allergy in Asthma from a Behavioral Medicine Viewpoint

“…The influence of psychic factors in con nection with allergy in bronchial asthma was especially differentiated by Block et al [1964], who found more psychopathic signs in children (as well as their parents) with a lower allergic disposition than in those with a higher disposition to allergy. If the assump tion of Block et al that psychic components in allergic asthmatic patients are less impor tant were correct, then a higher disposition towards allergy would contraindicate psy chotherapeutic treatment.…”

Mechanism of Psychogenic Asthmatic Attack in Children

“…These findings suggest that aller gic etiology alone, cannot completely explain the persistance of the asthma and suggest the possibility that psychological variables may help to explain the resid ual variance. The studies of Purcell (13), Block (2), McFadden (11) and others indicate that there is a subgroup of asthmatics, as high as 50 %, which is quite suggestible, essentially non-allergic, and in which emotions rank high among the précipitants of asthmatic attacks. This is the group which is likely to benefit most from the conjoint psychological management.…”