Al Ghriwati Nour, Winter Marcia A, Everhart Robin S, Fiese Barbara H
Department of Psychology, Virginia Commonwealth University.
Department of Human Development and Family Studies, Family Resiliency Center, University of Illinois at Urbana-Champaign.
Fam Syst Health. 2017 Dec;35(4):439-449. doi: 10.1037/fsh0000264. Epub 2017 Apr 13.
Family factors are directly associated with the psychosocial adjustment of children with chronic illnesses such as asthma (Kaugars, Klinnert, & Bender, 2004). Research indicates that negative family factors may also contribute to child disease severity via bio-behavioral mechanisms of effect. For instance, children from more conflicted families often experience greater internalizing symptoms that subsequently impact their asthma severity (Wood et al., 2006). These pathways have yet to be examined with a comprehensive focus on strength-based family factors. This study examined whether factors such as family cohesion, problem-solving abilities, and communication influence asthma severity via their effects on child depression and anxiety symptoms.
Participants were 215 children (136 males and 79 females), ages 5 to 12 years old, and their families. Primary caregiver, child, and teacher ratings of child and family functioning in addition to objective measures of parent-child interactions and asthma severity were collected.
Using structural equation modeling, the authors identified significant indirect associations between family factors and child asthma severity via child depressive symptoms; however, these associations were not present in models with child anxiety symptoms.
Results suggest an indirect effect of family functioning on children's lung function, with differential roles of anxiety and depression in these pathways. This article also highlights the importance of incorporating multirater multimethod measures to understand children's experiences in pediatric asthma. (PsycINFO Database Record
家庭因素与哮喘等慢性病患儿的心理社会适应直接相关（考加斯、克林纳特和本德，2004年）。研究表明，负面家庭因素也可能通过生物行为作用机制导致儿童疾病严重程度增加。例如，来自冲突较多家庭的儿童往往会出现更多内化症状，进而影响其哮喘严重程度（伍德等人，2006年）。这些途径尚未在全面关注基于优势的家庭因素的情况下进行研究。本研究考察了家庭凝聚力、解决问题的能力和沟通等因素是否通过对儿童抑郁和焦虑症状的影响来影响哮喘严重程度。
研究对象为215名5至12岁的儿童（136名男性和79名女性）及其家庭。收集了主要照顾者、儿童和教师对儿童及家庭功能的评价，以及亲子互动和哮喘严重程度的客观测量数据。
通过结构方程模型，作者发现家庭因素与儿童哮喘严重程度之间通过儿童抑郁症状存在显著的间接关联；然而，在包含儿童焦虑症状的模型中不存在这些关联。
结果表明家庭功能对儿童肺功能有间接影响，焦虑和抑郁在这些途径中发挥不同作用。本文还强调了采用多评价者多方法测量来理解儿童在小儿哮喘中的经历的重要性。（《心理学文摘数据库记录》
