Elsevier

The Journal of Pediatrics

Volume 155, Issue 3, September 2009, Pages 398-403
The Journal of Pediatrics

Original Article
Asthma and Social Anxiety in Adolescents

https://doi.org/10.1016/j.jpeds.2009.04.004Get rights and content

Objective

To examine the relationship between self-reported social anxiety and asthma in a non-clinical sample of adolescents.

Study design

High school students (n = 765) completed the Social Anxiety Scale for Adolescents (SAS-A), the Social Phobia and Anxiety Inventory for Children (SPAI-C), and questions on asthma diagnosis, asthma symptoms, and asthma-related limitations and medical care. Relationships were examined between social anxiety symptoms and asthma, including history of diagnosis, diagnosis plus current symptoms, and severity.

Results

Compared with students without an asthma diagnosis and no symptoms, students with a diagnosis and current symptoms reported heightened social anxiety symptoms related to fear of negative evaluations and generalized discomfort in social settings as measured by the SAS-A. Additionally, a greater proportion of students with an asthma diagnosis and current symptoms were in the clinical range of social anxiety on the SAS-A. Differences on the SAS-A by history of asthma diagnosis and by severity were not supported. No differences were found on the SPAI-C for history of asthma diagnosis, diagnosis plus current symptoms or severity.

Conclusions

Students with current asthma symptoms were more likely to report social anxiety, perhaps related to concerns about exhibiting symptoms or taking medication in front of peers. These findings may suggest advantages for medical providers to identify and treat social anxiety in patients with asthma.

Section snippets

Methods

Participants were 765 adolescents from 2 urban, Catholic high schools. Their mean age was 15.2 years (SD, 0.79); 76.9% were female. Most were Caucasian (87.0%). The grade distribution was 33.6% ninth graders, 48.3% 10th graders, and 18.1% 11th graders. Data were obtained as part of a school-wide social anxiety screening for a controlled trial evaluating the efficacy of a cognitive-behavioral intervention for high school students with SAD.14 Procedures were approved by the New York University

Social anxiety

SAS-A total scores ranged from 18 to 90, with a mean of 37.3 (SD, 11.9). SPAI-C total scores ranged from 0 to 44, with a mean of 11.0 (SD, 7.6). Overall, 13.7% and 15.6% of the sample reported clinically significant social anxiety on the SAS-A and SPAI-C, respectively, as indicated by the recommended cutoff points (50 for SAS-A and 18 for SPAI-C).

Asthma diagnosis and severity

Having an asthma diagnosis was reported by 18.6% of the sample, and 11.2% of the sample had current asthma (ie, a diagnosis and current symptoms).

Discussion

We examined the relation between social anxiety and asthma in adolescents. Consistent with results from a community sample that found no relationship between a history of asthma attacks and social phobia,26 we found no differences in reports of social anxiety by asthma diagnosis. However, adolescents with current asthma (ie, a diagnosis and current asthma symptoms) endorsed higher levels of social anxiety on the SAS-A than peers without asthma. More specifically, teenagers with an asthma

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    C.M.W. received funding from the National Institutes of Mental Health (5K23MH065373). J.-M.B. received partial funding from National Heart, Lung, and Blood Institute (R01HL079953) for the preparation of this manuscript. There is no potential, perceived, or real conflict of interest for any of the authors. The sponsor played no role in the study design, the collection, analysis and interpretation of data, the writing of the report, and the decision to submit the manuscript.

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