Stressful life events, caregiver depressive symptoms, and child asthma symptom-free days: a longitudinal analysis

Abstract

Objective

To examine relationships among stressful life events (SLE), caregiver depression, and asthma symptom free days (SFDs) in publicly insured Black children aged 4–12 years with persistent asthma.

Methods

Secondary analysis of longitudinal data from a clinical trial assessing the efficacy of a six-month parental stress management intervention. Using repeated measures Poisson regression, we constructed four models of SLE (Rochester Youth Development Stressful Life Events scale—Parent Items), caregiver depression (Center for Epidemiologic Studies Depression scale ≥ 11), and child asthma symptom-free days (SFDs) in the prior 14 days.

Results

There was no association between SLE and child SFDs, but there was for caregiver depression (Incidence Rate Ratio [IRR]: 0.904; 95% CI 0.86–0.95). The interaction between SLE and caregiver depression was not significant. A specific SLE (recent serious family accident or illness) predicted fewer child SFDs (IRR: 0.91, 95% CI: 0.85–0.98). In the interaction model between caregiver depression and recent accident/illness, caregiver depression was associated with fewer child SFDs (IRR: 0.95, 95% CI: 0.91–0.99) as was the interaction between caregiver depression and recent accident/illness (IRR: 0.77, 95% CI 0.66–0.91); but the relationship between recent accident/illness and child SFDs was not (IRR: 1.00, 95% CI, 0.92–1.09), meaning accident/illness was only associated with fewer child SFDs among depressed caregivers.

Conclusions

In a sample of publicly insured Black children with persistent asthma, caregiver depression was negatively associated with child SFDs while overall SLE were not. A recent family accident or illness was negatively associated with child SFDs only when the caregiver was depressed.

Keywords:

• Life stress
• depression
• parent
• pediatric
• psychosocial
• health equity
• social determinants of health

Acknowledgements

Research reported in this article was funded by an award from the Patient-Centered Outcomes Research Institute (AS-1307-05284). The views, statements, and opinions in this article are solely the responsibility of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute, its Board of Governors or Methodology Committee. The Patient-Centered Outcomes Research Institute had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Declaration of interest

The authors report no conflicts of interest.

Additional information

Funding

Stephen Teach reports funding from the NIH, DC Health, and EJF Philanthropies. He also serves as a Section Editor for UptoDate.