Emotionally triggered asthma and its relationship to panic disorder, ataques de nervios, and asthma-related death of a loved one in Latino adults

OBJECTIVE

Research has demonstrated high comorbidity between asthma and panic disorder (PD). Less is known about the relationship between asthma and the Latino cultural idiom of distress of ataques de nervios, as well as the role that psychosocial stressors play. The current study tested the hypotheses that Latino asthma patients who experience PD, ataques de nervios, and/or asthma-related death of a loved one endorse greater psychological triggers of asthma, greater perceived impact of asthma triggers, and greater difficulty controlling such triggers than do those without these conditions.

METHODS

Data originated from an interview conducted prior to a randomized controlled trial in which 292 Latino adults with self-reported asthma were recruited from outpatient clinics in the Bronx, NY. The PRIME-MD Patient Health Questionnaire (PHQ) was used to screen for PD symptoms, while the Structured Clinical Interview for DSM-IV (SCID-I) was used to confirm diagnosis of PD. Lifetime history of ataques de nervios and asthma-related death of a loved one were based upon self-report. Asthma triggers were examined using the Asthma Trigger Inventory (ATI).

RESULTS

PD, ataques de nervios, and asthma-related death of a loved one each predicted a higher frequency of psychological asthma triggers, controlling for gender and comorbid medical conditions. Participants with PD also reported greater impact of asthma triggers than those without PD, while no significant differences in perceived control were observed.

CONCLUSION

Providers should screen for PD, ataques de nervios, and asthma-related death of a loved one in Latino asthma patients, given their observed association with emotionally triggered asthma.

Family Influences on the Relationship Between Hurricane Exposure and Ataques de Nervios

This study focused on characteristics of the family environment that may influence the relationship between hurricane exposure and ataques de nervios in Puerto Rican children and youth. Approximately 18 months after Hurricane Georges hit Puerto Rico in 1998, participants were randomly selected based on a probability household sample using 1990 US Census block groups. Caregivers and children were interviewed about past year and lifetime experience of ataques de nervios, hurricane exposure, and the family environment in Spanish. Areas of the family environment assessed include parent-child relationship quality, parent-child involvement, parental monitoring, discipline, and parents' relationship quality. Structural equation models were estimated for parents and children, and by age group. For children (4-10 years old, N = 582), hurricane exposure was directly related to lifetime experience of ataques, but not for past year experience of ataques. However, for children, none of the family variables had a significant mediating role in the relation between hurricane exposure and either past year or lifetime experience of ataques; rather, parent-child involvement decreased risk for lifetime and past year ataques. For youth (11-17 years old, N = 569), per youth report, positive discipline mediated the hurricane exposure to lifetime experience of ataques relationship, whereas parents' relationship quality mediated the relationship between exposure and past year experience of ataques. Hurricane exposure decreased positive discipline and parents' relationship quality, and positive discipline and parents' relationship quality decreased risk for ataques. Per parent report, parent-child involvement decreased risk for past year or lifetime experience of ataques. Implications for post-disaster mental health recovery efforts are discussed.