Investigating the Role of Child and Caregiver Ataques de Nervios in Childhood Anxiety, Depression and Asthma Control

Abstract

Background: The aim of this study was to determine whether there was a relationship between child and caregiver lifetime history of ataques de nervios and level of child anxiety and depression symptoms, frequency of child illness-specific panic-fear during asthma attacks, and level of asthma control in an inner-city sample of Puerto Rican and Mexican children with asthma.;Methods: Participants included 71 children with asthma ( M = 9.3, SD=1.5 years, range: 7 to 11 years) and their caregivers recruited from inner-city hospitals. The study included Puerto Rican (n = 59) and Mexican (n =12) child-caregiver dyads. Children completed an interview about personal history of ataques de nervios, the Children's Asthma Symptom Checklist (CASCL), the Children's Depressive Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC). Caregivers completed questionnaires about personal history of ataques de nervios, child history of ataques de nervios, and the Parent Children's Asthma Symptom Checklist (P-CASCL). Caregivers and children completed relevant questions of the Child Asthma Control Test (C-ACT). Qualitative content analyses and quantitative analyses were used.;Results: No demographic differences were observed among children and their caregivers with and without ataques de nervios . Themes such as feelings of anger and anxiety during ataques de nervios emerged from child qualitative descriptions, however there was variability in the symptoms described overall. Children frequently cited arguments and school as stressors related to ataques de nervios. Child lifetime history of ataques de nervios (F (1,68)=4.99, p=.029) and caregiver lifetime history of ataques de nervios (F(1, 60)=6.07, p=.017) was significantly associated with increased child physical anxiety symptoms. Caregiver history of ataques de nervios was also associated with more severe generalized child anxiety symptoms (F(1, 60)=4.16, p=.046), child negative mood symptoms as a trend (F(1, 60)=3.09,p = .084) and higher frequency of child illness-specific panic fear based on caregiver report (F (1, 50)=4.80, p=.033). Neither child nor caregiver lifetime history of ataques de nervios was associated with child-reported frequency of illness-specific panic fear or level of asthma control.;Conclusions: Symptoms of asthma, anxiety and depression were associated with child and caregiver lifetime history of ataque de nervios. History of ataques de nervios also influenced caregiver report of child emotional symptoms in response to asthma. Endorsement of history of ataques de nervios may be used as a screening tool for mental health diagnoses in clinical settings. These findings also highlight the need for future research to help improve internalizing symptoms in Latino children with asthma and their caregivers.