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The relationship between negative emotions and acute subjective and objective symptoms of childhood asthma
1Department of Clinical Psychology, University of Amsterdam, The Netherlands.
Insights
Negative emotions in children with asthma exacerbate subjective breathlessness, not objective lung function. This suggests emotional states influence how children perceive asthma symptoms, particularly after exercise.
Area of Science:
- Pediatric Pulmonology
- Psychology
- Behavioral Medicine
Background:
- Children with asthma are susceptible to negative emotions, which may trigger asthma attacks.
- Existing research on the link between negative emotions and asthma symptoms yields mixed results.
- This study investigated whether negative emotions impact subjective (breathlessness) versus objective (airways obstruction) asthma symptoms.
Purpose of the Study:
- To determine if negative emotions influence subjective or objective symptoms in childhood asthma.
- To differentiate the effects of emotional stimuli and physical exercise on asthma indicators.
- To explore the relationship between anxiety, breathlessness, and lung function in asthmatic children.
Main Methods:
- Forty children (7-18 years) with asthma were exposed to emotional films, physical exercise, or a combination.
- Lung function, breathlessness, and state anxiety were measured before and after interventions.
- Continuous respiration recordings assessed emotional breathing patterns.
Main Results:
- Emotional film viewing alone did not increase airways obstruction or breathlessness.
- Significant increases in airways obstruction and breathlessness occurred only after exercise.
- Breathlessness was reported more frequently when negative emotions preceded exercise, independent of lung function or anxiety levels.
Conclusions:
- Negative emotions primarily affect subjective asthma symptoms, like breathlessness, rather than objective measures.
- Children experiencing negative emotions may interpret normal exercise sensations as asthma symptoms.
- This perception can lead to reporting increased breathlessness, irrespective of actual airway status.
Background:
Children with asthma are vulnerable to negative emotions, but clinical observations and research suggest that negative emotions can also be precipitants of asthma attacks. Empirical data provided mixed results. The hypothesis was tested that negative emotions influence subjective rather than objective symptoms of asthma, breathlessness and airways obstruction, respectively.
Methods:
Forty asthmatic children (aged 7 to 18 years) were randomly assigned to one of four experimental conditions: 1, viewing an emotional film of 10 min; 2, performing standardized physical exercise of modest intensity up to a heartbeat of 170 b/min; 3, combination of conditions, order conditions, 1 + 2; and 4, combination of conditions, order conditions 2 + 1. Lung function, breathlessness and state anxiety were measured pre-test and post-test. Respiration sounds were recorded continuously for assessment of emotional breathing patterns.
Results:
The data and responses to exit questions, confirmed a successful induction of anxiety via increased state anxiety and respiratory rate. Viewing the emotional film did not by itself enhance airways obstruction or breathlessness. Airways obstruction and breathlessness increased significantly after exercise only. Significantly more breathlessness was reported when negative emotions preceded exercise. Breathlessness was statistically independent of lung function, severity of asthma, symptoms in the past 4 weeks, anxiety or age.
Conclusion:
Negative emotions affect subjective, rather than objective symptoms of childhood asthma. It was suggested that children in a negative emotional state, uncertain about the condition of their airways, are inclined to interpret exercise-related general sensations (fatigue, heart pounding, sighing) in line with expectations as symptoms of airways obstruction. Consequently, they may report relatively high breathlessness, irrespective of actual objective symptoms of asthma.