ABSTRACT
OBJECTIVE: Using electronic diaries (eDiaries), this study examined temporal links between child and maternal anger, as well as positive mood and perceived stress, in children with attention-deficit/hyperactivity disorder (ADHD) versus comparison peers. METHODS: Across 7 days, half-hourly eDiaries were completed independently by mothers and their 8-12-year-old children (51 receiving medication for ADHD and 58 comparison peers). RESULTS: Cross-informant analyses revealed systematic patterns of negative maternal moods in relation to child anger in both groups along with evidence of slower recovery in the ADHD group. Analogously, for both groups, children's anger reports increased and good-mood reports decreased in relation to maternal anger, whereas elevated stress in relation to maternal anger was restricted to children with ADHD. CONCLUSIONS: The findings indicate that a negative affective climate is more likely to persist in ADHD than in comparison families. They also affirm the utility of child as well as parent eDiary reports and suggest that children may be willing to report low positive mood when reluctant to report negative mood. The promise of incorporating real-time data on mood patterning into tailored treatments for children with ADHD and their families is discussed.
Subject(s)
Affect , Anger , Attention Deficit Disorder with Hyperactivity/psychology , Mother-Child Relations , Mothers/psychology , Adult , Child , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Patient Selection , Personality Inventory , Self-Assessment , Stress, Psychological/psychology , Surveys and QuestionnairesABSTRACT
The importance of aeroallergens as triggers for asthma is well recognized, but the relationship between asthma severity and atopic profiles in childhood has not been elucidated. This study assessed the relationship of allergen sensitization to asthma severity in a study of 114 asthmatic children followed for 8 weeks in three Southern California areas. Increased controller medication and beta-agonist use were positively associated with number of positive skin tests and allergy to mold and pollens. Mold was associated with increased asthma symptoms. Degree of atopy and reactivity to mold and pollens plays a significant role in asthma severity in asthmatic children.
Subject(s)
Asthma/etiology , Hypersensitivity/etiology , Adolescent , Allergens/immunology , Animals , Animals, Domestic , Asthma/drug therapy , Cats/immunology , Child , Dust , Female , Fungi/immunology , Humans , Male , Mites/immunologyABSTRACT
Attention-deficit/hyperactivity disorder (ADHD) has an impact on the family as well as the affected child. This study developed and tested an electronic diary for mapping the challenges of everyday family life in a sample of children with ADHD being treated with pharmacotherapy. Across 7 days, mothers and children (27 ADHD; 25 non-ADHD) independently reported their moods, behaviors, and social contexts every 30 min during nonschool hours. Symptomatic behaviors and negative moods were elevated in the ADHD group, combined with maternal perceptions of lower parenting effectiveness and quality of life. Differences in the contexts of maternal anger were salient, with mothers in the ADHD group more often angry when with their children and comparison mothers more often angry when not. Although mothers' diaries were more informative, children's diaries also distinguished the two groups, especially during mornings and weekends. The need for family-wide interventions, the utility of child self-reports, and the promise of electronic diaries are discussed.
Subject(s)
Activities of Daily Living/psychology , Attention Deficit Disorder with Hyperactivity/psychology , Medical Records , Mother-Child Relations , Mothers/psychology , Sickness Impact Profile , Stress, Psychological/psychology , Adult , Affect/physiology , Attention Deficit Disorder with Hyperactivity/drug therapy , Child , Child Behavior/psychology , Computers, Handheld , Female , Humans , Male , Middle Aged , Quality of Life/psychology , Reference Values , Self Disclosure , Social BehaviorABSTRACT
OBJECTIVE: This study was designed to examine context effects or provocation ecologies in the daily lives of children with ADHD. METHOD: Across 7 days, mothers and children (27 children with attention-deficit/hyperactivity disorder [ADHD] taking stimulant medication; 25 children without ADHD; ages 7-12 years) provided electronic diary reports every 30 +/- 5 minutes during non-school hours. Child and maternal perceptions of behaviors, moods, and interaction quality during preparatory and transitional ("getting ready") activities were compared with those during other activities. RESULTS: Maternal reports revealed that child symptomatic behaviors and negative moods, maternal negative moods, and parent-child disagreement were elevated in the ADHD but not in the comparison group while getting ready versus other activities. Children's self-ratings also revealed situational effects, indicating that school-age children with ADHD can give meaningful self-reports using carefully structured electronic diaries. CONCLUSIONS: Even when children with ADHD are receiving stimulant pharmacotherapy, the preparatory tasks of daily living are especially challenging and linked disproportionately to child behavior problems, parent negative affect, and contentious interactions. Treatment targeted on these transitional hurdles may improve child behavior patterns and enhance parent-child relationships and family harmony.
Subject(s)
Activities of Daily Living/psychology , Attention Deficit Disorder with Hyperactivity/psychology , Computers, Handheld , Medical Records , Mother-Child Relations , Adult , Affect , Attention Deficit Disorder with Hyperactivity/diagnosis , Child , Female , Humans , Linear Models , Logistic Models , Male , Middle Aged , Mothers/psychology , Patient ComplianceABSTRACT
Personal nephelometers provide useful real-time measurements of airborne particulate matter (PM). Recent studies have applied this tool to assess personal exposures and related health effects. However, a thorough quality control (QC) procedure for data collected from such a device in a large-scale exposure assessment study is lacking. We have evaluated the performance of a personal nephelometer (personal DataRAM or pDR) in the field. We present here a series of post hoc QC procedures for improving the quality of the pDR data. The correlations and the ratios between the pDRs and the collocated gravimetric measurements were used as indices of the pDR data quality. The pDR was operated in four modes: passive (no pump), active (with personal sampling pumps), active with a heated inlet, and a humidistat. The pDRs were worn by 21 asthmatic children, placed at their residences indoors and outdoors, as well as at a central site. All fixed-site pDRs were collocated with Harvard Impactors for PM2.5 (HI2.5). By examining the differences between the time-weighted average concentrations calculated from the real-time pDRs' readings and recorded internally by the pDRs, we identified 9.1% of the pDRs' measurements suffered from negative drifts. By comparing the pDRs' daily base level with the HI2.5 measurements, we identified 5.7% of the pDRs' measurements suffered from positive drifts. High relative humidity (RH) affected outdoor pDR measurements, even when a heater was used. Results from a series of chamber experiments suggest that the heated air stream cooled significantly after leaving the heater and entering the pDR light-scattering chamber. An RH correction equation was applied to the pDR measurements to remove the RH effect. The final R2 values between the fixed-site pDRs and the collocated HI2.5 measurements ranged between 0.53 and 0.72. We concluded that with a carefully developed QC procedure, personal nephelometers can provide high-quality data for assessing PM exposures on subjects and at fixed locations. We also recommend that outdoor pDRs be operated in the active mode without a heater and that the RH effect be corrected with an RH correction equation.
