PARENTAL CRITICISM AND TREATMENT OUTCOME IN ADOLESCENTS HOSPITALIZED FOR SEVERE, CHRONIC ASTHMA

This pilot study investigated the relationship between parental critic ism and medical treatment outcome across an inpatient hospitalization in 19 adolescents with severe, chronic asthma. Parental criticism towa rd their asthmatic adolescent was assessed using the Five Minute Speec h Sample technique (FMSS) at the beginning of the adolescent's inpatie nt stay at a national asthma referral center. Those adolescents whose parents were rated as high in criticism on the FMSS were found to have greater improvement in their overall asthma severity, greater reducti on in their steroid medication dose, and shorter lengths of stay in th e hospital than those whose parents were rated as low in criticism. Th e adolescents whose parents were rated as high in criticism also showe d lower compliance with their prescribed theophylline and oral steroid medication at admission than the low criticism group. These findings do not appear to be due to misdiagnosis secondary to the presence of v ocal cord dysfunction or to the allergy status of the children. Clinic al implications and possible causal mechanisms underlying these findin gs are discussed.