Original article
Parental criticism and treatment outcome in adolescents hospitalized for severe, chronic asthma

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Abstract

This pilot study investigated the relationship between parental criticism and medical treatment outcome across an inpatient hospitalization in 19 adolescents with severe, chronic asthma. Parental criticism toward their asthmatic adolescent was assessed using the Five Minute Speech Sample technique (FMSS) at the beginning of the adolescent's inpatient 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 reduction in their steroid medication dose, and shorter lengths of stay in the hospital than those whose parents were rated as low in criticism. The adolescents whose parents were rated as high in criticism also showed 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 vocal cord dysfunction or to the allergy status of the children. Clinical implications and possible causal mechanisms underlying these findings are discussed.

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    A prior version of this paper was presented at the conference, “Physical Illness, Psychologic Development, and How the Twain Shall Meet,” Keystone, Colorado, 24–27 June 1993. This research has been supported by the Clinical Investigation Committee at NJCIRM, NIH grants #R03-MH48683 and #M01-RR00051.

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