Self-Reported Stressful Life Events During Adolescence and Subsequent Asthma: A Longitudinal Study

Abstract

Although exposure to stressful life events in adolescence has been associated with poor health as measured by number of physicians' visits and symptom scores, little is known regarding stress in adolescence and either concurrent or subsequent asthma. The objective of this study was to explore whether life events in adolescence are associated with either concurrent or new active asthma. The Tucson Children's Respiratory Study, a prospective population-based birth cohort, surveyed participants at 10 ages between 6 and 29 years regarding respiratory health. Asthma was defined as a physician-diagnosis of asthma withsymptoms during the previous year. At age 16, participants (n= 318) were queried regarding stressful life events using the 67-item Life Events Questionnaire for Adolescents (LEQA). LEQA scores were examined in relation to both concurrent and new active asthma. Estimates were obtained with logistic regression and mixed models. There was no relation between asthma prevalence at age 16 and LEQA scores in the overall sample, although males with high LEQA scores had higher prevalence of asthma compared with males with low scores (relative risk [RR]: 3.03; 95% confidence interval [CI]: 1.37, 6.69; P= .006). Among adolescents with no asthma through age 16, risk of new asthma was greater for those with high LEQA scores (adjRR: 4.07; 95% CI: 1.33, 12.43; P=.014), after adjustment for potential confounders including smoking. Emotional support from family and friends slightly diminished the relation of stress to new asthma. Stressful life events during adolescence are associated with subsequent new asthma. Additional biological and psychological measures of stress would complement these findings.