Linda Herbert

Perceived History of Anaphylaxis and Parental Overprotection, Autonomy, Anxiety, and Depression in Food Allergic Young Adults

This study examined autonomy, anxiety, depression, and perceptions of parental behavior in 86 food allergic young adults and 344 healthy young adults between the ages of 18 and 22. Participants completed an online survey measuring self-reported autonomy, anxiety, depression, and perceptions of parental behavior. Results indicated that, as a group, food allergic young adults did not differ from healthy peers. However, food allergic young adults who reported having experienced an anaphylactic reaction described their disease as more severe, reported more worry about their disease, and rated their parents as more overprotective than food allergic young adults who reported never having experienced anaphylaxis. The experience of anaphylaxis may be a reliable indicator of food allergic individuals who are at risk for psychological distress.

Effects of Videogame Distraction and a Virtual Reality Type Head-Mounted Display Helmet on Cold Pressor Pain in Young Elementary School-Aged Children

OBJECTIVE This study examined the effects of videogame distraction and a virtual reality (VR) type head-mounted display helmet for children undergoing cold pressor pain. METHODS Fifty children between the ages of 6 and 10 years underwent a baseline cold pressor trial followed by two cold pressor trials in which interactive videogame distraction was delivered via a VR helmet or without a VR helmet in counterbalanced order. RESULTS As expected, children demonstrated significant improvements in pain threshold and pain tolerance during both distraction conditions. However, the two distraction conditions did not differ in effectiveness. CONCLUSIONS Using the VR helmet did not result in improved pain tolerance over and above the effects of interactive videogame distraction without VR technology. Clinical implications and possible developmental differences in elementary school-aged childrens ability to use VR technology are discussed.

Parenting and Independent Problem-Solving in Preschool Children With Food Allergy

OBJECTIVE To examine autonomy-promoting parenting and independent problem-solving in children with food allergy. METHODS 66 children with food allergy, aged 3-6 years, and 67 age-matched healthy peers and their mothers were videotaped while completing easy and difficult puzzles. Coders recorded time to puzzle completion, childrens direct and indirect requests for help, and maternal help-giving behaviors. RESULTS Compared with healthy peers, younger (3- to 4-year-old) children with food allergy made more indirect requests for help during the easy puzzle, and their mothers were more likely to provide unnecessary help (i.e., explain where to place a puzzle piece). Differences were not found for older children. CONCLUSIONS The results suggest that highly involved parenting practices that are medically necessary to manage food allergy may spill over into settings where high levels of involvement are not needed, and that young children with food allergy may be at increased risk for difficulties in autonomy development.

Maternal intolerance of uncertainty, anxiety, and adherence with food challenge referrals

Anxiety regarding food challenges may serve an important role in parents’ decisions to adhere to their child’s food challenge referrals. This study examined the role of intolerance of uncertainty in food challenge referral adherence by assessing state/trait anxiety among mothers whose children were referred for a food challenge. Mothers whose children passed a food challenge reported significant decreases in anxiety regarding allergic reactions, but intolerance of uncertainty did not predict adherence. Trust in the physician was a primary reason mothers attended the food challenge, suggesting that physicians should consider the impact of the physician–patient relationship when treating these families.

Development of a Tool to Measure Youths’ Food Allergy Management Facilitators and Barriers

OBJECTIVE This studys aims are to identify factors related to allergen avoidance and epinephrine carriage among youth with food allergy, develop a tool to measure food allergy management facilitators and barriers, and investigate its initial reliability and validity.  METHODS The Food Allergy Management Perceptions Questionnaire (FAMPQ) was developed based on focus groups with 19 adolescents and young adults with food allergy. Additional youth with food allergy (N = 92; ages: 13-21 years) completed food allergy clinical history and management questionnaires and the FAMPQ.  RESULTS Internal reliability estimates for the FAMPQ Facilitators and Barriers subscales were acceptable to good. Youth who were adherent to allergen avoidance and epinephrine carriage had higher Facilitator scores. Poor adherence was more likely among youth with higher Barrier scores.  CONCLUSIONS Initial FAMPQ reliability and validity is promising. Additional research is needed to develop FAMPQ clinical guidelines.

Parent employment and school/daycare decisions among parents of young children with type 1 diabetes

ABSTRACT This study explored the employment and school/daycare experiences of parents of young children with type 1 diabetes (T1D). Parents (n = 134) of young children with T1D (ages 1–6) responded to open-ended questions. Responses were systematically reviewed to identify themes. Four parent employment themes were identified: work cessation/reduction, employment flexibility, significant career impact, and financial pressure. Three school/daycare attendance themes were identified: school/daycare structure and setting, previous experience with T1D, and school/daycare importance. Insulin regimen, child age, and family income were related to parents’ decisions. Parents may benefit from clinical programs that assist them with employment and school/daycare decisions.

Are Adolescents with ADHD Interested in Genetic Testing for Nicotine Addiction Susceptibility

It has been well-established that some adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for cigarette smoking. Current research on the genetic basis of this association could ultimately translate into genetic tests capable of identifying smoking-prone adolescents with ADHD. In this study we examined 81 ADHD affected adolescents’ (age 13–21) interest in genetic testing for nicotine addiction susceptibility. Fifty-seven percent of adolescents indicated a fair amount of interest or more in testing. Most adolescents indicated that the personal information revealed from testing would be either useful (29%) or interesting (37%). Implications for genetically-informed smoking prevention and cessation interventions in high risk adolescents with ADHD are discussed.

Food Allergy Perceptions and Health-Related Quality of Life in a Racially Diverse Sample

This study examined caregiver perceptions of risk of food allergen exposure, and food allergy severity, worry, and health-related quality of life, and identified variations by race/ethnicity. Given the lack of data on racial/ethnic background in research on the psychosocial impacts of food allergy, this study meets a pressing need for research regarding food allergy-related experiences among diverse populations. This study found there were significant differences in perceived risk of allergen exposure among racial/ethnic groups with Asian Americans reporting significantly higher perceived risk of allergen exposure than Hispanic, Caucasian, and African American caregivers. There were no significant differences in food allergy severity, food allergy worry, or health-related quality of life among racial/ethnic groups; however, variability among racial/ethnic groups was apparent. Data may inform screening, counseling, and education practices for families from diverse backgrounds and aid in hypothesis generation for future research.