Children's self-esteem can affect their response to asthma

While many urban children suffer from asthma, those who have high self-esteem and good problem-solving skills may be less likely to have their asthma symptoms interfere with school, a new study finds.

"Our results suggest that in spite of facing asthma symptoms, stressors related to urban residence, as well as family life stressors, children's individual characteristics such as higher levels of problem-solving beliefs and self-esteem were associated with fewer school absences, more participation in activities, and less missed sleep," says lead author, Daphne Koinis Mitchell, PhD, with the Bradley Hasbro Children's Research Center (BHCRC) and Brown Medical School.

This study, published in the December 2005 issue of the Journal of School Health, is an important step towards identifying ways in which school systems can develop plans to help students with asthma improve their academic performance.

Asthma can influence school absences, increase emergency room visits, limit physical activities, and account for sleep loss. If not properly treated, asthma can negatively impact children's ability to learn when in school, the authors write.

But are there are factors that might mitigate these effects? The authors studied a group of urban, school-aged children (and their mothers) with asthma from minority backgrounds.

They found that self-esteem and children's beliefs about their problem-solving abilities functioned as "resource factors", or personality characteristics, that helped counter the negative effects of asthma and urban living. In fact, more positive problem-solving beliefs were associated with more participation in activities and less missed sleep.

Research shows that urban living and its associated family stressors like poverty and exposure to violence can also compromise children's school functioning. In addition, as one of the most prevalent childhood chronic illnesses in the US, asthma is overrepresented in children from urban, low socioeconomic and ethnic minority backgrounds.

"Pediatric asthma should be a focus of attention in school systems due to its increased prevalence in urban areas and its association with difficulties in children's psychosocial and academic functioning," says Koinis Mitchell.

Given the heightened risks that urban children face, it is imperative for research to identify factors that might contribute to optimal asthma-related, psychological, and school functioning. An enhanced understanding of these issues may allow health providers and educators to promote children's academic and asthma-related functioning despite exposure to illness-related and urban stresses, the authors conclude.

"Enhancing children's self-esteem and problem-solving beliefs may be important targets for future school-based interventions with urban children who have asthma," says Koinis Mitchell.


The Childhood Asthma Research Program at the Bradley Hasbro Children's Research Center (BHCRC), has numerous NIH-funded research projects to investigate factors that contribute to variations in asthma management behaviors in children. A recent initiative involves understanding what type of protective factors may help promote asthma-related resilience and minimize school-related asthma morbidity in urban children.

Founded in 1931, Bradley Hospital ( was the nation's first psychiatric hospital operating exclusively for children. Today, it remains a premier medical institution devoted to the research and treatment of childhood psychiatric illnesses. Bradley Hospital, located in Providence, RI, is a teaching hospital for Brown Medical School and ranks in the top third of private hospitals receiving funding from the National Institutes of Health. Its research arm, the Bradley Hasbro Children's Research Center (BHCRC), brings together leading researchers in such topics as: autism, colic, childhood sleep patterns, HIV prevention, infant development, obesity, eating disorders, depression, obsessive-compulsive disorder (OCD) and juvenile firesetting. Bradley Hospital is a member of the Lifespan health system.

Last reviewed: By John M. Grohol, Psy.D. on 30 Apr 2016
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