Social anxiety in school-age children with asthma: Application of the disability-stress-coping model of adjustment

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Annette La Greca - Committee Chair


Children with asthma may be at particular risk for social adjustment problems. Specifically, asthma severity and functional status may impede children's social interactions, leading to peer rejection and feelings of social anxiety. Based on Wallander and Varni's disability-stress-coping model of adjustment (1989), the present study investigated the association between asthma severity, functional status, peer rejection, and social anxiety in a cross-sectional design. Children with asthma (65 boys, 30 girls; 7--13 years) from diverse ethnic backgrounds were recruited during scheduled appointments in a pulmonary clinic. Parents and their children completed measures assessing functional status, peer rejection, and social anxiety. Parents and physicians additionally completed asthma severity measures. Results revealed that greater asthma severity was associated with poorer functional status, which in turn was associated higher social anxiety, partially mediated by peer rejection. Furthermore, results consistently demonstrated that younger children exhibited more social anxiety than older children, minority children had more severe asthma and had greater levels of peer rejection than nonminority children, and boys had more severe asthma and more peer rejection than girls. The final model fit the data better using social anxiety as the outcome compared to general anxiety. In conclusion, because of the social limitations that asthma may impose on a child, social anxiety appears to be a particularly salient area for research in pediatric asthma. Revisions of Wallander and Varni's model of adjustment (1989) seem necessary to evaluate social anxiety in children with asthma, as well as other specific adjustment variables across chronic illnesses. Study limitations and future research directions are discussed.


Psychology, Clinical

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