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OBJECTIVE: Research shows that children with asthma are at risk for behavioral

maladjustment, particularly internalizing symptoms (McQuaid et al., 2001), and that negative parenting behavior compromises child mental and physical health (Lim et al., 2011). However, pathways of effect are not clear. This study examined the relation between critical/harsh parenting and child asthma severity. A model was tested to assess whether children’s internalizing symptoms mediate the relation between maternal rejection/harshness and asthma severity.

METHODS: 215 children with asthma (ages 5-12) and their families participated. Mothers reported child internalizing symptoms (CBCL) and functional asthma severity (CHAS); a Pediatric Pulmonologist reported lung function via spirometry results. Maternal criticism was observed in a 15-minute family activity; harsh/critical behavior was coded on a 1-5 scale.

RESULTS: We conducted bootstrapping analyses, with 5000 samples, to examine the indirect effect of maternal rejection/criticism on pulmonary functioning via child internalizing symptoms, while controlling for child age, SES, and adherence, using the PROCESS SPSS Macro (Hayes, 2013). The estimate of the indirect effect between maternal rejection/criticism and objective lung functioning was supported, with a point estimate of -.03 (SE = .02; 95% CI = -.0846 to -.0007). However, the estimate of the indirect effect between maternal rejection/criticism and subjective/parent-reported lung functioning was not supported.

CONCLUSION: Results support a theorized pathway, in which critical parenting indirectly affects a child’s lung functioning by increasing his/her internalizing symptoms (Wood et al., 2007). These findings only apply to objective physiological measures of asthma severity, perhaps suggesting a unique way that internalizing symptoms may impact lung functioning. Proposed psychological interventions include helping families understand connections between emotional and physical well-being, reducing critical parenting behavior, and treating child internalizing symptoms.

Publication Date



asthma, pediatric asthma, child, internalizing symptoms, family, anxiety, depression, psychology


Child Psychology | Health Psychology

Faculty Advisor/Mentor

Marcia Winter, PhD

Is Part Of

VCU Graduate Research Posters

Critical Parenting’s Role in Asthma Severity: How Does A Child's Emotional Adjustment Matter?