Psychosocial distress and anxiety in food allergic youth: identification and risk factors
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Pediatric food allergies (FA) are increasing in prevalence and have been associated with decreased quality of life (QOL) and impairment in physical, social, academic, and family functioning; however, little is known about the risk factors for psychological distress in this cohort. This was the first large-scale study to examine child, parent, and FA-related factors that may affect functioning in youth with FA. The sample consisted of 533 mothers of children with FA and 241 mothers of children with no chronic medical conditions, recruited through online forums. Mothers completed online questionnaires assessing their child's psychosocial health, physical health, and FA characteristics, as well as their own parenting behaviors and symptoms of psychological distress. It was hypothesized that (1) FA children would exhibit poorer functioning than healthy children; (2) mothers of FA children would exhibit higher levels of psychological distress than mothers of Healthy Control (HC) children; (3) higher FA severity would predict poorer child functioning; and (4) maternal psychological symptoms, overprotection, and gender would moderate the associations between presence of FA and child functioning, and between FA severity and child functioning. Results showed that (1) FA youth exhibited significantly better functioning than healthy children; (2) mothers of FA youth reported significantly less psychological distress than mothers of healthy children; (3) higher FA severity predicted poorer child functioning; and (4) these associations were moderated by maternal depression, anxiety, stress, and overprotection, but not by gender. Specifically, associations between presence of FA and child health-related QOL, child psychosocial health, and physical health were significantly stronger among children whose mothers were more depressed, anxious, and stressed. The associations between presence of FA and child psychosocial health were significantly weaker among highly overprotective mothers, indicating that in line with the anxiety disorder literature, overprotection in mothers of children with FA may serve a maladaptive function. These findings suggest that FA youth and their mothers are a particularly vulnerable population who may benefit from psychosocial interventions to address the psychological distress and interference associated with having FA.