Volunteer with Psychology

Professor of Clinical Psychology Louise Sharpe is investigating the development of anxiety in children with asthma. Unlike children with only anxiety, children with both conditions face a complicated predicament: their anxiety cannot be treated unless they face their fear, but what if their fear, asthma attacks, may actually kill them?

By Tim Groenendyk

Child with asthma spacer

“The fact that their fear – of an asthma attack - actually has more of an element of truth you have to treat it a bit differently." Professor Louise Sharpe [Image: Child with asthma spacer used under the Creative Commons licence.]

Professor Louise Sharpe at the School of Psychology is recruiting four groups of children to compare for this research study.

“We’re looking for children with asthma, both who have and do not have anxiety disorders, and we’re looking for children just with anxiety and no asthma or co-morbid medical problems, and then we’re also looking at healthy controls.”

Sharpe specialises in health psychology, looking at how people adjust to chronic illness and the psychological processes.

“Most chronic illnesses are associated with higher levels of depression and anxiety, and depending on the illness those might manifest slightly differently to the way that you see them in healthy people.

To develop a treatment for children with both asthma and anxiety Sharpe examines the role of parents, who may support ‘avoidance’ when the child is confronted with a situation that may trigger panic.

“Parents are in a very difficult situation. When their child is anxious and distressed your motivation is to make your child less distressed and the easiest way is take them out of upsetting situations.”

However, this is one of the worst recourses a parent can take because avoidance only reinforces anxiety.

“We would typically encourage children to put themselves in situations that they’re afraid of to teach them there’s nothing to be afraid of.

“If you’re afraid of dogs and every time you see a dog in the distance and you run away from it you will never learn that dogs usually aren’t harmful and it leads to the fear generalising.”

But, as Sharpe explains, when the source of the child’s anxiety is their own asthma attacks then that threat could prove to be quite genuine.

“The fact that their fear – of an asthma attack - actually has more of an element of truth you have to treat it a bit differently, and that’s what we’re trying to work out.

By applying their understanding of the development of anxiety her team is attempting to observe whether there is a different pattern of development in asthma, studying how children respond to threatening stimuli.

“If you present children who have anxiety with something most people would think of as threatening, a word or a picture for example, they will actually respond more quickly to that than most people.

“And we’re trying to see is whether or not that’s also the case for children with asthma who also have anxiety, or whether they’re actually responding specifically to asthma-related cues, like the word breathlessness for example.”

This may seem like a monumental task, given the contradictory nature of how the two illnesses are treated, but it’s not unfamiliar territory for Sharpe who has previously studied the presence of anxiety in suffers of emphysema - now known as chronic obstructive pulmonary disease.

“COPD is a chronic and ultimately fatal disease, so eventually patients end up dying through lack of breath because of their emphysema. Understandably they often become very anxious, when they have exacerbations of COPD, that they’re about to die, now.”

But by using cognitive behaviour therapy Sharpe’s team was able to prevent the development of any new cases of panic disorder emerging in COPD sufferers.

“The evidence is very good for cognitive behavioural therapy in treating children who have anxiety disorders alone.

“For children to tolerate the distress that they’re experiencing you have to set up the treatment in a sensible, gradual way. So don’t introduce them to a Rottweiler if they’re afraid of dogs.”