Recent Trends in Asthma Research

  • Thomas L. Creer
  • Bruce G. Bender
Part of the Springer Series in Rehabilitation and Health book series (SSRH)


If there is one word that peppers any discussion of asthma, it is complex. The term repeatedly reappears throughout recent discussions of the disorder, whether it occurs in proposing how to define the condition or in describing the pathophysiology of the condition. Furthermore, it is a rare conversation among scientists who investigate asthma, especially those who have studied the disorder for a period of time, that does not end with participants shaking their heads and muttering something about how complex asthma seems to have become. Readers will come to appreciate this complexity during the following brief discussion of three topics: definition of asthma, characteristics of the disorder, and model of pathophysiology.


Peak Flow Childhood Asthma Peak Expiratory Flow Rate Medication Compliance Pill Count 
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  1. Anonymous. (1989). The American Asthma Report. New York: Research and Forecasts, Inc.Google Scholar
  2. Arkes, H. (1991). Costs and benefits of judgment errors: Implications for debiasing. Psychological Bulletin, 110, 486–498.CrossRefGoogle Scholar
  3. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.PubMedCrossRefGoogle Scholar
  4. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  5. Baum, D., & Creer, T. L. (1986). Medication compliance in children with asthma. Journal of Asthma, 23, 49–59.PubMedCrossRefGoogle Scholar
  6. Bauman, A. E., Craig, A. R., Dunsmore, J., Browne, G., Allen, D. H., & Vandenberg, R. (1989). Removing barriers to effective self-management of asthma. Patient Education and Counseling, 14, 217–226.CrossRefGoogle Scholar
  7. Becker, M. H., Maiman, L. A., Kirscht, J. D., Haefher, D. L., Drachman, R. H., & Taylor, D. W. (1979). Patient perceptions and compliance: Recent studies of the health belief model. In R. B. Hayes, D. W. Taylor, & D. L Sackett (Eds.), Compliance in health care (pp. 79–109). Baltimore, MD: Johns Hopkins University.Google Scholar
  8. Bender, B. G., Lerner, J. A., & Kollasch, E. (1988). Mood and memory changes in asthmatic children receiving corticosteroids. American Academy of Childhood and Adolescent Psychiatry, 27, 720–725.CrossRefGoogle Scholar
  9. Bender, B. G., Lerner, J. A., & Poland, J. E. (1991). Association between corticosteroids and psychologic change in hospitalized asthmatic children. Annals of Allergy, 66, 414–419.PubMedGoogle Scholar
  10. Bender, B., & Milgrom, H. (1992). Theophylline-induced behavior change in children: An objective evaluation of parents’ perceptions. Journal of the American Medical Association, 267, 2621–2624.PubMedCrossRefGoogle Scholar
  11. Bernstein, I. L (1983). Asthma in adults: Diagnosis and treatment. In E. Middleton, Jr., C. E. Reed, & E. F. Ellis (Eds.), Allergy: Principles and practice (pp. 901–934). St. Louis, MO: Mosby.Google Scholar
  12. Boston Collaborative Drug Juvenile Program. (1972). Acute adverse reactions in relation to dosage. Clinical Pharmacology, 13, 694–698.Google Scholar
  13. Boulet, L.-P., Deschesnes, F., Turcotte, H., & Gignac, F. (1991). Near-fatal asthma: Clinical and physiologic features, perception of bronchoconstriction, and psychologic profile. Journal of Allergy and Clinical Immunology, 88, 838–846.PubMedCrossRefGoogle Scholar
  14. Busse, W. W., & Reed, C. E. (1988). Asthma: Definitions and pathogenesis. In E. Middleton, Jr., C. E. Reed, E. F. Ellis, N. F. Adkinson, Jr., & J. W. Yunginer (Eds.), Allergy: Principles and practice (pp. 969–998). St. Louis, MO: Mosby.Google Scholar
  15. Canny, G. J., & Levison, H. (1990). Childhood asthma: A rational approach to treatment. Annals of Allergy, 64, 406–416.PubMedGoogle Scholar
  16. Cherniack, R. M., & Cherniack, L. (1983). Respiration in health and disease (3rd ed.). Philadelphia: Saunders.Google Scholar
  17. Clark, N. M., Evans, D., & Mellins, R. B. (1992). Patient use of peak flow monitoring. Annual Review of Respiratory Disease, 144, 722–725.CrossRefGoogle Scholar
  18. Conrad, P. (1985). The meaning of medications: Another look at compliance. Social Science and Medicine, 20, 29–37.PubMedCrossRefGoogle Scholar
  19. Cramer, J. A., Mattson, R. H., Prevey, M. L., Scheyer, R. D., & Ouellette, V. L (1989). How often is medication taken as prescribed? Journal of the American Medical Association, 261, 3273–3277.PubMedCrossRefGoogle Scholar
  20. Creer, T. L. (1979). Asthma therapy: A behavioral health-care system for respiratory disorders. New York: Springer.Google Scholar
  21. Creer, T. L. (1982). Asthma. Journal of Consulting and Clinical Psychology, 50(6), 912–921.PubMedCrossRefGoogle Scholar
  22. Creer, T. L. (1990). Strategies for judgment and decision making in the management of childhood asthma. Pediatric Asthma and Allergy Immunology, 4, 253–264.CrossRefGoogle Scholar
  23. Creer, T. L. (1991a). Medication compliance and asthma. Journal of Respiratory Diseases, 12, 543–548.Google Scholar
  24. Creer, T. L. (1991b). Psychologic and behavioral assessment of childhood asthma. Part I: Psychologic instruments. Pediatric Asthma, Allergy, and Immunology, 5, 317–328.CrossRefGoogle Scholar
  25. Creer, T. L. (1991c). The application of behavioral procedures to childhood asthma: Current and future perspectives. Patient Education and Counseling, 17, 9–22.PubMedCrossRefGoogle Scholar
  26. Creer, T. L. (1992). Psychological and behavioral assessment of childhood asthma: Part II. Behavioral approaches. Pediatric Asthma, Allergy, and Immunology, 6, 21–34.CrossRefGoogle Scholar
  27. Creer, T. L., Backial, M., Burns, K. L., Leung, P., Marion, R J., Miklich, D. R., Morrill, G., Taplin, P. S., & Uliman, S. (1988). Living with Asthma: Part I. Genesis and development of a self-management program for childhood asthma. Journal of Asthma, 25, 335–362.PubMedCrossRefGoogle Scholar
  28. Creer, T. L., & Christian, W. P. (1976). Chronically-ill and handicapped children: Their management and rehabilitation. Champaign, IL: Research Press.Google Scholar
  29. Creer, T. L., & Kotses, H. (1990). An extension of the Reed and Townley cocneption of the pathogenesis of asthma: The role of behavioral and psychological stimuli and responses. Pediatric Asthma, Allergy, and Immunology, 2, 169–184.CrossRefGoogle Scholar
  30. Creer, T. L., Kotses, H., & Wigal, J. KL (1992). A second-generation model of asthma self-management. Pediatric Asthma, Allergy, and Immunology, 6, 143–165.CrossRefGoogle Scholar
  31. Creer, T. L., Renne, C. M., & Christian, W. P. (1976). Behavioral contributions to rehabilitation and childhood asthma. Rehabilitation Literature, 37, 226–232, 247.PubMedGoogle Scholar
  32. Creer, T. L., Reynolds, R.V.C., & Kotses, H. (1991). A handbook for asthma self-management: A leader’s guide to living with asthma. Athens, OH: Ohio University Press.Google Scholar
  33. Creer, T. L., Wigal, J. K., Kotses, H., & Lewis, P. D. (1990). A critique of 19 self-management programs for childhood asthma: Part II. Comments regarding the scientific merit of the programs. Pediatric Asthma, Allergy, and Immunology, 4, 41–55.CrossRefGoogle Scholar
  34. Creer, T. L., Wigal, J. K., Tobin, D. L., Kotses, H., Snyder, S. E., & Winder, J. A. (1989). The Revised Asthma Problem Behavior Checklist. Journal of Asthma, 26, 17–29.PubMedCrossRefGoogle Scholar
  35. Downey, J., Ehrhardt, A. A., Gruen, R., Bell, J. J., & Morishima, A. (1989). Psychopathology and social functioning in women with Turner syndrome. Journal of Nervous and Mental Disease, 177, 191–201.PubMedCrossRefGoogle Scholar
  36. Eisen, S. A., Miller, D. K., & Woodward, R. S. (1990). The effect of prescribed daily dose frequency on patient medication compliance. Archives of Internal Medicine, 150, 1881–1884.PubMedCrossRefGoogle Scholar
  37. Ellis, E. F. (1988). Asthma in infhacy and childhood. In J. E. Middleton, Jr., C. E. Reed, E. F. Ellis, J.N.F. Adkinson, & J. W. Yunginer (Eds.), Allergy: Principles and practice (pp. 969–998). St. Louis, MO: Mosby.Google Scholar
  38. Eraker, S. A., Kirscht, J. P., & Becker, M. H. (1984). Understanding and improving patient compliance. Annals of Internal Medicine, 100, 258–268.PubMedCrossRefGoogle Scholar
  39. Firestone, P., & Martin, J. (1979). An analysis of the hyperactive syndrome: A comparison of hyperactive, behavior problem, asthmatic, and normal children. Journal of Abnormal ChildPsychology, 7, 261–273.CrossRefGoogle Scholar
  40. Furukawa, C. T., DuHamel, T. R., Weimer, L., Shapiro, G. G., Pierson, W. E., & Bierman, C. W (1988). Cognitive and behavioral findings in children taking theophylline. Journal of Allergy and Clinical Immunology, 81, 83–88.PubMedCrossRefGoogle Scholar
  41. Furukawa, C. T., Shapiro, G. G., DuHamel, T., Weiner, L., Pierson, W. E., & Bierman, C. W. (1984). Learning and behavior problems associated with theophylline therapy. Lancet, 1, 621.PubMedCrossRefGoogle Scholar
  42. Harm, D. L., Kotses, H., & Creer, T. L. (1985). Improving the ability of peak expiratory flow rates to predict asthma. Journal of Allergy and Clinical Immunology, 76(5), 688–694.PubMedCrossRefGoogle Scholar
  43. Harris, J. C., Carel, C. A., Rosenberg, L. A., Joshi, P., & Leventhal, B. G. (1986). Intermittent high dose corticosteroid treatment in childhood cancer. Journal of the American Academy of Child Psychiatry, 25, 120–124.PubMedCrossRefGoogle Scholar
  44. Hyland, M. E., Finnis, S., & Irvine, S. H. (1991). A scale for assessing quality of life in adult asthma sufferers. Journal of Psychosomatic Research, 35, 99–110.PubMedCrossRefGoogle Scholar
  45. Joad, J., Ahrens, R. C., Lindgren, S. D., & Weinberger, M. M. (1986). Extrapulmonary effects of maintenance therapy with theophylline and inhaled albuterol in patients with chronic asthma. Journal of Allergy and Clinical Immunology, 78(6), 1147–1153.PubMedCrossRefGoogle Scholar
  46. Juniper, E. G., Guyatt, G. H., Epstein, R. S., Ferrie, P. J., Jaeschke, R., & Hiller, T. K. (1992). Evaluation of impairment of health related quality of life in asthma: Development of a questionnaire for use in clinical trials. Thorax, 47, 76–83.PubMedCrossRefGoogle Scholar
  47. Kinsman, R. A., Luparello, T., O’Banion, K., & Spector, S. (1973). Multidimensional analysis of the subjective symptomatology of asthma. Psychosomatic Medicine, 35, 250–267.PubMedGoogle Scholar
  48. Kotses, H., Stout, C., Wigal, J. K., Carlson, B., Creer, T. L., & Lewis, P. (1991). Individualized asthma self-management: A beginning. Journal of Asthma, 28, 287–289.PubMedCrossRefGoogle Scholar
  49. Levison, H. (1991). Canadian consensus on the treatment of asthma in children. Canadian Medical Association Journal, 145, 1440–1445.Google Scholar
  50. Ling, M.H.M., Perry, P. J., & Tsuang, M. T. (1981). Side effects of corticosteroid therapy. Archives of General Psychiatry, 38, 471–477.PubMedCrossRefGoogle Scholar
  51. Lohr, K. N. (1989). Conceptual background and issues in quality of life. In F. Mosteller & J. Falotico-Taylor (Eds.), Quality of life and technology assessment (pp. 1–6). Washington, DC: National Academy Press.Google Scholar
  52. Loren, M. L., Leung, P. K., Cooley R. L., Chai, H., Bell, T. D., & Buck, V. M. (1978). Irreversibility of obstructive changes in severe asthma in children. Chest, 74, 126–129.PubMedCrossRefGoogle Scholar
  53. Madison, J. M. (1991). Chronic asthma in the adult: Pathogenesis and pharmacotherapy. Seminars in Respiratory Medicine, 12, 175–184.CrossRefGoogle Scholar
  54. Marlatt, G. A. (1982). Relapse prevention: A self-control program for the treatment of addictive behaviors. In R. B. Stuart (Ed.), Adherence, compliance and generalization in behavioral medicine. New York: Brunner/Mazel.Google Scholar
  55. Mawhinney, H., Spector, S. L., Kinsman, R. A., Siegel, S. C., Rachalefsky, G. S., Katz, R. M., & Rohr, A. S. (1991). Compliance in clinical trials of two nonbronchodilator antiasthma medications. Annals of Allergy, 66, 294–299.PubMedGoogle Scholar
  56. McCarthy, M. M. (1981). Speech effects of theophylline. Pediatrics, 68, 749.PubMedGoogle Scholar
  57. McFadden Jr., E. R. (1980). Asthma: Pathophysiology. Seminars in Respiratory Medicine, 1, 297–303.CrossRefGoogle Scholar
  58. Murphy, M. B., Dillon, A., & Fitzgerald, M. X. (1980). Theophylline and depression. British Medical Journal, 281, 1322.PubMedCrossRefGoogle Scholar
  59. Pinzone, H. A., Carlson, B. W., Kotses, H., & Creer, T. L. (1991). Prediction of asthma episodes in children using peak expiratory flow rates, medication compliance, and exercise. Annals of Allergy, 67, 461–647.Google Scholar
  60. Plaut, T. F. (1988). Children with asthma: A manual for parents (2nd ed.). Amherst, MA: Pedipress.Google Scholar
  61. Premack, D. (1959). Toward empirical behavioral laws: Positive reinforcement. Psychological Review, 66, 219–233.PubMedCrossRefGoogle Scholar
  62. Rachelefsky, G., Wo, J., Adelson, J., Spector, S., Katz, R., Siegel, S., & Rohr, A. (1986). Behavior abnormalities and poor school performance due to oral theophylline usage. Journal of Allergy and Clinical Immunology, 77, 145.Google Scholar
  63. Rand, C. S., Wise, R. A., Nides, M., Simmons, M. S., Bleecker, E. R., Kusek, J. W., Li, V. C., & Tashkin, D. P. (1992). Metered-dose inhaler adherence in a clinical trial. American Review of Respiratory Disease, 146, 1559–1564.PubMedCrossRefGoogle Scholar
  64. Rappaport, L., Cofiman, H., Guare, R., Fenton, T., DeGraw, C., & Twarog, F. (1989). Effects of theophylline on behavior and learning in children with asthma. American Journal of Diseases of Children, 143, 368–372.PubMedGoogle Scholar
  65. Reed, C F., & Townley, R. G. (1983). Asthma: Classification and pathogenesis. In E. Middleton Jr., C. E. Reed, & E. F. Ellis (Eds.), Allergy: Principles and practice (pp. 811–831). St. Louis, MO: Mosby.Google Scholar
  66. Renne, C. M., & Creer, T. L. (1985). Asthmatic children and their families. In M. L Walraich & D. K. Routh (Eds.), Advances in developmental and behavioral pediatrics (pp. 41–81). Greenwich, CN: JAI Press.Google Scholar
  67. Roth, H. P., Carson, H. S., & Hsi, B. P. (1970). Measuring intake of a prescribed medication: A bottle count and tracer technique compared. Clinical Pharmacology and Therapeutics, 11, 228–237.PubMedGoogle Scholar
  68. Sbarbaro, J. A., & Steiner, J. F. (1991). Noncompliance with medications: Vintage wine in new (pill) bottles. Annals of Allergy, 66, 273–275.PubMedGoogle Scholar
  69. Schlieper, A., Alcock, D., Beaudry, P., Feldman, W., & Leikin, L (1991). Effect of therapeutic plasma concentrations of theophylline on behavior, cognitive processing, and affect in children with asthma. Journal of Pediatrics, 118, 449–455.PubMedCrossRefGoogle Scholar
  70. Sibbald, B. (1989). Patient self-care in acute asthma. Thorax, 44, 97–101.PubMedCrossRefGoogle Scholar
  71. Spector, S. L., Lewis, C. E., Feldman, C. H., Haynes, R. B., Hindi-Alexander, M., Kinsman, R. A., Menendez, R. A., & Sbarbaro, J. A. (1986). Workshop 6: Compliance factors. Journal of Allergy and Clinical Immunology, 78, 529–533.CrossRefGoogle Scholar
  72. Springer, C., Goldenberg, B., Ben Dov, L., & Godfrey, S. (1985). Clinical, physiologic, and psychologic comparison of treatment by cromolyn or theophylline in childhood asthma. Journal of Allergy and Clinical Immunology, 76, 64–69.PubMedCrossRefGoogle Scholar
  73. Stout, C., Kotses, H., Carlson, B. W., & Creer, T. L. (1991). Predicting asthma in individual patients. Journal of Asthma, 28, 41–47.PubMedCrossRefGoogle Scholar
  74. Sulzer-Azaroff, B., & Mayer, G. R. (1991). Behavior analysis for lasting change. Ft. Worth, TX: Holt, Rinehart & Winston.Google Scholar
  75. Taplin, P. S., & Creer, T. L. (1978). A procdure for using peak expiratory flow-rate data to increase the predictability of asthma episodes. The Journal of Asthma Research, 16(1), 15–19.PubMedCrossRefGoogle Scholar
  76. Tashkin, D., Rand, C., Nides, M., Simmons, M., Wise, R., Coulson, A. H., Li, V., & Gong, H. (1991). A nebulizer chronolog to monitor compliance with inhaler use. The American Journal of Medicine, 91(Suppl. 44), 33–36.CrossRefGoogle Scholar
  77. Tobin, D. L., Wigal, J. K., Winder, J. A., Holroyd, K. A., & Creer, T. L. (1987). A self-efficacy scale for asthma. Annals of Allergy, 59(10), 273–277.PubMedGoogle Scholar
  78. Wasser, W. G., Bronheim, H. E., & Richardson, B. K. (1981). Theophylline madness. Annals of Internal Medicine, 95, 191.PubMedCrossRefGoogle Scholar
  79. Wigal, J. K., Creer, T. L., Kotses, H., & Lewis, P. D. (1990). A critique of 19 self-management programs for childhood asthma: Part I. The development and evaluation of the programs. Pediatric Asthma, Allergy, and Immunology, 4, 17–39.CrossRefGoogle Scholar
  80. Williams, J. L., & Wood-Dauphinee, S. (1989). Assessing quality of life: Measures and utility. In F. Mosteller & J. Falotico-Taylor (Eds.), Quality of life and technology assessment (pp. 65–115). Washington, DC: National Academy Press.Google Scholar
  81. Wright, B. M., & McKerrow, C. B. (1959). Maximum forced expiratory flow rate as a measure of ventilatory capacity: With a description of a new portable instrument for measuring it. British Medical Journal, 2, 1041–1047.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Thomas L. Creer
    • 1
  • Bruce G. Bender
    • 2
  1. 1.Department of PsychologyOhio UniversityAthensUSA
  2. 2.National Jewish Center for Immunology and Respiratory MedicineDenverUSA

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