Background and Aims: Maternal depression is associated with child depression and poor asthma control. We examined whether insecure attachment and autonomic dysregulation (specifically vagal bias) mediates the effect of maternal depression on child asthma.
Methods: Asthmatic children (N=94;age7-17) and mothers were studied. Maternal and child depression were assessed by self-report (BDI and CDI respectively), attachment by child report (RQ), and disease activity was assessed using symptoms and pulmonary function tests. Children were studied in a laboratory film stress protocol to determine whether insecure attachment predicted autonomic dysregulation (specifically vagal bias) and pulmonary compromise under stress. Respiratory sinus arrhythmia (RSA) method measured vagal activation and pre-ejection period (PEP) of the heart cycle measured sympathetic activation. Vagal Bias was indexed by the formula (Zrsa –Zpep). . Structural Equation Modeling (SEM) tested the pathways of effect.
Results: Maternal depression contributed to child depression and insecure attachment, which each contributed to asthma disease activity, (Χ2(24)= 31.03, p =.15;IFI .97, CFI.97, RMSEA (.04). Lab findings showed that insecurely attached asthmatic children showed greater vagal bias (p<.05) accompanied by higher airway resistance (p<.05).
Conclusions: Maternal depression affects child asthma through insecure attachment mediated by accompanying vagal bias.