SUSTAINABLE RESILIENCE

Allergies and AnxietyPreventative Strategies

Paula Barrett

Pathways Health and Research Centre

www.pathwayshrc.com.auUniversity of Queensland

Acknowledgments• My family: Ana, Tom, Brad and our pets

• Pathways Team

• All the families we have worked with

“Our mind can overcome almost any adversity “

Norman Doidge

Risk and Protective Factors for Human Development

Risk Factors:• Temperament

Physiological sensitivity – low thresholds for stress

• Neurological/brain development

• Life Events traumas

• Physical Health

Protective Factors:• Attachment/Affection• Cognitive style• Family• Sleep• Daily Exercise• Diet• School /Work• Evidence Based

Prevention

What we know:• One in five adults & children suffer anxiety or

depression (more prevalent than drug use,

ADHD, or any other health problem)

• One in five adults or children suffer from

allergies and associated anxiety

• Less than 5 % of cases receive effective

preventative interventions

What we know:

90% of major emotional and psychological

difficulties and allergies start before 18 years of

age !

What we know

Parents and Health Professionals do not know how

to access and implement preventative Psychological

Evidence Based Interventions

Physiological

Awareness of body cluesRelaxation techniques

Self-regulation Managing physical conditions

Cognitive Positive

thinking skills about self,

others and the environment

LearningProblem solving skills

Coping Behavioural SkillsPositive role models Support networks

Evidence based interventions

AttachmentStable, unconditionally

loving relationships, Self - soothing,

mirror self-worth, acceptance,

safety

Australian Evidence Based Resilience Program: Friends for Life

• F = Feelings (awareness and empathy)• R = Relaxation (self reg & self soothing)• I = Unhelpful vs helpful thinking• E = Problem Solving and step plans• N = Nurturing confidence• D = Don’t forget the ongoing practise• S = Stay calm, You know what is

happening, You know what to do

“We cannot always build the future for our youth, but we can build our youth for the

future”

Early Intervention

• Preventative Interventions - Early prior to onset of a disorder

• Preventative Interventions - Early developmentally in a child’s life

What WE CAN do:

• Education rather than stigma• Prevention rather than waiting• Empowerment rather than blaming• Focus on interactions and learning skills• Focus on strengths rather than deficits• Focus on solutions rather than problems

“ Externalising the anxiety and allergy

challenges empowers the child

and the family”

Friedman and Morris, REVIEW Journal of Clinical Psychology in Medical Settings

• There is an increasing prevalence of anxiety disorders and allergic conditions in children and adolescents - these illnesses are often comorbid.

• Anxiety management skills are needed for parents and children

• Allergy management skills are needed for parents and children

Friedman and MorrisWhat can be done:

• We must identify at-risk children• We must study the family history• We must conduct validated assessments for

comorbid anxiety and allergies• We need to target anxious parents and to

implement exposure and other CBT skills• We need to develop and evaluate treatments

that reduce fear associated with the physiological symptoms of allergic reactions

Teufel et al, 07What can be done:

It is important to acknowledge the complex interplay between body and mind: adults and children suffering from food allergy

show impaired quality of life and a higher level of stress and anxiety. We need to

develop strategies for an optimized management of the various types of

adverse reactions to food.

DunnGalvin et al, 09What can be done:

1 - A developmental framework must link health related quality of life and the maturation of the immune system.

2 - It must also link psychological stress, temperament and emotion to neuro-immuno-regulation and increased risk of negative impact.

3 – It must explain both physiological and psychological phenomena and their interaction.

Preventative skills Be happy Nurture important relationships Have fun with children Let children be children Monitor, cohesion, consistency Spend time, interpersonal rewards Sleep, Diet, Exercise, Play

DunnGalvin et al, 09

Children whose parents encouraged independence and self-management were more likely to describe positive coping strategies

“If there's food around, I will be careful, but otherwise I don't think about it”

“I always tell people I'm food allergic…its safer that way and then you don't have to keep explaining

Cummings Ped All Imm 2010

Anxiety can be managed by both parents and children with positive outcomes for all independent of

allergy severity and type experienced by the children.

Graves et al, 2010Journal of Pediatric Psychology

• Summarises 70 studies doen with children with chronic illness mainly allergies

• Only 50% of families with children adhere to treatment and prevention protocols

• Adherence maximises long term health benefits

THANK YOU!

WWW.PATHWAYSHRC.COM.AU“The brain that changes itself” Doidge, 07

“Allergies and Anxiety in Children and Adolescents: A Review of the Literature” Friedman and Morris, 06

“Psychological burden of food allergy” Teufel et al, 07

“Developmental Pathways in food allergy: a new theoretical framework” DunnGalvin et al, 09