Psychosocial predictors of asthma onset during mid-adulthood: evidence from the National Child Development Study

This paper provides evidence about how psychosocial factors predict asthma onset during mid-adulthood. Questions addressed are: 1. Do life course adversities predict asthma onset? What types of adversity are important? 2. What factors confound and mediate associations between childhood adversity and asthma onset? 3. In the context of life course adversity, do psychological factors predict asthma onset? Data from the National Child Development Study from birth to age 42 were used. Asthma onset was measured between 33 and 42. To reduce bias and maintain numbers, missing values were imputed in multiple data sets. Logistic regression analyses were conducted of asthma onset on life course adversities, classified as material (including occupation-related) and social (family-/relationship-related, child loss, traumatic). Nested models were used to address questions 2 and 3, and a wide range of factors tested. After adjustment for gender, asthma onset during mid-adulthood was more common among cohort members who reported life course adversities (odds ratio per category = 1.232 (1.140-1.332)) in eight categories. Social adversities predicted asthma onset after adjustment for material adversities. The association between childhood adversity and asthma onset was mediated by subsequent adversity and depressive symptoms at 33. Asthma onset was predicted by female gender, atopic history, life course adversity, internalising childhood temperament and depressive symptoms at 33. This study contributes to a small evidence base that life course adversities substantially increase the risk of adult-onset asthma, and highlights the importance of psychosocial pathways. The salience of depressive symptoms shortly before diagnosed onset is a new finding.