How are mental representations of asthma triggers and symptoms related to interpersonal risk perceptions? A psychometric investigation of caregivers of children with asthma

Objective: Parents and guardians (hereafter caregivers) make decisions for their children’s medical care. However, many caregivers of children with asthma struggle to understand their child’s illness. We used the psychometric paradigm to investigate how caregivers conceptualize, or mentally represent, asthma triggers and symptoms and how these representations are linked to perceived asthma exacerbation risk. Methods: We asked 377 caregivers of children with asthma across the U.S. to rate 20 triggers or 20 symptoms along 15 characteristics. Caregivers also indicated their perceived risk of their child having an asthma exacerbation (hereafter interpersonal risk perceptions). Using principal components analysis, we extracted key dimensions underlying caregivers’ ratings on the characteristics. Then we related the triggers’ and symptoms’ scores on the dimensions to caregivers’ interpersonal risk perceptions. Results: Interpersonal risk perceptions were higher for triggers with high ratings for the dimensions severe and relevant, and negative affect—yet manageable, but not chronic—yet unpredictable. Risk perceptions were also higher for symptoms with high ratings for the dimensions severe and unpredictable, and relevant and common, but not self-blame or manageable despite unknown cause. Conclusion: By identifying key dimensions underlying caregivers’ mental representations of asthma triggers and symptoms, these findings can inform a new approach to asthma education.