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There is an enormous body of literature on the general subject of psychological factors in asthma. At one time, asthma was widely regarded as a psychologically driven disorder. For that, you could go back to Franz Alexander's book Psychosomatic Medicine. That perception changed as the physical aspects of the disease were described more fully. The introduction of effective medications for the disorder also led to reduced interest in psychological treatments. However, the fact remains that there are multiple links between asthma and psychology.

Psychosocial stressors often play a triggering role in the disorder, for example. How often? Decades ago, most cases involved something of the sort, though only a minority were primarily due to psychosocial factors. Nowadays, that proportion has probably declined. But it remains true that roughly half of all asthmatics experience emotionally triggered attacks. So for an asthmatic adolescent wrestling with identity issues, it would not be surprising to find that situations associated with acute identity struggles would also be triggers for asthma attacks.

There continues to be interest in the interplay between adjustment and the course of illness. Adherence or compliance with medical treatment is affected, obviously. And there are many psychological treatments that can help with asthma, though they are not usually substituted for medication.

Here are a few classic references that may be of some help:

Salvator Minuchin et al. (1975). A conceptual model of psychosomatic illness in children: Family organization and family therapy. Archives of General Psychiatry, 32, 1031-1038.

Robert W. Levenson (1979). Effects of thematically relevant and general stressors on specificity of responding in asthmatic and nonasthmatic subjects. Psychosomatic Medicine, 41, 28-39.

Howard Friedman et al. (1987). The disease-prone personality: A meta-analysis of the construct. American Psychologist, 42, 539-555.

William MacLean et al. (1992). Psychological adjustment of children with asthma: Effects of illness severity and recent stressful events. Journal of Pediatric Psychology, 17, 159-171.

Paul Lehrer et al. (1993). Asthma and emotion: A review. Journal of Asthma, 30, 5-21.

Thomas Campbell & Joan Patterson (1995). The effectiveness of family interventions in the treatment of physical illness. Journal of Marital and Family Therapy, 21, 545-583.

Most of the more recent work will have to do with adjustment and treatment, not causation.

In addition to the excellent historical references above, the most recent literature is looking at the relationship of stress-related physiology and asthma exacerbation. Clearly, adolescent identity conflicts can pose significant stress even leading to suicidal ideation (see Michael Feldman et al.'s paper on sexual identity and suicidal risk among adolescents). And so, one place to make a link between these two areas would be through HPA-axis functioning and cytokines a) in association with identity conflicts and b) in association with asthma. For the latter, here are just a few recent references for you to look at:

Allostatic load biomarkers and asthma in adolescents.

Bahreinian S, Ball GD, Vander Leek TK, Colman I, McNeil BJ, Becker AB, Kozyrskyj AL.

Am J Respir Crit Care Med. 2013 Jan 15;187(2):144-52. doi: 10.1164/rccm.201201-0025OC. Epub 2012 Sep 6.

Basal or stress-induced cortisol and asthma development: the TRAILS study.

Vink NM, Boezen HM, Postma DS, Rosmalen JG.

Eur Respir J. 2013 Apr;41(4):846-52. doi: 10.1183/09031936.00021212. Epub 2012 Jul 12.

Contribution of stress to asthma worsening through mast cell activation.

Theoharides TC, Enakuaa S, Sismanopoulos N, Asadi S, Papadimas EC, Angelidou A, Alysandratos KD.

Ann Allergy Asthma Immunol. 2012 Jul;109(1):14-9. doi: 10.1016/j.anai.2012.03.003. Epub 2012 Mar 22. Review.

Prospectively assessed early life experiences in relation to cortisol reactivity in adolescents at risk for asthma.

Kelsay K, Leung DY, Mrazek DA, Klinnert MD.

Dev Psychobiol. 2013 Mar;55(2):133-44. doi: 10.1002/dev.21006. Epub 2012 Feb 7.

A Uruguyan team of M. Altmann and S. Gril had reported interesting psychodynamic research in this area. Unfortunately, the untimely death of Silvia Gril did not permit some of those publications to go forward-- some are in Spanish and some remain as chapters or congress abstracts.

Best of Luck in this important search.

Here is the reference to the Feldman paper that I was mentioning:

J Am Acad Child Adolesc Psychiatry. 2000 Aug;39(8):1047-54.

Sexual attitudes and associated psychiatric features among youths in a community sample.

Feldman MJ, Bird HR, Hoven C, Moore RE, Bin F.

Thank you should follow up and some pilot exploration should help me.

Thanks all of you for these info. That's will give me reading for a while if I keep my activities balanced. Two reasons:

_to develop my Visual mathematician approach of psychology, it's relation with the quantum world (fractals), Zen and Gestalt.

_to understand more and maybe explain it to my Respirologist who don't understand my exacerbation recovery speed. Suffering of asthma as a child, I'm now COPD severe on "palliative care"(lol, sorry).

Thank Vijay, for the question. So important for me. But never ask, deeply feeling somebody will do it when I need it.

Two thing I believe psychologist should have a peak::

_the particle wave duality

_the Heisenberg principal of uncertainty.

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