Psychological factors associated with emergency room visits among asthmatic patients.

The team asked adults with asthma about their ER visits. They also asked how much panic-fear they felt and how sure they were they could handle an attack.

They compared the answers of people who visit the ER often with people who rarely go.

Frequent ER users said they feel more panic-fear and less self-efficacy. They did not differ in general anxiety or how bad their asthma looks on paper.

In short, panic-fear and low self-efficacy, not lung scores, drive the trips.

Bouck et al. (2016) extends this idea to college kids. They show that fear of bodily sensations predicts stronger asthma symptoms in the lab.

Dunton et al. (2016) also extend the link. They used real-time texts and found that social stress like teasing or parent fights worsens asthma symptoms within hours in Hispanic teens.

Lunsky et al. (2011) is methodologically similar. They found that life events such as housing change or police contact predict ER visits in adults with intellectual disabilities. Both studies flag non-medical drivers of emergency care.

You can add two quick questions to your intake: "How much panic do you feel when you wheeze?" and "How sure are you you can handle an attack?" High panic and low confidence signal future ER use. Target these with brief coping-skills training before the next ambulance ride.