Honors Theses

Date of Award

Spring 5-1-2021

Document Type

Undergraduate Thesis


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First Advisor

Aaron Lee

Second Advisor

Sujith Ramachandran

Third Advisor

Laura Dixon

Relational Format



Effective control of asthma symptoms requires daily self-management activities, including use of short-acting or “rescue” inhaled medications. Overuse of short-acting inhaled medications, such as albuterol, can have negative side-effects, including respiratory infections and worse asthma symptom control. Existing research suggests that emotion plays an important role in airway inflammation and asthma symptom control. The objective of this study was to determine whether difficulties regulating emotion was associated with overuse of short-acting inhaled medications and acute medical care usage in adults with asthma. The sample included 401 adults with asthma recruited from an online panel of adults with chronic respiratory disease. Respondents completed a survey that included measures of short-acting medication use, acute medical service use, and emotion regulation (Difficulties in Emotion Regulation Scale [DERS]). Sequential binary logistic regression models were used to examine the association between DERS scores with two indicators of short-acting inhaled medication overuse: using >3 canisters of short-acting inhaled medications in the past three months or self-reported overuse (i.e., using short-acting inhaled medications more than prescribed) while controlling for patient characteristics (current smoking and health insurance status) and comorbid mental health conditions (probable depression and probable anxiety). The results showed that greater difficulties in emotion regulation was significantly associated with greater odds of using more than three canisters in the past three months (AOR = 1.023, 95%CI [1.012, 1.035], p < .001) and using short-acting inhaled medications more than prescribed (AOR = 1.024, 95%CI [1.014, 1.035], p < .001) as well as with greater odds of emergency department visits (AOR = 1.018, 95%CI [1.009, 1.028], p AOR = 1.017, 95%CI [1.007, 1.028], p=.001) in the prior 12-months – even after adjusting for probable depression and probable anxiety, current smoking, and health insurance status. In conclusion, emotion dysregulation may play an important role in overuse of short-acting inhaled medications and acute medical care utilization among adults with asthma. Evidence-based interventions to reduce difficulties in emotion regulation may help improve problematic patterns of short-acting medication overuse among adults with asthma.



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