ASC panic-fear and length of hospitalization in asthma.

A prior study’ has demonstrated the relationship between MMPI PanicFear scores and length of hospitalization in several respiratory illness groups, including asthma, Myco bacterium tuberculosis, Myco bacterium intracellulare-auium, and Mycobacterium kansasii. In general, MMPI Panic-Fear scores related linearly to length of hospitalization, with High MMPI Panic-Fear patients being hospitalized the longest and Low MMPI Panic-Fear patients being hospitalized the shortest length’ of time. These findings were found to be independent of pulmonary function measurements in asthma and of bacteriological type and drug resistance in tuberculosis. As the MMPI Panic-Fear scale was empirically derived from the Asthma Symptom Checklist (ASC) PanicFear cluster’, it would appear reasonable to assume that ASC Panic-Fear scores would also relate to length of hospitalization in asthma. However, recent studies have found important differences between these two scales. Conceptually, MMPI Panic-Fear measures a personality trait associated with the reported frequency of such subjective symptoms accompanying asthmatic attacks as feeling scared, panicky, worried, and frightened, while ASC Panic-Fear directly measures these subjective symptoms3. A later formulation4 notes that ASC Panic-Fear defines a specific, situational Panic-Fear response to breathing difficulties experienced during an asthma attack, while MMPI Panic-Fear defines a personality trait which taps a general, diffuse anxiety. More re~ently,~ ASC Panic-Fear has been referred to as vigilance or signal anxiety about asthmatic attacks, while MMPI Panic-Fear assesses the patient’s ego controls for dealing with that signal anxiety. Empirical findings suggest that ASC and MMPI Panic-Fear do not always relate in the same manner to either intensity of prescribed oral cortico~teroids~ or to rehospitalization rates‘. Indeed, the best predictors of treatment outcome appear to be found in the interactions between ASC and MMPI Panic-Fear scores. Given the above, it was decided to investigate the relationship between ASC Panic-Fear scores and length of hospitalization for asthmatic patients in intensive long-term treatment.