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Trauma Research: Coping and Posttraumatic Stress Symptoms in Children with Food Allergies

By Danielle Weiss & Meghan L. Marsac

In short, what is the study about?

Food allergies are an unfortunate common medical condition for many children and their families. Even with the millions of families that must manage food allergies, research on the emotional impact of food allergy is in its infancy. Children with food allergy reactions can face life-threatening physical reactions (e.g., anaphylaxis5) if they are exposed to their allergen. Children also may face social challenges (e.g., bullying8). Thus, to learn how to best support children with food allergy, we wanted to better understand how children cope with food allergy-related challenges, and identify the prevalence of posttraumatic stress symptoms (given the potential life-threatening reactions) among children with food allergies.

What would be the most important take-home messages from the study?

From our pilot study, we suggest three primary findings. Firstly, we found that children cope with food allergy-related challenges in a variety of ways. Specifically, children reported using cognitive restructuring (e.g., told yourself that you could handle this problem), social support (e.g., talked about your feelings to someone who really understood), and avoidant (e.g., didn’t think about it) coping to manage their food allergies. Secondly, we found that more than one-third of our sample (36% of children) reported significant posttraumatic stress symptoms related to their food allergy experiences. Finally, we found that in particular, children who had experienced an anaphylactic reaction to food had significantly more posttraumatic stress symptoms than children who had never experienced an anaphylactic reaction.

How are these findings important in practice?

While more research is needed, clinically, our findings suggest that it is advisable for clinicians to be aware that children cope with their food allergies differently, and that children with food allergies may benefit from screening and intervention to prevent posttraumatic stress, particularly those who have experienced an anaphylactic reaction to food.

What other studies can be recommended to further an understanding/application of the findings?

A number of studies of children with food allergies has documented an increased susceptibility to anxiety,1,4,7 peer victimization,6 and decreased health-related quality of life.3 To our knowledge PTSS in children with food allergy has not been documented prior to the current study, however, one study looked at adults who had experienced an anaphylactic reaction and posttraumatic stress, finding that 12% met criteria for Posttraumatic Stress Disorder.2  More research is needed to learn the full impact of food allergies in children and how to best target interventions to support children and families.


  1. Avery, N. J., King, R. M., Knight, S., & Hourihane, J. O. B. (2003). Assessment of quality of life in children with peanut allergy.Pediatric Allergy and Immunology14(5), 378-382.
  2. Chung, M. C., Walsh, A., & Dennis, I. (2011). Trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder, and psychiatric comorbidity among people with anaphylactic shock experience. Comprehensive psychiatry52(4), 394-404.
  3. King, R. M., Knibb, R. C., & Hourihane, J. B. (2009). Impact of peanut allergy on quality of life, stress and anxiety in the family. Allergy64(3), 461-468.
  4. Mandell, D., Curtis, R., Gold, M., & Hardie, S. (2002). Families coping with a diagnosis of anaphylaxis in a child.ACI International14, 96-101.
  5. Mayo Clinic. (2014). Food allergy symptoms. http://www.mayoclinic.org/diseases-conditions/food-allergy/basics/symptoms/CON-20019293.
  6. Muraro, A., Polloni, L., Lazzarotto, F., Toniolo, A., Baldi, I., Bonaguro, R., … & Masiello, M. (2014). Comparison of bullying of food-allergic versus healthy schoolchildren in Italy. Journal of Allergy and Clinical Immunology134(3), 749.
  7. Ravid, N. L., Annunziato, R. A., Ambrose, M. A., Chuang, K., Mullarkey, C., Sicherer, S. H., … & Cox, A. L. (2015). Mental health and quality-of-life concerns related to the burden of food allergy. Psychiatric Clinics of North America38(1), 77-89.
  8. Shemesh, E., Annunziato, R. A., Ambrose, M. A., Ravid, N. L., Mullarkey, C., Rubes, M., … & Sicherer, S. H. (2013). Child and parental reports of bullying in a consecutive sample of children with food allergy. Pediatrics,131(1), e10-e17.

Link to the Primary Study

Weiss, D., & Marsac, M. L. (2016). Coping and posttraumatic stress symptoms in children with food allergies. Annals of Allergy, Asthma, and Immunology. Advance online publication. DOI: 10.1016/j.anai.2016.08.022

Danielle Weiss

Danielle Weiss

Danielle Weiss, MS, is a research assistant at the Children’s Hospital of Philadelphia in the Center for Injury Research & Prevention and the Center for Amplified Musculoskeletal Pain Syndromes.



Meghan Marsac

Meghan Marsac

Dr. Meghan Marsac, Ph.D., is a pediatric psychologist at Kentucky Children’s Hospital and an Assistant Professor at the University of Kentucky. She specializes in promoting adjustment to pediatric medical conditions in children and their families.




About Danielle Weiss, Research Assistant, Children’s Hospital of Philadelphia

Alternative Text

Danielle Weiss, MS, is a research assistant at the Children’s Hospital of Philadelphia in the Center for Injury Research & Prevention and the Center for Amplified Musculoskeletal Pain Syndromes.

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More on: Child Mental Health Care, Parenting, Trauma
Latest update: November 24, 2016