Allergies, anaphylaxis and post-traumatic stress in children, adolescents and their parents

Summary

The Leeds Institute of Health Sciences invites applications from prospective postgraduate researchers who wish to commence study for a PhD in the academic year 2024/25.

The prevalence of food allergy has been increasing over the past three decades with an estimated 3-10% of young people effected (Grabenhenrich, 2020; Santos 2023). In the UK between 1998-2018 the incidence of hospital admissions due to food anaphylaxis increased by 5.7%, with the largest increase observed among children under the age of 16 years (Baseggio, 2021).

Up to 12% of adult allergic patients who have experienced anaphylaxis meet diagnostic criteria for posttraumatic stress disorder (PTSD; Chung, 2011). Post-Traumatic Stress Disorder (PTSD) is a psychiatric diagnostic label used to describe adverse psychological reactions to highly stressful or life-threatening events, and includes symptoms such as hyperarousal, intrusive re-experiencing of the traumatic event(s), and emotional and/or behavioural avoidance of stimuli related to the traumatic event(s) (ICD-11; World Health Organization, 2019). Severe reactions to food allergies, including anaphylaxis, can be classed as traumatic events given the potential to cause severe anxiety, fear, and possible threat to life. Studies show that individuals who experience such reactions can develop PTSD (Chung et al., 2011; Lee et al., 2020). Furthermore, parents of children with anaphylaxis can also develop significant symptoms of anxiety and PTSD (Jeong, 2022; Roberts, 2021). A paediatric study on 7-13-year-old children with a food allergy, found that those who experienced anaphylaxis were significantly more likely to report posttraumatic stress symptoms (PTSS; Weiss & Marsac, 2016).

There is currently limited research into the prevalence, determinants and experience of PTSD in children and young people with allergies. The proposed PhD will address this gap in the literature through three phases of research, with the aim of developing evidence-based recommendations for improved identification, monitoring and support for young people and families following anaphylaxis.

Methodology

The precise structure will be determined by the PhD candidate, so they can have ownership of the project. However, at this proposal stage the PhD will involve three phases to answer the following questions:

1. What is the prevalence and nature of PTSD symptoms in young people and parents following an anaphylaxis experience?
2. How do young people and their parents adjust to these PTSD symptoms?

Literature review

Previous research will be reviewed in two topic areas:

• Anaphylaxis experiences of young people
• Post-traumatic stress disorder in young people

The results will provide context for the PhD alongside grounding the student in the topic. Insights gained from the reviews will inform the development of methodology in the following two phases.

Survey

Young people and their families under the care of the allergies clinic at Leeds Children’s Hospital will be surveyed to assess the prevalence, frequency and severity of allergic reaction and anaphylaxis in this population. If anaphylaxis experiences are reported then this will trigger follow-up questions in the survey related to the short and longer-term impact of these experiences on the young people and their families. Those reporting anaphylaxis experiences in the survey will be asked to participate in phase 3.

Qualitative

Interviews will focus on the circumstances of their anaphylaxis experience(s) and the details of the short and longer-term impact. These interviews will aim to add depth and richness to the data collected in phase 2 through detailing the impact of anaphylaxis experiences and the subsequent coping mechanisms and adjustments made by young people and families.

Applicants to research degree programmes should normally have at least a first class or an upper second class British Bachelors Honours degree (or equivalent) in an appropriate discipline. The criteria for entry for some research degrees may be higher, for example, several faculties, also require a Masters degree. Applicants are advised to check with the relevant School prior to making an application. Applicants who are uncertain about the requirements for a particular research degree are advised to contact the School or Graduate School prior to making an application.

Applicants whose first language is not English must provide evidence that their English language is sufficient to meet the specific demands of their study. The Faculty of Medicine and Health minimum requirements for this PhD are: • British Council IELTS - score of 6.5 overall, with no element less than 6.0. The test must be dated within 2 years of the start of the course in order to be valid.