Rape, asthma and dysfunctional breathing
Open accessAbstract
Functional breathing disorders are common, but poorly understood, causes of respiratory symptoms, and often co-exist with asthma and other respiratory diseases [1–3]. Hyperventilation syndrome is the most recognised form of dysfunctional breathing. It has long been suspected that dysfunctional breathing may have emotional origins, but there is little empirical evidence to support this [4]. A history of rape is a risk factor for dysfunctional breathing in adults of both sexes and for late-onset asthma diagnosis in women <http://bit.ly/2TFhdAH> We thank the study members and their friends and families for their continued support. We also thank the interviewers and respiratory physiologists and who obtained the data, Richie Poulton, the study director, Phil A. Silva, the study founder, and Malcolm Sears, Terrie Moffitt and Avshalom Caspi for their support.
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This lack of clarity has the potential to negatively influence the patient experience, with DB patients expressing frustration with a lack of recognition and delays in diagnosis.
“This lack of clarity also has the potential to negatively influence the patient experience, with DB patients expressing frustration with a lack of recognition and delays in diagnosis (19,43).”
From How is dysfunctional breathing characterised in the clinical literature? A scoping review (2026) · cites this paper as [43]
The discussion (@ERSpublications; page unavailable) says there are no objective criteria for diagnosing dysfunctional breathing and describes difficulty distinguishing it from asthma. It does not report patients expressing frustration, feeling unrecognised, or experiencing diagnostic delays, so the patient-experience claim is unsupported by this paper. (LLM, conf=0.78)
Experimental — accuracy not yet measuredA recent literature review highlighted the multidimensional nature of DB renders the use of a single assessment criterion as inadequate.
“A notion supported in a recent literature review highlighted the multidimensional nature of DB renders the use of a single assessment criterion as inadequate (43).”
From How is dysfunctional breathing characterised in the clinical literature? A scoping review (2026) · cites this paper as [43]
The discussion (@ERSpublications; page unavailable) says the Nijmegen questionnaire was developed as a screening rather than a diagnostic tool and that there are no objective criteria for diagnosing dysfunctional breathing. That supports caution about relying on one measure for diagnosis, but this paper is a cohort study, not a literature review, and it does not attribute that limitation to the multidimensional nature of dysfunctional breathing. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe absence of a consensus definition in DB potentially limits its identification in clinical practice.
“It has also been noted by Karkouli et al how the absence of a consensus definition in DB potentially limits its identification in clinical practice (43).”
From How is dysfunctional breathing characterised in the clinical literature? A scoping review (2026) · cites this paper as [43]
In the discussion (@ERSpublications; page unavailable), the paper says there are no objective criteria for diagnosing dysfunctional breathing and that the Nijmegen questionnaire is a screening rather than a diagnostic tool. This supports concern about identifying the condition, but the paper does not specifically say that an absence of a consensus definition limits identification in clinical practice; its discussion of identification concerns epidemiological research. (LLM, conf=0.83)
Experimental — accuracy not yet measured
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References 16 · Cited by 11
Research works printed but not linked: 11
- Vidotto LS, de Carvalho CRF, Harvey A, et al. Dysfunctional breathing: what do we know? J Bras Pneumol 2019; 45: e20170347.
- Pfeffer JM. The aetiology of the hyperventilation syndrome. A review of the literature. Psychother Psychosom 1978; 30: 47-55. https://doi.org/10.1183/13993003.02455-2019
- Scott KM, Smith DAR, Ellis PM. A population study of childhood maltreatment and asthma diagnosis: differential associations between child protection database versus retrospective self-reported data. Psychosom Med 2012; 74: 817-823.
- Coogan PF, Wise LA, O'Connor GT, et al. Abuse during childhood and adolescence and risk of adult-onset asthma in African American women. J Allergy Clin Immunol 2013; 131: 1058-1063.
- Bhan N, Glymour MM, Kawachi I, et al. Childhood adversity and asthma prevalence: evidence from 10 US states (2009-2011). BMJ Open Respir Res 2014; 1: e000016.
- Abajobir AA, Kisely S, Williams G, et al. The association between substantiated childhood maltreatment, asthma and lung function: a prospective investigation. J Psychosom Res 2017; 101: 58-65.
- Morris MJ, Allan PF, Perkins PJ. Vocal cord dysfunction: etiologies and treatment. Clin Pulm Med 2006; 13: 73-86.
- Hancox RJ, Gray AR, Poulton R, et al. The effect of cigarette smoking on lung function in young adults with asthma. Am J Respir Crit Care Med 2016; 194: 276-284.
- van Roode T, Dickson N, Herbison P, et al. Child sexual abuse and persistence of risky sexual behaviors and negative sexual outcomes over adulthood: findings from a birth cohort. Child Abuse Negl 2009; 33: 161-172.
- Breiding MJ, Smith SG, Basile KC, et al. Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization-national intimate partner and sexual violence survey, United States, 2011. MMWR Surveill Summ 2014; 63: 1-18.
- Douwes J, Brooks C, Pearce N. Asthma nervosa: old concept, new insights. Eur Respir J 2011; 37: 986-990. Copyright ©ERS 2020 https://doi.org/10.1183/13993003.02455-2019
- Authors
- Hancox, R. J., Morgan, J., Dickson, N., Connor, J., & Baxter, J. M.
- Affiliations
- University of Otago (NZ)
- Waikato Hospital (NZ)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2020-03-17
- Volume
- 55
- Issue
- 6
- Pages
- 1902455
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W3012456083
- Cited by
- 11
- References
- 16
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 4
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Duke University
- Health Research Council of New Zealand
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Keywords
- rape, dysfunctional breathing, hyperventilation syndrome, asthma, late-onset asthma, women, childhood trauma, respiratory symptoms
- MeSH terms
- Asthma, Breathing Exercises, Humans, Rape, Respiration, Respiration Disorders
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