Naturalistically-Observed Conflict and Youth Asthma Symptoms

OBSERVED CONFLICT AND ASTHMA 1

Supplementary Online Material (SOM) for

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This file includes:

Supplementary Methods

Supplementary Results

Table S1

Table S2

Table S3

Supplementary References Supplementary Methods

Multiple Imputation

Multiple imputation was applied to account for the missing data and to improve statistical power (Graham, 2009; Graham, Cumsille, & Elek‐ Fisk, 2003). We used a multiple imputation approach under a model that assumes values are missing at random meaning that the missing values do not depend on unobserved data, given the availability of observed outcome data and covariates (Little & Rubin, 1989). Thirty imputations were completed as recommended by

Graham et al. (2007) to prevent a falloff of statistical power. All analyses were carried out using

SPSS version 22 software.

Supplementary Results

Naturalistically-Observed and Self-Reported Conflict

We first examined bivariate correlations between caregiver-reported, youth-reported, and

EAR-observed measures of conflict. Table S1 presents bivariate correlations between all study measures using imputed data. Notably, there were no associations between EAR-observed conflict composites and the baseline self-reported measures of conflict (e.g., caregiver and youth

PEQ conflict). However, daily diary reports of negative interactions from the caregiver were significantly associated with baseline caregiver-reported conflict (e.g., caregiver-PEQ), youth daily reports of negative interactions, EAR-observed measures of interpersonal conflict, and

EAR-observed caregiver-youth conflict. Additionally, youth daily diary reports of negative interactions were significantly correlated with baseline youth-reported conflict (e.g., youth-

PEQ). Further, EAR-observed interpersonal conflict and EAR-observed caregiver-youth conflict were strongly associated, as would be expected given the composite codes share overlap (e.g., yelling by the mother and yelling by the youth). Conflict and Asthma Symptoms

We next explored the associations between the measures of conflict and asthma symptoms (See Table S2). Notably, there were no significant relationships between caregiver-

PEQ, youth-PEQ, and self- or daily reported asthma symptoms or EAR-observed wheezing.

However, with the daily diary reports of negative interactions, a relationship emerged. Daily youth reports of negative caregiver-youth interactions were significantly associated with greater daily asthma symptoms and marginally related with greater self-reported asthma symptoms.

EAR-observed interpersonal conflict was significantly associated with greater baseline self- reported asthma symptoms and daily asthma symptoms and marginally related with greater

EAR-observed wheezing. EAR-observed caregiver-youth conflict was significantly associated with greater EAR-observed wheezing and marginally related to baseline self-reported asthma symptoms.

Interpersonal Conflict and Asthma Symptoms

We next conducted several hierarchical multiple regression analyses to examine the independent effects of EAR-observed interpersonal conflict and daily diary measures of conflict on asthma symptoms. As displayed in Table S2, EAR-observed interpersonal conflict and the daily diary indices of conflict (e.g., youth-reported negative caregiver-youth interactions and caregiver-reported negative interactions) were entered as predictors. EAR-observed interpersonal conflict significantly predicted increased baseline self-reported asthma symptoms and, when daily reports of conflict where added to the regression, significantly predicted increased self-reported asthma symptoms.

EAR-observed interpersonal conflict also significantly predicted increased asthma symptoms reported via daily diary and when daily reports of conflict where added to the regression equation, the relationship was marginally significant. Notably, when entering daily reports of conflict, youth daily ratings of caregiver-youth conflict significantly predicted daily reported asthma symptoms.

EAR-observed interpersonal conflict marginally predicted increased EAR-observed wheezing. When including daily reports of caregiver-youth conflict in the regression, EAR- observed interpersonal conflict and youth daily ratings of caregiver-youth conflict were both marginally significant. After the addition of youth ethnicity, the relationship between EAR- interpersonal conflict and EAR-observed wheezing remained marginally significant.

Caregiver-Youth Conflict and Asthma Symptoms

We then conducted several hierarchical multiple regression analyses to examine the independent effects of EAR-observed caregiver-youth conflict and daily diary measures of conflict on asthma symptoms. As displayed in Table S3, EAR-observed caregiver-youth conflict and the daily diary indices of conflict (e.g., youth-reported negative caregiver-youth interactions and caregiver-reported negative interactions) were entered as predictors. EAR-observed caregiver-youth conflict was marginally associated with increased self-reported asthma symptoms. When adding daily measures of conflict into the regression equation, EAR-observed caregiver-youth conflict and youth daily ratings of caregiver-youth conflict marginally predicted increased self-reported asthma symptoms.

EAR-observed caregiver-youth conflict was not associated with daily reported asthma symptoms. When including daily diary reports of conflict, youth reports of negative interactions emerged as a significant predictor of daily reported asthma symptoms and not EAR-observed caregiver-youth conflict. Finally, EAR-observed caregiver-youth conflict significantly predicted EAR-observed wheezing. When including daily reports of caregiver-youth conflict in the regression, EAR- observed caregiver-youth conflict remained significant. After the addition youth ethnicity, the relationship between EAR-observed caregiver-youth conflict and EAR-observed wheezing remained significant. OBSERVED CONFLICT AND ASTHMA 6

Table S1

Bivariate Correlations between Study Variables using Imputed Data

2 3 4 5 6 7 8 9 10 11 1. Y-Age .08 .06 .04 .12 .01 -.07 .05 -.02 .07 .01 2. Y-Ethnicity -.10 .06 -.11 .01 .01 .07 .06 -.04 .21 3. Y-PEQ .38** .44** .12 -.03 -.01 .07 .21 -.27 4. C-PEQ .34** .42** .13 .09 -.10 -.01 -.16 5. Y-NG .38** .24 .24 .23+ .40** -.07 6. C-NG .43** .44** .03 .10 .08 7. EAR-Observed .80** .28* .28* .30+ Interpersonal Conflict 8. EAR-Observed .25+ .18 .34* Caregiver-Youth Conflict 9. Self-Report Asthma .49** .15 Symptom Questionnaire 10. Daily Diary Asthma -.08 Symptom Composite 11. EAR-Observed Wheezing

Note. + p < .10. * p < .05. ** p < .01. Y = Youth-Reported. C = Caregiver-Reported. PEQ = Parental Environment Questionnaire. NG = Daily Negative Caregiver-Youth Interactions. EAR = Electronically Activated Recorder. Table S2

Multiple Regression Analyses Pooled Coefficients after Multiple Imputation with EAR Interpersonal Conflict and Daily Caregiver- and Youth-Reports Predicting Asthma Symptoms

Self-Reported Asthma Daily Diary Reported EAR-Observed Symptoms Asthma Symptoms Wheezing Predictor Variables b-weight (SE) b-weight (SE) b-weight (SE) Step 1 EAR-Observed Interpersonal .42 (.19)* .04 (.02)* .30 (.15) + Conflict

Step 2 EAR-Observed Interpersonal Conflict .46 (.21)* .04 (.02)+ .35 (.18) + Y-NG 2.47 (1.46) + .46 (.14) ** -1.08 (1.59) + C-NG -.28 (.21) -.03 (.02) -.02 (.19)

Step 3 EAR-Observed Interpersonal Conflict .34 (.17) + Y-NG -.89 (1.57) C-NG -.03 (.19) Y-Ethnicity .26 (.16)

Note. + p < .10. * p < .05. ** p < .01. Y = Youth-Reported. C = Caregiver-Reported. NG = Daily Negative Caregiver-Youth Interactions. Table S3

Multiple Regression Analyses Pooled Coefficients after Multiple Imputation with EAR Caregiver-Youth Conflict and Daily Caregiver- and Youth-Reports Predicting Asthma Symptoms

Self-Reported Asthma Daily Diary Reported EAR-Observed Wheezing Symptoms Asthma Symptoms Predictor Variables b-weight b-weight b-weight Step 1 EAR-Observed Caregiver-Youth .35 (.19) + .03 (.02) .31 (.13)* Conflict

Step 2 EAR-Observed Caregiver-Youth Conflict .38 (.21) + .02 (.02) .36 (.15)* Y-NG 2.52 (1.47) + .48 (.14)** -1.08 (1.52) C-NG -.27 (.21) -.02 (.02) -.05 (.19)

Step 3 EAR-Observed Caregiver-Youth Conflict .35 (.15)* Y-NG -.91 (1.50) C-NG -.05 (.19) Y-Ethnicity .23 (.16)

Note. + p < .10. * p < .05. ** p < .01. Y = Youth-Reported. C = Caregiver-Reported. NG = Daily Negative Caregiver-Youth Interactions. Supplementary References

Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual

review of psychology, 60, 549-576.

Graham, J. W., Cumsille, P. E., & Elek‐Fisk, E. (2003). Methods for handling missing

data. Handbook of psychology.

Graham, J. W., Olchowski, A. E., & Gilreath, T. D. (2007). How many imputations are

really needed? Some practical clarifications of multiple imputation theory.

Prevention Science, 8(3), 206-213.

Little, R. J., & Rubin, D. B. (1989). The analysis of social science data with missing

values. Sociological Methods & Research, 18(2-3), 292-326.