This request for an RCDA is a companion grant to R01HD13820, """"""""Compliance and Control in Childhood Diabetes."""""""" The goal of both proposals is to better understand what psychological factors are important to health status in IDDM (insulin dependent diabetes mellitus) populations. The objective of the RCDA is to more intensively study psychological factors predictive of health in three populations who are """"""""high risk"""""""" for change in health status: 1) youngsters with IDDM entering adolescence; 2) newly diagnosed youngsters entering the total diabetic stage; and 3) nondiabetic individuals with islet cell autoantibodies (ICA), a marker considered to be predictive of diabetes onset. In the adolescent population, the extent to which the following variables are predictive of adherence behavior and health status will be assessed: a) patient/parent responsibility for diabetes management tasks; b) family eating and exercise habits; c) barriers to adherence; d) stress as indicated by parent/child conflict, daily hassles, and major """"""""life events""""""""; e) style of coping with stress; and f) parent/child communication about problem areas. Participants will be intensively studied for two 3-month intervals, 2 years apart. The same procedures and methods will be used to study the newly diagnosed group as well. However, the impact of the patient's developmental status (e.g. adolescence vs. pre-adolescence) during the """"""""honeymoon"""""""" phase will also be evaluated. In the population of individuals """"""""high risk"""""""" for developing diabetes, the following psychological variable will be considered as possible predictors of diabetes onset: a) dietary and exercise habits; b) stress as indicated by parent/child conflict or marital conflict, daily hassles, and major """"""""life events""""""""; and c) coping-with-stress style. Participants will be evaluated at 6-month intervals with phone contact during intervening months. Individuals may be followed for as long as 2-3 years. All the projects will involve measurement development/modification and/or the testing of the adequacy of available measures with these particular populations. Hopefully, the result will be the further development of adequate psychological measures appropriate for this population and useful to other investigators/clinicians in the field.
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