Data collection is now complete in this longitudinal study, the goals of which were to establish the prevalence, characteristics, and consequences of depressive and other psychiatric disorders among 8-to-13 year old children (n=95) with newly diagnosed insulin-dependent diabetes mellitus (IDDM). The extended follow-up yielded 7-to-14 years of observation for 82% of the Ss and enabled assessment of diabetic complications. The outcomes of central interest have occurred: as of the exit interviews, 42% of the Ss had a major psychiatric disorder; 29% had a depressive disorder; 38% evidenced pervasive noncompliance with the medical regimen; and 67% developed diabetic complications. The present renewal application is to fully analyze the accumulated data. The conceptual approach is organized along three themes; (a) major depressive and other psychiatric disorder outcomes, (b) poor health- maintenance behaviors or pervasive noncompliance with the medical regimen, and (c) developmental stage related outcomes from childhood, through adolescence, to young adulthood. Two dimensions that are common to these themes are: IDDM-related variables, i.e., duration, metabolic control, and diabetic complications; and gender differences as they emerge with time. A set of central hypotheses and salient research questions that will guide data analyses are elucidated. Statistical approaches to the study's longitudinal, repeated-measures, multidimensional data set are described. And two time-limited subprojects are proposed: one project, involving a one-time call-back and assessment of previous """"""""noncompliant"""""""" (n=25) or """"""""compliant"""""""" (n=25) S will test hypotheses as to heuristics and biases that characterize their IDDM-care related decision-making processes; the other project, involving a mail-questionnaire survey of 42 female previous Ss, will relate the existing longitudinal data on their past coping and IDDM- course to their attitudes and behaviors regarding pregnancy and reproductive health in young adulthood. The findings of this study will contribute to a better understanding of the psychiatric aspects of juvenile-onset IDDM from childhood up to young adulthood, the longitudinally evolving relationship of psychosocial and biomedical variables, and the importance of developmentally earlier variables for later course and outcome.
