The overall programmatic aim of this ongoing longitudinal project is to investigate the influences of family and individual psychosocial forces on clinically relevant diabetes outcomes, in order to identify risk factors that may be amenable to early psychosocial interventions. To carry out this goal, we propose to study, over time, an already identified and well-characterized onset cohort of insulin-dependent diabetic adolescents. These children and families are currently being followed from three perspectives: individual child and parent psychosocial functioning; family context (including both direct-observations and self-reports of the family); and medical dimensions (compliance with treatment, metabolic control, and early signs of retinopathy). Findings obtained from our analyses of this data shape the research questions and hypotheses of our proposed studies. The subjects are adolescent diabetic and acutely ill patients and their families. The acute illness sample is demographically matched with the diabetic one. The adolescents entered the study soon after the onset of their diabetes or acute illness. The two specific studies that we propose to carry out are: 1) Family and Individual Psychosocial Predictors of Adolescent Diabetes Outcomes; and, 2) The Impacts of Insulin-Dependent Diabetes Upon Adolescent and Family Functioning. Using a repeated measures design, we systematically assess individual adolescent patients and their families. Features specific to Study """"""""1"""""""" include the annual assessment of the adolescents in terms of diabetes-specific adjustment, knowledge, and compliance, as well as metabolic control and signs of early microvascular complications (retinopathy and nephropathy). In Study """"""""2"""""""", we continue to follow a matched sample on the same psychosocial variables, so as to identify most rigorously how diabetes may differentially affect adolescents and their families. The data analyses for these studies use multivariate statistical techniques, such as repeated measures analyses of variance and multiple set correlation.
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