The overall objective of the proposed research is to systematically assess the impact of psychosocial and stress dimensions upon outcome patterns of diabetic adolescents. Previous studies have indicated the importance of factors such as individual coping resources, life stress, and family environment in the adaptation of a patient to his or her chronic illness. Few studies have rigorously evaluated the influence of these variables upon favorable and unfavorable outcomes in Insulin-dependent Diabetes. In addition, none of the previous investigations have used longitudinal designs in studing the outcome. Our perspective is that to study those factors which underlie highly successful or problematic outcomes during adolescence, a multivariate research design is required. Our plan is to identify a cohort of newly-diagnosed diabetics, age 11-13 and a demographically matched control group of children being seen on an outpatient basis with an acute remitting illness. These patients and their families will be studied in terms of selected (through clinical and theoretical considerations) variables over the next four years. Variables to be studied include: 1) Familial coping strategies and interactions; 2) adolescent ego development and coping processes; 3) life stresses experienced by adolescents and their parents; 4) health locus of control; and 5) personality of adolescent and parents. In order to have our outcome measures most closely approximate the overall effect of a chronic disease, we have measures which are highly specific to diabetes (metabolic status and early long-term complications) and those which index other aspects of health status (self-esteem and psychosocial adjustment). Data analyses use multivariate statistical designs, with cross-sectional and longitudinal components.
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