Children's Self-Reports of Psychologic Adjustment and Coping Strategies During First Year of Insulin-Dependent Diabetes Mellitus

Abstract

Psychologic adjustment, assessed by self-ratings of anxiety, self-esteem, and depression, and cognitive as well as behavioral coping strategies, elicited by interview, were monitored longitudinally among school-age children with recent-onset insulin-dependent diabetes mellitus (IDDM). Our article documents the findings over the 1st yr of illness. From the start, the children viewed themselves as self-confident and emotionally comfortable. The diagnosis of IDDM created minimal emotional upheaval (which faded within 6 mo), despite this cohort's consistent report that the diet, insulin injections, and urine tests were difficult. The most prevalent cognitive strategies for coping with IDDM included wishful thinking, thoughts of forbidden foods, and resentful thoughts. Behavioral coping strategies, including information seeking, were evident from the beginning. The frequency of socially oriented coping behaviors (e.g., showing IDDM management to peers) indicated that the young patients actively tried to adapt to the illness and were more comfortable with aspects of home care than previously thought. Self-rated psychologic adjustment, psychiatric diagnosis, and illness-related coping behaviors were unrelated to one another; psychologic variables were similarly unrelated to the use of socially oriented coping strategies. Therefore, in juvenile cohorts, the presumed association between psychologic status and coping behaviors requires further examination.

General Quality of Life in Youth With Type 1 Diabetes

“…This difference arose from lower scores on the psychosocial subscale, which assessed parental perception of the child's adjustment at school and level of social and emotional functioning. Other investigators have also reported that while children with diabetes generally do not have severe psychological problems (24,25); when they do struggle, it is often in the socialemotional and peer relationship areas of functioning (26,27). Nonetheless, the remarkable similarity in general quality of life between youth with type 1 diabetes and a healthy sample contrasts with a recent report of quality of life from 106 severely obese youth (28).…”

Diabetes and behavioral medicine: The second decade.

“…This study, as well as others, subsequently found that by 1 year after diagnosis, symptoms resolved in the majority of children as well as their parents, suggesting that successful psychosocial adjustment occurs relatively quickly in most families (Jacobson et al, 1986;Kovacs et al, 1986). These positive findings were somewhat tempered by subsequent research that showed that psychosocial problems often re-emerge in youths several years after diagnosis and that difficulty in coping with diabetes can increase over time (Grey, Cameron, Lipman, & Thurber, 1995), especially in those patients who exhibit poor initial adjustment (Kovacs et al, 1986). Unfortunately, there have been no such longitudinal studies of psychosocial adjustment in adults, even though clinicians are frequently faced with the problem of "diabetes burnout," which is common in patients who have been dealing with the disease for a number of years (Polonsky, 1999).…”

Assesment of the effect of summer camp on the life quality of diabetic children

“…Other studies reported that children with type 1 DM generally did not have serious psychosocial problems and that the problems seen were related to emotional, social, and peer relationships (25,26,27). A descriptive crosssectional study of the economic situation involving three hundred diabetic patients showed that the social class had significant effects on quality of life and compliance with treatment (28).…”