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Journal of Pediatric Psychology 11(4) pp. 463-479, 1986
© 1986 Society of Pediatric Psychology

research-article

Adaptation to Diabetes: Behavior Symptoms and Family Context1

Donald Wertlieb2,, Stuart T. Hauser and Alan M. Jacobson

Eliot-Pearson Department of Child Study, Tufts University, and Institute for Health Research, Harvard Community Health Plan, Joslin Diabetes Center Boston and the Department of Psychiatry at Massachusetts Mental Health Center, Harvard Medical School

2All correspondence should be sent to Donald Wertlieb, Eliot-Pearson, Department of Child Study, Tufts University, Medford, Massachusetts 02155

Preliminary first-year data from a longitudinal study of a group of 46 recent-onset insulin-dependent diabetic children (ages 9–16 years) addressed relationships between family environment or context and behavior symptomatology. A group of 29 children with a recent acute illness served as a comparison group. Differences between groups on levels of internalizing and externalizing child behavior symptoms were nonsignificant when social class was controlled. Differences between groups on Family Environment Scales (Moos, 1974) were few and generally nonsignificant. However, a range of family environment variables was associated with symptoms. Common to both groups was an association between behavior symptomatology and high levels of family conflict, more so for diabetic families. Other relationships were specific to the clinically defined group. For diabetics, social and recreational family activities and clear routines and organization were linked with fewer behavior problems. In addition, a moral-religious emphasis correlated positively with internalizing symptoms. For the acutely ill group, low levels of family cohesion were associated with behavior symptoms. Moreover, family emphasis upon competition, achievement and control predicted higher levels of symptomatology. Ultimately, these findings must be integrated into longitudinal study for clarification of the implications of such different patterns of relationships between family processes and symptomatology in acutely and chronically ill adolescents.

Key words: diabetes; acute illness; behavior symptoms; family environment.


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