Psycholsocial Factors in Adolescent Adjustment to IDDM

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The goal of the proposed research is to examine the impact of insulin-dependent diabetes on quality of life over the transition through adolescence. The focus is on the implications of a set of gender-related traits for psychological and physical well-being. Gender-related issues are important during the transition to adolescence because gender-role norms become salient. The gender-related factors addressed in the proposed research are important because they have been linked to psychological and physical health. These traits are: communion, unmitigated communion, agency, unmitigated agency. We hypothesize that unmitigated communion and unmitigated agency will be associated with poor psychological and physical well- being, agency will be associated with good health outcomes, and communion will be related to a supportive environment. Children (ages 10-12) with diabetes and sex, age, race, and family structure matched healthy controls will be enrolled in the study and followed for four years. The longitudinal design will enable us to determine when and if the traits have implications for health. Among the children with diabetes, these traits also will be linked to self-care behaviors and a set of diabetes-related complications (e.g., poor metabolic control, early stage retinopathy). Children with and without diabetes will be interviewed in-person on an annual basis on five occasions. At each wave, parents will complete a set of brief questionnaires. Children and parents also will respond to 24-hour recall phone interviews to assess self-care behavior and aspects of the social environment once a month for three consecutive months each year. These methods will determine whether: (a) gender-related traits change over the course of adolescence to influence health or (b) whether the relation of gender-related traits to health becomes stronger over the transition to adolescence. These methods also will help to identify the personal (e.g., self-efficacy), interpersonal (e.g., social support), and behavioral processes (self-care behavior) that link gender-related traits to psychological and physical well-being.