Psycholsocial Factors in Adolescent Adjustment to IDDM

本研究的目的是研究胰岛素依赖型糖尿病对青春期过渡时期生活质量的影响。重点是一系列与性别有关的特征对心理和身体健康的影响。与性别相关的问题在向青春期过渡期间很重要，因为性别角色规范变得突出。拟议研究中涉及的与性别有关的因素很重要，因为它们与心理和身体健康有关。这些特征是：共融，完全共融，能动，完全能动。我们假设未减轻的共融和未减轻的代理将与不良的心理和身体健康有关，代理将与良好的健康结果有关，而共融将与支持性环境有关。患有糖尿病且性别、年龄、种族和家庭结构与健康对照相匹配的儿童（10-12岁）将被纳入研究并随访四年。纵向设计将使我们能够确定这些特征何时以及是否对健康有影响。在患有糖尿病的儿童中，这些特征也将与自我护理行为和一系列糖尿病相关并发症（例如，代谢控制不良，早期视网膜病变）有关。患有和不患有糖尿病的儿童每年将接受五次面对面访谈。在每一波中，家长将完成一套简短的调查问卷。儿童和家长也将接受24小时电话访谈，评估自我照顾行为和社会环境方面，每月一次，每年连续三个月。这些方法将确定：(a)与性别有关的特征是否在青春期期间发生变化从而影响健康，或(b)与性别有关的特征与健康的关系是否在向青春期过渡期间变得更强。这些方法还将有助于识别将性别相关特征与心理和身体健康联系起来的个人（如自我效能）、人际（如社会支持）和行为过程（如自我照顾行为）。

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.