The perceived self-competence of adolescents with insulin-dependent diabetes mellitus: deficit or strength?

Two studies were conducted in an attempt to replicate an earlier finding of self-esteem deficits in adolescent girls with early onset of insulin-dependent diabetes mellitus (IDDM). Participants in Study 1 were 139 adolescents with IDDM who completed the Perceived Competence Scale for Children (Harter, 1979). A 2 (gender) X 2 (group: age of IDDM onset: early vs. late) multivariate analysis of variance (MANOVA) did not reveal a significant interaction effect. Study 2 included 136 adolescents (104 adolescents with IDDM and 32 physically healthy adolescents) who completed the Self-Perception Profile for Children (Harter, 1985). A 2 (gender) X 3 (early IDDM onset, late IDDM onset, physically healthy control) MANCOVA, controlling for the effects of social class and adolescent age, also indicated no significant interaction effect. Thus, we found no differences in self-esteem based on age at disease onset and gender in two independent samples of youths with IDDM. In Study 2, significant gender and group effects were revealed, but when these findings are compared with normative data and data from our physically healthy sample, the results suggest that the youths with IDDM were functioning within the normal range on self-esteem. The importance of these findings in regard to the deficit versus adaptation models of chronic illness is discussed.

Coping styles in youths with insulin-dependent diabetes mellitus.

The relationships between two coping styles (i.e., use of personal and interpersonal resources; ventilation and avoidance) and two health outcomes (i.e., adherence and metabolic control) were evaluated in 135 youths with insulin-dependent diabetes mellitus (IDDM). Individual characteristics (i.e., age, duration of illness) and contextual variables (i.e., stress, family relations) were used to predict coping styles. Poor adherence to treatment, older adolescent age, and long duration of IDDM were correlated with ventilation and avoidance coping. Youths with short duration of IDDM were more likely to cope through the use of personal and interpersonal resources, although this strategy was not associated with health outcomes. A multiple regression analysis indicated that high ventilation and avoidance coping was predicted by high stress, low family cohesion, and older adolescent age. In addition, the interaction between family adaptability and duration of IDDM significantly predicted ventilation and avoidance coping.