Impact on maternal parenting stress of receipt of genetic information regarding risk of diabetes in newborn infants.

Our objective was to investigate whether notification of high-risk status for type 1 diabetes in newborn infants results in an increased maternal-parenting stress level when compared with notification of low-risk status for type 1 diabetes. Maternal parenting stress level was assessed at 5-7 weeks postpartum (baseline) and was reassessed 4-5 months after parents were informed of their newborn infants' genetic screening results (follow-up). Parenting stress level was measured using the total stress score (TSS) of the Parenting Stress Index/Short Form. The outcome variable, change in TSS, was calculated by subtracting the baseline TSS from the follow-up TSS. Demographic variables such as maternal race, maternal age, maternal education level, maternal marital status, child's birth order, and total family income were assessed through a structured phone interview at the time of baseline assessment. The risk factor of interest was the child's human leukocyte antigen (HLA) status for type 1 diabetes, i.e., whether child was at a high or moderate (combined into "high") genetic risk or at a low genetic risk for type 1 diabetes. A sample of 88 mothers (23 with a high-risk child and 65 with a low-risk child) was evaluated. Baseline median TSSs were 65 and 74 for mothers of low-risk infants and mothers of high-risk infants, respectively. Both groups' median TSS decreased between baseline and follow-up. No significant differences were found between change in TSS and maternal age, race, education level, marital status, total family income, or child's birth order. Although the median decrease in TSS was smaller in mothers with a high-risk child when compared with mothers of a low-risk child, this difference was not statistically significant. We did not find an association between newborn's HLA status and change in maternal TSS. The results of this study suggest that notification of high-risk status for type 1 diabetes in newborn infants may not result in an increased level of parenting stress among mothers.

Assuming responsibility for diabetes management: what age? What price?

An examination of clinical and empirical evidence raises questions about how best to teach youngsters with insulin-dependent diabetes mellitus (IDDM) to assume responsibility for self-care. The thesis of this paper is that age alone gives insufficient information. Evidence is reviewed suggesting that caretakers consider a child's fund of diabetes knowledge, degree of cognitive development, actual performance of diabetes-related tasks, locus of control, and family environment to determine how and when to transfer responsibility for self-care to a young person. In addition, evidence is presented that suggests that shared responsibility between parent and child is most highly correlated with better metabolic control. It is concluded that informed decisions about self-care are best made by considering a variety of factors, with age being merely a guidepost.

Parental contexts of adolescent self-esteem: A developmental perspective.

Relationships between parental behaviors and adolescent self-esteem were analyzed in a group of 95 early adolescents from multiple settings. The study was designed to investigate hypotheses regarding associations between observed parental interactions (e.g., accepting and devaluing) and adolescent self-esteem. Parents' verbal interactions with their adolescents were assessed through application of the constraining and enabling coding system to transcribed family discussions, generated through a revealed differences procedure. Adolescent self-esteem was measured with the Coopersmith Self-Esteem Inventory. Parent interaction-self-esteem associations were examined in the pooled sample, as well as in specific sub-groups based on gender, health, and ego development (measured by the Washington University Sentence Completion Test). Boys had more numerous associations between their self-esteem and parental interactions than girls, and psychiatrically ill boys had particularly high associations. Parental interactions were found to be most strongly related to adolescent self-esteem for adolescents at the lowest levels of ego development. Our findings are consistent with the view that increasing individuation in self-esteem regulation occurs during adolescent development, such that adolescents at higher levels of ego development evaluate themselves more independently of parental feedback than do their less mature peers.

Interaction sequences in families of psychiatrically hospitalized and nonpatient adolescents.

A KEY theme running through competing views of family influences upon adolescent development is that of directionality, on two levels: influences within the flow of family interaction; and influences from family processes to individual adolescent development. In this paper our focus is upon the first level, intrafamilial sequences within families. More specifically, we study links between psychiatric impairment in adolescence and developmentally relevant parent-child and parent-parent sequences. This report extends a previous investigation (Hauser et al. 1984), which described our new family coding system and first correlational findings. We now study the flow of interactions within these families. Although there has been much recent empirical research in adolescent psychosocial development (e.g., Redmore and Loevinger 1979; Loevinger 1976; Adams and Fitch 1982; Hauser et al. 1984), one important area has received less attention--the relationship between developmentally relevant family processes and psychiatric disturbance during adolescence.

Sex differences within the family: Studies of adolescent and parent family interactions.

Sex differences in verbal family interactions were investigated in a group of 79 adolescents and parents from normal and psychiatric settings. The analyses were designed to study these differences in both generations, parent and adolescent. Parent and adolescent interactions with one another were observed in a semistructured, revealed-differences family discussion. All of the individual speeches were then scored with our Constraining and Enabling Coding System (CECS). Initial predictions involved both adolescent and parent differences. These hypotheses were only partially confirmed. The strongest findings pertained to parent sex differences, as we found strikingly higher levels of cognitive enabling speeches expressed by fathers and significantly more speeches addressed to fathers. We discuss several alternative interpretations of these findings. Perspectives included in our considerations are direction of effect and influences of task/context upon the expression of family sex differences.

Children with recently diagnosed diabetes: interactions within their families.

Cross-sectional findings drawn from the first year of a 4-year longitudinal study of preadolescent and early adolescent insulin-dependent diabetics and their families are presented. Using direct observation techniques and a specially designed coding system, the family interactions of 56 families with a recently diagnosed diabetic child are compared with those of 49 families with a child of similar age and sex, who has had a recent, serious acute illness. The two samples are contrasted in terms of each family member's (mother, father, and child) enabling and constraining interactions, controlling for social class differences. The findings reveal that the diabetic children and their parents expressed significantly more enabling (e.g., focusing, problem solving, active understanding) speeches than comparable members of the acute illness group. In addition, there are indications of particular constraining interactions (devaluing) occurring between fathers and diabetic children. Several alternative interpretations are offered to account for these results, together with plans for future research directions to investigate these hypothesized explanations.

Family contexts of pubertal timing.

This study examined the influence of pubertal timing upon family interactions in normal and psychiatric adolescent samples. An important feature of our approach is its emphasis upon micro-analysis of family behaviors (individual speeches) and family processes (theoretically specified speech pairings). Rather than assume that global family patterns (e.g., power) shift in response to pubertal changes, we follow how types of speeches and speech sequences are associated with different pubertal timing. Using the previously constructed family coding system, the Constrainig and Enabling Coding System, we found that on-time adolescents and their parents differed from both off-time groups (early or late). These results are discussed in terms of current implications and suggestions for future research.

Familial contexts of adolescent ego development.

In this paper we describe our newly constructed Constraining and Enabling Coding System (CECS). This scheme was constructed to identify family interactions that are conceptually relevant to adolescent ego development. First, we discuss the theoretical rationale and reliability properties of the codes. We then present results of applying the scales to observations of 61 families, consisting of 2 parents and an adolescent, drawn from matched high school and psychiatric populations. All families are upper and (predominantly) upper-middle class. Each member completed the Loevinger Sentence Completion Test and then participated in a revealed-differences task, using responses to Kohlberg Moral Dilemmas as discussion stimuli. Transcripts of these audiorecorded discussions formed the data base for the family analyses. After controlling for patient status and adolescent age, adolescent and parent ego-development scores still contributed to explained variance in family interactions. Adolescent ego development was positively associated with adolescent enabling behaviors (e.g., problem solving, empathy). In contrast, there were negative correlations between constraining behaviors (e.g., devaluing, withholding) and adolescent ego development. Parental behaviors were significantly associated with (a) parent ego development, and (b) adolescent ego development. The third dimension of our system, discourse change, also showed theoretically expected strong correlations between progressive discourse change and ego development. In our discussion we comment on the importance of now proceeding to sequence analyses in order to explore questions of directionality.

Sex-role-related differences in self-concept and mental health.

Examined the differences in serf-concept and psychological health between androgynous, sex-typed, cross-sex-typed, and undifferentiated males and females. Two hundred forty-nine students who were enrolled in introductory psychology classes were classified according to sex type on the basis of their scores on the Bem Sex-Role Inventory. Nine aspects of self-concept and five aspects of psychological health, obtained, from the Tennessee Self-Concept Scale, were analyzed as a function of Sex and Sex Type. A series of analyses of variance and subsequent individual comparisons across groups revealed a clear pattern wherein androgynous subjects manifested more positive self-concepts and more positive psychological health than sex-typed subjects. Undifferentiated subjects manifested the poorest self-concepts, while results for sex-typed and cross-sex-typed subjects varied more as a function of the sex of the subject. The data are discussed as appearing to be consistent with Bem's hypothesis that androgynous people may represent a more appropriate societal definition of mental health than strongly sex-typed people. Qualifications of this support are also discussed.