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Biomedical subjects

A M Delamater

Publications and source records attributed to A M Delamater.

17 recordsLinked to original sources
PubMed1993

Self- and spouse ratings of anger and hostility as predictors of coronary heart disease.

Self- and spouse ratings of anger and hostility were examined as predictors of coronary heart disease (CHD) in 185 cardiac patients. Patients completed the Multidimensional Anger Inventory (MAI) and the Marlowe-Crowne Social Desirability (MCSD) Scale; the MAI (rewritten to 3rd person) was completed by patients' spouses or by a peer. Thallium scans were used to measure CHD status. Results showed that patient-rated MAI scores were inversely correlated with MCSD. There were no gender differences for patient-rated MAI scores, but spouse ratings showed gender effects for Anger-Arousal and Hostile Outlook: Women rated their husband higher than men rated their wife. Patients with positive thallium scans were no different from those without CHD on patient-rated MAI scores; however, spouse ratings indicated that those with CHD had higher Hostile Outlook and Anger-In scores. After accounting for the effects of traditional CHD risk factors, only spouse-rated hostility contributed significant incremental variance to the prediction of CHD status.

Adult↗
PubMed1993

Stress management training for adolescents with diabetes.

Evaluated the effects of stress management training (SMT) for adolescents with diabetes in a 9-month controlled treatment-outcome study. Nine patients were randomly assigned to a stress management group while another 10 patients served as controls and received standard outpatient treatment. The treatment program consisted of 10 sessions over 3 months, 3 additional sessions over 3 months, and a 3-month follow-up without treatment. Diabetes-specific stress decreased significantly for patients in the SMT group over the course of the intervention and follow-up. However, metabolic control, regimen adherence, coping styles, and self-efficacy about diabetes were unchanged. These findings suggest a SMT program for adolescents with diabetes may be helpful in reducing diabetes-specific stress, but additional procedures are necessary to improve adherence, coping styles, and metabolic control.

Adaptation, Psychological↗
PubMed1992

Compliance with dietary prescriptions in children and adolescents with insulin-dependent diabetes mellitus.

This study investigated the relationship between compliance with a prescribed diabetic diet and metabolic control of insulin-dependent diabetes mellitus (IDDM). The study sought to determine the degree to which patients translated food exchange prescriptions into appropriate food choices and to identify correlations between metabolic control (as measured by glycosylated hemoglobin level) and compliance with prescribed food exchanges, body mass index (BMI), and intake of energy and fat. Subjects were 40 inpatients and 29 outpatients aged 4 to 18 years with IDDM. Records of the inpatients' food selections for 3 days and 3-day food records collected from the outpatients (or their parents) were analyzed. For all 69 subjects, the mean daily deviation from the prescribed food exchanges was 23.8%, which indicates that subjects added or deleted approximately one of four prescribed exchanges. Records of actual food intake revealed that both patient groups had greater mean energy intakes than had been prescribed: 196 additional kcal for inpatients and 372 additional kcal for outpatients; fat sources accounted for 92% and 68% of the greater energy intake, respectively. No correlation was found between glycosylated hemoglobin level and BMI, energy intake, or fat intake.

Adolescent↗
PubMed1991

Racial differences in metabolic control of children and adolescents with type I diabetes mellitus.

OBJECTIVE: This study evaluated racial differences in the metabolic control of children and adolescents with insulin-dependent (type I) diabetes mellitus and examined the interactive effects of race with age and sex. RESEARCH DESIGN AND METHODS: Data on several demographic and clinical variables were obtained for 102 black and 108 white children, including the percentage of total HbA1, age, age at diagnosis, duration of diabetes, pubertal status, insulin dose (U.kg-1.day-1), body mass index, number of clinic visits kept and missed, number of hospitalizations for diabetic ketoacidosis (DKA) for the year, and socioeconomic status (SES). RESULTS: Black children had higher insulin dosages (P less than 0.05) and lower SESs (P less than 0.001) than white children. HbA1 was higher in black than white children (P less than 0.01) after statistically adjusting for the effects of insulin dose, diabetes duration, and SES. With HbA1-based criteria, more black than white children were in poor and fewer in good metabolic control (P less than 0.001). Older children (greater than or equal to 13 yr) had higher HbA1 levels than younger (less than 13 yr) children (P less than 0.002), but there were no differences in HbA1 between males and females nor were there interactive effects of race, sex, and age-group. Black children were hospitalized for DKA more frequently than white children (P less than 0.04). More black than white children missed clinic visits (P less than 0.01), but they did not differ in number of visits kept. CONCLUSIONS: Black youths with type I diabetes mellitus are in poorer metabolic control than white youths.

Adolescent↗
PubMed1990

Learned helplessness in diabetic youths.

Determined the relationships among the learned helplessness attributional style, depression, regimen adherence, and metabolic control in a sample of diabetic youth. Fifty children (20 male and 30 female) between the ages of 10 and 16 completed the Children's Attributional Style Questionnaire and the Children's Depression Inventory. Regimen adherence was assessed with three 24-hr recall interviews conducted separately with patients and their mothers over a 1-week period. Metabolic control was measured by glycosylated hemoglobin A1 (HbA1). Learned helplessness was significantly associated with depression (p less than .001) and HbA1 (p less than .02), but was not associated with regimen adherence. Depression was unrelated to regimen adherence and metabolic control. The adherence measures together accounted for 24% of the variance of HbA1. Significant correlations were obtained between HbA1 and the exercise (p less than .05) and eating/testing frequency (p less than .05) adherence factors, indicating that lower levels of adherence were associated with worse metabolic control. Age, pubertal status, sex, disease duration, and SES were unrelated to regimen adherence and metabolic control. These results support the notion that the learned helplessness attributional style for negative events is related to both depression and long-term metabolic control problems in diabetic youths.

Adolescent↗
PubMed1990

Randomized prospective study of self-management training with newly diagnosed diabetic children.

This study was designed to evaluate the effects of a self-management training (SMT) program on metabolic control of children with insulin-dependent diabetes mellitus (IDDM) in the first 2 yr after diagnosis. After standard in-hospital diabetes education, 36 children (mean age 9.3 yr, range 3-16 yr) were randomized to conventional follow-up, conventional and supportive counseling (SC), or conventional and SMT, which emphasized use of data obtained from self-monitoring of blood glucose. SC and SMT interventions consisted of seven outpatient sessions with a medical social worker during the first 4 mo after diagnosis and booster sessions at 6 and 12 mo postdiagnosis. Groups were similar with respect to age, sex, body mass index, socioeconomic status, C-peptide, and severity of illness at diagnosis. Metabolic control, measured quarterly by glycosylated hemoglobin (HbA1), improved substantially in all three treatment groups during the first 6 mo. SMT patients had significantly lower HbA1 levels than conventional patients at 1 yr (P less than 0.01) and 2 yr (P less than 0.05) postdiagnosis. SMT patients also had lower HbA1 levels than SC patients, but this did not reach statistical significance. The lower HbA1 levels of SMT patients were not explained by severity of illness at diagnosis, or insulin dose, body mass index, and C-peptide levels at 2 yr. These results suggest that an SMT program during the first few months after diagnosis helps avoid the deterioration in metabolic control often seen in children with IDDM between 6 and 24 mo after diagnosis.

Adolescent↗
PubMed1989

Interpersonal behavior and cardiovascular reactivity in pharmacologically-treated hypertensives.

This study examined the interpersonal behavior and concomitant cardiovascular reactivity (CVR) of hypertensive patients whose resting blood pressure was controlled by antihypertensive medication. Thirty hypertensive and 30 normotensive subjects matched for age, sex and occupational status were recruited from an industrial setting. The groups were compared on measures of interpersonal behavior, blood pressure and heart rate while they engaged in both role-played (RP) and naturalistic interactions (NI) requiring positive and negative assertion. Interpersonal behavior of the groups was generally similar, with two exceptions: hypertensives made fewer requests for new behavior in the negative RP and verbalized more praise statements in the positive NI. There were no differences between the groups on measures of CVR during interpersonal interactions. Overall effectiveness during scenes requiring negative assertion was associated with increased cardiovascular reactivity, especially for hypertensives. The interpersonal behavior and cardiovascular responses of patients taking beta-blocker medication did not differ from those taking diuretics. These findings are discussed with regard to methodological considerations pertinent to the assessment of interpersonal behavior and the issue of heterogeneity among hypertensives.

Adrenergic beta-Antagonists↗
PubMed1989

Cardiovascular correlates of type A behavior components during social interaction.

This study examined the cardiovascular (CV) correlates of the primary Type A behavior components during social interactions. Brief dialogues were created to role-play (RP) stereotypic Type A and Type B ways of responding to three common social situations designed to elicit hostility (H), time-urgency (T), and competition (C). Situations and dialogues were validated by independent raters. Thirty undergraduate students were identified as Type A and 30 as Type B, with 15 males and 15 females in each group. Subjects were provided scripts for each of the six experimental RPs and rehearsed them prior to the CV assessment. Measures of systolic and diastolic blood pressure (SBP, DBP) and heart-rate (HR) were obtained during an adaptation period and during each RP. Analyses of the "A" (i.e. H, T, C) versus "B" (i.e. non-H, non-T, non-C) RPs indicated that DBP (p less than 0.03) and HR (p less than 0.002) were higher during the H as compared with non-H RP. Significantly higher SBP was observed in the T as compared with the non-T RP (p less than 0.04). No CV differences were observed in the comparison of the C and non-C RPs. Analyses comparing the three "Type A" RPs revealed higher SBP during H and T RPs, as compared with the C RP (p less than 0.003). Effects of subject Type (i.e. A/B) were not obtained in any analysis. These findings indicate that hostile and time-urgent social interactions are associated with significant increases in CV arousal which are independent of overall Type status.

Adult↗
PubMed1987

Stress and coping in relation to metabolic control of adolescents with type 1 diabetes.

The purpose of this study was to determine whether measures of anxiety, stress, and means of coping with stress differ in diabetic adolescents in good, fair, and poor metabolic control. Trait anxiety, perceived daily stress, and coping responses to a recent stressful event were assessed in 27 adolescents with Type 1 diabetes mellitus. Information also was obtained regarding the type of stressful events that subjects referred to in completing the coping measure, as well as their appraisals of the events. Hemoglobin A1 (HbA1) obtained at the time of the study was used as a measure of antecedent metabolic control. Based upon their HbA1, patients were divided into three metabolic control subgroups: good control (M = 8.4%; n = 8), fair control (M = 10.9%; n = 9), and poor control (M = 13.3%; n = 10). Patients in these subgroups were similar with regard to age, disease duration, and socioeconomic status. Results indicated that the subgroups did not differ on the anxiety and stress measures; however, analyses of the coping data indicated that patients in poor control employed significantly more wishful thinking and avoidance/help-seeking than did patients in good metabolic control. Furthermore, the metabolic control subgroups differed in the type of stressful events reported and their appraisals of the stressful events. These results support the hypothesis that the ways in which individuals with diabetes appraise and cope with stress is related to their metabolic control. The findings are discussed in relation to methodological issues and treatment implications.

Adaptation, Psychological↗
PubMed1983

Physiological correlates of conduct problems and anxiety in hyperactive and learning-disabled children.

Thirty-six learning disabled children (21 of whom were also classified as hyperactive) were subgrouped according to teacher ratings of tension-anxiety and conduct problems and then compared on measures of tonic and phasic autonomic arousal. The results indicated that children rated high on the conduct problem dimension evidenced smaller amplitude specific skin conductance responses, and that anxiety appeared to exert a moderating effect on physiological responses. When the hyperactive sample was considered separately, lower skin conductance levels were observed in children rated high on conduct problems than in hyperactive children rated low in conduct problems. These findings support the notion that hyperactive and learning-disabled children are heterogeneous at a physiological level and suggest that physiological differences previously attributed to hyperactivity may actually be correlates of the conduct problem dimension.

Anxiety↗
PubMed1981

ties"ties".

The diagnostic category of learning disabilities is a heterogeneous one, but few empirical attempts have been made to distinguish subgroups. Recent research, however, suggests that it may be meaningful to discriminate between "hyperactive" and "nonhyperactive" learning-disabled children. In the present study, 21 learning-disabled children identified as "hyperactive" through teacher nominations and ratings were compared to 15 learning-disabled children identified as "nonhyperactive" in the same manner. The two groups differed on rated behavior, birth order, amount of prescribed stimulant medication, amount of psychosocial stress, and Verbal, Performance, and Full Scale WISC-R IQ scores. They did not differ, however, on several demographic variables, the number of perinatal complications, reading achievement, and a number of tonic and phasic measures of autonomic activity. These findings support the distinction between "hyperactive" and "nonhyperactive" subgroups of learning-disabled children, but suggest that the two subgroups may have a similar biological substrate.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

Self-monitoring of blood glucose by adolescents with diabetes: technical skills and utilization of data.

Two studies of adolescent patients were conducted to determine their technical skills and utilization of data obtained by self-monitoring of blood glucose (SMBG). In Study 1, direct observations of 58 adolescents revealed an overall SMBG technical accuracy score of 82%. Most frequent errors were not cleaning fingers (45%), not placing blood on strips correctly (21%), and wiping strip at wrong time (14%). Technical performance was inversely correlated with blood glucose concentration, but was unrelated to other variables. In Study 2, a questionnaire was used to determine SMBG practices among 64 adolescents. Although the majority of patients reported doing daily SMBG, most did not record results in logbooks every time or utilize such data for self-management. No significant relationships were found between SMBG behaviors and other variables. We conclude that periodic evaluation and retraining are required for maintenance of SMBG skills and that methods to enhance utilization of SMBG data be developed for this patient population.

Adolescent↗