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Biomedical subjects

S T Hauser

Publications and source records attributed to S T Hauser.

36 records · Page 2Linked to original sources
PubMed1987

Psychologic predictors of compliance in children with recent onset of diabetes mellitus.

A group of 57 children with recent onset of insulin-dependent diabetes mellitus was studied over 18 months. Compliance with the prescribed diabetic treatment deteriorated over this period. Adolescents (aged 13 to 15 years) were less compliant than preadolescents (aged 9 to 12 years). Initial patient reports of self-esteem, perceived competence, social functioning, behavioral symptoms, and their adjustment to diabetes predicted subsequent compliance behaviors. The findings highlight the linkage of child personality and adjustment with self-care of diabetes, and suggest that psychosocial assessment soon after diabetes is diagnosed may help identify patients at risk for later compliance problems.

Adaptation, Psychological↗
PubMed1987

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.

Adjustment Disorders↗
PubMed1986

Evaluating ego defense mechanisms using clinical interviews: an empirical study of adolescent diabetic and psychiatric patients.

Ego defense mechanisms were studied in three groups of early adolescents: diabetic patients, non-psychotic psychiatric patients, and healthy high school students. Defenses were assessed from ratings of open-ended, in-depth interviews. High levels of denial and low levels of asceticism were found in all three groups. Comparisons between groups indicated that psychiatric patients had a distinctive profile of defense usage, in comparison to adolescents from the other two groups. An independent measure of ego development was positively correlated with the defenses of altruism, intellectualization, and suppression, while it was negatively correlated with acting out, avoidance, denial, displacement, projection, and repression. The findings of substantial differences in defense usage between the psychiatric and non-psychiatric samples, and the size and directions of the correlations with ego development level, lend support to the validity of the defense codes.

Acting Out↗
PubMed1986

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.

Adolescent↗
PubMed1984

Ego development and psychopathology: a study of hospitalized adolescents.

This paper explores the relationship between ego development and psychiatrically relevant behaviors in a group of hospitalized adolescents. Building on Loevinger's model of ego development, we administered the Sentence Completion Test to 114 adolescent girls and boys. To study psychiatric symptoms, Achenbach and Edelbrock's Child Behavior Checklist was used. With these procedures, the Achenbach and Edelbrock factor scores were compared to ego stage using correlational and multiple regression analyses. Findings indicate significant negative correlations with the externalizing and internalizing factors as well as a variety of behavioral subscales. A significant relationship also exists between the total number of symptoms and ego development. Ego development is found to be an important predictor for the externalizing factor and 2 subscales after the background variables of age, sex, and SES are partialed out. Our discussion addresses the question of the relationship between stages and transitions in ego development in relation to psychopathology. In addition, "age-stage dysynchronies" are discussed as ways of understanding psychopathology from a developmental perspective.

Acting Out↗
PubMed1984

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.

Adolescent↗
PubMed1983

Ego development and self-image complexity in early adolescence. Longitudinal studies of psychiatric and diabetic patients.

Ego development and multiple self-images were studied in nonpsychotic psychiatric patients, diabetic patients, and healthy high school students. The results reported are drawn from the first year of a four-year longitudinal project investigating the psychosocial development and family interactions of impaired and at-risk adolescents. Both groups of patients, especially the psychiatric group, were significantly lower in their ego development and showed less self-image complexity than the high school students. These findings are discussed both in terms of understanding developmental deviation in these two chronically ill groups, and as a strategy for investigating formulations being proposed in the new self-psychology framework.

Adjustment Disorders↗
PubMed1976

The content and structure of adolescent self-images. Longitudinal studies.

Using a specially designed Q-sort technique, multiple self-images held by 60 normal and psychiatrically hospitalized adolescents were studied initially and then every six months for 12 to 18 months. Each subject's self-images were analyzed for their overall coherence (integration) and for the evaluation of specific self-descriptive statements. The results showed that, as predicted clinically, the patients and normal subjects differed significantly on both integration and content evaluation dimensions. The patients had consistently lower integration scores on each trial, in contrast to the normal subjects' steadily increasing values. The patients evaluated their self-descriptive statements as steadily diminishing in importance while the normal subjects' evaluations remained at the same level over the trials. The patients' dual trends are discussed in terms of their reflecting the pattern of edentity diffusion described clinically by Erikson.

Adolescent↗
PubMedDate not supplied

Psychologic stress and glycemic control: a comparison of patients with and without proliferative diabetic retinopathy.

Using a case/control design, patients with (cases) and without (controls) proliferative diabetic retinopathy were compared using three psychosocial measures: life events, psychiatric symptomatology, and ego development. Cases reported significantly more symptoms. They also demonstrated a modest and significant correlation of negative life events with HgbA1c that was not shown in the controls. When the relationship of life events with glycemic control was explored in cases of varying durations of proliferative retinopathy, we found that the association between negative life events and HgbA1c was accounted for by the cases with a recent onset of retinopathy. Patients in this recent group showed a trend towards more negative life events that decreased with longer duration of proliferative retinopathy. This study suggests that the onset of proliferative retinopathy portends a life crisis during which metabolic control is sensitive to additional life stress and that this association is not found among patients whose illness is more stable.

Adult↗
PubMedDate not supplied

Family environment and glycemic control: a four-year prospective study of children and adolescents with insulin-dependent diabetes mellitus.

An onset cohort of children and adolescents with insulin-dependent diabetes mellitus (IDDM) and their parents were studied. Aspects of family environment were evaluated at study inception, and their influence on the initial level of, and change in, glycemic control over 4 years was examined. Family measures of expressiveness, cohesiveness, and conflict were linked to differences in the longitudinal pattern of glycemic control. In particular, the encouragement to act openly and express feelings directly (expressiveness) seemed to ameliorate deterioration of glycemic control over time in both boys and girls. Boys were especially sensitive to variations in family cohesiveness and conflict; those from more cohesive and less conflicted families showed less deterioration in glycemic control. This study demonstrated the important influence of family psychosocial factors present at diabetes onset on glycemic control in children and adolescents over the first 4 years of IDDM.

Adaptation, Psychological↗
PubMedDate not supplied

Self-efficacy in adolescent girls and boys with insulin-dependent diabetes mellitus.

Adolescents with insulin-dependent diabetes mellitus (IDDM) face increasing responsibilities for managing their own treatment. For some, implementing their treatment regimen enhances diabetes self-efficacy beliefs because they welcome the chance to exert control over their illness. Other adolescent patients, however, feel overwhelmed and helpless. We developed the self-efficacy for diabetes scale (SED) with a sample of adolescent boys (n = 34) and girls (n = 34) with IDDM. High reliability (internal consistency) and evidence for criterion validity were obtained for this measure, because SED scores predicted metabolic control. In addition, construct validity was established, because SED scores were related to theoretically relevant measures of locus of control and self-esteem. Although they showed similar expectancies for diabetes self-efficacy, girls had significantly positive correlations between their SED scores and metabolic control, whereas boys did not. We offer a new instrument for studying adolescent patient perceptions and physical health.

Adolescent↗
PubMedDate not supplied

Psychological adjustment of children with recently diagnosed diabetes mellitus.

Children with recent onset of insulin-dependent diabetes mellitus (IDDM) were compared with a sample of children with a recent acute medical problem. No differences were found in terms of self-esteem, locus of control, behavioral symptoms, or social functioning. A separate assessment of adjustment to diabetes was strongly correlated with each of these general personality, behavioral symptom, and social functioning measures. Sociodemographic factors such as age, gender, and social class did not predict the level of adjustment to diabetes. This study suggests that onset of diabetes does not necessarily lead to major disruptions of psychological adaptation. It also affirms the view that early adjustment to diabetes is embedded in a context of overall personality development and adaptation.

Acute Disease↗