Diabetic Adolescents and their Families: Stress, Coping, and Adaptation

Cover......Page 1
Half-tilte......Page 3
Series-title......Page 5
Title......Page 7
Copyright......Page 8
Contents......Page 9
Foreword......Page 11
References......Page 16
Preface......Page 17
Changes in the Spectrum of Illnesses and Causes of Death......Page 21
Epidemiology of Chronic Illnesses in Adolescence......Page 22
Psychological Perspectives on Chronic Illness: From the Biomedical to the Categorical Approach......Page 26
Current State of Research: Results of Two Meta-analyses......Page 29
Type of Illness......Page 32
Illness Severity......Page 34
Developmental Factors......Page 35
Gender......Page 37
Social Support......Page 38
Critical Life Events and Normative Stressors......Page 40
Universal and Illness-Specific Coping Strategies......Page 41
Psychopathology......Page 42
3 Coping with Diabetes: A Longitudinal Study......Page 45
Medical Characteristics......Page 46
Impact on the Afflicted Adolescents and Their Families......Page 47
A Preliminary Model......Page 48
A Longitudinal Approach to Studying Coping with Diabetes in Adolescence......Page 49
Sample Characteristics......Page 51
Procedure: Recruitment of the Sample, Annual Survey, Care and Maintenance of the Sample......Page 53
Cooperation with Physicians and Psychotherapists......Page 56
Methods: Interviews, Questionnaires, and Family Tasks......Page 57
A Developmentally Oriented Model of Coping with Diabetes in Adolescence......Page 58
4 Knowledge of the Illness, Compliance, and Patient–Physician Relationships......Page 62
Etiological Factors, Manifestation, and Course of the Illness......Page 63
Illness Duration and Quality of Metabolic Control......Page 65
Instability of Metabolic Control over Time......Page 66
Type of Insulin Therapy, Complications......Page 67
Adolescents’ Acceptance of Medical Care......Page 68
Relationships Between Physicians and Diabetic Adolescents......Page 69
The Physician’s Evaluation of Cooperation and Compliance......Page 71
The Influence of Knowledge of the Illness and Compliance on Metabolic Control......Page 74
Illness-Related Knowledge, Attitudes, and Compliance......Page 75
Factors That Influence Metabolic Control......Page 78
Changes in Illness Management, Attitude Towards the Illness, and Compliance over Time......Page 80
The Self-Concept of Ill Adolescents......Page 83
Evaluation of Health Status......Page 85
How Healthy Are "Healthy" Adolescents?......Page 87
Perceived Health in Diabetic Adolescents......Page 88
The Body Image of Healthy Adolescents......Page 91
The Body Image of Diabetic Adolescents......Page 92
Changes in the Body Image over the Course of Several Years......Page 95
"One Body for Two": Diabetic Adolescents and Their Mothers......Page 96
Tanya......Page 98
6 Adolescent, Parental, and Family Coping with Stressors......Page 104
Types of Stressors, Timing, and Synchronism of Stressors......Page 105
Are Critical Life Events Responsible for the Onset of Diabetes?......Page 108
Martin......Page 109
Discrepancies Between Adolescents’ and Parents’ Perceptions of Stress......Page 110
High Levels of Illness-Specific Stressors......Page 112
Changes in Perceived Stress over Time......Page 113
Family Coping: A Forgotten Contribution to Adolescents’ Coping with Illness?......Page 115
Adolescents’ Coping with Everyday Stressors and Illness-Specific Stressors......Page 118
Parental Coping: Dealing with Family and Illness-Specific Problems......Page 121
Family Coping with the Illness......Page 123
Individual and Family Coping: An Integration......Page 126
The Influence of Gender, Illness Duration, and Metabolic Control......Page 127
The Initial Phase: Dealing with the Diagnosis......Page 129
Orsi......Page 131
Tom......Page 132
Changes in the Years after First Manifestation of the Illness......Page 133
Conceptual Approaches for Understanding Family Dynamics in Families Dealing with Chronic Illness......Page 138
The Family’s Organization Around the Illness......Page 142
Impact on Parental Roles and Family Climate......Page 144
Changes in Family Climate Over Time?......Page 148
The Highly Structured Family Climate: Functional or Dysfunctional for Metabolic Control?......Page 149
Communication in Families with Diabetic Adolescents......Page 152
Consequences of Continual Stress in Families with Diabetic Adolescents......Page 157
Fathers of Ill Adolescents: Their Roles in the Coping Process......Page 158
The Distinctive Roles of Fathers in Comparison with Mothers of Chronically Ill Adolescents......Page 159
Chronically Ill Adolescents and Their Fathers......Page 162
The Difficulty of Involving the Father......Page 165
When the Father is Too Involved......Page 167
Janina......Page 168
Does Illness Solidify an Existing Pattern in the Father–Adolescent Relationship?......Page 169
Sibling Relationships in Healthy and Chronically Ill Adolescents......Page 171
The Importance and Role of Siblings in the Family Unit......Page 172
Sibling Relationships in Adolescence......Page 173
Sibling Relationships of Chronically Ill Children and Adolescents......Page 175
Diabetic Adolescents’ Stronger Bonds to Their Siblings......Page 179
Louis......Page 182
Thusitha......Page 184
The Friendships of Chronically Ill Adolescents......Page 186
Friendships in Adolescence: From Instrumentality to Intimacy......Page 187
Chronically Ill Adolescents’ Relationships with Peers and Close Friends......Page 191
Network Size and Quality of Friendships......Page 194
Christoph......Page 197
Developing Romantic Relationships......Page 199
Sexual Experiences and Romantic Development in Adolescence......Page 200
Chronically Ill Adolescent’s Romantic Relationships......Page 202
Continuity and Discontinuity in Relationships with Close Friends and Romantic Partners......Page 206
Chronically Ill Adolescents’ School Experiences and Career Choices......Page 209
The Constant Demand for Higher Qualifications......Page 210
Illness-Specific Restrictions and Discrimination in Employment......Page 212
Carola......Page 215
Coping with Problems at School......Page 217
Perspectives and Concerns about the Future......Page 219
Does Chronic Illness Lead to Developmental Delays?......Page 223
Developmental Tasks in Adolescence......Page 224
Is Development Impaired by Chronic Illness in Adolescence?......Page 227
Deficits in Adolescent-Specific Developmental Tasks......Page 229
Do Diabetic Adolescents Catch Up to the Developmental Level of Healthy Adolescents over the Course of Several Years?......Page 232
Conditions That Contribute to or Maintain Developmental Delays......Page 235
Psychopathology in Chronically Ill Adolescents......Page 238
Prevalence of Psychological Symptoms and Disorders in Adolescence......Page 239
Psychopathology in Chronically Ill Adolescents......Page 241
Psychopathology in Diabetic Adolescents......Page 243
Changes in Symptomatology over Time......Page 246
The Problem of Denial in Chronically Ill Adolescents......Page 249
10 Pathways for Resolving the Dilemma between Developmental Progression and Adaptation to the Illness......Page 252
Veronika......Page 253
Moritz......Page 256
Monika......Page 257
Denial and Trivialization of the Illness: A Way Out?......Page 259
Matthias......Page 260
David......Page 262
Milena......Page 264
Susanna......Page 267
Sophie......Page 271
Conny......Page 274
Different Pathways for Solving the Dilemma......Page 276
11 Implications for Prevention and Intervention......Page 279
Do Chronic Illnesses Share Similar Characteristics?......Page 280
The Need for a Developmentally Oriented Model......Page 281
Deficits in Internal Resources but Also Improvements with Time......Page 283
Focusing on the Illness and Sequencing of Developmental Tasks......Page 284
Understanding the Parents’ Perspectives......Page 285
Parents as Coping Models......Page 286
Strengthening the Resources of Adolescents and Their Families......Page 287
The Coping Potential Offered by the Broader Social Network......Page 288
Phases of the Illness and the Desire to Receive Professional Help......Page 290
Improving the Relationship between Adolescent Patients and Their Physicians......Page 291
Understanding Noncompliance and the Function of Cheating......Page 292
Education about Unstable Blood Glucose Levels in Puberty......Page 293
Are Adolescents Unmotivated Patients?......Page 294
What Sorts of Intervention are Available to Diabetic Adolescents and Their Families?......Page 295
Intervention for Few–Prevention for All?......Page 297
Revising the Treatments Offered......Page 298
References......Page 301
Index......Page 339