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Youths with insulin-dependent diabetes mellitus (IDDM) have been shown to be at increased risk for psychosocial problems (Davis, Hess, & Hiss, 1988; Lustman, Griffith, Clouse, & Cryer, 1986; Popkin, Callies, Lentz, Colon, & Sutherland, 1988). Social support in the form of peer relationships is thought to be a mediating factor in combating the negative effects of stress associated with chronic illness (White, Richter, & Fry, 1992). The beneficial effects of social support may not be realized if diabetic children and adolescents have misconceptions about the illness attitudes of their healthy counterparts. The present study examined diabetic and well youths' attitudes toward diabetes, examined the diabetic youths' perceptions of well youths attitudes toward diabetes, and measured both groups' knowledge about diabetes. Participants were 147 diabetic and 117 well children between the ages of 7 and 14. They completed a diabetes knowledge questionnaire and a diabetes attitude questionnaire. The attitude measure was given twice with participants told to answer the first time as they normally would answer and told a second time to answer how others would answer. Statistical analysis found that diabetic youths had more positive attitudes toward children with diabetes than well youths. Diabetic youths and healthy youths perceived a discrepancy between their own and others' attitudes toward children with diabetes with their own attitudes being more positive. Diabetic youths knew more about diabetes and assigned a lower level of responsibility for the diabetic condition than healthy youth. Knowledge about diabetes was found to be positively related to attitudes about diabetes. Implications of research findings were discussed.

The present study evaluated the effectiveness of a behavioral family intervention on adherence and metabolic control in insulin dependent diabetic children (IODM). Specifically, assumption of regimen responsibilities between the parent and child were manipulated to facilitate regimen adherence. The intervention delivered was a target-specific behavioral contract extended sequentially across four target behaviors (Le., blood glucose testing, insulin injections, diet, and exercise). Regimen components were targeted in a within subjects, multiple baseline design across behaviors to assess the relationship between adherence and metabolic control. Metabolic control was assessed with a measure of glycosylated hemoglobin (e.g., HbA1C.) Five IDDM children (3 female,2 male), who met study criteria (Le., nonadherence to blood glucose testing defined as oS. 2 tests daily and metabolic status outside the optimal range using standard laboratory reference values) were recruited from physician referrals and media announcements. Subjects were between the ages of 10 and 15 years (M = 12.6); four were Caucasian and one was African-American. Mean duration of diabetes upon entry into the study was 4.3 years. Results revealed that four subjects responded to the intervention and three of those four evidenced clinically significant improvements in metabolic control at mid - and/ or post-study. One subject demonstrated only moderate intervention effects and no improvement in metabolic control while another increased adherence, but decrements in metabolic control were noted. These results suggest that adherence may mediate the relationship between family variables and metabolic status. Two additional subjects demonstrating consistently good metabolic were employed to assess the validity of target behaviors. The results were related to various family and diabetes-specific psychosocial indices. Master of Science