Clarissa Holmes - Academia.edu (original) (raw)

Papers by Clarissa Holmes

Research paper thumbnail of Original Research Article: Predictors of Youth Diabetes Care Behaviors and Metabolic Control: A Structural Equation Modeling Approach

Objective To empirically test a biopsychosocial model of predictors of youth diabetes care behavi... more Objective To empirically test a biopsychosocial model of predictors of youth diabetes care behaviors and metabolic control. Methods A cross-sectional multisite study of youths (N = 222) with T1D (mean age = 12.6) used structural equation modeling to examine interrelations among predictors, with follow-up analyses of covariance (ANCOVAs). Results Youths’ memory skills related to diabetes knowledge which, along with self-efficacy and age, was associated with greater youth responsibility that in turn predicted poorer self-care behaviors. Less frequent/briefer exercise and less frequent blood glucose monitoring/eating were found; the latter directly related to poorer metabolic control. Behavior problems also were associated directly with poorer metabolic control. A parsimonious model found memory directly related to blood glucose testing. Conclusions Continued parental supervision of adolescents, along with monitoring diabetes knowledge and efficacy, may help optimize transfer of diabet...

Research paper thumbnail of Advances in Clinical Child Psychology (Book)

Journal of Clinical Child Psychology, Sep 1, 1987

Research paper thumbnail of Cognitive Functioning and Diabetes: Broadening the Paradigm for Behavioral and Health Psychology?

Research paper thumbnail of Adolescents with cleft lip and palate: self-perceptions of appearance and behavior related to personality adjustment

The Cleft palate journal, 1985

Two groups of adolescents with cleft lip and palate were compared on their self-ratings of facial... more Two groups of adolescents with cleft lip and palate were compared on their self-ratings of facial appearance and behavior. The two groups were identified as well adjusted (N = 19) or poorly adjusted (N = 17), based on their parents' ratings of behavior. T-test comparisons indicate that the group with good adjustment have realistic perceptions of facial appearance (based on independent ratings by their teachers), and their self-perceptions of behavior are similar to those of their parents. The poorly adjusted group have unrealistic perceptions of facial appearance and perceive their behavior as more socially acceptable than do their parents.

Research paper thumbnail of Use of Booster Calls in a Behavioral Intervention for Adolescents with Type 1 Diabetes

Journal of Mobile Technology in Medicine, 2012

Behavioral interventions are commonly utilized to prevent declines in adherence and glycemic cont... more Behavioral interventions are commonly utilized to prevent declines in adherence and glycemic control among adolescents with type 1 diabetes (T1D). Mobile health strategies may maintain participant engagement and improve retention rates and outcomes in such interventions. The present study explored the use of booster calls (BCs; quick telephone check-ins), in maintaining participant engagement throughout an ongoing RCT for adolescents with T1D. Data are available from 143 adolescent-parent dyads (Mchild age= 12.96 years) who were randomized to the treatment condition. Most adolescents were female (54%) and Caucasian (68%), and ninety-two percent of parents were mothers. Most were prescribed a basal bolus or pump regimen (75%), and average glycosolated hemoglobin (HbA1c) at baseline was 8.69%. Dyads participated in four treatment sessions designed to improve coping skills and promote medical regimen adherence. BCs were conducted one month after each session, and participants completed follow-up assessment 3 months after their final session. Ninety-six percent of participants completed at least one BC; 29% completed all four. On average, 2.88 contact attempts were made per BC and completed calls lasted eight minutes. Adolescents on a basal bolus/pump regimen were more likely to complete BCs (p < .05); however, child age, gender, and A1c were unrelated to BC completion. Families who completed at least one BC were more likely to participate in follow-up assessment (p < .05). Overall, families reported that BCs were "somewhat helpful" (34%), or "pretty helpful"/ "very helpful" (46%). Many families participated in BCs and found them helpful, and completion of BCs was related to participant retention at 3 month follow-up, suggesting that this mHealth strategy may be a promising tool for improving participant retention and treatment outcomes in behavioral interventions. Further exploration of the use of mhealth strategies among adolescents with T1D participating in behavioral RCTs and their families is warranted.

Research paper thumbnail of Individual and family strengths: An examination of the relation to disease management and metabolic control in youth with type 1 diabetes

Families, Systems, & Health, 2011

We examined the association of youths' positive qualities, family cohesion, disease management, a... more We examined the association of youths' positive qualities, family cohesion, disease management, and metabolic control in Type 1 diabetes. Two-hundred fifty-seven youthϪparent dyads completed the Family Cohesion subscale of the Family Environment Scale, the Diabetes Behavior Rating Scale, 24-hour diabetes interview, and youth completed the Positive Qualities subscale of the Youth Self Report (YSR-PQ). Structural equation modeling demonstrated that YSR-PQ scores were associated with metabolic control mediated by associations with more family cohesion and better disease management. That is, youth with higher YSR-PQ scores had more cohesive families, better disease management, and, indirectly, better metabolic control. Family cohesion was indirectly associated with better metabolic control mediated by its association with better disease management, but not mediated by its association with YSR-PQ scores. Youth who reported more positive qualities, as measured by the YSR-PQ subscale, had better disease management and metabolic control through the association with more family cohesion. However, the current results did not support an alternative hypothesis that cohesive families display better diabetes management mediated by higher YSR-PQ scores.

Research paper thumbnail of Advances in Clinical Child Psychology (Book)

Journal of Clinical Child Psychology, 1986

Research paper thumbnail of Blood Glucose Control and Visual and Auditory Attention in Men with Insulin-dependent Diabetes

Diabetic Medicine, 1988

Assessment of 16 young men with insulin-dependent diabetes mellitus was undertaken with neuropsyc... more Assessment of 16 young men with insulin-dependent diabetes mellitus was undertaken with neuropsychological measures of attention, decision-making, and motor tasks. Those patients in very good, or near-normal, blood glucose control demonstrated decreased attention on visual and auditory simple reaction-time tasks, compared with those in moderate blood glucose control. Patient groups did not differ in their decision-making performance; nor did they differ in motor skill performance. These results replicate earlier findings of differences in visual attention in groups of patients according to degree of blood glucose control and show between-group differences with an auditory reaction time measure. The results suggest that patients with near-normal blood glucose control may exhibit slowed simple attention, whether information presentation is visual or aural.

Research paper thumbnail of Disease and Demographic Risk Factors for Disrupted Cognitive Functioning in Children with Insulin-Dependent Diabetes Mellitus (IDDM)

School Psychology Review, 1999

ABSTRACT Reviews research on insulin-dependent diabetes mellitus (IDDM) and the acute and chronic... more ABSTRACT Reviews research on insulin-dependent diabetes mellitus (IDDM) and the acute and chronic metabolic abnormalities related to poorer neuropsychological functioning in the areas of information processing speed, visual spatial ability, and memory in childhood. The studies reviewed suggest that children with IDDM demonstrate lower intellectual functioning than controls with some subgroups at greater risk than others. Poorer metabolic control including both recurrent hypoglycemia and severe hyperglycemia, earlier age of disease onset, and longer disease duration have been related to lower IQ scores. Lower academic achievement scores have also been found, and a substantial proportion of children with diabetes have received special school services, especially those children from the higher risk groups. Neurodevelopmentally, the evidence presented indicates that boys rather than girls are at greater risk for learning problems, and that gender effects are magnified with diabetes. Results supporting that poorer metabolic control is consistently associated with lower SES groups, and that boys from lower SES families have clinically lower IQ scores are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Research paper thumbnail of Family environment and the interrelation of family structure, child behavior, and metabolic control for children with diabetes

Journal of pediatric …, 1995

Examined perceptions of the family environment in a cross-regional sample of 90 families who had ... more Examined perceptions of the family environment in a cross-regional sample of 90 families who had children with diabetes and 89 controls. Families were classified as either traditional (intact) or nontraditional (single-parent or blended families). Parents of children with diabetes reported less family expressiveness, which was a predictor of clinically higher levels of child behavior problems than controls. Parents in nontraditional families reported lower levels of organization, less emphasis on active-recreational pursuits, and more child behavior problems than traditional families. An additive effect of diabetes and nontraditional family structure was found for children with diabetes from nontraditional families, who reported substantially less cohesion than all other groups. Nontraditional family structure was more disruptive for children with diabetes than for controls; it was the best predictor of behavior problems and was related to poorer metabolic control.

Research paper thumbnail of Maternal depressive symptoms and disease care status in youth with type 1 diabetes

Research paper thumbnail of Predictors of Youth Diabetes Care Behaviors and Metabolic Control: A Structural Equation Modeling Approach

Journal of Pediatric Psychology, 2005

Objective To empirically test a biopsychosocial model of predictors of youth diabetes care behavi... more Objective To empirically test a biopsychosocial model of predictors of youth diabetes care behaviors and metabolic control. Methods A cross-sectional multisite study of youths (N = 222) with T1D (mean age = 12.6) used structural equation modeling to examine interrelations among predictors, with follow-up analyses of covariance (ANCOVAs). Results Youths' memory skills related to diabetes knowledge which, along with self-efficacy and age, was associated with greater youth responsibility that in turn predicted poorer self-care behaviors. Less frequent/briefer exercise and less frequent blood glucose monitoring/eating were found; the latter directly related to poorer metabolic control. Behavior problems also were associated directly with poorer metabolic control. A parsimonious model found memory directly related to blood glucose testing. Conclusions Continued parental supervision of adolescents, along with monitoring diabetes knowledge and efficacy, may help optimize transfer of diabetes care from parents to youths. Behavior problems warrant immediate attention because of their direct and adverse relation to metabolic control.

Research paper thumbnail of Family and Youth Factors Associated With Health Beliefs and Health Outcomes in Youth With Type 1 Diabetes

Journal of Pediatric Psychology, 2012

Objective To examine the association of family organization with metabolic control in adolescents... more Objective To examine the association of family organization with metabolic control in adolescents with type 1 diabetes through the mechanisms of family self-efficacy for diabetes and disease management. Method Data from the baseline assessment of a longitudinal RCT were used, wherein 257 adolescentparent dyads (adolescents aged 11-14) each completed the family organization subscale of the Family Environment Scale, the self-efficacy for Diabetes Self-Management Scale, the Diabetes Behavior Rating Scale, and 2 24-hr diabetes interviews. Results Structural equation modeling showed greater family organization was associated indirectly with better disease management behaviors via greater family self-efficacy (b ¼ .38, p < .001). Greater self-efficacy was indirectly associated with better metabolic control via better disease management both concurrently (b ¼ À.37, p < .001) and prospectively (b ¼ À.26, p < .001). The full model indicates more family organization is indirectly associated with better metabolic control concurrently and prospectively through greater self-efficacy and better disease management (b ¼ À.13, p < .001). Conclusions Understanding the mechanisms by which family organization is associated with metabolic control provides insight into possible avenues of prevention/intervention for better diabetes management.

Research paper thumbnail of Randomized Clinical Trial of Clinic-Integrated, Low-Intensity Treatment to Prevent Deterioration of Disease Care in Adolescents With Type 1 Diabetes

Diabetes Care, 2014

OBJECTIVE To evaluate the efficacy of two office-based treatments designed to prevent deteriorati... more OBJECTIVE To evaluate the efficacy of two office-based treatments designed to prevent deterioration in glycemic control in young adolescents with type 1 diabetes in a randomized clinical trial. An individualized, more intensive family teamwork Coping skills program was compared with a diabetes Education treatment. RESEARCH DESIGN AND METHODS A baseline assessment was followed by four brief treatment sessions and immediate posttesting over the course of 1.5 years. Families of 226 early adolescents (ages 11–14) were randomized to receive either individualized coping skills education or diabetes education as adjunctive treatment to quarterly medical appointments. Continued follow-up occurred at 3.5-month intervals for a long-term follow-up of up to 3 years. A post hoc Usual Care group facilitated comparisons of glycemic control. RESULTS Growth curve analysis showed that both treatment groups successfully prevented deterioration in adolescent disease care and simultaneously improved ado...

Research paper thumbnail of A four-year follow-up of hyperactive boys with and without conduct disorder

The British Journal of Psychiatry, 1983

Summary: A four-year follow-up of clinically selected hyperactive boys with and without associate... more Summary: A four-year follow-up of clinically selected hyperactive boys with and without associated conduct disorder investigated their outcome during early adolescence and was taken from a structured behavioural interview and standard psychological testing. Boys originally ...

Research paper thumbnail of Parents' and teachers' differing views of short children's behaviour

Child: Care, Health and …, 1982

Research paper thumbnail of Demographic risk factors, mediators, and moderators in youths’ diabetes metabolic control

Annals of Behavioral Medicine, 2006

Background: Socioeconomic status (SES) is one of the most frequently identified and potent predic... more Background: Socioeconomic status (SES) is one of the most frequently identified and potent predictors of disease morbidity and mortality. It also predicts diabetes care and metabolic control, yet it is often confounded with parental marital status and ethnicity in pediatric samples. Purpose: Key demographic risk factors for poorer metabolic control in adolescents with type I diabetes are examined to distinguish their relative effects, along with disease care mediators and family environment moderators. Methods and Results: When SES, ethnicity, and marital status are considered simultaneously with path analysis, living with married biological parents is the sole predictor of better metabolic control in a predominantly middle-class sample. Specifically, adolescents who lived with their biologic parents had glycosylated hemoglobin levels that were approximately .5% lower on average than those who lived in alternative family arrangements (i.e., blended and single-parent families). More frequent meals and snacks and more blood glucose monitoring mediates this effect. Under favorable conditions of greater familial harmony, children from married biologic families experience a stronger beneficial health effect, with average glycohemoglobin levels that are approximately .81% lower in less conflicted families and .62% lower in more cohesive families. Conclusions: In toto, marital status eclipsed the well known effects of SES in the prediction of metabolic control in a primarily middle-class sample of children with diabetes. The 8.0% average glycohemoglobin level of youths from married biologic families is similar to that of intensively treated adolescents in the Diabetes Control and Complications Trial and, if maintained, should be associated with clinically significant reductions in disease complications.

Research paper thumbnail of Cognitive functioning and academic achievement in children with insulin-dependent diabetes mellitus (IDDM)

School Psychology Quarterly, 1995

Consistent evidence relates Insulin Dependent Diabetes Mellitus (IDDM) to lower intellec-tual fun... more Consistent evidence relates Insulin Dependent Diabetes Mellitus (IDDM) to lower intellec-tual functioning in children, although performance is still in the average range. Disease risk factors for lower IQ scores are age of disease onset, severe hypoglycemia, and diabetic ...

Research paper thumbnail of Gender Differences in the Learning Status of Diabetic Children

Journal of Consulting and Clinical Psychology, 1992

The learning status of 95 diabetic boys and girls and 97 matched controls was evaluated using the... more The learning status of 95 diabetic boys and girls and 97 matched controls was evaluated using the Wechsler Intelligence Scale for Children—Revised IQ factors and school histories. Of interest was whether diabetic boys would evidence more learning difficulties. Results indicated that diabetic boys had significantly lower Freedom From Distractibility scores compared with scores of diabetic girls and control Ss and

Research paper thumbnail of Gender Differences in Memory and Learning in Children with Insulin-Dependent Diabetes Mellitus (IDDM) over a 4-year Follow-up Interval

Journal of Pediatric Psychology, 2003

Objective To examine demographic and disease predictors of memory and learning perfor- mance for ... more Objective To examine demographic and disease predictors of memory and learning perfor- mance for children with diabetes and controls. Method Children with diabetes (N = 95) and demographically similar control children (N = 100) were administered the Rey Auditory Verbal Learning Test (RAVLT) initially and 4 years later. Results Unlike other groups, boys with diabetes did not make expected developmental

Research paper thumbnail of Original Research Article: Predictors of Youth Diabetes Care Behaviors and Metabolic Control: A Structural Equation Modeling Approach

Objective To empirically test a biopsychosocial model of predictors of youth diabetes care behavi... more Objective To empirically test a biopsychosocial model of predictors of youth diabetes care behaviors and metabolic control. Methods A cross-sectional multisite study of youths (N = 222) with T1D (mean age = 12.6) used structural equation modeling to examine interrelations among predictors, with follow-up analyses of covariance (ANCOVAs). Results Youths’ memory skills related to diabetes knowledge which, along with self-efficacy and age, was associated with greater youth responsibility that in turn predicted poorer self-care behaviors. Less frequent/briefer exercise and less frequent blood glucose monitoring/eating were found; the latter directly related to poorer metabolic control. Behavior problems also were associated directly with poorer metabolic control. A parsimonious model found memory directly related to blood glucose testing. Conclusions Continued parental supervision of adolescents, along with monitoring diabetes knowledge and efficacy, may help optimize transfer of diabet...

Research paper thumbnail of Advances in Clinical Child Psychology (Book)

Journal of Clinical Child Psychology, Sep 1, 1987

Research paper thumbnail of Cognitive Functioning and Diabetes: Broadening the Paradigm for Behavioral and Health Psychology?

Research paper thumbnail of Adolescents with cleft lip and palate: self-perceptions of appearance and behavior related to personality adjustment

The Cleft palate journal, 1985

Two groups of adolescents with cleft lip and palate were compared on their self-ratings of facial... more Two groups of adolescents with cleft lip and palate were compared on their self-ratings of facial appearance and behavior. The two groups were identified as well adjusted (N = 19) or poorly adjusted (N = 17), based on their parents' ratings of behavior. T-test comparisons indicate that the group with good adjustment have realistic perceptions of facial appearance (based on independent ratings by their teachers), and their self-perceptions of behavior are similar to those of their parents. The poorly adjusted group have unrealistic perceptions of facial appearance and perceive their behavior as more socially acceptable than do their parents.

Research paper thumbnail of Use of Booster Calls in a Behavioral Intervention for Adolescents with Type 1 Diabetes

Journal of Mobile Technology in Medicine, 2012

Behavioral interventions are commonly utilized to prevent declines in adherence and glycemic cont... more Behavioral interventions are commonly utilized to prevent declines in adherence and glycemic control among adolescents with type 1 diabetes (T1D). Mobile health strategies may maintain participant engagement and improve retention rates and outcomes in such interventions. The present study explored the use of booster calls (BCs; quick telephone check-ins), in maintaining participant engagement throughout an ongoing RCT for adolescents with T1D. Data are available from 143 adolescent-parent dyads (Mchild age= 12.96 years) who were randomized to the treatment condition. Most adolescents were female (54%) and Caucasian (68%), and ninety-two percent of parents were mothers. Most were prescribed a basal bolus or pump regimen (75%), and average glycosolated hemoglobin (HbA1c) at baseline was 8.69%. Dyads participated in four treatment sessions designed to improve coping skills and promote medical regimen adherence. BCs were conducted one month after each session, and participants completed follow-up assessment 3 months after their final session. Ninety-six percent of participants completed at least one BC; 29% completed all four. On average, 2.88 contact attempts were made per BC and completed calls lasted eight minutes. Adolescents on a basal bolus/pump regimen were more likely to complete BCs (p < .05); however, child age, gender, and A1c were unrelated to BC completion. Families who completed at least one BC were more likely to participate in follow-up assessment (p < .05). Overall, families reported that BCs were "somewhat helpful" (34%), or "pretty helpful"/ "very helpful" (46%). Many families participated in BCs and found them helpful, and completion of BCs was related to participant retention at 3 month follow-up, suggesting that this mHealth strategy may be a promising tool for improving participant retention and treatment outcomes in behavioral interventions. Further exploration of the use of mhealth strategies among adolescents with T1D participating in behavioral RCTs and their families is warranted.

Research paper thumbnail of Individual and family strengths: An examination of the relation to disease management and metabolic control in youth with type 1 diabetes

Families, Systems, & Health, 2011

We examined the association of youths' positive qualities, family cohesion, disease management, a... more We examined the association of youths' positive qualities, family cohesion, disease management, and metabolic control in Type 1 diabetes. Two-hundred fifty-seven youthϪparent dyads completed the Family Cohesion subscale of the Family Environment Scale, the Diabetes Behavior Rating Scale, 24-hour diabetes interview, and youth completed the Positive Qualities subscale of the Youth Self Report (YSR-PQ). Structural equation modeling demonstrated that YSR-PQ scores were associated with metabolic control mediated by associations with more family cohesion and better disease management. That is, youth with higher YSR-PQ scores had more cohesive families, better disease management, and, indirectly, better metabolic control. Family cohesion was indirectly associated with better metabolic control mediated by its association with better disease management, but not mediated by its association with YSR-PQ scores. Youth who reported more positive qualities, as measured by the YSR-PQ subscale, had better disease management and metabolic control through the association with more family cohesion. However, the current results did not support an alternative hypothesis that cohesive families display better diabetes management mediated by higher YSR-PQ scores.

Research paper thumbnail of Advances in Clinical Child Psychology (Book)

Journal of Clinical Child Psychology, 1986

Research paper thumbnail of Blood Glucose Control and Visual and Auditory Attention in Men with Insulin-dependent Diabetes

Diabetic Medicine, 1988

Assessment of 16 young men with insulin-dependent diabetes mellitus was undertaken with neuropsyc... more Assessment of 16 young men with insulin-dependent diabetes mellitus was undertaken with neuropsychological measures of attention, decision-making, and motor tasks. Those patients in very good, or near-normal, blood glucose control demonstrated decreased attention on visual and auditory simple reaction-time tasks, compared with those in moderate blood glucose control. Patient groups did not differ in their decision-making performance; nor did they differ in motor skill performance. These results replicate earlier findings of differences in visual attention in groups of patients according to degree of blood glucose control and show between-group differences with an auditory reaction time measure. The results suggest that patients with near-normal blood glucose control may exhibit slowed simple attention, whether information presentation is visual or aural.

Research paper thumbnail of Disease and Demographic Risk Factors for Disrupted Cognitive Functioning in Children with Insulin-Dependent Diabetes Mellitus (IDDM)

School Psychology Review, 1999

ABSTRACT Reviews research on insulin-dependent diabetes mellitus (IDDM) and the acute and chronic... more ABSTRACT Reviews research on insulin-dependent diabetes mellitus (IDDM) and the acute and chronic metabolic abnormalities related to poorer neuropsychological functioning in the areas of information processing speed, visual spatial ability, and memory in childhood. The studies reviewed suggest that children with IDDM demonstrate lower intellectual functioning than controls with some subgroups at greater risk than others. Poorer metabolic control including both recurrent hypoglycemia and severe hyperglycemia, earlier age of disease onset, and longer disease duration have been related to lower IQ scores. Lower academic achievement scores have also been found, and a substantial proportion of children with diabetes have received special school services, especially those children from the higher risk groups. Neurodevelopmentally, the evidence presented indicates that boys rather than girls are at greater risk for learning problems, and that gender effects are magnified with diabetes. Results supporting that poorer metabolic control is consistently associated with lower SES groups, and that boys from lower SES families have clinically lower IQ scores are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Research paper thumbnail of Family environment and the interrelation of family structure, child behavior, and metabolic control for children with diabetes

Journal of pediatric …, 1995

Examined perceptions of the family environment in a cross-regional sample of 90 families who had ... more Examined perceptions of the family environment in a cross-regional sample of 90 families who had children with diabetes and 89 controls. Families were classified as either traditional (intact) or nontraditional (single-parent or blended families). Parents of children with diabetes reported less family expressiveness, which was a predictor of clinically higher levels of child behavior problems than controls. Parents in nontraditional families reported lower levels of organization, less emphasis on active-recreational pursuits, and more child behavior problems than traditional families. An additive effect of diabetes and nontraditional family structure was found for children with diabetes from nontraditional families, who reported substantially less cohesion than all other groups. Nontraditional family structure was more disruptive for children with diabetes than for controls; it was the best predictor of behavior problems and was related to poorer metabolic control.

Research paper thumbnail of Maternal depressive symptoms and disease care status in youth with type 1 diabetes

Research paper thumbnail of Predictors of Youth Diabetes Care Behaviors and Metabolic Control: A Structural Equation Modeling Approach

Journal of Pediatric Psychology, 2005

Objective To empirically test a biopsychosocial model of predictors of youth diabetes care behavi... more Objective To empirically test a biopsychosocial model of predictors of youth diabetes care behaviors and metabolic control. Methods A cross-sectional multisite study of youths (N = 222) with T1D (mean age = 12.6) used structural equation modeling to examine interrelations among predictors, with follow-up analyses of covariance (ANCOVAs). Results Youths' memory skills related to diabetes knowledge which, along with self-efficacy and age, was associated with greater youth responsibility that in turn predicted poorer self-care behaviors. Less frequent/briefer exercise and less frequent blood glucose monitoring/eating were found; the latter directly related to poorer metabolic control. Behavior problems also were associated directly with poorer metabolic control. A parsimonious model found memory directly related to blood glucose testing. Conclusions Continued parental supervision of adolescents, along with monitoring diabetes knowledge and efficacy, may help optimize transfer of diabetes care from parents to youths. Behavior problems warrant immediate attention because of their direct and adverse relation to metabolic control.

Research paper thumbnail of Family and Youth Factors Associated With Health Beliefs and Health Outcomes in Youth With Type 1 Diabetes

Journal of Pediatric Psychology, 2012

Objective To examine the association of family organization with metabolic control in adolescents... more Objective To examine the association of family organization with metabolic control in adolescents with type 1 diabetes through the mechanisms of family self-efficacy for diabetes and disease management. Method Data from the baseline assessment of a longitudinal RCT were used, wherein 257 adolescentparent dyads (adolescents aged 11-14) each completed the family organization subscale of the Family Environment Scale, the self-efficacy for Diabetes Self-Management Scale, the Diabetes Behavior Rating Scale, and 2 24-hr diabetes interviews. Results Structural equation modeling showed greater family organization was associated indirectly with better disease management behaviors via greater family self-efficacy (b ¼ .38, p < .001). Greater self-efficacy was indirectly associated with better metabolic control via better disease management both concurrently (b ¼ À.37, p < .001) and prospectively (b ¼ À.26, p < .001). The full model indicates more family organization is indirectly associated with better metabolic control concurrently and prospectively through greater self-efficacy and better disease management (b ¼ À.13, p < .001). Conclusions Understanding the mechanisms by which family organization is associated with metabolic control provides insight into possible avenues of prevention/intervention for better diabetes management.

Research paper thumbnail of Randomized Clinical Trial of Clinic-Integrated, Low-Intensity Treatment to Prevent Deterioration of Disease Care in Adolescents With Type 1 Diabetes

Diabetes Care, 2014

OBJECTIVE To evaluate the efficacy of two office-based treatments designed to prevent deteriorati... more OBJECTIVE To evaluate the efficacy of two office-based treatments designed to prevent deterioration in glycemic control in young adolescents with type 1 diabetes in a randomized clinical trial. An individualized, more intensive family teamwork Coping skills program was compared with a diabetes Education treatment. RESEARCH DESIGN AND METHODS A baseline assessment was followed by four brief treatment sessions and immediate posttesting over the course of 1.5 years. Families of 226 early adolescents (ages 11–14) were randomized to receive either individualized coping skills education or diabetes education as adjunctive treatment to quarterly medical appointments. Continued follow-up occurred at 3.5-month intervals for a long-term follow-up of up to 3 years. A post hoc Usual Care group facilitated comparisons of glycemic control. RESULTS Growth curve analysis showed that both treatment groups successfully prevented deterioration in adolescent disease care and simultaneously improved ado...

Research paper thumbnail of A four-year follow-up of hyperactive boys with and without conduct disorder

The British Journal of Psychiatry, 1983

Summary: A four-year follow-up of clinically selected hyperactive boys with and without associate... more Summary: A four-year follow-up of clinically selected hyperactive boys with and without associated conduct disorder investigated their outcome during early adolescence and was taken from a structured behavioural interview and standard psychological testing. Boys originally ...

Research paper thumbnail of Parents' and teachers' differing views of short children's behaviour

Child: Care, Health and …, 1982

Research paper thumbnail of Demographic risk factors, mediators, and moderators in youths’ diabetes metabolic control

Annals of Behavioral Medicine, 2006

Background: Socioeconomic status (SES) is one of the most frequently identified and potent predic... more Background: Socioeconomic status (SES) is one of the most frequently identified and potent predictors of disease morbidity and mortality. It also predicts diabetes care and metabolic control, yet it is often confounded with parental marital status and ethnicity in pediatric samples. Purpose: Key demographic risk factors for poorer metabolic control in adolescents with type I diabetes are examined to distinguish their relative effects, along with disease care mediators and family environment moderators. Methods and Results: When SES, ethnicity, and marital status are considered simultaneously with path analysis, living with married biological parents is the sole predictor of better metabolic control in a predominantly middle-class sample. Specifically, adolescents who lived with their biologic parents had glycosylated hemoglobin levels that were approximately .5% lower on average than those who lived in alternative family arrangements (i.e., blended and single-parent families). More frequent meals and snacks and more blood glucose monitoring mediates this effect. Under favorable conditions of greater familial harmony, children from married biologic families experience a stronger beneficial health effect, with average glycohemoglobin levels that are approximately .81% lower in less conflicted families and .62% lower in more cohesive families. Conclusions: In toto, marital status eclipsed the well known effects of SES in the prediction of metabolic control in a primarily middle-class sample of children with diabetes. The 8.0% average glycohemoglobin level of youths from married biologic families is similar to that of intensively treated adolescents in the Diabetes Control and Complications Trial and, if maintained, should be associated with clinically significant reductions in disease complications.

Research paper thumbnail of Cognitive functioning and academic achievement in children with insulin-dependent diabetes mellitus (IDDM)

School Psychology Quarterly, 1995

Consistent evidence relates Insulin Dependent Diabetes Mellitus (IDDM) to lower intellec-tual fun... more Consistent evidence relates Insulin Dependent Diabetes Mellitus (IDDM) to lower intellec-tual functioning in children, although performance is still in the average range. Disease risk factors for lower IQ scores are age of disease onset, severe hypoglycemia, and diabetic ...

Research paper thumbnail of Gender Differences in the Learning Status of Diabetic Children

Journal of Consulting and Clinical Psychology, 1992

The learning status of 95 diabetic boys and girls and 97 matched controls was evaluated using the... more The learning status of 95 diabetic boys and girls and 97 matched controls was evaluated using the Wechsler Intelligence Scale for Children—Revised IQ factors and school histories. Of interest was whether diabetic boys would evidence more learning difficulties. Results indicated that diabetic boys had significantly lower Freedom From Distractibility scores compared with scores of diabetic girls and control Ss and

Research paper thumbnail of Gender Differences in Memory and Learning in Children with Insulin-Dependent Diabetes Mellitus (IDDM) over a 4-year Follow-up Interval

Journal of Pediatric Psychology, 2003

Objective To examine demographic and disease predictors of memory and learning perfor- mance for ... more Objective To examine demographic and disease predictors of memory and learning perfor- mance for children with diabetes and controls. Method Children with diabetes (N = 95) and demographically similar control children (N = 100) were administered the Rey Auditory Verbal Learning Test (RAVLT) initially and 4 years later. Results Unlike other groups, boys with diabetes did not make expected developmental