Effects of Social Demand on Reports of Self-Monitored Blood Glucose in Adolescents with Type 1 Diabetes Mellitus

The purpose of this study was to test the hypothesis that social demand could substantially affect reports of self-monitored blood glucose (BG) in adolescents with insulin-dependent diabetes mellitus. Of 34 patients initially enrolled in the study, 10 were excluded because they did not bring any BG records with them to an outpatient clinic appointment. The remaining 24 patients were randomly assigned to either a low or high social demand condition that provided instructions for monitoring of BG for the week following the appointment. The subjects' BG records were quantified to provide frequency of measurement and mean reported BG for the week prior to and after the clinic visit. Five subjects did not return their BG records for the week following the intervention. The analyses were therefore based on the 19 subjects from whom complete records were obtained. The 12 subjects in the low social demand group and 7 subjects in the high social demand group were equivalent with regard to age, duration of diabetes, socioeconomic status, and glycosylated hemoglobin. Frequency of BG measurement was similar in both groups during both weeks. The mean BG value reported in the week prior to intervention was similar for the groups. However, analyses of the post-intervention BGs revealed that subjects in the low-demand group reported significantly higher BGs compared to pre-intervention and to subjects in the high-demand group. These findings suggest that self-monitoring and reporting of BG is a social behavior that is affected by the demand characteristics of the interpersonal patient-health provider relationship. Because optimal treatment planning for individuals with diabetes requires accurate BG records, care must be taken to interpret them in light of the social demand characteristics associated with clinical assessment.     

Preventing Substance Abuse Among American-Indian Adolescents: A Bicultural Competence Skills Approach

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.     

Attempted suicide in youth: Its relationship to school achievement,educational goals,and socioeconomic status

Twenty-six suicide attempters, 9 to 18 years of age, were compared with 725 nonattempters on measures of school achievement, educational goals, socioeconomic status, and depression. As has been found in studies using clinical samples, suicide attempters in our communitybased sample had significantly lower school achievement than nonattempters. The relationship between attempted suicide and low school achievement seemed to be explained by the effects of depression. Lower-SES youth tended to be more likely to attempt suicide than higher-SES youths. However, SES appeared to have little effect on the relationship between attempted suicide and school achievement. Results also suggest that children of mothers with low educational goals for them may be more at risk for attempted suicide than youths whose mothers have higher educational goals for their children.This research was supported by the National Institute of Mental Health, Grant No. MH36971.     

Confidence in judgments based on incomplete information: An investigation using both hypothetical and real gambles

This study assessed how confidence in judgments is affected by the need to make inferences about missing information. Subjects indicated their likelihood of taking each of a series of gambles based on both probability and payoff information or only one of these sources of information. They also rated their confidence in each likelihood judgment. Subjects in the Explicit Inference condition were asked to explicitly estimate the values of missing information before making their responses while subjects in the Implicit Inference condition were not. The manner in which probability information was framed was also manipulated. Experiment 1 employed hypothetical gambles and Experiment 2 employed gambles with real money. Expressed likelihood of taking gambles was higher when probability was phrased in terms of '% chance of winning' rather than '% chance of losing', but this difference was somewhat less with real gambles than with hypothetical gambles. Confidence ratings in each experiment were actually higher on incomplete information trials than on complete information trials in the Explicit Inference condition. Results were related to the general issue of confidence in judgments.     

Attitudes toward older and younger adults: a meta-analysis

Attitudes toward the elderly have been examined in a number of empirical studies, yet the question of whether the elderly are viewed more negatively than younger persons has not been resolved. A meta-analysis of the literature was conducted to examine this question; results demonstrated that attitudes toward the elderly are more negative than attitudes toward younger people. However, smaller differences between the evaluations of elderly and younger targets were found when (a) the study used measures of personality traits (compared with measures of competence), (b) there were a larger number of dependent measures included in the effect size, (c) specific information was provided about the target person (compared with when a general target such as old person was used), and (d) a between-subjects design (compared with a within-subjects design) was used. These results support Lutsky's (1981) conclusion that age, in and of itself, seems to be less important in determining attitudes toward the elderly than other types of information. The methodological limitations within the literature and a need to consider multiple components of attitudes toward older individuals are discussed.     

An "Epidemic" Model of Adolescent Cigarette Smoking

The prevalence of regular smoking increases rapidly during adolescence. We applied modeling methods from the study of epidemic infectious disease to smoking behavior. Our "epidemic" models dealt with the process of transition among four states: nonsmoker (susceptible), trier (exposed), regular smoker (infected), and ex-smoker (recovered). The best fitting model was one in which the transition from nonsmoker to trier was a social contagion process where nonsmokers contacted either triers or regular smokers. All other transitions were treated as constant rate processes in which a constant proportion of eligible individuals made the transition in a given year. The recursive equation model embodying these assumptions was able to predict accurately the proportion of adolescents in each state in Grades 6–11. Our results support a "stage" model of smoking, suggesting that different psychological and physiological processes are involved in the initiation of smoking than in developing a habit of regular smoking. A possible sex difference was found in the non-contact transition between trier and smoker states, with the transition being more probable in females than in males.     

Life event categories differentially predict psychopathology symptom levels.

The present study used a prospective design to investigate whether eight categories of daily negative life events or "hassles" differentially predict psychopathology levels, and/or changes in psychopathology levels over 1 month in a mixed-sex, nonclinical sample of undergraduate subjects. Hassles were assessed using the Revised Hassles Scale (HS-R; DeLongis, 1985); psychopathology was assessed using the Hopkins Symptom Checklist (SCL-90; Derogatis, Lipman, & Covi, 1973) on two occasions, separated by 1 month. Scores on all eight HS-R subscales predicted Time 2 scores on most or all of the SCL-90 psychopathology scales. However, the magnitudes of these correlations varied widely, indicating that these subscales may be substantially different in their abilities to predict psychopathology levels.