The descriptive study which explored the insulin dependent diabetics' and non-insulin dependent diabetics' perceptions of susceptibility to diabetic complications, severity of diabetes, and benefits of and barriers to preventive measures. The Wortell Diabetic Perception Scale was developed by the researcher for this study, and administered to a convenience sample of 71 subjects. The Subjects' age ranged from 22 to 80 years. There were 33 females and 38 males in the sample. Forty three percent of the diabetics were classified as insulin dependent diabetics and 57% as non-insulin dependent diabetics. Findings indicated that insulin dependent diabetics perceived diabetes to be significantly more severe than did non-insulin dependent diabetics. No significant difference was found to exist between the insulin dependent diabetics and non-insulin dependent diabetics with regards to perceived susceptibility to diabetic complications, and benefits of and barriers to preventive measures.

Memory performance was measured in 48 persons between the ages of 40 - 65 with Type II diabetes. Correlations between performance on the California Verbal Learning Test, tests of Working Memory, Priming Memory, and Prospective Memory and several predictor variables were examined. These variables included the Slosson Intelligence Test Scores, demographic variables, presence of diabetic complications, finger-stick and HbA1c measures. Subjects performed worse than the normative sample on the California Verbal Learning Test. Higher chronic and acute blood glucose tended to be associated with worse performance on the CVLT, Priming, and Working Memory. However, after the effects of intelligence, education, and sex were statistically controlled, glycemic status predicted performance on just a few memory measures. These were short-delay recall compared with recall on List A trial 5, and List B on the CVLT, and recall accuracy on digit forward of the Working Memory Test. Glucose status was unrelated to performance on a prospective memory test. Several other demographic and diabetic complication factors predicted performance beyond the contribution of intelligence. These results contrast with previous studies which found strong effects of glycemic control, but did not statistically control for the contribution of intelligence. Differential effects of diabetic status on different aspects of memory were discussed.

The focus of the research study is to explore chronically ill African American, Latino, and White patients' causal attributions of symptoms of depression and factors that predict depression care treatment preferences among these groups. Research has demonstrated that perception of illness impacts what treatments a person will deem appropriate for their mental health problems and from whom they will seek treatment. Research also indicates that certain ethnic groups are more likely to seek treatment for their symptoms of depression in the primary care setting. Yet, it is unclear how they actually perceive their symptoms and what best predicts the treatments that they are likely to consider acceptable. A convenient sample of 109 HIV+ adults, 79 diabetic adults, and 3 adults with both conditions were recruited for this study. Participants had to be receiving services for either HIV, diabetes, or both conditions in one of the three central Austin facilities and be a representative from one of three racial/ethnic groups: African Americans, Latino, and White. Differences were found across ethnicity with regard to causal beliefs and treatment preferences for the symptoms of depression both among the HIV and the diabetic subgroups. Latinos in both groups were more likely than Whites to prefer counseling or a single form of treatment over combined treatment methods. Diabetic Latinos were more likely to prefer counseling for symptoms of depression. HIV seropositive individuals who reported the least number of symptoms of physical illness were more likely to attribute their symptoms of depression to stressful life events, whereas those who reported the greatest number of symptoms of physical illness were more likely to attribute their symptoms of depression to their medical illness. Additionally among the HIV subgroup, individuals who reported high stress tended to predict the preferences for treatment provided by a psychiatrist/psychologist and Whites scored highest on this factor. Finally, differences in depression scores across race/ethnicity were also revealed. The utility of assessing a patient's understanding of symptoms of depression in order to determine how personal illness models impact treatment preferences and knowledge of patient's causal attributions can aid medical social workers and physicians in collaborative management of chronic illness and depression are discussed.

While insulin omission has been found to be a common behavior in those with type I diabetes, it has been primarily studied within the context of disordered eating behavior. Previous research supports medical providers and patients lack of comfort in discussing insulin omission. This study was designed to answer two questions. Why do young adult college students with type I diabetes omit insulin? and what factors facilitate and act as barriers to open communication regarding insulin omission in the patient-provider interaction. A total 13 (10 females, 3 males) college students completed a qualitative interview focused on insulin omission and communication of this behavior to medical providers, and 11 of the 13 completed a modified EAT-26. Using consensual qualitative research methods CQR (Hill, Thompson, & Williams, 1997), domains that emerged were reasons for insulin, predominant reason for insulin omission, motivators to give insulin as prescribed (i.e., adhere), overall communication of insulin omission to medical providers, and factors facilitating and barriers inhibiting communication regarding insulin omission to medical providers. Typical reasons for insulin omission included forgetting or delaying and forgetting, worrying about hypoglycemia and its social implications, being in situations where limited access to food/medical supplies, planning to be physically active, or being unsure of carbohydrate count in food. Insulin omission as a weight loss behavior was not reported by any of the participants during the interviews and all denied using insulin as a way to control their weight or shape on the EAT-26. Clinical implications and future research directions are discussed. / Department of Counseling Psychology and Guidance Services

Compared to the general population, diabetic patients experience a higher prevalence of depression, which can often exacerbate diabetic symptoms and complicate treatment. Studies show that religion is associated with both better physical health and better psychological functioning; however, studies incorporating religion and depression among diabetic individuals are scarce. The present study addressed this gap in the literature by examining archival data from the 2008 and 2010 data waves of the Health and Retirement Study (HRS). Cross-sectional findings confirmed that stronger religiosity was positively correlated with perceived diabetes control and positive diabetes change, and negatively correlated with total number of depressive symptoms and total number of weeks depressed. Longitudinal findings confirmed that stronger religiosity in 2008 was positively correlated with perceived diabetes change in 2010 and negatively correlated with total number of depressive symptoms in 2010. Logistic regression and multiple regression analyses were performed to test four moderation models. Results showed that religiosity significantly moderated the relationship between perceived diabetes control and total number of weeks depressed. More specifically, for diabetics with low levels of religiosity, whether they believed their diabetes was under control or not did not make a significant difference in the total number of weeks depressed. However, high levels of religiosity served as a buffer against the duration of depressive symptoms but only for diabetics who perceived to have their diabetes under control. Understanding how these constructs jointly influence diabetes management and psychological functioning is critical in that medical professionals may utilize such knowledge to enhance treatment outcomes.

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