Jacobson A M, Hauser S T, Lavori P, Willett J B, Cole C F, Wolfsdorf J I, Dumont R H, Wertlieb D
Mental Health Department, Joslin Diabetes Center, Massachusetts Mental Health Center, Boston 02215.
Psychosom Med. 1994 Sep-Oct;56(5):401-9. doi: 10.1097/00006842-199409000-00004.
An onset cohort of children and adolescents with insulin-dependent diabetes mellitus (IDDM) and their parents were studied. Aspects of family environment were evaluated at study inception, and their influence on the initial level of, and change in, glycemic control over 4 years was examined. Family measures of expressiveness, cohesiveness, and conflict were linked to differences in the longitudinal pattern of glycemic control. In particular, the encouragement to act openly and express feelings directly (expressiveness) seemed to ameliorate deterioration of glycemic control over time in both boys and girls. Boys were especially sensitive to variations in family cohesiveness and conflict; those from more cohesive and less conflicted families showed less deterioration in glycemic control. This study demonstrated the important influence of family psychosocial factors present at diabetes onset on glycemic control in children and adolescents over the first 4 years of IDDM.
对一组患有胰岛素依赖型糖尿病（IDDM）的儿童和青少年及其父母进行了研究。在研究开始时评估了家庭环境的各个方面，并考察了它们对4年期间血糖控制初始水平及变化的影响。家庭表达性、凝聚力和冲突的测量指标与血糖控制纵向模式的差异相关。特别是，鼓励公开行动和直接表达情感（表达性）似乎能改善男孩和女孩随着时间推移血糖控制的恶化情况。男孩对家庭凝聚力和冲突的变化尤为敏感；来自更具凝聚力且冲突较少家庭的男孩血糖控制恶化程度较小。这项研究表明，糖尿病发病时存在的家庭心理社会因素对IDDM患儿和青少年头4年的血糖控制具有重要影响。
