Journal of Youth and Adolescence

, Volume 15, Issue 5, pp 419–428 | Cite as

Development of a self-report measure of adherence for children and adolescents with insulin-dependent diabetes

  • C. Israel
  • D. J. Berndt
  • P. Barglow


Two samples of insulin-dependent diabetic youths were studies in successive attempts to refine a brief patient self-report measure of general long-term adherence to a diabetic regimen. Validity and reliability were assessed for both samples by measuring a number of related variables: locus of control, stressful life events, knowledge of diabetes, parent report, and glycosylated hemoglobin. Initial evidence of validity was demonstrated in a variety of criterion areas. Both reliability and validity were replicated on the second sample. Adherence is discussed as a complex multidimensional variable, the measurement of which requires several different methods, including the selfreport measure described here. Warnings about social desirability as a confounding factor were discussed, as were suggestions for other adherence measures.


Confounding Factor Health Psychology School Psychology Related Variable Social Desirability 
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  1. Barglow, P., Berndt, D. J., Burns, J., and Hatcher, R. (1986). Neuroendocrine and psychosocial factors in childhood diabetes mellitus.Amer. Acad. Child Psychiat.Google Scholar
  2. Barglow, P., Edidin, D. V., Budlong-Springer, A. S., Berndt, D. J., Phillips, R., and Dubow, E. (1983). Diabetic control in children and adolescents: Psychosocial factors and therapeutic efficacy.J. Youth Adoles, 12: 77–94.Google Scholar
  3. Barglow, P., Hatcher, D., Berndt, D. J., Edidin, D. V., and Sloan-Rossiter, D. (1984). Stress and metabolic control in diabetes: Psychosomatic evidence and evaluation of methods.Psychosom. Med. 46(2).Google Scholar
  4. Berndt, D. J., Israel, C., and Barglow, P. (1983).Development of a self-report measure of compliance for insulin-dependent diabetics. Paper presented at the Midwestern Psychological Association meeting, Chicago.Google Scholar
  5. Blackwell, B. (1973). Drug therapy: Patient compliance.NEJM 289: 246–252.Google Scholar
  6. Bunn, H. F., Gabbay, K. H., and Gallop, P. M. (1978). The glycosylation of hemoglobin: Relevance to diabetes mellitus.Science 200: 21–27.PubMedGoogle Scholar
  7. Chase, H. P., and Jackson, G. G. (1981). The role of emotional factors in the etiology and course of diabetes mellitus: A review of recent literature.Amer. J. Med. Sci. 244: 93–109.Google Scholar
  8. Coddington, R. D. (1972). The significance of life events as etiological factors in the disease of children: A study of a normal population.J. Psychosom. Res. 16: 205–209.PubMedGoogle Scholar
  9. Crowne, D. P., and Marlowe, D. (1960). A new scale of social desirability independent of psychopathology.J. Consult. Psychol. 24: 349–354.PubMedGoogle Scholar
  10. Dunbar, J. M., and Stunkard, A. J. (1979). Adherence to medical regimen. In Levy, Rifkind, Dennis, & Ernst (eds.),Nutrition, Lipids, and Coronary Heart Disease, Raven Press, New York.Google Scholar
  11. Flesch, R. F. (1949).The Art of Readable Writing, Harper, New York.Google Scholar
  12. Gordis, L., Markowitz, M., and Lillenfield, A. (1969). The inaccuracy of using interviews to estimate patient reliability in taking medications at home.Medical Care 7: 49–54.PubMedGoogle Scholar
  13. Gunning, R. (1952).The Technique of Clear Writing, McGraw-Hill, New York.Google Scholar
  14. Hamburg, B. A., Lipsett, L. F., Inoff, G. E., and Drash, A. L. (1979).Behavioral and Psychosocial Issues in Diabetes, Workshop IV, U. S. Department of Health and Human Services, pp. 269–275.Google Scholar
  15. Harris, R., Skyler, J., Linn, M., et al. (1982). Relationship between the health belief model and compliance as a basis for intervention in diabetes mellitus.Pediatr. Adolesc. Endocrinol. 10: 123–132.Google Scholar
  16. hauser, S. T., and Pollets, D. (1979). Psychological aspects of diabetes mellitus: A critical review.Diabetes Care 2: 227–233.PubMedGoogle Scholar
  17. Hauser, S. T., Pollets, D., Turner, B., et al. (1979). Ego development and self-esteem in diabetic youth.Diabetes Care 2: 465–471.Google Scholar
  18. Hauser, S. T., Powers, S. I., Noam, G. G., et al. (1984). Familial contexts of adolescent ego development.Child Develop, 55: 195–213.PubMedGoogle Scholar
  19. Haynes, R. B., Taylor, D. W., and Sackett, D. L. (1979).Compliance, in Health Care, Johns Hopkins University Press, Baltimore, MD.Google Scholar
  20. Holmes, T. H., and Rahe, R. (1967). The Social Readjustment Rating Scale.J. Psychom. Res. 11: 213.Google Scholar
  21. Israel, C. (1985).Psychosocial Factors Affecting Adherence Behavior in Children and Adolescents with Diabetes Mellitus. Unpublished doctoral dissertation, University of Chicago.Google Scholar
  22. Israel, C., Berndt, D. J., and Barglow, P. (1984). Stress and diabetes control.The Female Patient 9: 53–67.Google Scholar
  23. Jackson, D. N. (1970). A sequential system for personality scale development. In Spielberger, C. D. (ed.),Current Topics in Clinical and Community Psychology (vol 2), Academic Press, New York.Google Scholar
  24. Jacobson, A. M., Hauser, S. T., Powers, S., et al. (1983). Ego development in diabetics: A longitudinal study. In Laron, A., & Galatzer, A. (eds.),Psychological Aspects of Diabetes in Children and Adolescents (the published proceedings of the fifth Beilinson Symposium on Psychosocial Aspects of Diabetes, Israel, 1981), Basel: Karger.Google Scholar
  25. Mazze, R. S., Shamoon, H., Pasmantier, R., et al. (1984). Reliability of blood glucose monitoring by patients with diabetes mellitus.Harvard J. Med. 77(2): 211–217.Google Scholar
  26. Minuchin, S., Rosmon, B., and Baker, L. (1978).Psychosomatic Families, Anorexia Nervosa in Context, Harvard Univesity Press, Cambridge, MA.Google Scholar
  27. Shouval, R., Ber, R., and Galatzer, A. (1982). Family social climate and the health status and social adaptation of diabetic youth. In Psychological Aspects of Diabetes, in Children and Adolescents,Pediatric Adolescent Endocrinology 10: 89–93.Google Scholar
  28. Strahan, R., and Gerbasi, K. C. (1972). Short, homogeneous versions of the Marlowe-Crowne Social Desirability Scale.J. Clin. Psychol. 28: 191–193.Google Scholar
  29. Svensson, P. G., Ludvigsson, al. (1980). Interdisciplinary research in the area of public health and health care: Compliance and the health belief model—Its relevance to the treatment of juvenile diabetes mellitus.Scandinavian J. Soc. Med. 18 (suppl).Google Scholar
  30. Watkins, J., Roberts, D., Williams, T. F., et al. (1966). Observations of medication errors made by diabetic patients in the home.Diabetes 16: 229–230.Google Scholar
  31. Watkins, J. D., Williams, T. F., Martin, D. A., et al. (1967). A study of diabetic patients at home.Amer. J. Public Hlth. 57: 452–459.Google Scholar
  32. Williams, T., Martin, D. A., Mogan, M., et al. (1967). The clinical picture of diabetic control in studies in four settings.Amer. J. Public Hlth. 57: 441–451.Google Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • C. Israel
    • 1
  • D. J. Berndt
    • 2
    • 3
  • P. Barglow
    • 4
    • 3
  1. 1.Department of PsychologyPhilips AcademyMassachusettsAndover
  2. 2.Department of PsychiatryMichael Reese Hospital and Medical CenterChicago
  3. 3.Pritzker School of MedicineUniversity of ChicagoChicagoUSA
  4. 4.Michael Reese Hospital and Medical CenterChicago

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