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As part of a prospective, longitudinal study of school-aged children with newly diagnosed insulin-dependent diabetes mellitus (IDDM), we examined how the parents adjusted to the illness. The present article documents this process for the first year of IDDM. We found no support for earlier claims that most parents resort to blatantly neurotic or psychopathologic behavior to cope. Instead, the initial strain of living with IDDM generally elicited mild and subclinical depression, anxiety, and overall distress. Mothers were more affected than fathers: they were more symptomatic (about one of four developed a mild grief reaction) and the bulk of them worried considerably about their children. However, the parents' initial emotional upheaval resolved in approximately equal to 6 mo; most mothers came to terms with IDDM by the end of the first year; and other areas of parental functioning (e.g., quality of their marriage) were not affected. Therefore, along with our previous report on how the children coped initially, the findings document the emotional resiliency of families during the first year of IDDM.

Psychologic adjustment, assessed by self-ratings of anxiety, self-esteem, and depression, and cognitive as well as behavioral coping strategies, elicited by interview, were monitored longitudinally among school-age children with recent-onset insulin-dependent diabetes mellitus (IDDM). Our article documents the findings over the 1st yr of illness. From the start, the children viewed themselves as self-confident and emotionally comfortable. The diagnosis of IDDM created minimal emotional upheaval (which faded within 6 mo), despite this cohort's consistent report that the diet, insulin injections, and urine tests were difficult. The most prevalent cognitive strategies for coping with IDDM included wishful thinking, thoughts of forbidden foods, and resentful thoughts. Behavioral coping strategies, including information seeking, were evident from the beginning. The frequency of socially oriented coping behaviors (e.g., showing IDDM management to peers) indicated that the young patients actively tried to adapt to the illness and were more comfortable with aspects of home care than previously thought. Self-rated psychologic adjustment, psychiatric diagnosis, and illness-related coping behaviors were unrelated to one another; psychologic variables were similarly unrelated to the use of socially oriented coping strategies. Therefore, in juvenile cohorts, the presumed association between psychologic status and coping behaviors requires further examination.