No abstract

Studies of diabetes control have traditionally focused on patients' regulation of insulin, diet, and exercise. Although psychosocial stress may also influence blood glucose, researchers have infrequently accounted for the three primary physiological factors when estimating the effects of stress. In addition, few investigators have considered the influence of everyday minor stressors on health outcome. The Tennessee Camp for Diabetic Children provided an opportunity to monitor insulin administration, dietary intake, and exercise levels and to obtain measures of blood glucose and perceived minor stressors. The best index of stress was one in which number and magnitude of negative stressors were combined into a cumulative stress measure. Negative cumulative stress significantly correlated with blood glucose levels after controlling for the effects of insulin, diet, and exercise. In addition, diabetes control tended to be better when adolescents, particularly boys, adjusted well to negative stress. These findings suggest that minor stressors can influence health outcome, but positive and negative stress need to be assessed independently.

This paper contains the guidelines for postdoctoral training in Rehabilitation Psychology that were jointly developed by the APA Rehabilitation Psychology Division and the American Congress of Rehabilitation Medicine. The guidelines integrate the relevant sections produced at the 1992 Ann Arbor Conference on Postdoctoral Training in Professional Psychology. A brief history of the development of postdoctoral training in general psychology, as well as the specialty area of rehabilitation, is presented.

Although poor adjustment has been linked to preventable deaths following spinal cord injury (SCI), our understanding of the psychological factors important to post-injury adjustment is limited. In this study. we investigated the relationship between coping and adjustment (including psychological distress, acceptance of disability, vocational hours, and medical status) five to six years post-injury. Twenty-eight people who had provided coping data during acute rehabilitation completed the Ways of Coping scale, the SCL-90-R, the Acceptance of Disability scale and a Vocational and Medical Data form. The results indicated that coping strategies during acute rehabilitation were not associated with longterm adjustment. However, at five-year follow-up, Cognitive Restructuring was positively associated and Wish-Fulfilling Fantasy was negatively associated with Acceptance of Disability. Self-Blame was related to psychological distress during acute rehabilitation but not at five-year follow-up. These results suggest that the importance of specific coping strategies to adjustment changes over time and support the belief that coping is a dynamic process.It is estimated that there are 250, 000 people with spinal cord injury in the United States, and that 8000 additional people sustain a spinal cord injury (SCI) each year (Trieschmann, 1988). Although the mortality rate from spinal cord

The current Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association (APA, 2002a) places increased emphasis on respect for different cultures. For example, culture has been added as an important factor in respecting the rights and dignity of those with whom psychologists work (Principle E). APA has also released guidelines meant to influence psychologists' sensitivity and behavior toward multicultural issues in various aspects of professional work (APA, 2002b). The purpose of this article is to discuss cultural issues in the context of rehabilitation practice. The authors focus on Latinos, the fastest growing minority group in the United States. The case example of Cesar Garza is used as a vehicle for discussing how to integrate consideration of cultural factors into rehabilitation practice, consistent with sound ethical decision making. The case illustrates missed opportunities, for which the authors offer concrete solutions that reflect appropriate ethical conduct. The authors also hope to demonstrate that integration of cultural issues is consistent with overall rehabilitation psychology practice.