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S Paulauskas

Publications and source records attributed to S Paulauskas.

5 recordsLinked to original sources
PubMed1985

Initial coping responses and psychosocial characteristics of children with insulin-dependent diabetes mellitus.

School-aged children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) were studied longitudinally in order to document how they adjusted to the medical illness and to assess salient background factors. The extent of life stress and the prevalence of psychiatric disorders that predated the IDDM were within normative ranges, and there was no characteristic preexisting "diabetic personality." The initial strain of living with IDDM elicited two general modes of coping. The prototypical and subdued reaction (seen in 64% of the children) consisted of mild sadness, anxiety, feeling of friendlessness, and social withdrawal. The rest of the children (36%) exhibited reactions that met criteria for a psychiatric disorder; depressive syndromes were the most common presentations. Anamnestic factors and the parents' initial responses to their children's IDDM were unrelated to how the children themselves coped. However, psychiatrically diagnosable reactions were more likely among children whose parents were of low socioeconomic status and had marital distress. Coping with the diagnosis and the early impact of IDDM took no more than 7 to 9 months, no matter how severe the child's response was initially.

Adaptation, Psychological↗
PubMedDate not supplied

Depressive disorders in childhood. III. A longitudinal study of comorbidity with and risk for conduct disorders.

As part of a longitudinal nosologic study of major depressive disorder (MDD), dysthymic disorder, and adjustment disorder with depressed mood in 104 school-aged probands, the prevalence and consequences of comorbid conduct disorders (CD) were examined. During the index depressive episodes, 16% of the patients had comorbid CD; during the full study observation 23% had CD; and the estimated time-dependent risk of conduct disorder developing was 36% by age 19. For most cases, comorbid CD developed as a complication of the depression and persisted after the depression remitted. Comorbid CD was not differentially associated with the type of depression at study entry, did not affect depressive symptom presentation, was similarly distributed among boys and girls, and was unrelated to demographic factors. Additionally, comorbid CD did not affect recovery from the index depressive episodes and did not influence the symptom-free interval before a recurrent depression among cases with MDD. The risk of CD developing was not altered by chronologically earlier family variables or demographic factors. But girls who had attention deficit disorder, compared to those who did not, seemed to be at higher risk for CD during study observation. Finally, in this depressed cohort, having CD any time was associated with an increased rate of long-term functional problems.

Adjustment Disorders↗
PubMedDate not supplied

Initial psychologic responses of parents to the diagnosis of insulin-dependent diabetes mellitus in their children.

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.

Adaptation, Psychological↗
PubMedDate not supplied

Children's self-reports of psychologic adjustment and coping strategies during first year of insulin-dependent diabetes mellitus.

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.

Adaptation, Psychological↗