Psychological stress and the onset of IDDM in children.

OBJECTIVE: The purpose of the study was to determine whether psychosocial stress during different life periods could be a risk factor in the etiology/pathogenesis of insulin-dependent diabetes mellitus (IDDM) in children. RESEARCH DESIGN AND METHODS: In a population-based sample of 67 case patients 0-14 years of age and 61 matched healthy control subjects, life events during the entire lifespan before the onset of IDDM were recorded as well as measures of child behavior before onset, social support, and family function. RESULTS: Negative life events occurring during the first 2 years of life, life events with difficult adaptation, child behavioral deviances, and a more chaotic family function were more common in the case group. A stepwise logistic regression indicated that negative life events in the first 2 years increased the risk of IDDM and that premorbid child behavior as well as dysfunctional hierarchical family pattern affect the risk. CONCLUSIONS: Stress early in life may increase the risk for IDDM, presumably by affecting the autoimmune process. To confirm these results, it is necessary to make a truly prospective study.

Parental social support and child behaviour problems in different populations and socioeconomic groups: a methodological study.

In many research projects there is a need to apply a multifactorial approach. Practical reasons often make it necessary to use instruments that are not too time-consuming for each factor to be investigated. The Interview Schedule of Social Integration (ISSI) is proposed by Undén and Orth-Gomér as a suitable tool in measuring social support. It is increasingly used in Sweden. To further investigate its usefulness in measuring parental social support of importance for the children, an examination of the relation between the ISSI variables and Child Behaviour as well as Parental Psychopathology was undertaken, based on data from four studies: Psychosocial Factors and Child Diabetes, Single Parent Families in a child guidance clinic, a Clinical Child Psychiatric Ward Group and an Epidemiological Study of a Normal Swedish Population. The findings were that social support measured by ISSI had the expected associations to child behaviour as well as to parental psychopathology in the higher socioeconomic groups but not in the lower ones. The interpretation is made that ISSI does not measure qualitative aspects of social support but the sense of satisfaction with it. In the higher socioeconomic groups the sense of satisfaction may be a fairly good approximation of the actual quality even if it is probably confounded with personality trait factors. The same approximation cannot be made in lower socioeconomic groups and in psychiatric populations. In these cases there is a need to pay more attention to the actual quality of the social network.