Adolescents' health attitudes and adherence to treatment for insulin-dependent diabetes mellitus.

Adolescents' health attitudes and adherence to treatment for insulin-dependent diabetes mellitus (IDDM) were evaluated using the protection motivation theory (PMT). We expected cognitive appraisals of adherence (self-efficacy for treatment management, response efficacy of treatment, response costs of adherence) to be more influential for adherence than appraisals of nonadherence (rewards of nonadherence, perceptions of the risks of nonadherence, perceived severity of the risks). Adolescents (N = 101) with IDDM completed self-report measures of treatment adherence and of the PMT variables. Hierarchical regression analyses revealed that cognitions concerning adherence explained a statistically significant proportion of the variance in treatment adherence (sr2 = .17). Response costs of adherence produced the strongest correlations with overall adherence and with three of the four individual components of IDDM treatment (insulin injections, blood glucose monitoring, diet). The findings suggest that persuasive health communications might focus on appraisals of adherence rather than on risks of nonadherence.

Psychosocial and health status variables independently predict health care seeking in fibromyalgia.

OBJECTIVE: To determine whether variables derived from the self-regulatory model of health and illness behavior accurately predict status as a patient or nonpatient with fibromyalgia (FM). METHODS: Subjects were 79 patients who met American College of Rheumatology (ACR) criteria for FM and 39 community residents who met ACR criteria for FM but had not sought medical care for their symptoms (nonpatients). Subjects were administered 14 measures that produced 6 domains of variables: background demographics and pain duration; psychiatric morbidity; and personality, environmental, cognitive, and health status factors. These domains were entered in 4 different hierarchical logistic regression analyses to predict status as patient or nonpatient. RESULTS: The full regression model was statistically significant (P < 0.0001) and correctly identified 90.7% of the subjects with a sensitivity of 92.4% and a specificity of 87.2%. The best individual predictors of group status were self-reports of self-efficacy, negative affect, recent stressful events, and perceived pain. Relative to nonpatients, patients reported higher levels of negative affect and perceived pain and a greater number of recent stressful experiences, as well as lower levels of self-efficacy. CONCLUSION: Consistent with the self-regulatory model of health and illness behavior, psychosocial and health status variables predict health care-seeking behavior in persons with FM independently of background demographics and psychiatric morbidity. These variables may influence the severity of symptoms experienced by persons with this disorder as well as their health care-seeking behavior, but they are not necessary to produce abnormal pain sensitivity in FM.