Contributions to Psychology and Medicine

Transcription

1 Contributions to Psychology and Medicine

2 Contributions to Psychology and Medicine The Psychology of Childhood Illness Christine Eiser Psychological Aspects of Early Breast Cancer Colette Ray/Michael Baum Medical Thinking: The Psychology of Medical Judgment and Decision Making Steven Schwartz/Timothy Griffin Women With Cancer: Psychological Perspective Barbara L. Anderson, Editor The Somatizing Child: Diagnosis and Treatment of Conversion and Somatization Disorders Elsa G. Shapiro/Alvin A. Rosenfeld with Norman Cohen and Dorothy Levine Individual Differences, Stress, and Health Psychology Michel Pierre Janisse, Editor The Psychology of the Dentist Patient Relationship Stephen Bochner Prospects of Heart Surgery: Psychological Adjustments to Coronary Bypass Grafting Alan Radley Neuropsychological and Behavioral Aspects of Diabetes Clarissa S. Holmes, Editor

3 Clarissa s. Holmes Editor Neuropsychological and Behavioral Aspects of Diabetes With 12 Illustrations Springer-Verlag New York Berlin Heidelberg London Paris Tokyo Hong Kong

4 Clarissa S. Holmes Department of Pediatrics The University of Iowa Hospitals and Clinics The University of Iowa Iowa City, IA USA Advisor J. Richard Eiser Department of Psychology Washington Singer Laboratories University of Exeter Exeter EX4 4QG England Library of Congress Cataloging-in-Publication Data Neuropsychological and behavioral aspects of diabetes/clarissa S. Holmes, editor. p. cm.-(contributions to psychology and medicine) Includes index. TSBN-13: (alk. paper) I. Diabetes-Psychological aspects. 2. Clinical neuropsychology. I. Holmes, Clarissa S. II. Series. [DNLM: I. Diabetes Mellitus-psychology. 2. Neuropsychology. WK 810 N494] RC660.N '62'0019-dc20 DNLMIDLC Printed on acid-free paper 1990 by Springer-Verlag New York Inc. Softcover reprint of the hardcover 1 st edition 1990 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer-Verlag, 175 Fifth Avenue, New York, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now know or hereafter developed is forbidden. The use of general descriptive names, trade names, trademarks, etc. in this publication, even if the former are not especially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone. Typeset by Caliber Design Planning, Inc ISBN-13 : e-isbn-13 : DOT: /

5 Preface Behavioral medicine has blossomed as an area of systematic investigation during the past years. Throughout its steady growth, there have been increasing interest and specialization in the study of neuropsychological and behavioral aspects of diabetes. This book attempts to capture and report exciting new developments in the study of both insulin-dependent (Type I) and non-insulin-dependent (Type II) diabetes mellitus. Accordingly, it is divided into two major sections. Physiological aspects of each disease, which differ significantly in pathophysiology and course, are discussed in separate medical overviews that introduce each major section. These overviews are written by Drs. Tsalikian and Zimmerman, leading medical researchers in insulinand non-insulin-dependent diabetes, respectively. Each section also contains chapters describing neuropsychological and cognitive disease correlates, psychosocial patterns of adjustment, and treatment adherence issues. Psychological aspects of insulin-dependent diabetes have been studied more extensively than non-insulin-dependent diabetes, perhaps because it is more often associated with graver medical complications. Therefore, there is a larger body of research to review and the first section has been divided into chapters on cognitive disease sequelae in populations of children and adults, separately. In his chapter, Dr. Ryan discusses developmental factors related to the unique sensitivity of the brain to metabolic derangement. Dr. Holmes reviews studies of adults with diabetes and the cognitive correlates of both acute and chronic blood glucose disruption. Developmental disease issues are further covered in Dr. Delamater's chapter of children's adaptation to disease following initial diagnosis, and Dr. johnson's review of adherence and health issues in children. Familial adaptation of pediatric and adult patients is discussed in Dr. Anderson's chapter.

6 VI Preface Because of the relatively fragile metabolic balance of patients with Type I diabetes, these patients are particularly vulnerable to the effects of eating disorders. Further, since individuals with insulin-dependent diabetes must conscientiously monitor, calculate, and manage their food intake, such undue attention may place them at increased risk for eating disorders. This evidence is reviewed by Dr. Marcus in her chapter describing eating problems. Dr. Gonder-Frederick and her colleagues discuss the ability of patients to perceive, and ultimately to treat, variations in blood glucose levels. This issue is important, given the lability of blood glucose fluctuation in Type I diabetes, and the risk of severe hypoglycemia. Non-insulin-dependent diabetes more frequently occurs in obese adults than does the insulin-dependent type; accordingly, different disease management issues are present. The effect of stress interacts systematically with metabolic control in Type II diabetes, and the physiological framework, and experimental findings, of this work are described by Dr. Surwit in his chapter. Strategies for weight loss and their relative success are reviewed by Dr. Wing, for both the adult population as a whole, and those with non-insulin-dependent diabetes. Dr. Perlmuter and colleagues describe studies of cognitive functioning and its relation to both disease and motivational variables. Dr. Geringer's chapter on affective disorders points out some of the hormonal similarities between Type I and II diabetes. Both environmental and, most interestingly, physiological evidence is reviewed that may relate to elevated rates of depression with these diseases. Studies of affective disorders in diabetic populations frequently compare the status of patients with both types of disease; therefore, depression in these two groups is reviewed within the same chapter. It is the hope of the editor that collection of this information into one source will aid both researchers and practitioners in the evaluation of relevant disease factors that may require further study or clinical monitoring and intervention. June, 1989

7 Acknowledgments The editor wishes to express her appreciation to Dr. Suzanne Bennett Johnson and Dr. Lawrence Perlmuter for their assistance in identifying potential contributors to the book. Kathy Funk was instrumental in her typing assistance and in her help with coordinating various aspects of the project. Finally, the editor wishes to thank her family, Bill and Ashley Cooper, for the inspiration and fortitude that they have provided for her.

8 Contents Preface Acknowledgments Contributors v Vll xv Section I Insulin-Dependent Diabetes Chapter 1 Insulin-Dependent (Type I) Diabetes Mellitus: 3 Medical Overview EVA TSALIKIAN Etiology-Epidemiology 3 Presentation-Management 4 Hypoglycemia 7 Complications of IDDM 8 Chapter 2 Adaptation of Children to Newly Diagnosed 12 Diabetes ALAN M. DELAMATER Psychosocial Adaptation 13 Effects of Age at Diabetes Onset 18 Treatment Studies 20 Methodological Issues and Future Research 22 Summary 25 Chapter 3 Adherence Behaviors and Health Status in 30 Childhood Diabetes SUZANNE BENNETT JOHNSON

9 x Contents Adherence and Health Status: Conceptual Issues 31 Assessing Adherence 32 Assessing Daily Diabetes Management by 24-Hour Recall 35 Interview Adherence in Childhood Diabetes: Developmental Issues 40 Adherence in Childhood Diabetes: A Unitary or 43 Multidimensional Concept? Adherence/Health Status Relationships in Childhood 46 Diabetes: Summary of Current Knowledge Base Methodological Issues and Guidelines for Future 48 Research Chapter 4 Chapter 5 Chapter 6 Neuropsychological Consequences and Correlates 58 of Diabetes in Childhood CHRISTOPHER M. RYAN Introduction 58 The Relationship Between Diabetes, Brain Dysfunction, 59 and Psychosocial Disorders Early Studies of Cognitive Functioning in Diabetic 62 Children Juvenile-Onset Diabetes and Neuropsychological 65 Functioning: The Age at Onset Effect Other Risk Factors for Neuropsychological Dysfunction 76 in Diabetic Children Juvenile-Onset Diabetes and Neuropsychological 79 Dysfunction: Some Final Thoughts Diabetes and Adaptations in Family Systems 85 BARBARA J. ANDERSON Why Study the Family's Role in Insulin-Dependent 86 Diabetes Mellitus (IDDM) and Non-Insulin- Dependent Diabetes (NIDDM)? Theories of the Family's Role in Diabetes 86 Research on Family Adaptation to Diabetes in 88 Childhood and Adolescence Research on Family Adaptation to Diabetes in 96 Adulthood Priorities for Future Research on Families and Diabetes 98 Eating Disorders and Diabetes 102 MARSHA D. MARCUS AND RENA R. WING Anorexia Nervosa and Bulimia Nervosa 102 Subclinical Eating Disorders 104 Eating Disorders and IDDM-Clinical Reports 105 Prevalence of Eating Disorders in IDDM Patients 107 Eating Disorders and Medical Consequences 109

10 Contents Xl Subclinical Eating Problems in Patients with IDDM 110 IDDM and Vulnerability to Eating Disorders 112 Treatment of Eating Disorders 114 Prevention of Eating Disorders 116 Conclusion 117 Chapter 7 Neuropsychological Sequelae of Acute and 122 Chronic Blood Glucose Disruption in Adults with Insulin-Dependent Diabetes CLARISSA S. HOLMES Transient Changes in Neuropsychological Function 123 During Acute Blood Glucose Alteration Neuropsychological Effects of Chronic Glucose 138 Alteration Implications and Directions for Further Research 148 Chapter 8 Symptom Perception and Blood Glucose Feedback 155 in the Self-Treatment of IDDM LINDA A. GONDER-FREDERICK AND DANIEL J. Cox Introduction 155 BG Feedback and Self-Treatment 156 BG Symptoms 158 Accuracy of Symptom Beliefs 160 Ability to Recognize Hypoglycemia and Hyperglycemia 162 Intervention to Improve BG Perception 167 Summary and Future Directions 170 Section II Non -I ns ulin-dependent Diabetes Chapter 9 Non-Insulin-Dependent (Type II) Diabetes: 177 Medical Overview BRUCE R. ZIMMERMAN Introduction 177 Diagnosis and Classification 177 Pathophysiology and Heredity 178 Management Approach to the Patient 179 Chronic Diabetic Complications 181 Summary 182 Chapter 10 Stress, Behavior, and the Autonomic Nervous 184 System in Type II Diabetes Mellitus RICHARD S. SURWIT, SUZANNE L. Ross, AND MARK N. FEINGLOS

11 Xli Contents The Role of Stress in the Onset of Type II Diabetes 185 Human Studies The Relationship Between Stress and Glycemic Control 187 in Type II Diabetes Relaxation Therapy and Type II Diabetes 191 Altered Adrenergic Sensitivity and Type II Diabetes 193 Summary and Conclusions 194 Chapter 11 Behavior Strategies for Improving Weight Loss in 198 Obese Type II Diabetic Patients RENA R. WING, LEONARD H. EpSTEIN, AND MARSHA D. MARCUS Obesity as a Risk Factor for the Development of Type II 198 Diabetes Benefits of Weight Control 199 Weight Loss and Mood 202 Differences Between Diabetic and Nondiabetic Patients 203 Participating in Weight Control Studies Overview of Early Studies on Dietary Interventions for 205 Type II Diabetic Patients Behavioral Weight Control versus Nonbehavioral 206 Treatments Exercise 209 Self-Monitoring Blood Glucose 211 Spouse Support 213 Very Low Calorie Diet Regimen 215 Predictors of Outcome 216 Conclusion 217 Chapter 12 Cognitive Function in Non-Insulin-Dependent 222 Diabetes LAWRENCE C. PERLMUTER, STEVEN H. GOLDFINGER, ANNE R. SHORE, AND DAVID M. NATHAN Methodological Considerations 223 Cognitive Function in NIDDM 224 Improving Performance through Choice 226 Motivation and the Improvement in Performance 227 NIDDM and Information Retrieval from Long-Term 230 Memory NIDDM and Self-Reported Memory Problems 231 Failures to Find NIDDM-Related Cognitive Deficits 232 Cognitive Function and Metabolic Control in NIDDM 233 Summary and Conclusion 235 Chapter 13 Affective Disorders and Diabetes Mellitus 239 EDITH GERINGER Definitions of Affective Disorders 240

12 Contents Xlll Epidemiology of Affective Disorders and Diabetes 242 Mellitus Mechanisms Underlying the Association of Diabetes and 248 Depression: Why Do Diabetics Get Depressed? Mechanisms Underlying an Association between Mania 260 and Depression Treatment Issues in Patients with Affective Disorder 261 and DM Conclusion 264 Author Index 273 Subject Index 279

13 Contributors BARBARA J. ANDERSON, PH.D. Joslin Clinic, Boston, MA 02215, USA DANIEL J. Cox, PH.D. Department of Psychiatry, University of Virginia School of Medicine, Charlottesville, V A 22901, USA ALAN M. DELAMATER, PH.D. Department of Psychology, Wayne State University, Detroit, MI 48202, USA LEONARD H. EpSTEIN, PH.D. University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA MARK N. FEINGLOS, M.D. Division of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA EDITH S. GERINGER, M.D. Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02108, USA STEVEN H. GOLDFINGER, PH.D. VA Outpatient Clinic, Boston, MA 02108, USA LINDA A. GONDER-FREDERICK, PH.D. University of Virginia, Charlottesville, V A 22901, USA

14 XVI Contributors CLARISSA S. HOLMES, PH.D. Departments of Psychology and Pediatrics, Tulane University, New Orleans, LA 70118, USA SUZANNE BENNETT JOHNSON, PH.D. Department of Psychiatry, J. Hillis Miller Health Center, University of Florida, Gainesville, FL 32610, USA MARSHA D. MARCUS, PH.D. Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA DAVID M. NATHAN, M.D. Harvard Medical School, Boston, MA 02108, USA LAWRENCE PERLMUTER, PH.D. Memory and Learning Clinic, V A Outpatient Clinic, Boston, MA 02108, USA SUZANNE L. Ross, PH.D. Division of Medical Psychology, Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA CHRISTOPHER M. RYAN, PH.D. Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA ANNE R. SHORE, B.A. Memory and Learning Clinic, V A Outpatient Clinic, Boston MA, 02108, USA RICHARD S. SURWIT, PH.D. Division of Medical Psychology, Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA EVA TSALIKIAN, M.D. Division of Pediatric Endocrinology, Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA RENA R. WING, PH.D. Western Psychiatric Institute and Clinics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA BRUCE R. ZIMMERMAN, M.D. Department of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA