Catherine J. Brack

Longitudinal Relationship of Asymptomatic Hypoglycemia to Cognitive Function in IDDM

Early-onset insulin-dependent diabetes mellitus (IDDM) is linked to subsequent learning deficits. To investigate the relationship of learning deficits to metabolic control, 23 children with IDDM (age at testing 71 ± 21 mo, age at diagnosis 35 ± 15 mo) diagnosed before 5 yr of age were followed for periods of 6–78 mo. Mean glycosylated hemoglobin (HbA,), episodes of severe hypoglycemia, and frequency of self-monitoring blood glucose (SMBG) measurements <2.8 mM (50 mg/dl, asymptomatic hypoglycemia) were recorded every 3 mo. Six subjects entered the study 12.3 ± 6.7 mo after diagnosis, and only severe hypoglycemia was present before entry. For the remaining 17 subjects, HbA, and severe and asymptomatic hypoglycemia were present from the time of diagnosis of diabetes. Mean HbA, level was 10.1 ± 1.0%, and mean severe hypoglycemic episodes per patient was 2.9, but the frequency was highly skewed; one patient had 37 episodes, and 14 had none. The mean percentage of SMBG readings <2.8 mM was 2.4 ± 2.1. On the revised Stanford-Binet Intelligence Scale there was no correlation between any subscale and severe hypoglycemia. However, the relative frequency of asymptomatic hypoglycemia correlated with scores on the abstract/visual reasoning scale (r = –.39, P = .037). This relationship was primarily accounted for by the relationship of asymptomatic hypoglycemia to performance on the copying subscale (r = –.42, P = .022). Children with frequent asymptomatic hypoglycemic episodes had lower mean copying scores and abstract reasoning scores than those with infrequent episodes. These findings are consistent with those of previous crosssectional studies of early-onset IDDM and extend previous results by suggesting that hypoglycemia, even if mild or asymptomatic, may be related to the neuropsychological changes previously described.

Codependency's Relationship to Defining Characteristics in College Students

Abstract Evidence garnered by this study may help provide college counselors with a clinically useful model of codependency, informing their assessment and treatment planning of students who present with self-identified codependency characteristics. Specifically, codependence inclined students may exhibit tendencies toward self-defeating and covert patterns of narcissistic relating (e.g., rejection sensitivity, attachments to painful relationships, shame-proneness, caretaking to earn relationship). Additionally, this study raises the possibility that codependency might be as closely related to fears of intimacy and being hurt in relationship as it is related to a preoccupied concern over maintaining or controlling a security relationship. These results, together with the negative relationship between codependency and overt narcissism, lend preliminary support for Cermaks conceptualization of codependency as a complement to narcissism.

Relationship of Cognitive Appraisals and Attachment to Emotional Events within the Family of Origin

Appraisal theorists believe that discrete emotional states are the result of specific cognitive appraisals. This theory has not been tested with familyrelated events, especially negative emotions and the potential influence of attachment towards significant others. This study found that individuals cognitively process family events much as predicted by appraisal theorists and that attachment does not appear to have a global influence on this process. This finding suggests that cognitivefamily therapists can directly link appraisals with negative affect.

Couples Counseling with Survivors of Child and Adolescent Abuse

This article provides information on working with couples in which one or both of the partners are survivors of emotional, physical, or sexual abuse in childhood or adolescence. It covers what to look for and do. It lists resources for clients and includes case examples to illustrate the points discussed.

STRUCTURE OF PROBLEM BEHAVIORS IN YOUNG ADOLESCENTS

The syndrome of problem behaviors (problem drinking, illicit drug use, delinquent-type behavior and precocious sexual intercourse) has been demonstrated among older adolescents and college students. To determine if this complex of behaviors is present in early adolescence, 709 junior high students were surveyed. 50 % were male; the mean age was 13.5 yrs. 77 % were white. All Hollingshead socioeconomic groups (SES) were represented. The prevalence of health damaging behaviors increased with age (p<.001), e.g. 23 % of 12 yr olds and 71 % of 15 yr olds reported intercourse. Principal axis factor analysis with varimax rotation confirmed the presence of 2 behavioral clusters: (1) problem behaviors (PROB) and (2) psychological symptoms (PSYCH). Both factors were independent of race and SES. PSYCH were more common among girls (p<.001) and PROB were more common among boys (p<.001). Self-esteem and PSYCH (r=-.412;p<.001) but not PROB were significantly correlated. This data confirm that the syndrome of problem behaviors is a stable construct among young adolescents and suggest that lowered self-esteem is not etiologically involved in the origin of health damaging behaviors.

Family of Origin Characteristics and Symptomatology in a Counseling Center Population

Abstract The relationship between family of origin characteristics and symptomatology of a college counseling center population was examined using self-report information on abuse history, parental substance abuse, familial adaptability and cohesion as measured by the FACES-II, and symptomatology. Students indicated substantial clinical symptomatology and/or histories of abuse. Three types of childhood abuse were correlated with each other and with adaptability and cohesion. Adaptability and cohesion were correlated to parental substance abuse. Childhood emotional abuse had higher correlations with symptomatology and predicted depressive symptoms. Adaptability predicted panic symptoms. Childhood abuse predicted the same type of abuse in adulthood. Implications for therapists in college counseling centers are discussed.