Adherence behavior among adolescents with type I insulin-dependent diabetes mellitus: the role of cognitive appraisal processes.

Guided by a transactional stress and coping model, this study examined the contribution of cognitive appraisal processes to diabetes adherence behavior among adolescents 12 to 18 years old (n = 40). Multiple hierarchical regression analyses indicated that esteem related to physical appearance accounted for a significant 16% of the variance in checking one's blood sugar. Perceived control when ill and attributional style for negative events each accounted for significant increments of variance as well (10 and 6%, respectively), yielding a total of 32% of the variance explained by appraisal processes. Results suggest that adolescents who (a) have a negative perception of their bodies, (b) perceive little internal control over health when ill, and (c) have an external attributional style for negative events were at greatest risk for poor compliance as indicated by less frequent checking of blood sugar.