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Adolexcents are more susceptible to non-adherance due to the impact of emotional and physical demands.( Fleming, Bernie & Warren 2002). There appears to be an attitude of indestructability in which long term consequences of poorly managed diabetes is not a consideration. �Developmentally, older teenagers have a sense of �invulnerability� and tend to discount risks to their future health and the need for medical care� Research indicates that many adolescents with �diabetes experience a decrease in their quality of life in comparison to the general population� (Jacobson, Naess, Rubin, & Peyrot, as cited in Karlsen, 2002, p. 460). This decrease in quality of life may or may not be directly related to the high incidence of psychiatric disorders. However, the extent of this literature review has not fully explored the possibility of this correlation. �Psychiatric disorders have been shown to be more common in both adolescents and young adults with type 1 diabetes than in nondiabetic populations� (Blanz et. al., & Mayou, et. al., as cited in Bryden, Peveler, Stein et al., 2001, p. 1536).

Poor glycemic control has been directly associated with behavioral problems. Bryden et al., (2001) conducted a study to explore the clinical and psychological course of diabetes and the association with glycemic control. �Interestingly, there was a trend for emotional problems, such as anxiety and depression, to be associated with lower glycemic control� (Bryden et al., 2001, p. 1540). An adolescent�s perception of illness is quite altered in comparison to older individuals. According to Connell et al., (1995), �the impact and stigma of chronic disease are greater among younger adults than older ones. Younger adults with chronic conditions perceive themselves to be relatively worse of f than their age peers� (as cited in Karlsen et al., 2002, p. 469). This then correlates directly to research conducted in (1959) by Coombs and Snygg, as cited in Wichowski and Kubsch (1997). The literature clearly states that � one thinks and behaves according to the concept one holds about one�s self and one�s abilities� (p. 549). Therefore, if an individual feels that he or she is fatally ill then it seems pointless to adhere to any medical recommendations.

Bryden, K.S., Peveler, R.C., Stein, A., Neil, A., Mayou, R.A., & Dunger, D.B. (2001). Clinical and psychological course of diabetes form adolescence to young adulthood. Diabetes Care, 24, 1536-1540.

Fleming, E., Bernie, C., & Warren, G. (2002). The transition of adolescents with diabetes from the children�s health care service into the adult health service. Journal of Clinical Nursing, 11, 560-568.

Karlsen, B., Bru, E., & Hanestad, B.R. (2002). Self-reported psychological well-being and disease-related strains among adults with diabetes. Psychology and Health, 17, 459-473.

Wolpert, H.A., & Anderson, B.J. (2001). Young adults with diabetes: Need for a new treatment paradigm. Diabetes Care, 24, 1513-1514.

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