THE PROBLEM AREAS IN DIABETES SCALE - AN EVALUATION OF ITS CLINICAL UTILITY

OBJECTIVE - To evaluate the reliability and concurrent and discriminan t validity of the Problem Areas in Diabetes (PAID) scale, a new measur e of emotional functioning in diabetes. RESEARCH DESIGN AND METHODS - A battery of questionnaires, including the PAID, was completed by 256 volunteer diabetic outpatients. In our analyses, we examined the PAID' s internal structure and compared mean IDDM and NIDDM treatment group scores in regression analyses to explore its discriminant validity. We also evaluated concurrent validity from the correlations between the PAID and diabetes-specific measures of coping and health attitudes and HbA(1c). RESULTS - Principal component analyses identified a large em otional adjustment factor, supporting the use of the total score. Sign ificant sizable correlations were found between the PAID and a range o f selected health attitudinal measures. There were significant differe nces (with small-to-moderate effect sizes) in PAID scores between IDDM and NIDDM patients and between IDDM and NIDDM insulin- and tablet-tre ated subgroups; no differences were found between NIDDM insulin- and t ablet-treated subgroups. CONCLUSIONS - The study findings provided sup port for the construct validity of the PAID, including evidence for di scriminant validity from its ability to detect differences between IDD M and NIDDM treatment groups expected to differ in the emotional impac t of life with diabetes. Future studies should explore the PAID's perf ormance in nonspecialist treatment settings as well as its responsiven ess to clinical change.