Predicting diabetic control from competence, adherence, adjustment, and psychopathology.
OBJECTIVE
To determine what psychological and behavioral factors were most predictive of diabetic control.


METHODS
Seventy-nine youths with diabetes were assessed cross-sectionally, using youths' reports of self-esteem, anxiety, and attitudes about diabetes, and parents' reports of competence and psychopathology (from the Child Behavior Checklist) and diabetic adherence as independent variables. Glycosylated hemoglobin A1c was the dependent variable, reflecting diabetic control. After the effects of several background variables were partialed out, a principal-components analysis grouped the substantive variables into three larger components.


RESULTS
Among the background variables, duration of illness and family size significantly predicted diabetic control. Among substantive components, Competence/Adherence (including Total Competence, dietary compliance, and frequency of blood glucose checks) was highly predictive of diabetic control, primarily due to the effect of Total Competence. Adjustment (including self-esteem, anxiety levels, and attitudes about diabetes) and Psychopathology were less predictive. A model was constructed showing the relationships between these predictive components and diabetic control.


CONCLUSIONS
In this generally well-adjusted sample, that Total Competence, more than other measures, predicted diabetic control suggests it could be used by clinicians to anticipate diabetic youths at risk.
Department of Psychiatry, University of Utah, Salt Lake City, USA.
W B
WB
Daviss
H
H
Coon
P
P
Whitehead
K
K
Ryan
M
M
Burkley
W
W
McMahon
D000293:Adolescent; D002165:Camping; D002648:Child; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology* / Q000534:rehabilitation; D003927:Diet, Diabetic; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007389:Internal-External Control; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D012648:Self Care / Q000523:psychology; D012649:Self Concept; D012803:Sick Role; D014589:Utah
D006442:Glycated Hemoglobin