title: Eating disturbances in girls with diabetes: the contribution of adolescent self-concept, maternal weight and shape concerns and mother-daughter relationships.
abstract: BACKGROUND
  This study examined the relative contribution of adolescent self-concept, maternal weight and shape concerns (WSC), and mother-daughter relationships to eating disturbances among girls with type 1 diabetes mellitus (DM).
  
  
  METHODS
  Eighty-eight adolescent girls (mean = 15.0 years, S.D. = 2.2) and their mothers completed self-report measures of disordered eating and weight control behaviours, with teens also reporting on disturbed eating and body attitudes. Based on reported symptoms, adolescents were classified as highly (N = 18), mildly (N = 30) and non-eating disturbed (N = 40). Self-concept was assessed by adolescent self-report. Mother-daughter relationships were assessed by adolescent self-report and by observed mother-daughter interactions that were rated using a macroanalytic coding system that assesses intimacy and autonomy in these relationships.
  
  
  RESULTS
  Hierarchical regressions illustrated that adolescent self-concept deficits, maternal WSC, and impaired mother-daughter relationships significantly predicted eating disturbances in girls with DM, accounting for 57% of the variance. Mothers who engaged in dieting and binge-eating were more impaired in their ability to support their daughters' emerging autonomy. The quality of mother-daughter relationships partly mediated the influence of maternal WSC on adolescent eating disturbances. Moreover, the impact of maternal WSC and mother-daughter relationships on eating disturbances was mediated by adolescent self-concept.
  
  
  CONCLUSIONS
  Findings illustrate two pathways through which mother-daughter relationships may impact upon risk of eating disturbances in girls with DM and highlight the need to evaluate family-based interventions specifically tailored for this high-risk population.
authors.affiliation: Department of Psychiatry, Toronto General Hospital, University Health Network and University of Toronto, Ontario, Canada.
authors.forename: S I
authors.initials: SI
authors.lastname: Maharaj
authors.forename: G M
authors.initials: GM
authors.lastname: Rodin
authors.forename: M P
authors.initials: MP
authors.lastname: Olmsted
authors.forename: J A
authors.initials: JA
authors.lastname: Connolly
authors.forename: D
authors.initials: D
authors.lastname: Daneman
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D012307:Risk Factors; D012649:Self Concept