title: The impact of cognitive distortions, stress, and adherence on metabolic control in youths with type 1 diabetes.
abstract: OBJECTIVE
  To investigate the role of cognitive distortions in the relationship between adherence behavior, diabetes-specific stress, general stress, and metabolic control.
  
  
  METHODS
  Obtained questionnaire data, glucometer readings, and glycosylated hemoglobin (HbgA(1c)) assays from 143 youths (11-18 years old) with type 1 diabetes. Examined path model of relationships between cognitive distortions, stress, adherence behavior, and metabolic control. Data were analyzed using path analysis.
  
  
  RESULTS
  Higher levels of negative cognitive distortions were associated with more stress (both diabetes-specific and general). Higher levels of general stress then led to less adherent behavior and subsequently poorer metabolic control (higher HbgA(1c)). More diabetes-specific stress also led to poorer metabolic control, as well as general stress.
  
  
  CONCLUSIONS
  The findings indicate an indirect role of negative cognitive distortions in metabolic control. The current findings suggest that instead of the proposed direct link between cognitive distortions and adherence behavior, an indirect relationship may exist through stress.
authors.affiliation: University of Wisconsin Children's Hospital, 600 Highland Avenue, mail code 2424, Madison, WI 53792, USA. sp.farrell@hosp.wisc.edu
authors.forename: Stephanie P
authors.initials: SP
authors.lastname: Farrell
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Hains
authors.forename: W Hobart
authors.initials: WH
authors.lastname: Davies
authors.forename: Philip
authors.initials: P
authors.lastname: Smith
authors.forename: Elaine
authors.initials: E
authors.lastname: Parton
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D003072:Cognition Disorders / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin