Decision-making competence and adherence to treatment in adolescents with diabetes.
OBJECTIVE
To examine decision-making competence (the ability to form effective plans for managing different situations) in a sample of adolescents with type I diabetes and their parents. We hypothesized that adolescent decision-making competence would mediate the relationship between parent-adolescent communication and adherence to treatment.


METHODS
The sample consisted of 63 adolescents and their parents. Parent-adolescent communication during a problem-solving task was assessed, as well as adolescent maladaptive decision-making (adolescent report), adherence to treatment (parent and provider report; number of glucose tests), and metabolic control (HbA1C).


RESULTS
Parent-adolescent communication was associated with adherence to treatment but not with adolescent decision-making. Poorer decision-making was associated with lower adherence per parent report but not provider report or the number of glucose tests. Decision-making competence did not mediate the relationships between parent-adolescent communication and adherence.


CONCLUSIONS
These results are consistent with prior research demonstrating associations between parent-adolescent communication and adherence and identify adolescent decision-making competence as another potentially important correlate of adherence. These findings highlight several areas for future research.
Miller
Victoria A
VA
Department of Psychology, Case Western Reserve University, USA. millerv@email.chop.edu.
Drotar
Dennis
D
D000293:Adolescent; D001076:Aptitude; D002648:Child; D003142:Communication; D003657:Decision Making; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010349:Patient Compliance / Q000523:psychology*; D011340:Problem Solving; D012648:Self Care / Q000523:psychology; D012803:Sick Role; D013223:Statistics as Topic