title: From caregiver psychological distress to adolescent glycemic control: the mediating role of perceived burden around diabetes management.
abstract: OBJECTIVE
  To examine whether perceived caregiver burden around diabetes management mediated the relationship between caregivers' psychological distress and adolescents' glycemic control.
  
  
  METHODS
  Across three visits spanning 9 months, caregivers of 147 adolescents with type 1 diabetes completed measures of anxiety and depressive symptoms and a measure of perceived burden specific to diabetes management. Adolescents' glycemic control was also measured.
  
  
  RESULTS
  Perceived burden mediated the relationship between caregiver depressive symptoms and adolescents' glycemic control. The overall model was significant, F(10,132) = 5.0, p < .001, R(2) = 0.27. Fifty percent of the relationship was explained by diabetes-specific burden. The relationship between caregiver anxiety symptoms and adolescent glycemic control was partially mediated by diabetes-specific burden, F(10,133) = 5.7, p < .001, R(2) = 0.30, explaining 26% of this relationship.
  
  
  CONCLUSIONS
  A variable linking caregiver psychological distress to adolescent glycemic control is perceived caregiver burden around diabetes management. Implications for clinical practice include targeting caregiver psychological functioning and reducing global and diabetes-specific distress.
authors.affiliation: Center for Treatment Adherence, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center MLC 7039, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Natoshia Raishevich
authors.initials: NR
authors.lastname: Cunningham
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Vesco
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
authors.forename: Korey K
authors.initials: KK
authors.lastname: Hood
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D001786:Blood Glucose; D015190:Blood Glucose Self-Monitoring / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003863:Depression / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose