title: Explaining the family conflict-glycemic control link through psychological variables in adolescents with type 1 diabetes.
abstract: To examine whether individual psychological variables mediate the family conflict-glycemic control relationship. During three study visits spanning 9 months, 147 adolescents with type 1 diabetes completed questionnaires measuring anxiety and depressive symptoms, and diabetes-specific worry. Caregivers similarly completed a measure of diabetes-specific family conflict. Blood glucose monitoring frequency and glycemic control were also obtained during study visits. Separate mediation analyses revealed that anxiety was the only individual psychological variable that mediated the caregiver-reported family conflict-glycemic control link. Anxiety accounted for 20% of the family conflict-glycemic control link, compared to 8.5% for depression and 6% for diabetes-specific worry. Results suggest that anxiety symptoms may be promoted in a family environment characterized by conflict and these symptoms have detrimental effects on glycemic control. Continued monitoring of family functioning and adolescents' anxiety symptoms, as well as refinement of interventions, is needed to promote positive health outcomes.
authors.affiliation: Center for the Promotion of Treatment Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, MLC 7039, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Herzer
authors.forename: Anthony
authors.initials: A
authors.lastname: Vesco
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Ingerski
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
authors.forename: Korey K
authors.initials: KK
authors.lastname: Hood
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications / Q000523:psychology; D001294:Attitude to Health; D015190:Blood Glucose Self-Monitoring / Q000523:psychology* / Q000706:statistics & numerical data; D017028:Caregivers / Q000523:psychology; D003863:Depression / Q000150:complications / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000523:psychology*; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human