title: An exploratory study of positive and incongruent communication in young children with type 1 diabetes and their mothers.
abstract: BACKGROUND
  The incidence of type 1 diabetes is increasing in young children. However, they are overlooked in treatment adherence and intervention research despite evidence that parents often experience difficulty securing their treatment cooperation, especially with the diet. We investigated positive and incongruent (i.e. the co-occurrence of contradictory verbal and non-verbal messages) communication in the mother-child dyad and their association with child adjustment and dietary adherence outcomes.
  
  
  METHODS
  Participants were 23 6- to 8-year-old children with type 1 diabetes and their mothers. We conducted dietary adherence interviews with mothers and performed nutritional analyses to assess children's consumption of extrinsic sugars (e.g. confectionary). Mothers completed a standardized assessment of child psychological adjustment. Mothers and children engaged in a videotaped problem-solving task related to the dietary regimen, with maternal and child utterances and non-verbal behaviours analysed for positive dyadic and incongruent communication.
  
  
  RESULTS
  Positive dyadic communication correlated with lower levels of child incongruent communication, fewer behavioural problems and better overall adjustment. Higher levels of maternal and child incongruent communication correlated with more behavioural and emotional problems and poorer overall adjustment. Higher levels of maternal incongruent communication correlated with poorer dietary adherence.
  
  
  CONCLUSIONS
  Results converged to form a conceptually and empirically coherent pattern in that behavioural indices of poorer communication in both mother and child consistently correlated with poorer child adjustment outcomes. This study shows that specific features of dyadic, child and maternal communication could be targeted in developmentally sensitive interventions to promote positive communication in the home management of type 1 diabetes care for young children.
authors.affiliation: Department of Psychology, Queen Margaret University, Edinburgh, UK.
authors.forename: V
authors.initials: V
authors.lastname: Chisholm
authors.forename: L
authors.initials: L
authors.lastname: Atkinson
authors.forename: L
authors.initials: L
authors.lastname: Bayrami
authors.forename: K
authors.initials: K
authors.lastname: Noyes
authors.forename: A
authors.initials: A
authors.lastname: Payne
authors.forename: C
authors.initials: C
authors.lastname: Kelnar
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology; D003927:Diet, Diabetic / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009034:Mother-Child Relations / Q000523:psychology; D009035:Mothers / Q000193:education / Q000523:psychology; D016487:Parenting / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology; D011340:Problem Solving; D012606:Scotland; D011795:Surveys and Questionnaires; D014741:Video Recording