title: Parent-adolescent conflict, treatment adherence and glycemic control in Type 1 diabetes: the importance of adolescent externalising symptoms.
abstract: Parent-adolescent conflict has been demonstrated to relate to treatment adherence and glycemic control in adolescents with Type 1 diabetes. The present longitudinal study investigated how these variables were interrelated over time, and examined whether externalising and internalising symptoms function as mediating variables. A total of 109 adolescents with diabetes participated at four annual time points and completed measures on conflict with parents, internalising and externalising symptoms. Information on treatment non-adherence and glycemic control was obtained from treating physicians. Cross-lagged analyses from a structural equation modelling approach indicated that father-adolescent but not mother-adolescent conflict positively influenced treatment non-adherence over time, which, in turn, was associated with higher glycosylated haemoglobin-values. Further, externalising but not internalising symptoms were found to mediate the pathway from father-adolescent conflict to treatment adherence over time. Finally, mother-adolescent conflict was found to relate indirectly to treatment non-adherence through its relationship with externalising symptoms. Hence, the present longitudinal study provides evidence that externalising symptoms represent an important mechanism through which earlier experiences of parent-adolescent conflict may influence later treatment non-adherence and poorer glycemic control. Implications and suggestions for future research are outlined.
authors.affiliation: a Psychology and Educational Sciences , Catholic University Leuven , Leuven , Belgium .
authors.forename: Koen
authors.initials: K
authors.lastname: Luyckx
authors.forename: Inge
authors.initials: I
authors.lastname: Seiffge-Krenke
authors.forename: Lies
authors.initials: L
authors.lastname: Missotten
authors.forename: Jessica
authors.initials: J
authors.lastname: Rassart
authors.forename: Kristina
authors.initials: K
authors.lastname: Casteels
authors.forename: Eveline
authors.initials: E
authors.lastname: Goethals
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D003220:Conflict, Psychological; D003922:Diabetes Mellitus, Type 1 / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008960:Models, Psychological; D010287:Parent-Child Relations; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012648:Self Care / Q000523:psychology*; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin