title: Maternal depressive symptoms and disease care status in youth with type 1 diabetes.
abstract: OBJECTIVE
  The current study assessed relations among maternal depressive symptoms, poorer youth diabetes adherence, and glycemic control. Specifically, hypothesized mediating links of lowered expectations of parental involvement, less parental monitoring, and more conflict were examined.
  
  
  METHODS
  Participants included 225 mothers and their young adolescents, aged 11-14 years (M = 12.73 years, SD = 1.2) diagnosed with T1D. Maternal depressive symptoms and outcome expectancies for maternal involvement were evaluated with self-report questionnaires. Multisource, parent/youth, and multimethod assessment of adherence, parental monitoring, and conflict were evaluated during a baseline assessment from a larger randomized clinical trial.
  
  
  RESULTS
  The first hypothesized structural equation model demonstrated a good fit and indicated that more maternal depressive symptoms were directly associated with less parental monitoring and more conflict, which in turn each were associated with poorer adherence and glycemic control. Although higher involvement expectancies were associated with more monitoring and less conflict, they were not associated with other model variables. A second alternative model also fit the data well; poorer youth adherence was associated with more conflict that in turn related to maternal depressive symptoms.
  
  
  CONCLUSIONS
  Two models were tested by which maternal depressive symptoms and poorer youth adherence were interrelated via less monitoring and more conflict. Follow-up longitudinal evaluation can best characterize the full extent of these relations.
authors.affiliation: Children's National Health Systems.
authors.forename: Eleanor R
authors.initials: ER
authors.lastname: Mackey
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Kari
authors.initials: K
authors.lastname: Struemph
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Priscilla W
authors.initials: PW
authors.lastname: Powell
authors.affiliation: Center For New Designs In Learning & Scholarship, Georgetown University.
authors.forename: Rusan
authors.initials: R
authors.lastname: Chen
authors.affiliation: Children's National Health Systems.
authors.forename: Randi
authors.initials: R
authors.lastname: Streisand
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Clarissa S
authors.initials: CS
authors.lastname: Holmes
mesh_terms: D000293:Adolescent; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data; D002648:Child; D003863:Depression / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology / Q000628:therapy*; D054541:Family Conflict; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology*; D010287:Parent-Child Relations; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin