title: Associations of disordered eating behavior with the family diabetes environment in adolescents with Type 1 diabetes.
abstract: OBJECTIVE
  To examine associations of disordered eating behaviors with aspects of the family eating and diabetes management environments among adolescents with Type 1 diabetes (T1D).
  
  
  METHODS
  Data were collected from 151 adolescents (mean age = 15.6 years) with T1D and their parents. Adolescents and parents completed self-report measures of the family eating environment (priority, atmosphere and structure/rules surrounding family meals, and the presence of restricted and special foods in the household) and diabetes family management environment (diabetes family conflict and responsibility sharing). Adolescents completed measures of parent modeling of healthy eating and disordered eating behaviors. Linear regression models were used to assess the relationship of disordered eating behaviors with aspects of the family eating and diabetes management environments.
  
  
  RESULTS
  In unadjusted models, adolescent, but not parent, report of aspects of the family eating environment was associated with adolescents' disordered eating behaviors. Both adolescent and parent report of diabetes family conflict were positively associated with disordered eating behaviors. The adjusted adolescent model including all family eating and diabetes management variables accounted for 20.8% of the variance in disordered eating behaviors (p < .001, R² = .208). Factors associated with greater risk of disordered eating included being female (β = .168, p = .029), lower priority placed on family meals (β = -.273, p = .003), less parental modeling of healthy eating (β = -.197, p = .027), more food restrictions in the household β = .223, (p = .005), and greater diabetes family conflict (β = .195, p = .011).
  
  
  CONCLUSIONS
  Findings suggest that aspects of the family eating environment and diabetes family conflict may represent important factors for disordered eating risk in adolescents with T1D.
authors.affiliation: *Department of Psychology, Virginia Commonwealth University, Richmond, VA; †Division of Intramural Population Health Research, NIH, DHHS, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; ‡Pediatric, Adolescent and Young Adult Section, Genetics and Epidemiology Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Caccavale
authors.forename: Tonja R
authors.initials: TR
authors.lastname: Nansel
authors.forename: Virginia
authors.initials: V
authors.lastname: Quick
authors.forename: Leah M
authors.initials: LM
authors.lastname: Lipsky
authors.forename: Lori M B
authors.initials: LM
authors.lastname: Laffel
authors.forename: Sanjeev N
authors.initials: SN
authors.lastname: Mehta
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005190:Family / Q000523:psychology*; D054541:Family Conflict / Q000523:psychology; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D012648:Self Care