title: Depressive symptoms, daily stress, and adherence in late adolescents with type 1 diabetes.
abstract: OBJECTIVE
  To examine whether depressive symptoms are associated with greater perceived daily stress and moderate the link between stress severity and poorer daily adherence in late adolescents with Type 1 diabetes (T1D).
  
  
  METHODS
  175 late adolescents with T1D completed measures of depressive symptoms and glycemic control during a baseline laboratory assessment. This assessment was followed by a 14-day daily diary during which adolescents rated the severity of general (GS) and diabetes-specific (DSS) stressful events, as well as adherence to their diabetes regimen.
  
  
  RESULTS
  Multilevel modeling revealed that adolescents with more depressive symptoms reported more severe daily stress and poorer daily adherence on average, and had poorer glycemic control. On days with more severe DSS, but not GS, adolescents reported poorer adherence. This association was moderated by an interaction between depressive symptoms and the mean level of DSS severity experienced across the 2-week diary. In adolescents with low levels of depressive symptoms, poorer adherence was reported on days with more severe DSS across all levels of mean DSS severity. In adolescents with average or high levels of depressive symptoms, poorer adherence was reported on days with more severe DSS only when mean DSS severity was average or high.
  
  
  CONCLUSIONS
  Depressive symptoms are associated with poorer daily adherence and greater stress severity, and interact with mean DSS severity to moderate the link between daily stress and adherence. The results point to the importance of depressive symptoms for understanding associations between stress and adherence during late adolescence.
authors: Department of Psychology, University of Utah.
authors: Katherine J W
authors: KJ
authors: Baucom
authors: Department of Psychology, University of Utah.
authors: Tara L
authors: TL
authors: Queen
authors: Department of Psychological Sciences, University of California, Merced.
authors: Deborah J
authors: DJ
authors: Wiebe
authors: Department of Psychology, University of Utah.
authors: Sara L
authors: SL
authors: Turner
authors: Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center.
authors: Kristin L
authors: KL
authors: Wolfe
authors: Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center.
authors: Elida I
authors: EI
authors: Godbey
authors: Division of Family Medicine, Department of Family and Preventive Medicine, University of Utah.
authors: Katherine T
authors: KT
authors: Fortenberry
authors: Department of Psychology, University of Utah.
authors: Jessica H
authors: JH
authors: Mansfield
authors: Department of Psychology, University of Utah.
authors: Cynthia A
authors: CA
authors: Berg
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D015190:Blood Glucose Self-Monitoring / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin