title: Depressive Symptoms in a Trial Behavioral Family Systems Therapy for Diabetes: A Post Hoc Analysis of Change.
abstract: OBJECTIVE
  The objective was to test whether Behavioral Family Systems Therapy for Diabetes (BFST-D), an evidence-based family therapy, produces individual changes in depressive symptoms for adolescents with type 1 diabetes in suboptimal glycemic control (HbA(1c) ≥9.0% [≥74.9 mmol/mol]).
  
  
  METHODS
  Data were from a randomized controlled trial (RCT) comparing two modes of BFST-D delivery: in clinic versus Internet videoconferencing. There were no significant differences between groups in the RCT, so groups were collapsed into a within-group prepost design for secondary analyses. A multiple regression analysis was performed to test for mediation of treatment outcomes by changes in family processes.
  
  
  RESULTS
  Significant improvements in glycemic control, depressive symptoms, and family functioning were found from pre- to posttreatment. A multiple regression analysis for within-subject mediation indicated that improvements in depressive symptoms were partially mediated by improvements in parent-youth conflict; however, family process changes did not mediate diabetes health outcomes.
  
  
  CONCLUSIONS
  In addition to improving treatment adherence and glycemic control, BFST-D has collateral benefits on depressive symptoms.
authors.affiliation: Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Riley
authors.affiliation: Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR Harold Schnitzer Diabetes Health Center, Portland, OR.
authors.forename: Danny C
authors.initials: DC
authors.lastname: Duke
authors.affiliation: Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR.
authors.forename: Kurt A
authors.initials: KA
authors.lastname: Freeman
authors.affiliation: Stanford University School of Medicine, Palo Alto, CA.
authors.forename: Korey K
authors.initials: KK
authors.lastname: Hood
authors.affiliation: Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR Harold Schnitzer Diabetes Health Center, Portland, OR harrismi@ohsu.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy; D001786:Blood Glucose / Q000032:analysis; D003863:Depression / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology* / Q000628:therapy*; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D049269:Videoconferencing
chemical_list: D001786:Blood Glucose