title: Depressive Symptoms, Emotion Dysregulation, and Bulimic Symptoms in Youth With Type 1 Diabetes: Varying Interactions at Diagnosis and During Transition to Insulin Pump Therapy.
abstract: This study evaluated the associations between depressive symptoms, emotion dysregulation and bulimic symptoms in youth with type 1 diabetes (T1D) in the context of the diagnosis and treatment of T1D. Study participants were 103 youth in 2 distinct groups: newly diagnosed (New) or transitioning to pump therapy (continuous subcutaneous insulin infusion [CSII]; "Pump"), who completed questionnaires regarding symptoms of depression, emotion dysregulation, and bulimia. Glycemic control (A1c), height, weight, and questionnaires were evaluated within 10 days of diagnosis (n = 58) or at education/clinic visit before starting insulin utilizing CSII (n = 45). In the newly diagnosed group, only depression accounted for significant variance in bulimia scores (β = .47, P < .01). For the group with disease treatment experience (Pump), but not for the newly diagnosed group (New), greater depressive symptoms and emotion dysregulation were associated with greater bulimic symptoms. Depressive symptoms and emotion dysregulation, an indicator of poor coping/behavioral control, could help explain adoption of disordered eating behaviors in youth with T1D who are transitioning to pump therapy.
authors.affiliation: Office of Behavioral and Social Sciences Research, Office of the Director, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Young-Hyman
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA claire.peterson@cchmc.org.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Peterson
authors.affiliation: Department of Psychology, George Mason University, Fairfax, VA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Jessica T
authors.initials: JT
authors.lastname: Markowitz
authors.affiliation: School of Medicine, Emory University, Atlanta, GA, USA.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Muir
authors.affiliation: Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Laffel
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000523:psychology; D002032:Bulimia / Q000523:psychology*; D002648:Child; D003863:Depression / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005260:Female; D006801:Humans; D007332:Insulin Infusion Systems / Q000523:psychology*; D008297:Male; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care
keywords: bulimic symptoms; depression; eating disorders; emotion regulation; type 1 diabetes