Semester

Spring

Date of Graduation

2024

Document Type

Thesis

Degree Type

MS

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Kevin Larkin

Committee Member

Janelle Heddings

Committee Member

Nicholas Turiano

Abstract

Background: Type 1 diabetes (T1D) is a chronic disease that impacts the lives of millions of children and adolescents in the United States. Adherence to diabetes medical regimens is often challenging, particularly among adolescents. Based on previous research, diabetes-specific psychological flexibility, or the ability of an individual with T1D to psychologically adjust to, accept, and commit action to manage their diagnosis, may improve adherence in youth with T1D. Factors such as diabetes-specific family conflict (i.e., conflict within parent-child dyads that is specifically related to T1D management) and diabetes-specific parental distress (i.e., emotional distress experienced by a parent or caregiver as the result of their child having a T1D diagnosis) may serve as barriers to adherence in youth with TID. Methods: The current study evaluated the relations between these variables by using a cross-sectional and observational design. Adolescents completed a measure of diabetes-specific psychological flexibility, while caregivers completed measures of demographics, diabetes-specific family conflict, and parental distress. Study staff completed a chart review to obtain enrolled adolescents’ HbA1c level, which served as a measure of adherence. Correlations were run among all primary study variables to examine relations. Hayes’ PROCESS macro was used in SPSS to run a moderation analysis to evaluate if diabetes-specific parental distress and diabetes-specific family conflict functioned as a moderator of the relation between diabetes-specific psychological flexibility and HbA1c.

Results: A total of 60 adolescent-caregiver dyads participated in the current study. Diabetes-specific psychological flexibility and HbA1c were not significantly correlated (r = -0.05, p = 0.69). Several significant correlations were found between primary study variables, including between diabetes-specific psychological flexibility and diabetes-specific parental distress (r = -0.33, p = 0.01), between diabetes-specific parental distress and diabetes-specific family conflict (r = 0.04, p = 0.002), and between diabetes-specific family conflict and HbA1c (r = 0. 31, p = 0.02). A completed moderation interaction including diabetes-specific psychological flexibility, family conflict, and parental distress was found to be significant (F (7, 50) = 3.90, R2 = 0.35, p = 0.002). HbA1c in adolescents who reported high diabetes-specific psychological flexibility, high family conflict, and low parental distress was found to be lower (average HbA1c = 8.17) than adolescents who reported both high family conflict and parental distress (average HbA1c = 8.22). Discussion: The current study demonstrates the interplay between several individual level and familial factors that impact the self-management of T1D in adolescents. Importantly, a significant effect was found between diabetes-specific psychological flexibility, family conflict, and parental distress on HbA1c (as a measure of adherence). The protective effect of diabetes-specific psychological flexibility was found to be strongest when diabetes-specific family conflict and parental distress were both low, or when only one variable (i.e., diabetes-specific family conflict or parental distress) was high in the adolescent-caregiver dyad. Future studies should continue to explore associations between psychological flexibility and family factors. Clinical care should incorporate assessment and treatment of these family-level factors should they be found to be significant in families of youth with T1D.

Download

Share

COinS