Semester

Summer

Date of Graduation

2025

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

Michelle Roley-Roberts

Committee Member

Nicholas Turiano

Abstract

Background: Type 1 diabetes (T1D) is a common pediatric chronic illness that requires complicated management by both the child and their caregiver. Research and clinical guidelines have highlighted adherence (as measured by HbA1c) and health-related quality of life (HRQOL) as important outcomes particularly in adolescents with T1D. Notably, diabetes distress has been identified as a risk factor contributing to poor adherence and HRQOL outcomes in this population. Given these considerations, understanding what resilience factors contribute to optimal outcomes is vitally important to inform future interventions. Grit and benefit-finding are two novel resilience factors that have yet to be fully evaluated in pediatric T1D. Methods: The current study investigated the relation between grit, benefit-finding, diabetes distress, HbA1c, and HRQOL using a cross-sectional design. Seventy participant dyads were recruited during regularly scheduled endocrinology appointments at WVU Medicine. Adolescents completed measures of diabetes distress, grit, benefit-finding, and HRQOL. Caregivers filled out measures of their own diabetes distress and grit. Adolescent HbA1c was collected from the medical chart. The study aims investigated the direct effect of grit and benefit-finding on both HRQOL and HbA1c using linear regression, as well as the moderating effect of grit and benefit-finding on the relation between diabetes distress, HRQOL, and HbA1c using the PROCESS macro. Results: Three significant findings were found in this study. First, adolescent grit was positively associated with adolescent HRQOL, F(1,68) = 6.44, p = .01. Second, adolescent grit moderated the relation between adolescent diabetes distress and HRQOL, F(3, 66) = 36.35, R2 = 0.62, p < .001. Specifically, when an adolescent had less diabetes distress and more grit, HRQOL was better. However, when an adolescent had more diabetes distress and more grit, HRQOL was worse. Third, adolescent benefit-finding moderated the relation between diabetes distress and HRQOL, F(3,66) = 35.00, R2 = .61, p < .001. Similar to our finding with grit, when there was less diabetes distress and more benefit-finding, HRQOL was better. However, when there was more diabetes distress and more benefit-finding, HRQOL was worse. Discussion: These findings highlight that grit and benefit-finding may not be universal protective factors in adolescents with T1D. Instead, it is important to consider these factors within the context of distress. Future studies should investigate how coping strategies, stigma, social support and distress tolerance may play a role in these findings to potentially inform future intervention.

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