OBJECTIVETo examine the role of parenting style in achieving metabolic control and treatment adherence in adolescents with type 1 diabetes.RESEARCH DESIGN AND METHODSParents of 100 adolescents with type 1 diabetes completed assessments of their parenting style and sense of helplessness. Parents and patients rated patient adherence to the treatment regimen. Glycemic control was evaluated by HbA1c values.RESULTSAn authoritative paternal parenting style predicted better glycemic control and adherence in the child; a permissive maternal parenting style predicted poor adherence. A higher sense of helplessness in both parents predicted worse glycemic control and lesser adherence to treatment. Parental sense of helplessness was a significant predictor of diabetes control after correcting for other confounders (patient age, sex, and treatment method).CONCLUSIONSAn authoritative nonhelpless parenting style is associated with better diabetes control in adolescents. Paternal involvement is important in adolescent diabetes management. These results have implications for psychological interventions.
Summary Context Growth hormone (GH) treatment of short healthy children is based on the belief that short stature is associated with psychosocial problems and a diminished quality of life. Objective To determine the impact of GH therapy on psychosocial well‐being and the ability of psychological metrics to define short stature‐related distress. Methods Sixty prepubertal boys with idiopathic short stature (age: 10.0 ± 1.4 years, height‐SDS: −2.38 ± 0.3) were enrolled in this 4‐year intervention study (1‐year double‐blinded, randomized, placebo‐controlled [GH/placebo‐2:1] and 3‐year open‐labelled GH therapy). Explicit (conscious/voluntary) psychological metrics (Pediatric Quality of Life Inventory [PedsQL], Silhouette Apperception Test [SAT], Rosenberg Self‐Esteem Scale [RSES], Child Behavior Checklist [CBCL]) and implicit (unconscious/involuntary) psychological metrics (Single‐Category Implicit Association Test for height [SC‐IAT‐H], Height Perception Picture Test [HPPT]). Psychosocial evaluations were performed at study entry, after 1 and 4 years. Results At study entry, PedsQL of boys with idiopathic short stature was lower than Israeli norms (P = 0.001). After 1‐year blinded intervention, only the GH‐treated boys improved their actual and anticipated adult height perception (SAT, P < 0.001 and P = 0.022) with reduced short stature‐related distress (SC‐IAT‐H, P < 0.001). At study end, RSES and SC‐IAT‐H improved significantly (P < 0.001), with no change in PedsQL and CBCL. Conclusions Our finding of improved psychosocial functioning only in the GH‐treated boys after 1‐year blinded intervention suggests that it was the GH therapy, rather than being enrolled in a clinical trial, which contributed to the outcome. Long‐term open‐labelled GH treatment significantly improved height perception and self‐esteem. Future studies are needed to fully assess the relevance of complementing the routinely used explicit self‐report measures with the implicit measures.
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