Cognitive adaptation theory as a predictor of adjustment to emerging adulthood for youth with and without type 1 diabetes

Abstract

Objective: The purpose of the study was to determine whether resilience, defined by cognitive adaptation theory, predicted emerging adulthood outcomes among youth with and without type 1 diabetes. Methods: Youth with (n = 118) and without type 1 diabetes (n = 122), who were part of a previous longitudinal study during adolescence, completed on-line questionnaires during their senior year of high school and one and two years later. They were average age 18, 53% female, and 93% white. Questionnaires assessed cognitive adaptation theory (CAT) indicators (self-esteem, mastery, optimism) and psychological, relationship, behavioral, vocational, and, for those with diabetes, diabetes outcomes. Results: The CAT index at baseline predicted reduced psychological distress, enhanced psychological well-being, increased friend support, reduced friend conflict, the presence of romantic relationships, reduced likelihood of romantic breakups, higher GPA, higher work satisfaction, and lower work stress during the transition to emerging adulthood. Among those with diabetes, the CAT index predicted better self-care behavior and revealed a marginal relation to better glycemic control. Analyses controlled for baseline levels when appropriate. Findings were stronger one year than two years post high school graduation, and findings were stronger for those with than without diabetes. Youth with diabetes also scored lower on the CAT index than youth without diabetes. Conclusions: These findings suggest that the implications of CAT include not only psychological health but also relationship, vocational, and diabetes outcomes. Those who score lower on CAT indicators should be identified as children so that interventions designed to enhance resilience can be implemented.

Do Clinical And Psychosocial Factors Affect Health-Related Quality of Life in Adolescents with Chronic Diseases?

“…Additionally, the results of the present research are in line with previous studies reporting the importance of such protective factors, namely psychosomatic health (Suris, Bélanger, Ambresin, Chabloz, & Michaud, 2011), resilience (Guilera, Pereda, Paños, & Abad, 2015;Helgeson, Reynolds, Siminerio, Becker, & Escobar, 2014;, self-regulation (Gois et al, 2012) and social support (Békési et al, 2011;Wu, Geldhof, Roberts, Parikshak, & Amylon, 2013). Resilience, social support, symptom's control and self-management may allow a good adaptation in adolescents, while facing adverse health conditions and potentially stressful new situations, and help to reduce stress, increase control and improve outcomes in HRQoL.…”

“…Resilience, social support, symptom's control and self-management may allow a good adaptation in adolescents, while facing adverse health conditions and potentially stressful new situations, and help to reduce stress, increase control and improve outcomes in HRQoL. Therefore, these variables can be considered promising candidates for future interventions (Chao, Whittemore, Minges, Murphy, & Grey, 2014;Gaspar et al, 2012;Guilera et al, 2015;Helgeson et al, 2014). Moreover, because literature has previously indicated that adolescents with chronic conditions who need to develop more disease-related skills (e.g.…”

Eating Disorders During Emerging Adulthood: A Systematic Scoping Review

“…One longitudinal study found that thought suppression during EA predicted ED symptoms in female university students three months later, when controlling for ED symptoms at the earlier time-point (Collins et al, 2014). Another study compared a T1D group and non-T1D group, and found that a self-esteem, mastery and optimism composite appeared to negatively predict EDs symptoms in EAs with T1D but not those without (Helgeson et al, 2014). This study did not include a comparison group of adolescents or adults; it is therefore not possible to determine the extent to which such psychological factors are uniquely relevant to EAs.…”

Type 1 Diabetes in Young Adulthood

“…Those with type 1 diabetes scored lower on perceived competence, including global self-worth, than the comparison group at the 10-year follow up. In a more recent study, the self-esteem of young adults with and without type 1 diabetes was examined as part of a resilience or cognitive adaptation index that included self-esteem, mastery, and optimism [57]. Across the three annual assessments, those with type 1 diabetes scored lower on the resilience index than those without type 1 diabetes.…”

“…Specifically, the group with the deteriorating glycemic control was most likely to be characterized by a low score on positive self-concept [63]. In a longitudinal study of young adults with and without type 1 diabetes, a resilience index, predicted an array of positive young adulthood outcomes, including enhanced psychological health, better relationship functioning, reduced risk behavior, and positive vocational outcomes [57]. In some cases, the links were stronger for those with than without type 1 diabetes.…”