Collaborative and overinvolved parenting differentially predict outcomes in adolescents with Type 1 diabetes.

Abstract

Objective The current study examined the impact of collaborative and intrusive parenting on depression and glycemic control in children with Type 1 diabetes (T1D). Research examining the association between parenting and child adjustment in this population has been limited by a reliance primarily on questionnaire data and cross-sectional analyses. To address these gaps, the current study used an observational coding system to measure the effects of parenting on child adjustment over a 1-year period. Method Youth (10 to 16 years old) with T1D and their mothers (N = 81) were recruited from an outpatient pediatrics diabetes clinic. Mothers' symptoms of anxiety and depression and children's depressive symptoms were assessed by self- reports; parenting behaviors were assessed via video-recorded observations coded using the Iowa Family Interaction Rating Scales; and adolescents' glycosylated hemoglobin (HbA1c) was obtained from medical records. Results Bivariate correlations and linear regression analyses revealed that higher levels of observed collaborative parenting were related to significantly lower HbA1c 12 months later, and higher levels of observed overinvolved parenting were related to significantly greater child depressive symptoms 12 months later. Further, age and treatment type moderated the relation between overinvolved parenting and child depressive symptoms. Conclusions Collaborative and overinvolved parenting appears important for adolescents in predicting both psychological and health-related outcomes over time. Parenting behaviors may serve as an important target for future interventions to enhance adjustment in these children.

Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association

“…Because youth are dependent on social support systems (family and care providers) and must eventually transition to independent diabetes self-management, their families and related social networks need to be included in psychosocial assessment and treatment (92–94). Parents of children with type 1 diabetes are prone to high rates of depression, especially around the time of diagnosis (95,45).…”

Adapting to the changing needs of adolescents: parenting practices and challenges to sensitive attunement

“…Among families with adolescents diagnosed with Type 1 Diabetes, collaborative communication predicted improved management of symptoms over the subsequent 12 months. By contrast, markers of non-cooperative communication, which included reciprocated hostile exchanges 32, 28 or overinvolved parenting that failed to engage the adolescent 33 , contributed to increased internalizing and externalizing symptoms.…”

Authoritarian parenting style predicts poorer glycemic control in children with new-onset type 1 diabetes

“…Several cross‐sectional studies show that an authoritative style may promote better T1D management, and relate to better glycemic control in adolescents with T1D . Similarly, at least two observational studies in adolescents, show that high maternal responsiveness and sensitivity are associated with better glycemic control and psychosocial outcomes, while another study examining collaborative parenting style (described as high responsiveness) found a positive association with glycemic control at baseline and 12‐month follow‐up . In sum, these studies suggest that high responsiveness coupled with communication about T1D may be important for short‐ and long‐term glycemic control.…”