Diabetic Children and Their Parents: Personality Correlates of Metabolic Control

Abstract

Test measures of field-dependence-independence and impulsiveness-control were obtained from two groups of diabetic children and their parents, the children being in optimal (0, n=12) or poor (P, n=27) metabolic control and, according to the judgment of clinicians, showing optimal or poor psychological adaptation. Children of the 0-group scored lower in impulsiveness and higher in realistic functioning than those of the P-group. Differences which parallelled these were found between the two groups of fathers. The P-group fathers were decidedly more field-dependent than their wives, while the opposite was found for the 0-group. Group differences of the kind obtained were seen as possible determinants of disturbed family interaction or emotional stress in the child in the P-group and of autonomy and self-reliance in the child in the 0-group. It is concluded that the role of fathers of diabetic children has been underestimated. Key words: juvenile diabetes mellitus, IDDM, psychosocial factors, personality, family.Various psychological factors relevant to family functioning can be assumed to be important in influencing the adaptation to the treatment and the metabolic control of insulin-dependent diabetes mellitus in childhood. Particular attention has been directed in this connection to disturbances in the mother-child relationship (1-3) and in family interaction (4-7) which have been found to be linked to poor metabolic control of the diabetes.Two factors that have recurrently been suggested to determine familial patterns associated with good metabolic control are 1) that the parents are able to balance in a constructive way the age-appropriate independence of the child with control of the child's behaviour (8, 9) and, 2) that both the parents and the child show a realistic adjustment to the diabetic condition and a lack of wishful and impulsive behaviour (2, 10). Thus it seems promising to investigate dependence-independence and impulsiveness-control in the search for the characteristics of children and their families related to the adaptation to and the metabolic control of diabetes.Clearly, both the individual degree of dependence-independence and the capacity for impulse control can be expected to correlate with family patterns. Thus, individual and family analyses should be complementary rather than contradictory in character.The present study is part of a larger investigation concerning the outcome of family therapy and also of the individual and family characteristics of possible relevance to how successfully the family adapts to the treatment of childhood diabetic mellitus. The aim was to explore the psychological dimensions of dependence-independence and impulsiveness-control as possible factors associated with poor versus optimal psychological adaptation and metabolic control.

Detached, distraught or discerning? Fathers of adolescents with chronic illness: a review of the literature

“…Fathers interviewed in a study noted the increased strength and quality of marital relationships, particularly when approaching the illness as a team (11) . Other studies highlighted that a child ' s illness placed enormous amounts of stress on the parents ' relationship (10,39,40) . For interviewees in a couple of studies, the marriage was a source of instability and stress in the long-term.…”

Child and parental personality are associated with glycaemic control in Type 1 diabetes

“…A single study in 34 diabetic children found an association between mothers’ Negative Emotionality, Withdrawal and Rigidity and poorer child glycaemic control [4]. In contrast, a second study reported no relationships to the personalities of the mothers, but indicated that Impulsiveness and Realistic functioning of fathers were associated with glycaemic control [9].…”

Chronic conditions in adolescents

“…Earlier studies of children with T1DM demonstrate an association between good executive functions, treatment adherence and consequent good metabolic control (76). Good metabolic control has also been associated with lower impulsiveness when compared to patients with poor metabolic control (77). …”