Maternal Expressed Emotion and Metabolic Control of Children and Adolescents with Diabetes mellitus

Abstract

Background: The objectives of this study of children and adolescents with diabetes were to: (1) examine whether maternal expressed emotion (EE), in the form of critical comments (CC), hostility and emotional overinvolvement (EOI), is related to metabolic control; (2) determine if CC and EOI are separately related to poor metabolic control, and (3) ascertain whether high EE is related to psychopathology in these children. Methods: The Present Episode version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (Kiddie-SADS-P/K-SADS-P) interview was administered to 55 children and adolescents with diabetes and the parental EE instrument, the 5-min speech sample, to 55 mothers. The same instruments were utilized with the 54 controls and their mothers. Glycosylated hemoglobin A1 values were used as a measure of metabolic control. Results: More than half of the children with diabetes (58.2%) had mild to moderate symptoms of anxiety or depression as compared to 9.3% of the controls. High EE was exhibited by 70.9% of the index group mothers in contrast to only 29.6% of the control group mothers. High maternal EE was not related to the psychopathology of children with diabetes. High maternal EE and in particular its EOI component and excessive detail (a subcategory of EOI) were related to poor metabolic control of the index children. Conclusions: Maternal EE is related to metabolic control in childhood diabetes; maternal EOI in particular is related to poor metabolic control. Mental health professionals should work with mothers of children with diabetes in an effort to modify such attitudes and emotions.

Self-efficacy and its interrelation with family environment and metabolic control in Turkish adolescents with type 1 diabetes

“…The HbA1c levels of adolescents with diabetes in our study were mostly similar to those of other studies (19, 20). We found no association of HbA1c with age and duration of diabetes, and this concurs with other studies (21, 22). In the present study, girls had higher HbA1c levels than boys.…”

Routine Psychological Screening in Youth With Type 1 Diabetes and Their Parents

“…Studies have consistently found that high family conflict is related to poorer diabetes self-care behaviors and poorer metabolic control, while positive family attributes such as support, warmth, and cohesion are associated with better diabetes self-care behaviors and metabolic control (31,33,108 -110). Data from several studies indicate that parental (predominantly maternal) psychological wellbeing correlates positively with all diabetes metabolic outcomes in their children (i.e., happier mother and better outcomes) (111,112). This finding is similar to a study of patient-perceived family stress in adults by Parkerson et al (113) but is at odds with a more recent study of diabetes-related stress by Stallwood (114).…”

Children with Diabetes Compared to Peers: Depressed? Distressed?

“…The overall effect for psychopathology also was not significant in the initial analyses (see Table 2), but moderator analysis found that the size of the effect varied according to comparison group equivalence. The study with the most equivalent comparison group ([6]; rating of 4) had a negative effect size ( d = −0.35) suggesting that the comparison group had more psychopathology than those with diabetes, and the study with the least equivalent comparison group [54] suggested that those with diabetes had more psychopathology than the comparison group ( d =0.43), with the two studies with mid-level comparison group equivalence (rated 3) reporting effect sizes near 0 ([45], d =0.06; [46]: d =0.12).…”