Parent–child relationships in Type 1 diabetes: Associations among child behavior, parenting behavior, and pediatric parenting stress.

Abstract

Purpose Interactions between parents and children can influence behavioral and emotional functioning related to type 1 diabetes (T1D), yet have been relatively unexplored during preadolescence. The present study examined associations among child problem behaviors, critical parenting behaviors, and pediatric parenting stress in a sample of preadolescent youth with T1D. Methods Data are available from 86 preadolescent-parent dyads who participated in the initial baseline assessment of an RCT designed to assess the efficacy of an adherence promotion program. Measures included the Eyberg Child Behavior Inventory, the Diabetes Family Behavior Checklist, and the Pediatric Inventory for Parents. Results After controlling for significant demographic and medical characteristics, parents who reported their child’s behavior as more problematic reported more difficulty with pediatric parenting stress, which was also associated with more child-reported critical parenting behaviors. Conclusions Child problem behaviors and critical parenting behaviors were associated with one another, partially via their association with increased pediatric parenting stress. Potential clinical applications include interventions geared towards helping parents manage difficult child behaviors as well as cope with pediatric parenting stress, with the ultimate goal of improving the parent child relationship and management of T1D.

Good Cop, Bad Cop: Quality of Parental Involvement in Type 1 Diabetes Management in Youth

“…Intrusive involvement is not only associated with lower adherence and suboptimal glycemic control [42–44] but has also been linked with poorer health-related quality of life [37] and greater family conflict [37, 44]. These critical parenting practices may be especially harmful in older adolescents [45, 46] or adolescents with externalizing behavior problems (e.g., aggression, disobedience, defiance) [45]. …”

“…For example, problematic child behaviors (e.g., disruptive or defiant behaviors) have been linked with critical parenting, and this association was mediated by parenting stress [46]. In addition, as noted above, child secrecy has been associated with poorer adherence [39], which may in turn impact parental involvement.…”

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

“…In the diabetes literature specifically, parent–child relationships characterized by overprotection, strict rules/limits, harshness and low emotional support are associated with poorer adherence, worse glycemic control, and increased depressive symptoms in youth (Cameron et al, 2008; Hood, Butler, Anderson, & Laffel, 2007). Intrusive parenting practices may be especially harmful when directed toward older adolescents by impeding their ability to attain proper self-care behaviors (Duke et al, 2008; Sweenie, Mackey, & Streisand, 2014). …”

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

“…An authoritarian parenting style couples low level of responsiveness with high demandingness and is known for its highly structured, rule‐based approach with minimal focus on warmth and emotional support. With respect to T1D, numerous studies using self‐report and observational measures have shown that more restrictiveness and critical parenting leads to poorer metabolic control . Additionally, research has shown that authoritarian‐like parenting may be associated with elevated levels of T1D ‐distress, parent‐child conflict, and poorer T1D management compared to authoritative‐like parenting .…”