Secrecy From Parents and Type 1 Diabetes Management in Late Adolescence

Abstract

Secrecy about type 1 diabetes management is uniquely associated with diabetes outcomes independent of other relationship characteristics and problem behaviors.

Adolescent Disclosure to Parents and Daily Management of Type 1 Diabetes

“…For adolescents with type 1 diabetes, disclosure to parents has been associated with better adherence to the diabetes regimen (Osborn et al, 2013). Although disclosure to parents declines in frequency across early adolescence (Keijsers & Poulin, 2013), it may be especially important during late adolescence (Main et al, 2015), as this may be the primary vehicle through which parents gain knowledge about their adolescents' diabetes, given their less proximate daily contact with adolescents.…”

“…Further, mothers are more knowledgeable about adolescents' daily activities through both mothers' greater solicitation of information and being the target of adolescent disclosures (Waizenhofer, Buchanan, & Jackson-Newsom, 2004). Mothers' greater involvement than fathers in adolescents' daily lives generally holds true in diabetes management as well (Seiffge-Krenke, 2002), and there is recent evidence that adolescents disclose more to mothers than to fathers about diabetes (Main et al, 2015). Adolescent daily disclosures to mothers may thus be more beneficial than disclosures to fathers because of higher maternal involvement in the daily details of disease management.…”

Integrated Primary Medical-Behavioral Health Care for Adolescent and Young Adult Depression: Predictors of Service Use in the Youth Partners in Care Trial

“…It is also possible that the QI intervention overcame age-related individual characteristics that have been found to influence service use. For example, as adolescents grow older they exhibit a greater tendency to be secretive about their health behaviors (Main et al, 2015) and be more responsive to models of care that forefront shared decision making (Bejarano et al, 2015). Thus, the QI intervention, which emphasized integrated and collaborative medical-behavioral primary care, may have fostered a more open, empowering patient-provider relationship that promoted increased use of needed services.…”

Reasons for Open and Closed Attitudes Regarding Type 1 Diabetes

“…The literature examining closed attitudes largely focuses on children and adolescents. Studies show that adolescents tend to be more secretive and closed about diabetes-related issues because of anticipated disapproval and punishment from parents (12), shame and self-blame for diabetes (6), low parental warmth (13), fear of negative peer and friend reactions (14), and negative feedback from teachers (15).…”