1型糖尿病青少年晚期的抑郁症状、日常压力与依从性
Depressive symptoms, daily stress, and adherence in late adolescents with type 1 diabetes.
作者信息
Baucom Katherine J W, Queen Tara L, Wiebe Deborah J, Turner Sara L, Wolfe Kristin L, Godbey Elida I, Fortenberry Katherine T, Mansfield Jessica H, Berg Cynthia A
机构信息
Department of Psychology, University of Utah.
Department of Psychological Sciences, University of California, Merced.
出版信息
Health Psychol. 2015 May;34(5):522-30. doi: 10.1037/hea0000219. Epub 2015 Mar 23.
OBJECTIVE
To examine whether depressive symptoms are associated with greater perceived daily stress and moderate the link between stress severity and poorer daily adherence in late adolescents with Type 1 diabetes (T1D).
METHOD
175 late adolescents with T1D completed measures of depressive symptoms and glycemic control during a baseline laboratory assessment. This assessment was followed by a 14-day daily diary during which adolescents rated the severity of general (GS) and diabetes-specific (DSS) stressful events, as well as adherence to their diabetes regimen.
RESULTS
Multilevel modeling revealed that adolescents with more depressive symptoms reported more severe daily stress and poorer daily adherence on average, and had poorer glycemic control. On days with more severe DSS, but not GS, adolescents reported poorer adherence. This association was moderated by an interaction between depressive symptoms and the mean level of DSS severity experienced across the 2-week diary. In adolescents with low levels of depressive symptoms, poorer adherence was reported on days with more severe DSS across all levels of mean DSS severity. In adolescents with average or high levels of depressive symptoms, poorer adherence was reported on days with more severe DSS only when mean DSS severity was average or high.
CONCLUSIONS
Depressive symptoms are associated with poorer daily adherence and greater stress severity, and interact with mean DSS severity to moderate the link between daily stress and adherence. The results point to the importance of depressive symptoms for understanding associations between stress and adherence during late adolescence.
目的
探讨抑郁症状是否与更高的日常压力感知相关，以及是否会调节1型糖尿病（T1D）青少年晚期压力严重程度与较差的日常治疗依从性之间的联系。
方法
175名患有T1D的青少年晚期患者在基线实验室评估期间完成了抑郁症状和血糖控制的测量。此次评估之后是为期14天的每日日记，在此期间青少年对一般（GS）和糖尿病特异性（DSS）应激事件的严重程度以及他们对糖尿病治疗方案的依从性进行评分。
结果
多层次模型显示，抑郁症状较多的青少年平均报告的日常压力更严重，日常依从性更差，血糖控制也更差。在DSS更严重的日子里（而非GS），青少年报告的依从性较差。抑郁症状与整个两周日记中经历的DSS严重程度平均水平之间的相互作用调节了这种关联。在抑郁症状水平较低的青少年中，在所有平均DSS严重程度水平下，DSS更严重的日子里报告的依从性较差。在抑郁症状水平为中等或较高的青少年中，只有当平均DSS严重程度为中等或较高时，在DSS更严重的日子里报告的依从性才较差。
结论
抑郁症状与较差的日常依从性和更高的压力严重程度相关，并与平均DSS严重程度相互作用，调节日常压力与依从性之间的联系。研究结果指出了抑郁症状对于理解青少年晚期压力与依从性之间关联的重要性。
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