Center for Technology and Behavioral Health at Dartmouth.
Dartmouth Geisel School of Medicine.
J Pediatr Psychol. 2018 Jun 1;43(5):525-533. doi: 10.1093/jpepsy/jsx134.
This study explored the associations between problems with self-regulation and glycemic control (HbA1c) in teens experiencing challenges with managing type 1 diabetes by examining greater diabetes-related family conflict and poorer adherence as serial mediators of the link between greater problems with self-regulation and higher HbA1c.
Teens experiencing challenges with managing type 1 diabetes (n = 93, HbA1c ≥8%, 96% White, 57% male) completed an HbA1c test, and their parents completed assessments including measures of adherence and family conflict related to diabetes management during an intake for a larger Web-based intervention study or fMRI study. Teen problems with self-regulation were indexed the Child Behavior Checklist using the dysregulation profile.
Bivariate correlations found significant associations between greater problems with self-regulation, greater family conflict about diabetes management, poorer adherence, and higher HbA1c. However, only greater family conflict, and not adherence, significantly explained the association between greater self-regulation problems and higher HbA1c.
These findings suggest that among teens experiencing challenges with managing type 1 diabetes, interventions that decrease family conflict may be critical to promoting optimal glycemic control in those teens with greater problems with self-regulation.
本研究通过考察更大的糖尿病相关家庭冲突和较差的依从性作为更大的自我调节问题与更高的 HbA1c 之间联系的串联中介，探讨了青少年在管理 1 型糖尿病方面遇到挑战时自我调节问题与血糖控制（HbA1c）之间的关联。
经历 1 型糖尿病管理挑战的青少年（n=93，HbA1c≥8%，96%为白人，57%为男性）完成了 HbA1c 测试，其父母在接受更大的基于网络的干预研究或 fMRI 研究的入组时完成了与糖尿病管理相关的依从性和家庭冲突评估，包括对青少年自我调节问题的评估。使用儿童行为检查表（Child Behavior Checklist）的失调指标来衡量青少年的自我调节问题。
双变量相关性发现，更大的自我调节问题、更大的糖尿病管理家庭冲突、较差的依从性与更高的 HbA1c 之间存在显著关联。然而，只有更大的家庭冲突，而不是依从性，显著解释了更大的自我调节问题与更高的 HbA1c 之间的关联。
这些发现表明，在经历 1 型糖尿病管理挑战的青少年中，减少家庭冲突的干预措施可能对促进那些自我调节问题更大的青少年的最佳血糖控制至关重要。
