School Psychology and Development in Context, KU Leuven, Leuven, Belgium.
Research Foundation Flanders, Brussels, Belgium.
J Youth Adolesc. 2020 Feb;49(2):449-466. doi: 10.1007/s10964-019-01180-2. Epub 2019 Dec 18.
Youth with type 1 diabetes are confronted with the challenging task of integrating diabetes into their identity. This integration process, referred to as illness identity, may play an important role in how youth with type 1 diabetes cope with normative and illness-specific challenges. In line with socio-ecological theorizing, the present study investigated the longitudinal interplay between illness identity and two important social contexts for youth, the parent and peer contexts. A total of 559 (54.5% female; mean age = 18.8 years) adolescents (14-17 years) and emerging adults (18-25 years) with type 1 diabetes completed questionnaires at three time-points with intervals of one year. A total of 98% of these participants had the Belgian nationality, and all of them spoke Dutch. At each time point, illness identity (i.e., acceptance, enrichment, rejection, and engulfment), peer support, extreme peer orientation, parental responsiveness, parental psychological control, and parental overprotection were self-assessed. The present findings show that overprotective parenting may lead to youth feeling engulfed by their diabetes. Further, when type 1 diabetes becomes adaptively integrated into youth's identity, the data suggest that youth may be better prepared to engage in healthy peer relationships. Thus, the present findings show that illness identity may be affected by the social context, and in turn may have an impact on parent and peer relationships as well. In general, the present findings underscore the importance of adaptive illness integration for youth with type 1 diabetes, and further emphasize the importance of achieving a coherent identity.
青少年 1 型糖尿病患者面临着将糖尿病融入自身身份认同的艰巨任务。这个整合过程，即疾病认同，可能在青少年 1 型糖尿病患者应对规范和疾病特定挑战方面发挥重要作用。根据社会生态理论，本研究调查了疾病认同与青少年两个重要社会环境（父母和同伴环境）之间的纵向相互作用。共有 559 名（54.5%为女性；平均年龄为 18.8 岁）青少年（14-17 岁）和成年早期（18-25 岁）1 型糖尿病患者在三年时间内，每一年进行一次问卷调查。这些参与者中，共有 98%的人具有比利时国籍，并且所有人都说荷兰语。在每个时间点，青少年自我评估了疾病认同（即接受、充实、拒绝和吞噬）、同伴支持、极端同伴导向、父母反应能力、父母心理控制和父母过度保护。本研究结果表明，过度保护的养育方式可能导致青少年感到被糖尿病吞噬。此外，当 1 型糖尿病适应地融入青少年的身份时，数据表明，青少年可能更准备好建立健康的同伴关系。因此，本研究结果表明，疾病认同可能会受到社会环境的影响，反过来又可能对父母和同伴关系产生影响。总的来说，本研究结果强调了对青少年 1 型糖尿病患者进行适应性疾病整合的重要性，进一步强调了实现一致身份认同的重要性。
