Martin-Martinez Nuria, Caro-Cañizares Irene, Carballo Juan J, Parellada Mara
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain.
Department of Psychology, School of Health and Educational Sciences, UDIMA (Universidad a Distancia de Madrid), 28400, Collado Villalba, Spain.
Eur J Pediatr. 2025 Jun 25;184(7):446. doi: 10.1007/s00431-025-06266-7.
Type 1 diabetes (T1D) is a common childhood disease with a complex management that could adversely impact the quality of life of young sufferers. Executive functioning problems and psychopathology are factors that appear to have a detrimental effect on T1D-related quality of life (T1D-QoL). However, research on these factors is limited, and the pathways through which they do so remain unclear. This study aims to replicate the relationship between EF and T1D-QoL and to explore the possible mediating role of the clinical dysregulation profile (CBCL-DP) in this relationship. A total of 68 children and adolescents aged 10-18 living with T1D were recruited for this cross-sectional study. Parents reported on youth executive functioning, T1D-QoL, CBCL-DP, and socio-demographic data. In addition, clinical records of the youth were consulted to collect endocrinological information. Statistical analyses encompassed bivariate correlations, linear regressions, and bootstrap analyses to test the mediation model. Results demonstrate that executive function, CBCL-DP, and T1D-QoL are significantly correlated. The mediation model of the CBCL-DP variable in the relationship between executive function and T1D-QoL is significant. In linear regressions, executive function ceases to be significant on T1D-QoL when CBCL-DP is taken into account. The CBCL-DP significantly accounts for 55% of the variance in T1D-QoL.
This study identifies the CBCL-DP as a full mediator between executive function and T1D-QoL, highlighting the importance of emotional and behavioral regulation for quality of life in youth with T1D. The CBCL-DP scale may be useful in identifying regulatory issues and guiding early interventions to improve outcomes in children and adolescents with T1D.
• Previous studies have suggested that EF problems may negatively affect T1D-QoL; however, no studies have investigated the underlying mechanisms by which these variables are associated and the mediating role of CBCL-DP.
•This study suggests that there is an absence of a direct association between EF problems and T1D-QoL and identifies the CBCL-DP as a complete mediator between these variables. Furthermore, the study indicates that clinical dysregulation acts as a risk factor for diminished T1D-QoL in children and adolescents with T1D.
1型糖尿病（T1D）是一种常见的儿童疾病，其管理复杂，可能对年轻患者的生活质量产生不利影响。执行功能问题和精神病理学因素似乎对1型糖尿病相关生活质量（T1D-QoL）有不利影响。然而，关于这些因素的研究有限，它们产生影响的途径仍不明确。本研究旨在复制执行功能与T1D-QoL之间的关系，并探讨临床失调概况（CBCL-DP）在这种关系中可能的中介作用。本横断面研究共招募了68名10-18岁患有T1D的儿童和青少年。父母报告了青少年的执行功能、T1D-QoL、CBCL-DP和社会人口学数据。此外，查阅了青少年的临床记录以收集内分泌学信息。统计分析包括双变量相关性、线性回归和引导分析，以检验中介模型。结果表明，执行功能、CBCL-DP和T1D-QoL显著相关。CBCL-DP变量在执行功能与T1D-QoL关系中的中介模型显著。在线性回归中，当考虑CBCL-DP时，执行功能对T1D-QoL不再显著。CBCL-DP显著解释了T1D-QoL中55%的方差。
本研究确定CBCL-DP是执行功能与T1D-QoL之间的完全中介变量，突出了情绪和行为调节对T1D青少年生活质量的重要性。CBCL-DP量表可能有助于识别调节问题，并指导早期干预以改善T1D儿童和青少年的预后。
•先前的研究表明，执行功能问题可能对T1D-QoL产生负面影响；然而，尚无研究调查这些变量相关的潜在机制以及CBCL-DP的中介作用。
•本研究表明，执行功能问题与T1D-QoL之间不存在直接关联，并确定CBCL-DP是这些变量之间的完全中介变量。此外，该研究表明，临床失调是T1D儿童和青少年T1D-QoL降低的危险因素。
