Freitag Gabrielle F, Mali Luiza V, Morris Stephanie S J, Sanchez Janine, Delamater Alan M
Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, Miami, United States.
Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, Miami, United States.
J Clin Psychol Med Settings. 2025 Aug 30. doi: 10.1007/s10880-025-10095-z.
Few studies have examined effects of intrinsic motivation (IM) on adaptive behaviors among adolescents with type 1 diabetes (T1D), although greater IM has been associated with less diabetes-related family conflict (FC) and increased regimen adherence. Greater FC has also been associated with disordered eating behaviors (DEBs). We examined the moderating role of IM between FC and DEBs in a culturally diverse sample of youth with T1D. 226 adolescents (Mage = 15.03, 59.3% female, 65.8% Hispanic, 19.0% Black, MA1c = 8.19%, 74.30% eligible for subsidized health insurance) completed pre-visit screening measures assessing IM, FC, and DEBs. Gender, race, ethnicity, A1c, BMI, and insurance status were obtained from medical records and treated as covariates. Black youth had higher rates of DEBs (p < .01) and A1c levels (p < .001) than White youth. Significant correlations were observed across study variables. Accounting for covariates, IM moderated the relationship between FC and DEBs, whereby the effect of FC on DEBs emerged strongest at low IM (p < .001). As IM levels increased, the effect of FC on DEBs decreased, making the relationship between FC and DEBs non-significant. Greater IM for diabetes management attenuates the association between FC and DEBs. Promoting IM may decrease FC and DEBs in youth with T1D.
很少有研究考察内在动机(IM)对1型糖尿病(T1D)青少年适应行为的影响,尽管更高的内在动机与较少的糖尿病相关家庭冲突(FC)以及更高的治疗方案依从性有关。更大的家庭冲突也与饮食失调行为(DEB)有关。我们在一个文化背景多样的T1D青少年样本中考察了内在动机在家庭冲突和饮食失调行为之间的调节作用。226名青少年(年龄中位数=15.03岁,59.3%为女性,65.8%为西班牙裔,19.0%为黑人,糖化血红蛋白(A1c)=8.19%,74.30%符合获得补贴医疗保险的条件)完成了访前筛查措施,评估内在动机、家庭冲突和饮食失调行为。性别、种族、民族、糖化血红蛋白、体重指数和保险状况从医疗记录中获取,并作为协变量处理。黑人青少年的饮食失调行为发生率(p<0.01)和糖化血红蛋白水平(p<0.001)高于白人青少年。在研究变量之间观察到显著的相关性。考虑到协变量,内在动机调节了家庭冲突和饮食失调行为之间的关系,由此家庭冲突对饮食失调行为的影响在低内在动机水平时最为显著(p<0.001)。随着内在动机水平的提高,家庭冲突对饮食失调行为的影响减弱,使得家庭冲突和饮食失调行为之间的关系不显著。更高的糖尿病管理内在动机减弱了家庭冲突和饮食失调行为之间的关联。促进内在动机可能会减少T1D青少年的家庭冲突和饮食失调行为。