Maternal Intrusive Involvement and Adolescent Functioning in Youth with Type I Diabetes
One factor affecting emotional and physical well being in adolescents with type 1 diabetes is the degree of maternal involvement. Adolescents whose mothers are actively involved in the daily management of their diabetes tend to follow their regimen more consistently and are in better glycemic control. However, intrusive levels of involvement have been correlated with increased depression, decreased adherence, and poor metabolic control. In the past intrusive involvement has been seen as a consequence of innate maternal characteristics such as trait anxiety, and as the cause of poor child functioning in adolescents with intrusively involved caregivers. More current research takes a transactional perspective in which intrusive involvement interacts with child functioning in a reciprocal manner. To investigate the current transactional perspective, the current study explored the temporal relationships between intrusive maternal involvement in adolescent diabetes management and child functioning variables including depression, adherence, and metabolic control across two time points (an average of 16 months apart) using cross-lagged panel correlation analyses and hierarchical linear regression. The current study also investigated the role of maternal trait anxiety in the development of intrusive involvement by proposing one potential transactional process and testing it in the sample. Adolescents (N = 83, 10 to 15 years of age, 53% male) with type 1 diabetes mellitus (duration of at least 1 year) completed measures of adherence, depression, and intrusive involvement, and their mothers provided relevant demographic and illness related information. Metabolic control was collected from participants' medical records. This study found no evidence to support the workings of a transactional process within mother-teen dyads for adolescents with type 1 diabetes. However, consistent with the traditional linear model, results indicated that intrusive involvement was associated with higher levels of depressive symptoms in females at Time 1, and that the effects continued to be seen over time. No association was found between intrusive involvement and depressive symptomatology for males at either time point. These findings point to the need for interventions geared toward improving mother-daughter interactions and reducing depressive symptomatology in teenage girls with type 1 diabetes.
Diabetes Mellitus, Type 1, Mother-Child Relations, Medication Adherence
University of Texas Southwestern Medical Center
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