Developmental Processes Associated With Longitudinal Declines in Parental Responsibility and Adherence to Type 1 Diabetes Management Across Adolescence

• Published in: Journal of pediatric psychology Vol. 39; no. 5; pp. 532 - 541
• Main Authors: Wiebe, Deborah J., Chow, Chong Man, Palmer, Debra L., Butner, Jonathan, Butler, Jorie M., Osborn, Peter, Berg, Cynthia A.
• Format: Journal Article
• Language: English
• Published: Atlanta, GA Oxford University Press 01.06.2014
• Subjects: Adolescent; Adolescent Behavior - psychology; Adolescent Development; Biological and medical sciences; Child; Child clinical studies; Diabetes Mellitus, Type 1 - psychology; Diabetes Mellitus, Type 1 - therapy; Diabetes. Impaired glucose tolerance; Disease Management; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Longitudinal Studies; Male; Medical sciences; Medication Adherence - psychology; Parent-Child Relations; Parenting; Parents; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regular; Self Care - psychology; Self Efficacy; longitudinal research; type 1 diabetes; adolescents; adherence; self-efficacy; puberty; parenting; Endocrinopathy; Social environment; Human; Immunopathology; Parental behavior; Puberty; Compliance; Parent; Autoimmune disease; Management; Responsibility; Adhesion; Type 1 diabetes; Follow up study; Adolescent; Family environment; Development; Self efficacy
• ISSN: 0146-8693; 1465-735X
• DOI: 10.1093/jpepsy/jsu006

Objective To identify whether changes in pubertal status and self-efficacy for diabetes management are associated with longitudinal declines in parental responsibility for diabetes, and to determine whether these factors moderate associations between declining parental responsibility and deteriorating adherence across adolescence. Methods Adolescents (N = 252; 53.6% females) with type 1 diabetes, mothers, and 188 fathers participated in a 2.5-year longitudinal study. Self-reports of pubertal status, adolescent efficacy, parental responsibility, and adherence were completed every 6 months (6 time points). Results Latent growth curve modeling revealed that longitudinal increases in efficacy and pubertal maturation were uniquely associated with longitudinal declines in parental responsibility. Declines in parental responsibility were related to deterioration in adherence especially when adolescents did not report concomitant growth in self-efficacy. Conclusions Transfer of responsibility for diabetes management across adolescence may be more optimal when adolescents’ increased independence is titrated to their changing self-efficacy beliefs.