Abstract
Background
Longitudinal studies including parental distress when examining adverse health outcomes in adolescents with type 1 diabetes are lacking. This study examined whether parental depression and anxiety predict adolescent emotional distress and glycated hemoglobin A1c (HbA1c) 1 year later and whether a relation between parental distress and HbA1c is mediated by the level of parental involvement in diabetes care and by treatment behaviors.
Methods
Longitudinal path modeling was applied to data from 154 adolescents and parents from diabetes centers participating in the Longitudinal study of Emotional problems in Adolescents with type 1 diabetes and their Parents/caregivers (Diabetes LEAP). At baseline and 1-year follow-up, participants completed measures of depression and anxiety. HbA1c was extracted from medical charts. Responsibility and treatment behavior questionnaires were completed by adolescents at baseline.
Results
Baseline parental depressive and anxiety symptoms were not associated with 1-year adolescent depressive symptoms, anxiety symptoms, and HbA1c. Responsibility division and treatment behaviors did not mediate associations between parental emotional distress and 1-year HbA1c.
Conclusions
Parental depressive and anxiety symptoms did not predict adolescent health outcomes 1 year later. Future studies may determine whether the link is present in case of mood/anxiety disorders or severe diabetes-specific distress, or whether adolescents are resilient in the face of parental distress.
Impact
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Adolescents with T1D are a vulnerable group in terms of psychological and health outcomes. Whether parental emotional distress (i.e., depressive and anxiety symptoms) is prospectively associated with adolescent emotional distress and/or HbA1c has been understudied.
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Our results show that parental distress was not related to adolescent distress or HbA1c 1 year later.
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Responsibility division and treatment behaviors did not mediate associations between parental emotional distress and 1-year HbA1c.
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Future studies could determine whether these links are present in case of mood/anxiety disorders or severe diabetes-specific distress, or whether adolescents are resilient in the face of parental distress.
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Acknowledgements
We thank all participants of Diabetes LEAP. This study was supported by a Dutch Diabetes Research Foundation Junior Fellowship granted to G.N., with F.P. as senior researcher (2013.81.1645). The sponsor had no role in the study design, the collection and analysis and interpretation of data, the writing of the report, and the decision to submit the manuscript for publication.
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L.A.N., F.P., H.-J.A., and G.N. substantially contributed to the conception and design of the study, the acquisition of data, the analysis and interpretation of data, the drafting of the article, and critically revised the article for important intellectual content. E.H. and P.W. substantially contributed to acquisition of data, the interpretation of data, and critically revised the article for important intellectual content. P.L. substantially contributed to the analysis and interpretation of data, the drafting of the article, and critically revised the article for important intellectual content. All authors gave approval of the version to be published.
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Nguyen, L.A., Pouwer, F., Lodder, P. et al. Depression and anxiety in adolescents with type 1 diabetes and their parents. Pediatr Res 91, 188–196 (2022). https://doi.org/10.1038/s41390-021-01392-y
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DOI: https://doi.org/10.1038/s41390-021-01392-y
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