Browsing by Subject "Mother-Child Relations"
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Item Maternal Depressive Symptoms and Its Relationship to Outcomes of Adolescents with Type 1 Diabetes in a Diverse Sample of Caucasian and Latino Youth(2012-05-18) Godbey, Elida Isabel; Wiebe, Deborah J.; Chiu, Chung-Yi; Reed, GabrielaPURPOSE/BACKGROUND: Maternal depression can have deleterious effects on adolescents' psychosocial adjustment and management of type1 diabetes. These associations have been primarily studied among Caucasian middle-income families. Ethnic minority status and economic disadvantage may alter the experience of maternal depressive symptoms and their association with adolescent diabetes management. The purpose of this study was to determine if mothers' depressive symptoms are similarly associated with adolescent diabetes outcomes in Caucasian and Latino/a youth, and whether associations occur independent of socioeconomic factors. METHODS: Participants were Caucasian and Latina mothers and their adolescents with type I diabetes (N=118 dyads; 48% Latino; 54% female; 10 to 15 years old; illness duration > 1 year; 25% on insulin pump). Mothers completed surveys assessing depressive symptoms, household income and parental education. Adolescents reported treatment adherence and depressive symptoms. Metabolic control was determined from HbA1c from medical records. Socio-demographic information was collected through a combination of maternal report and census tract data. RESULTS: Although Latino participants had lower socioeconomic status (SES) than Caucasian participants, there were no ethnic group differences in terms of parental marital status, adolescent age, adolescent gender, illness duration, or insulin pump status. Latina mothers reported significantly more depressive symptoms than Caucasian mothers t (112) = 2.48, p = .015, and these differences were independent of lower SES among Latina mothers. Hierarchical regression analyses revealed maternal reports of depressive symptoms were associated with higher adolescent depression t(108) = 1.98, p = .05, but this association was moderated by both a two-way interaction with adolescent age, t(105) = 2.13, p = .036, and a three-way interaction with age and ethnicity, t(104) = -2.05, p = .043. Among older Latino adolescents, maternal depressive symptoms were positively associated with adolescent report of depression; this association was not found among older Caucasian participants or among younger participants. There were no significant associations between maternal depressive symptoms and adolescent adherence. All associations remained independent of SES indicators, which were generally unrelated to adolescent outcomes. CONCLUSION: Maternal depressive symptoms may undermine the psychosocial adjustment of adolescents with diabetes, but appears to have complex associations with diabetes management across ethnic groups. The finding that Latino youth did not experience heightened depression despite the risks of their mother's elevated depressive symptoms and lower SES is potentially quite important. If replicable, further research should explore potential protective factors that may be contributing to adolescent diabetes outcomes in Latino families.Item Maternal Intrusive Involvement and Adolescent Functioning in Youth with Type I Diabetes(2007-12-17) Oroza, Maria Gabriela; Wiebe, Deborah J.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.Item Maternal Optimism and Its Relationship to Coping and Illness Management Among Adolescents with Type 1 Diabetes(2010-05-14) García, Ryan Michael; Wiebe, Deborah J.Optimism is an intriguing construct because of its relationships with positive physiological and psychological outcomes in times of adversity, including chronic illness. Coping styles often mediate significant relationships between optimism and these outcomes. Type 1 Diabetes can be difficult to manage for adolescents, and their mothers play important roles in helping and teaching them how to effectively manage their illness. Adolescents with Type 1 Diabetes often struggle with psychological adjustment, treatment adherence, and maintaining healthy metabolic control. The relationships between one maternal personality trait, dispositional optimism, and these three key outcome variables with regard to the management of adolescent Type 1 Diabetes were investigated using the Revised Life Orientation Test, Children‟s Depression Inventory, Revised Self Care Inventory, and HbA1c. Adolescent coping style, assessed by a structured Stress and Coping Interview, was investigated as a possible factor mediating the proposed relationships between maternal optimism and the outcome variables. Participants were 130 mother-adolescent dyads. Adolescents were 14.5 years old, 56% female, 93% Caucasian, and 59% were using an insulin pump. Initial correlations revealed maternal optimism was associated with better adolescent adherence and metabolic control, and trended towards a relationship with fewer adolescent depressive symptoms. Relationships between maternal optimism and adolescent adherence and metabolic control remained significant when controlling for maternal trait anxiety and adolescent insulin pump status. However, adolescent coping styles were not found to mediate these relationships. The absence of a mediation role for coping styles may have reflected the presence of very low levels of avoidance coping in the sample. Exploratory analyses examined an alternative mediational pathway, and verified maternal and adolescent reports of adherence as indirect pathways between maternal optimism and adolescent metabolic control. These findings are the first to reveal associations between caregiver personality traits and the health outcomes in those for whom they care, and provide evidence of the potential processes involved. These findings suggest that maternal optimism may serve as a resource during a difficult time of development for adolescents with Type 1 Diabetes.Item Parental Strategies for Adolescent Diabetes Management in Latino and Caucasian Youth(2013-01-16) Griffith, Katrina Courtney; Wiebe, Deborah J.Adolescence is a particularly challenging and important time for type 1 diabetes management. Parental involvement during this time has been associated with more effective diabetes management in adolescence and throughout adulthood, but research on adolescent diabetes management has primarily focused on Caucasian samples. The purpose of this study was to explore the parental strategies that Caucasian and Latina mothers employ when helping their adolescent deal with diabetes management problems, and to begin to illuminate the strategies that are associated with adolescent outcomes (i.e. metabolic control, adherence, and depressive symptoms) across ethnic groups. Participants were Caucasian and Latina mothers and their adolescents with type 1 diabetes (N=118 dyads; 48% Latino; 54% female adolescents; 10 to 15 years old; illness duration > 1 year; 25% on insulin pump). Qualitative data consisted of maternal and adolescent narrative responses to the open-ended question, “What do you (does your mother) do when diabetes management is not going well?” Quantitative data included maternal and adolescent report of adherence, teen report of depressive symptoms and metabolic control. Sociodemographic information was collected by maternal report. Qualitative analysis revealed 11 parental strategies that mothers employ when dealing with daily diabetes related problems. Across the full sample, take charge was the most commonly reported strategy by both mothers and teens, followed by negative emotional reaction and collaboration (by teen report) and collaboration and parental monitoring (by mother report). Across ethnic groups, take charge was commonly endorsed by all reporters. Caucasian families were more likely to report collaboration and general emotional support, while Latino families were more likely to report parental monitoring. Exploratory analyses of correlation differences across ethnic groups suggested parental strategies functioned differently for Caucasian and Latino families. Caucasian and Latino families differed on the frequency of parental strategies reported, as well as on associations between strategies and outcomes (i.e. glycemic control, adherence, and depressive symptoms). The mixed methods approach identified important parental strategies that enrich our understanding of how parents manage diabetes and illuminate interesting ethnic differences that should be further considered in the context of clinical intervention and future research.