Maternal Optimism and Its Relationship to Coping and Illness Management Among Adolescents with Type 1 Diabetes

Abstract

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.