Defense Date

2010

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Clinical Psychology

First Advisor

Clarissa Holmes

Abstract

Objectives: The rate and impact of depressive symptoms were examined with two models based on known effects of depression on variables related to diabetes management, parental involvement and diabetes conflict. The proposed models will measure potential effects high maternal depressive symptoms may have on parental monitoring and involvement and diabetes specific conflict and how these variables may in turn relate to poor regimen adherence. Methods: Participants included 225 mothers and young adolescents (aged 11-14) with T1D. Diabetes self-care behaviors were measured with the 24 Hour Recall Interview, parental involvement and monitoring were measured with the Parent Management of Diabetes Scale, and diabetes specific conflict was measured with the Diabetes Family Conflict Scale. Results: A significant portion of mothers (21%) reported clinically elevated levels of depressive symptoms. These high levels of depressive symptoms were related to low levels of parental involvement with diabetes care (r = -.19, p < .01). Depressive symptoms were indirectly related to lower frequency of blood glucose monitoring (C.95 = -.03, -.002), insulin use (C.95 = -.01, -.0007), and meals (C.95 = -.02, -.002) through low levels of parental involvement. Higher levels of depressive symptoms were also related to higher levels of diabetes specific conflict (r = .16, p < .01), however, this relationship did not have a significant indirect effect on frequency of self-care behaviors. Conclusions: A significant portion of mothers in the current sample reported symptoms of depression above the clinical cutoff. Mothers that reported higher levels of depressive symptoms also reported lower levels of parental involvement in management of disease-care behaviors. Low levels of parental involvement mediated a significant relation between depressive symptoms and less frequent disease-care behaviors. Diabetes conflict did not mediate a relation between depressive symptoms and disease-care behaviors. These findings suggest that the reported high levels of maternal depressive symptoms among mothers of children with T1D may interfere with good diabetes management through low parental involvement. Individual treatment for depressive symptoms and interventions targeted at increasing parental involvement without increasing diabetes conflict could help improve regimen adherence.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

August 2012

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