Psychological distress and parental involvement in diabetes management are predictors of self-care behaviors among adolescents with T1D. To date, little research has examined parental involvement as a moderator of the association between distress on self-care behaviors. This study examined whether shared responsibility (SR) moderates relations of distress on self-care.

Methods: A secondary analysis was conducted using longitudinal data from 132 adolescents with T1D (53% female; aged 10.7-14.2 years; 1-13 years duration of T1D) and their parents. Adolescents were interviewed and parents completed a questionnaire annually for 5 years. Adolescents and parents reported on the extent to which they shared diabetes care responsibilities. Adolescents reported on distress (depression, anxiety, anger) and self-care. Linear mixed modeling was used to assess whether SR moderated relations of concurrent and lagged psychological distress on self-care.

Results: For concurrent analyses, parent-reported SR moderated relations between both depressive symptoms and anxiety on self-care (p<.001) and anger on self-care (p=.001). For lagged analyses, parent-reported SR moderated relations between depression on self-care (p=.001) and anxiety on self-care (p=.003). Moderation varied over the 5 years. During early to middle adolescence (years 1-4), SR did not moderate relations between distress and self-care; however, during middle to late adolescence (year 5), lower distress was associated with better self-care for higher SR but not associated with self-care for lower levels of SR.

Conclusions: As adolescents get older, lower distress was associated with better self-care for those with higher levels of SR but not for those with low SR. Continuation of SR during adolescence may mitigate the effects of distress on self-care. Healthcare providers should promote parental involvement in diabetes management throughout adolescence for better diabetes outcomes.


H. Abujaradeh: None. V. Helgeson: None. S.M. Cohen: None. S.M. Sereika: None.

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