Longitudinal associations of maternal depressive symptoms, maternal involvement, and diabetes management across adolescence.
ABSTRACT To examine whether maternal depressive symptoms: (a) predicted the level of maternal involvement in diabetes management tasks across adolescence; and (b) moderated associations of involvement with adolescent adherence, metabolic control, and depression.
Eighty-two youth aged 10-15 years with type 1 diabetes and their mothers completed measures at baseline and 16 months later. Participants rated maternal involvement in diabetes tasks, adherence, and depressive symptoms; metabolic control was indexed from medical records.
Maternal depressive symptoms were associated with higher involvement at baseline, and slower declines in involvement across time. At baseline, involvement was associated with lower adolescent depression and better metabolic control, but this association was stronger when mothers reported fewer depressive symptoms. Interactions of maternal depression with involvement across time suggested maternal involvement was associated with better subsequent adherence primarily when mothers reported fewer depressive symptoms.
Mothers' depressive symptoms may undermine her care-giving effectiveness during adolescence.
- Psychopharmacology bulletin 02/1985; 21(4):995-8. · 1.35 Impact Factor
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ABSTRACT: Control interactions between 87 well and affectively ill mothers and their 15- to 51-month-old children were studied. Spontaneously occurring control interventions (conceptualized as episodes of interaction between mother and child) were coded from 90 minutes of videotaped interactions in a naturalistic laboratory apartment setting. The results suggest developmental changes in mother-child interaction in the 2nd to 4th years of life: the increase of the rate of immediate maternal success (p less than .05) and compromise (p less than .05), on the decrease in maternal use of power (ultimate success by enforcement, p less than .01). Well mothers achieved compromise with their children, particularly daughters, more often than did affectively ill mothers (p less than .05). Affectively ill mothers more often than well mothers avoided confrontation with their children (p less than .05). The impairments in control interventions of affectively ill mothers were exacerbated by the severity of the disorder.Journal of Abnormal Child Psychology 10/1987; 15(3):441-56. · 3.09 Impact Factor
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ABSTRACT: Treatment of IDDM in youth emphasized balancing children's self-care autonomy with their psychological maturity. However, few data exist to guide clinicians or parents, and little is known about correlates of deviations from this ideal. In this cross-sectional study, IDDM self-care autonomy of 100 youth was assessed using two well-validated measures. Three measures of psychological maturity (cognitive function, social-cognitive development, and academic achievement) were also collected for each child. Composite indexes of self-care autonomy and of psychological maturity were formed, and the ratio of the self-care autonomy index to the psychological maturity index quantified each child's deviation from developmentally appropriate IDDM self-care autonomy. Based on these scores, participants were categorized as exhibiting constrained (lower tertile), appropriate (middle tertile), or excessive (higher tertile) self-care autonomy. Between-group differences in treatment adherence, diabetes knowledge, glycemic control, and hospitalization rates were explored. Analysis of covariance controlling for age revealed that the excessive self-care autonomy group demonstrated less favorable treatment adherence, diabetes knowledge, hospitalization rates, and, marginally, glycemic control. Excessive self-care autonomy increased with age and was less common among intact two-parent families but was unrelated to other demographic factors. The findings indicate caution about encouragement of maximal self-care autonomy among youth with IDDM and suggest that families who succeed in maintaining parental involvement in diabetes management may have better outcomes.Diabetes Care 03/1996; 19(2):119-25. · 7.74 Impact Factor