Coping and resilience in adolescents with type 1 diabetes.

BACKGROUND Adolescents with type 1 diabetes (T1D) must cope with the ongoing stress of treatment management, so it is important to identify the most adaptive coping strategies. Previous studies, however, have typically measured broad categories of coping (e.g. approach/avoidance) and few used instruments specifically designed for this population. OBJECTIVE This article aimed to use a developmentally sensitive coping measure to explore how the use of specific coping strategies impacts resilience (i.e. quality of life, competence and metabolic control) in adolescents with T1D. METHODS Thirty adolescents with T1D between the ages of 10 and 16 and their mothers completed questionnaires on adolescents' coping strategy use, competence and quality of life. Clinical data (i.e. HbA1c) were obtained from adolescents' medical records. RESULTS Greater use of primary control coping strategies (e.g. problem solving, emotional expression) was associated with higher competence scores, better quality of life and better metabolic control. Secondary control coping strategies (e.g. acceptance, distraction) were related to higher social competence, better quality of life and better metabolic control. Finally, the use of disengagement coping strategies (e.g. withdrawal or denial) was linked with lower competence and poorer metabolic control. CONCLUSIONS The results of this study support the use of developmentally sensitive coping measures by researchers and clinicians to determine the most effective coping strategies for adolescents with T1D.

[1]  S. Henggeler,et al.  Social competence and parental support as mediators of the link between stress and metabolic control in adolescents with insulin-dependent diabetes mellitus. , 1987, Journal of consulting and clinical psychology.

[2]  J. Varni,et al.  Pediatric Health-Related Quality of Life Measurement Technology: A Guide for Health Care Decision Makers , 1999 .

[3]  B. Compas,et al.  Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. , 2001, Psychological bulletin.

[4]  M. Kovács,et al.  Psychological functioning among mothers of children with insulin-dependent diabetes mellitus: a longitudinal study. , 1990, Journal of consulting and clinical psychology.

[5]  M. Grey,et al.  Coping behaviors at diagnosis and in adjustment one year later in children with diabetes. , 1997, Nursing research.

[6]  L. Steinberg,et al.  Handbook of Adolescent Psychology: Lerner/Adolescent Psychology , 2004 .

[7]  M. Grey,et al.  Adaptation to chronic illness in childhood: diabetes mellitus. , 1991, Journal of pediatric nursing.

[8]  M. Grey,et al.  Stressors and self-care challenges faced by adolescents living with type 1 diabetes. , 2004, Applied nursing research : ANR.

[9]  E. Skinner,et al.  Searching for the structure of coping: a review and critique of category systems for classifying ways of coping. , 2003, Psychological bulletin.

[10]  N. White,et al.  Stress and Coping in Relation to Metabolic Control of Adolescents with Type 1 Diabetes , 1987, Journal of developmental and behavioral pediatrics : JDBP.

[11]  E. Chen,et al.  Prospective associations between coping and health among youth with asthma. , 2008, Journal of consulting and clinical psychology.

[12]  O. Søvik,et al.  The coping styles of adolescents with type 1 diabetes are associated with degree of metabolic control. , 2004, Diabetes care.

[13]  J. Weisz,et al.  Developmental Differences in Primary and Secondary Control Coping and Adjustment to Juvenile Diabetes , 1990 .

[14]  T. Skinner,et al.  Illness representations and coping as predictors of emotional well-being in adolescents with type 1 diabetes. , 2003, Journal of pediatric psychology.

[15]  B. Anderson,et al.  General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. , 2003, Diabetes care.

[16]  T. Wysocki,et al.  Paternal involvement in the management of pediatric chronic diseases: associations with adherence, quality of life, and health status. , 2006, Journal of pediatric psychology.

[17]  David A Cole,et al.  Latent variable analysis of coping, anxiety/depression, and somatic symptoms in adolescents with chronic pain. , 2006, Journal of consulting and clinical psychology.

[18]  B. Compas,et al.  Responses to stress in adolescence: measurement of coping and involuntary stress responses. , 2000, Journal of consulting and clinical psychology.

[19]  Ann S Masten,et al.  Resilience in developing systems: Progress and promise as the fourth wave rises , 2007, Development and Psychopathology.

[20]  W. Tamborlane,et al.  Personal and Family Factors Associated With Quality of Life in Adolescents With Diabetes , 1998, Diabetes Care.

[21]  M. Grey,et al.  Coping and Adaptation in Children with Diabetes , 1991, Nursing research.

[22]  J. Whitlock,et al.  Executive function, coping, and behavior in survivors of childhood acute lymphocytic leukemia. , 2008, Journal of pediatric psychology.

[23]  S. Luthar,et al.  The construct of resilience: a critical evaluation and guidelines for future work. , 2000, Child development.

[24]  K. Berlin,et al.  Attributions of adolescents with type 1 diabetes in social situations: relationship with expected adherence, diabetes stress, and metabolic control. , 2006, Diabetes care.

[25]  E. Dubow,et al.  Developmental and situational differences in coping among children and adolescents with diabetes. , 1995 .

[26]  E. Dubow,et al.  Contribution of Coping to Medical Adjustment and Treatment Responsibility among Children and Adolescents with Diabetes , 1994, Journal of developmental and behavioral pediatrics : JDBP.

[27]  E. Sanz.  Concordance and children's use of medicines , 2003, BMJ : British Medical Journal.

[28]  J. Willett,et al.  Psychological Adjustment to IDDM: 10-Year Follow-Up of an Onset Cohort of Child and Adolescent Patients , 1997, Diabetes Care.

[29]  V. Basevi.  Standards of medical care in diabetes--2007. , 2009, Diabetes care.

[30]  E B Fisher,et al.  I get by with a little help from my family and friends: adolescents' support for diabetes care. , 1995, Journal of pediatric psychology.

[31]  W. B. Daviss,et al.  Predicting diabetic control from competence, adherence, adjustment, and psychopathology. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[32]  Desmond E. Williams,et al.  The Burden of Diabetes Mellitus Among US Youth: Prevalence Estimates From the SEARCH for Diabetes in Youth Study , 2006, Pediatrics.

[33]  M. Grey,et al.  A pilot study of observed parenting and adjustment in adolescents with type 1 diabetes and their mothers. , 2010, Journal of pediatric psychology.

[34]  Auke Tellegen,et al.  The study of stress and competence in children: a building block for developmental psychopathology , 1984 .