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Family and Child Characteristics Associated with Coping, Psychological Adjustment and Metabolic Control in Children and Adolescents with Type 1 Diabetes

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Title: Family and Child Characteristics Associated with Coping, Psychological Adjustment and Metabolic Control in Children and Adolescents with Type 1 Diabetes
Author: Wesley, Michelle
Department: Department of Psychology
Program: Psychology
Advisor: Preyde, Dr. MichèleGrand, Dr. Michael P.
Abstract: This thesis is an investigation of the factors that impact psychological adjustment and metabolic control in children and adolescents with type 1 diabetes. Studies suggest that aspects of the family environment (stressful life events, family functioning and parent mental health) and child characteristics such as age, sex, executive functioning and hopeful thinking impact psychological adjustment and metabolic control. There is also evidence that coping processes mediate these associations. The purpose of this study was to 1) explore and identify developmental differences in coping processes in a sample of children with T1D, 2) identify the family system characteristics that are associated with child coping processes and psychological adjustment, and 3) identify the family and child characteristics that impact metabolic control. Survey data were collected through convenience sampling from an outpatient hospital clinic. Children aged 8 to 17 completed self-reports of hopeful thinking and illness-related coping style. Caregivers provided demographic information and completed questionnaires on their child’s physical health, stressful life events, mental health, family functioning, as well as the child’s initiative, emotional control, and psychological adjustment. Ratings of child metabolic control (HbA1C) were also retrieved from hospital patient records. A predictive model examining direct and indirect contributions of the family environment and coping variables toward child adjustment and metabolic control was tested. Age and sex differences in children’s coping style were identified. Family functioning and parent mental health were found to predict child psychological adjustment. Coping processes, including avoidant coping, coping efficacy and executive functioning mediated relations between family functioning and child adjustment. Results provided partial support for a mediational model of family system characteristics that influence psychological adjustment in the sample. Family functioning and parent mental health had a direct impact on children’s psychological adjustment, as well as indirect effects on adjustment through coping processes (i.e., coping style, coping efficacy, initiative and emotional control). Child age was found to moderate some paths in the proposed model. Clinical and research implications are discussed.
URI: http://hdl.handle.net/10214/3641
Date: 2012-04
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