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Journal of Pediatric Psychology Advance Access originally published online on September 10, 2007
Journal of Pediatric Psychology 2008 33(5):497-508; doi:10.1093/jpepsy/jsm081
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Parent and Adolescent Distribution of Responsibility for Diabetes Self-care: Links to Health Outcomes

Vicki S. Helgeson, PhD1, Kerry A. Reynolds, PhD1, Linda Siminerio, PhD2, Oscar Escobar, MD3 and Dorothy Becker, MBBCh3

1Carnegie Mellon University, 2University of Pittsburgh Medical Center, and 3Children's Hospital of Pittsburgh

All correspondence concerning this article should be addressed to Dr Vicki S. Helgeson, Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA. E-mail: vh2e{at}andrew.cmu.edu.


  Abstract

Objective To examine the relation of adolescent and parent responsibility distribution for diabetes self-care to psychological and physical health. Methods We interviewed children (mean age 12 years) annually for 3 years and asked parents to complete a questionnaire. Both reported how diabetes self-care was distributed in the family. Amount of responsibility held by the child only, the parent only, and shared between child and parent was calculated. Psychological distress, competence, and diabetes outcomes were assessed at each wave. Results In both cross-sectional and longitudinal (lagged) analyses, multilevel modeling showed that shared responsibility was consistently associated with better psychological health, good self-care behavior, and good metabolic control, whereas child and parent responsibility were not. In some cases, links of shared responsibility to health outcomes were stronger among older adolescents. Conclusions These findings highlight the importance of shared responsibility for diabetes self-care through early to middle adolescence.

Key words: adolescence; diabetes; responsibility..

Received January 25, 2007; revision received August 14, 2007; accepted August 15, 2007


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