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Journal of Pediatric Psychology Advance Access published online on May 22, 2006
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsj122
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Journal of Pediatric Psychology © The Author 3333. 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
Received August 25, 2005
Revised March 31, 2006
Accepted April 12, 2006

Article

Decision-Making Competence and Adherence to Treatment in Adolescents with Diabetes

Victoria A. Miller PhD 1 * and Dennis Drotar PhD 2

1 Department of Psychology, Case Western Reserve University, Philadelphia, Pennsylvania 19104
2 Case Western Reserve University School of Medicine and Rainbow Babies and Children’s Hospital, Philadelphia, Pennsylvania 19104

* To whom correspondence should be addressed.
Victoria A. Miller, E-mail: millerv{at}email.chop.edu


  Abstract

Objective To examine decision-making competence (the ability to form effective plans for managing different situations) in a sample of adolescents with type I diabetes and their parents. We hypothesized that adolescent decision-making competence would mediate the relationship between parent-adolescent communication and adherence to treatment. Methods The sample consisted of 63 adolescents and their parents. Parent-adolescent communication during a problem-solving task was assessed, as well as adolescent maladaptive decision-making (adolescent report), adherence to treatment (parent and provider report; number of glucose tests), and metabolic control (HbA1C). Results Parent-adolescent communication was associated with adherence to treatment but not with adolescent decision-making. Poorer decision-making was associated with lower adherence per parent report but not provider report or the number of glucose tests. Decision-making competence did not mediate the relationships between parent-adolescent communication and adherence. Conclusions These results are consistent with prior research demonstrating associations between parent-adolescent communication and adherence and identify adolescent decision-making competence as another potentially important correlate of adherence. These findings highlight several areas for future research.

Keywords: adherence; decision-making; parent-adolescent communication; type I diabetes.
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