Association of executive function problems and disordered eating behaviours in teens with type 1 diabetes.

Abstract

To explore cross-sectional associations between executive function problems and disordered eating behaviours in teens with type 1 diabetes. Executive function was assessed by the Behavior Rating Inventory of Executive Function (BRIEF), self-report and parent proxy-report versions. Scores ≥60 (on Global Executive Composite, Behavioral Regulation Index, Metacognition Index or clinical scales) indicated problems with executive function. Disordered eating behaviour was assessed by the Diabetes Eating Problem Survey Revised (DEPS-R) and categorized as follows: <10 low, 10-19 moderate and ≥20 high. In the 169 teens (46% girls, median age 16.0years [range 13.7-18.7], median diabetes duration 8.9years [range 1.4-16.6]), 29% had moderate and 12% had high level of disordered eating behaviours. Executive function problems were present in 9% by self report and 26% by parent proxy-report. Among teens with moderate/high level of disordered eating behaviours, 19% had executive function problems by self report (vs. 2% of teens with low level of disordered eating behaviours, p<0.001) and 33% had executive function problems by parent proxy-report (vs. 20% of teens with low level of disordered eating behaviours, p=0.056). A greater level of disordered eating behaviours was associated with executive function problems by teen self report on the General Executive Composite (p<0.001), Behavioral Regulation Index (p<0.001), emotional control clinical scale (p<0.001), shift clinical scale (p<0.001) and by parent proxy-report on the task initiation clinical scale (p=0.008). Assessing executive function and screening for disordered eating behaviours in teens with type 1 diabetes could help identify a subset of teens at high risk for adverse outcomes and need for intervention.