Abstract
Mother-child interactions around a shared activity have been shown to play a key role in the development of young children’s capacity to interact cooperatively with others. This evidence is particularly germane to type 1 diabetes (T1D) management in younger children where cooperation with parental treatment efforts is crucial for treatment success and where maternal distress and child behavioural problems are risk factors for treatment management, biomedical and psychological outcomes. In 49 4-to-8 year old children with T1D, we investigated whether the association between maternal affect and child problematic behaviour is mediated by mother-child interactions in the context of a T1D-relevant collaborative problem-solving activity. Mothers completed standardised measures of maternal and child psychological adjustment and interacted with their children in the problem-solving activity, analysed for quality of interpersonal engagement based on evaluations of maternal (sensitivity and cognitive stimulation) and dyadic (joint attention and warmth) behaviours. Mediation analyses confirmed the hypothesis that interpersonal engagement mediates the relation between maternal affective state and child behavioural problems. Specifically, more negative maternal affect is associated with lower levels of interpersonal engagement; these less engaged interactions in turn are associated with more behavioural problems in children. These findings are consistent with research involving typically developing children. The implications of our findings are twofold. First, in the context of psychological adjustment to T1D, maternal affect and mother-child interactions are 2 potential targets for interventions which promote cooperative interactions. Second, understanding and caring for children at biological risk requires attention to developmental psychology theory and method; in particular, research addressing parent-child cooperation carries both conceptual and clinical relevance.
Highlights
A guiding principle in early childhood socialisation research is that young children’s capacity to interact cooperatively with others develops through social experience
The development of a single variable attenuated the risk of type I error and the developmental research literature shows that the behaviours included in interpersonal engagement are associated with maternal affective state and behavioural adjustment in young children [32,34,35,38]
Younger children with type 1 diabetes (T1D) are relatively understudied in the illness adjustment literature, research findings consistently indicate that maternal distress, parent-child interaction difficulties and child behavioural problems are potent risk factors for more adverse outcomes [3,4,5,6,7,8,9]
Summary
A guiding principle in early childhood socialisation research is that young children’s capacity to interact cooperatively with others develops through social experience. Fundamental to this research is the premise that in early childhood, children’s ability to cooperate with environmental demands and expectations in the short-term and, to self-regulate in accordance with such external exigencies in the long-term, is developed through participation in shared activities with adults such as parents [1]. This view has particular resonance in relation to small children with type 1 diabetes (T1D) where treatment management must follow a developmental trajectory from cooperation with parental treatment efforts in early childhood to independent self-care capability in adolescence. We investigated whether the association between maternal affect and problematic behaviour in young children with T1D is mediated by mother-child interaction
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