The Role Of Authoritative Parenting In Type 1 Diabetes Adolescent Outcomes

Abstract

THE ROLE OF AUTHORITATIVE PARENTING IN TYPE 1 DIABETES ADOLESCENT OUTCOMES By Zach Radcliff, B. S. A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University. Virginia Commonwealth University, 2014 Director: Dr. Bruce Rybarczyk, Professor of Psychology Due to psychosocial and hormonal changes, adolescents with Type 1 Diabetes (T1D) are at risk for poorer regimen adherence, quality of life (QOL), and glycemic control (HbA1c). Authoritative parenting (AP) supports youth development during the transition into adolescence. To date, the mechanisms behind authoritative parenting and better HbA1c are yet to be examined. Parent-youth dyads completed measures of authoritative parenting, adherence, and QOL. As hypothesized, more authoritative parenting related to higher socioeconomic status (SES; β = -.13, p = .04) rather than ethnicity. Further, more authoritative parenting related to better glycemic control via the mechanisms of higher youth QOL (β = .24, p < .001) and better diabetes adherence (β = .17, p = .008). Parents who provide more authoritative parenting have youth with better QOL, better adherence, and better glycemic control. More authoritative parenting helps youth achieve better diabetes care and quality of life during the transition into adolescence. The Role Of Authoritative Parenting In Type 1 Diabetes Adolescent Outcomes Type 1 diabetes (T1D) is one of the most common pediatric medical conditions with more than 15,000 new diagnoses each year (Imperatore et al., 2012). In 2010, 2.4 per 1,000 youth under age 20 had T1D in the United States (Menke et al., 2013), compared to 1.5 per 1,000 in 2001 (SEARCH for Diabetes in Youth Study Group, 2006). As the incidence increases each year (Stanescu, Lord, & Lipman, 2012), the average age at diagnosis steadily decreases (SEARCH for Diabetes in Youth Study Group, 2007; Vehik et al., 2009). Given that T1D is most commonly diagnosed during childhood, parents play an integral role in TID management. T1D is a complex illness with a multifaceted regimen to which youth and their parents must adhere. The transition to adolescence is often characterized by a decrease in regimen adherence and blood glucose control as youth struggle to manage tasks amidst other developmentally normative activities (Amed et al., 2013). Parental involvement is especially critical during the adolescent transition when youth assume more responsibility for disease care. More specifically, parenting style, the strategies parents utilize in child rearing, might have implications for youth regimen adherence (Mlynarczyk, 2013). Parenting style also improves youth quality of life (QOL), as supportive parents foster positive views of T1D and its associated regimen (Lawrence et al., 2012; Mlynarczyk, 2013). The proposed study will examine the relation between parenting style and youth diabetes outcomes (adherence, QOL, and glycemic control). Insulin Dependent Diabetes Mellitus Type 1 Diabetes (T1D), or insulin dependent diabetes mellitus, is an auto-immune disease that destroys beta cells in the pancreas (Gorrell, Williams, & Powell, 2003). Beta cells are responsible for the production and secretion of insulin, which regulates glucose uptake in the