Title

The role of parent-adolescent attachment in the glycemic control of adolescents with type-1 diabetes

Date of Award

12-2006

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Marriage and Family Therapy

Advisor(s)

Linda Stone Fish

Keywords

Parent-adolescent attachment, Glycemic control, Adolescents, Diabetes

Subject Categories

Health Psychology | Marriage and Family Therapy and Counseling

Abstract

Using Bowlby's attachment theory and family systems theories, this study explored the associations between parent and adolescent reports of adolescent attachment and glycemic control in adolescents with Type 1 diabetes. I hypothesized that more secure attachment would correlate with better diabetes control, as would concordance between parents and adolescents. Method. Thirty-one families recruited from a diabetes treatment center or the Juvenile Diabetes Association completed written self-report questionnaires about adolescent attachment (Inventory of Parent and Peer Attachment (IPPA; Armsden & Greenberg, 1987)), demographic data and diabetes control (hemoglobin A1c, perceived overall control). Adolescents and parents reported on their perceptions of adolescents' attachment to mothers and fathers. Results. Mean HbA1c for the sample was 7.6% (SD= 1.14). Mothers' perceptions of adolescents' attachment were negatively correlated with adolescents' hemoglobin A1c ( r = -.42, p = .022). Neither fathers' perceptions nor adolescents' reports of attachment was significantly correlated with glycemic control. Adolescents' reports of attachment to mothers and fathers were significantly correlated with perceived control. HbA1c was correlated with perceived control of all members. I found no significant differences between mother and father reports of attachment with their adolescent or for male and female adolescents' attachment to either parent. In regression analyses, adolescent differences in reports of mother- and father-attachment ( p = 51, R 2 Δ = .03) and differences in mothers' and fathers' attachment were not significantly associated ( p = .65, R 2 Δ = .10) with perceived control. Adolescent differences in reports of mother- and father-attachment were not associated with perceptions of control, nor were adolescent-mother differences ( p = .19, R 2 Δ = .06), adolescent-father differences, or mother-father differences in perceptions of adolescent attachment ( p = .48, R 2 Δ = .09). Conclusions. Attachment appears to be associated with glycemic control in this population though the mechanisms are unclear. However, mother perceptions of attachment had the strongest associations with control, not adolescent reports. Parents' abilities to be emotionally responsive, engaged, trustworthy, and autonomy supportive, may enable adolescents to manage diabetes more successfully. Further research is needed to understand the mechanisms through which parent reports of adolescent attachment are associated with glycemic control.

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