Psychological care of youth with type 1 diabetes (T1D) as well as type 2 diabetes (T2D) is covered. • Additional sections on the psychological assessment, communication, the health care team and psychological impact of technology are added 2 | EXECUTIVE SUMMARY AND RECOMMENDATIONS 2.1 | Collaborative care • Psychosocial care should be integrated with collaborative, personcentered medical care and provided to all youth with diabetes and their families. A • Professionals with expertise in the mental health of children and adolescents are essential members of interdisciplinary diabetes health care team. B • Mental health professionals should be available to interact with youth and their families, and also to support the diabetes team in the recognition and management of mental health and behavior problems. C • It is preferable that mental health specialists who interact with children with diabetes have training in diabetes and its management. E 2.2 | Integrating psychosocial assessments in routine diabetes care • Age-appropriate and validated assessment tools should be routinely implemented in clinical practice to monitor and discuss
Nonsuicidal self-injury (NSSI) is a complex behaviour and occurs most commonly during adolescence. This developmental period is characterized by the drive to establish an equilibrium between personal autonomy and connectedness with primary caregivers. When an adolescent self-injures, caregivers often experience confusion about how to react. Reports of feeling guilt, fear, and shame are common in the wake of learning about a child's self-injury. This cascade of negative feelings and self-appraisals may lead to hypervigilance and increased caregiver efforts to control the child's behaviour. The adolescent may experience this as an intrusion, leading to worse family functioning and increased risk of NSSI. This cascade is not well acknowledged or articulated in current literature. This article remedies this gap by presenting the NSSI Family Distress Cascade.
To assess Belgian siblings' self-reported quality of life (QoL) and the impact of illness on four different paediatric illnesses. Healthy siblings (n = 131) of children with type 1 diabetes, cancer, congenital heart disease (CHD) and cystic fibrosis (CF) completed the Child Health Questionnaire and the Sibling Perception Questionnaire. Results were compared to those of a matched group of siblings of healthy children. Siblings reported a good QoL, similar to controls, with the exception that siblings reported better on the QoL domain pain (p < .01). QoL was not related to time since diagnosis but the impact of illness was higher nearer to the time of diagnosis (r = -.39, p < .001). QoL of siblings of children with CHD or cancer was lower than QoL in the CF or type 1 diabetes group whilst impact of illness was highest for the CHD group. QoL of siblings of a child with a chronic illness is similar to the QoL of peers. Studies investigating siblings' QoL or the impact of illness on siblings should include the day-to-day demands of the illness as well as less obvious illness-related issues like 'hidden stress' and 'sense of control'.
In the present study, the relationships among parental drinking, family environment, and child adjustment is investigated in a community sample of 207 10-14-year-olds. Multiple aspects of perceived family environment (e.g., cohesion, organization, conflict) as well as multiple indicators of adjustment (e.g., negative affect, feelings of competence, self-esteem) are taken into consideration. Parental alcohol problems are found to be associated with low family cohesion, poor family organization, and low global self-worth of the child. A mediational analysis reveals that the relation between parental drinking and low global self-worth is mediated by family cohesion.
Disturbed eating behavior (DEB) is prevalent in youth with type 1 diabetes and is accompanied by an increased risk for complications, morbidity, and mortality. Prospective studies on DEB in the challenging transition to adulthood are scarce. This longitudinal study examined DEB over a 1-year period and investigated the directionality of effects linking DEB to diabetes-specific functioning and depressive symptoms in adolescents and emerging adults. RESEARCH DESIGN AND METHODS Three hundred youth (16-28 years old) with type 1 diabetes participated in a twowave longitudinal study. Questionnaires measured DEB (Diabetes Eating Problem Survey-Revised [DEPS-R]), self-management, diabetes distress, and depressive symptoms. HbA 1c values were obtained from physicians. Mixed ANOVA and crosslagged analysis were used to examine prospective changes and directionality of effects, respectively. RESULTS Mean DEB remained stable in the total sample, but significant individual differences were observed based on the cutoff score of the DEPS-R: 19% displayed persistent DEB and 8% increased and 7.3% decreased in DEB over time. The remaining individuals scored low on DEB over time. These four groups were differentiated based on insulin restriction, omission, diabetes-specific functioning, and depressive symptoms. Cross-lagged analyses indicated that DEB predicted relative increases in depressive symptoms over time, whereas reciprocal associations with glycemic control were found. CONCLUSIONS This longitudinal study highlights the substantial impact DEB may have in the transition to adulthood, with a substantial portion of youth with type 1 diabetes being at risk for clinical DEB. Prospective pathways linking DEB to functioning were found, emphasizing the clinical relevance of assessing DEB over time. Type 1 diabetes constitutes a risk factor for developing disturbed eating behavior (DEB), including unhealthy weight-management behaviors, such as skipping meals, binge eating, and purging, as well as more severe eating disorders (1,2). DEB constitutes a substantial concern, as up to 30% of adolescent girls with type 1 diabetes display DEB (3-5
Aims: The aim of this study was to compare families with a child (2-12 years) with type 1 diabetes (T1D) to families which are not confronted with chronic illness, with regard to children's well-being, parental distress, and parenting behavior. In addition, differences were explored between families whose child has optimal vs suboptimal glycemic control.Methods: Mothers, fathers, and children of 105 families with pediatric T1D completed questionnaires assessing child well-being, parental distress, and parenting. The control group consisted of 414 families without chronic illness.Results: With regard to child well-being, children with T1D had more adjustment difficulties (as reported by mothers) and lower quality of life (QoL) (as reported by mothers and fathers), whereas children themselves (8-12 years) reported higher QoL compared to controls. In terms of parental distress, mothers, but not fathers, of children with T1D reported more stress, anxiety symptoms, and depressive symptoms than controls. With regard to parenting behavior, parent reports revealed less protectiveness in fathers and less autonomy support and responsiveness in both parents as compared to controls. No differences were found in parent-reported psychological
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