Parental Adjustment to Type 1 Diabetes

Although the majority of parents of children with type 1 diabetes adapt well, a subset of parents reports clinically significant psychological distress following initial diagnosis and throughout the course of their child's illness (e.g., Kovacs et al. 1990; Parker et al. 1994). Increased maternal psychological distress (e.g., symptoms of anxiety, somatiza-tion, anger, suspiciousness, depression, dysphoria) has been observed immediately following diagnosis. Parents of children with chronic illness have reported increased depressive symptoms (Mullins et al. 1995), greater negative affective states (Cadman et al. 1991), and higher global psychological distress (Chaney et al. 1997; Northam et al. 1996; Silver et al. 1998). Moreover, maternal distress after the ini tial diagnosis of child type 1 diabetes is highly predictive of subsequent maternal psychological symptomatology (Kovacs et al. 1990).

The transactional association between maternal distress and child distress has also been well documented in the literature in both medically well and non-medically well populations (Beardslee et al. 1983; Burge and Hammen 1991). Specifically, among children with type 1 diabetes, increased distress among fathers (Chaney et al. 1997) and mothers (Chaney 1991; Mullins et al. 1995) of children with type 1 diabetes predicted concurrent child psychological distress. Metabolic control of adolescents with diabetes has also been significantly associated with the physiological reactivity of parents to an acute stressor (Mengel et al. 1992). Such parent-child transactional relationships demonstrate the systemic nature of adjustment to chronic illness and argue for a family systems approach to the prevention of various forms of psychological distress in these populations.

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