The Role of Parental Overreactivity and Laxness in Diabetes Outcomes Among Children and Adolescents With Type 1 Diabetes
Parental disciplinary behaviors, such as overreactivity and laxness, can negatively affect children's behavior and well-being. We examined overreactivity and laxness in relation to parental emotional well-being and the behavioral, glycemic, and psychological outcomes of children and adolescents with T1D. A cross-sectional survey was conducted at five pediatric diabetes centers. Parents provided demographic and clinical information and completed questionnaires assessing parenting behavior, diabetes-specific distress, and depressive symptoms. Children reported their frequency of glucose checking and diabetes distress. Correlation and regression analyses were used. Child age was stratified into three groups (7-10, 11-14, and 15-18 years) for subgroup analyses. A total of 677 parents (mean age = 43.9 [±6.3] years, 77.1% mothers) and 654 children (mean age = 12.4 [±2.8] years, 44.7%female, diabetes duration = 5.4 [±3.8] years) participated. With increasing child age, parents reported less overreactivity (r = -0.114, p = 0.003) and more laxness (r = 0.104, p = 0.007). Higher overreactivity and laxness were associated with greater parental diabetes distress (r = 0.335, p < 0.001; r = 0.119, p < 0.01) and more depressive symptoms (r = 0.314, p < 0.001; r = 0.100, p < 0.01). After adjusting for demographic and clinical variables, both disciplinary behaviors were significant factors in child diabetes distress, and laxness predicted less frequent glucose checking. Age-stratified analyses showed that overreactivity was linked to greater diabetes distress in children aged 7-10 years. Laxness was associated with fewer glucose checks in the 7-10 and 15-18-year groups and with higher HbA1c and diabetes distress in adolescents aged 15-18 years. Parents appear to use more overreactivity with younger children and more laxness as children age. Both behaviors are associated with poorer diabetes-related outcomes. Supporting effective parenting practices may improve psychological well-being and self-management of youth with T1D.Introduction
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