Depleted parental psychological resources as mediators of the association of income with adherence and metabolic control

Abstract

For adolescents with Type 1 diabetes, lower family income may be associated with poorer diabetes management through depleted parental psychological resources (i.e., higher parental depressive symptoms, lower parental acceptance). Adolescents (N = 252; 46% male) aged 10-14 years with Type 1 diabetes assessed the acceptance of their mother and father (e.g., "gives me the feeling that she likes me as I am"; "she doesn't feel she has to make me over into someone else"). Mothers provided information on family income and demographics. Both mothers and fathers reported their depressive symptoms. HbA1c scores were indexed via medical records. Lower family income was associated with higher (i.e., worse) HbA1c, more mother and father depressive symptoms, and less acceptance from both parents. Mediation analyses revealed that the relationship of lower family income with metabolic control occurred indirectly through lower maternal and paternal acceptance and lower adherence. Lower family income may impair the quality of parent--adolescent relationships that are beneficial for good diabetes management.

Figure 1

Results of a structural model depicting associations between family income and adolescent diabetes outcomes: Yuanχ² Yuan-Bentler (27, n = 252 = 43.786, p = .038; CFI = .984; RMSEA = .029. Significant correlations and standardized path coefficients (p<.05) are presented as solid lines; non-significant parameters are presented as dashed lines.