Body Image Mediates Negative Family Climate and Deteriorating Glycemic Control for Single Adolescents With Type 1 Diabetes

摘要

Introduction: Glycemic control declines during adolescence, as youth with diabetes struggle with pubertal changes and a changing social world. The present study tests whether body image mediates longitudinal links between family climate and changes in adolescent glycemic control. Mediation was hypothesized for nondating adolescents but not for dating adolescents, because the former are thought to remain more family oriented than the latter. Method: Participants were German adolescents with Type 1 diabetes (51 girls, 58 boys; M = 15.84 years, SD = 1.44). Participants reported body image and family climate. Physicians assayed blood HbA1c levels (M = 8.22%, SD = 1.80%) to measure glycemic control. Results: For nondating adolescents, body image mediated associations between family climate and longitudinal changes in glycemic control. Poorer family climate was associated with poorer body image, which predicted deteriorating glycemic control. For dating adolescents, family climate was unassociated with changes in glycemic control. Discussion: Nondating adolescents may look to parents for feedback on body image, which affects how they manage the challenges of diabetes. Parents and practitioners alike should be alert to the fact that family climate continues to be an important determinant of adolescent adjustment, particularly for those who have not moved into romantic relationships. We know that body image matters to adolescents, but for some youth, body image may be the difference between health and serious physical problems.