Child Temperament and Differential Susceptibility to Parenting: Implications for Self-Management and Glycemic Control among Pediatric Type 1 Diabetes Patients

• In Event: Physical and mental health across the lifecourse

Abstract

Type 1 Diabetes Mellitus (T1DM) is a potentially deadly chronic autoimmune disease most commonly diagnosed during middle childhood to adolescence. Management of T1DM involves the maintenance of glycemic control and requires a daily regimen of health behaviors demanding high levels of self-regulation and parental involvement. Correspondingly, research suggests that children with high temperamental effortful control (EC; ability to suppress a dominant response to perform a subdominant response) and low negative affectivity (NA; heightened reactivity to negative emotional stimuli) achieve better glycemic control. Moreover, parents who provide frequent treatment-related assistance (e.g., helping to administer insulin) and support (e.g., encouraging, collaborative decision-making) and infrequent negative parenting (e.g., nagging, criticizing) facilitate better illness management. However, it is unclear whether and how parent and child factors interact to affect children’s glycemic control. The differential susceptibility hypothesis proposes that children with certain temperamental vulnerabilities may be more susceptible to the deleterious effect of negative parenting but also reap greater benefit from positive parenting. To elucidate the nature of joint parent and child influences on T1DM treatment, the present study tested the differential susceptibility hypothesis in a pediatric sample.
Participants included 103 dyads of children with T1DM (Mage=11.9, SD=2.5; male=58%) and their parent. Participant recruitment experienced delays due to COVID-19 but is ongoing and aims to reach n=125 by spring 2021. Parents reported demographic information, child temperament, and diabetes-specific parenting behaviors. Treatment information was obtained through children’s medical records. Preliminary results from a multiple regression analysis using maximum likelihood indicated that high child NA was significantly associated with poorer glycemic control (see Table 2). The interaction effects of NA and parental support, EC and behavioral assistance, and EC and support were significant. Analyses of conditional effects demonstrated that NA was only significantly associated with poorer glycemic control at low (i.e., one SD below the mean; B=1.05, SE=0.34, p =.00) and average (B=0.55, SE=0.23, p=.02) levels of parental support, but not at high levels of support. Low EC was significantly associated with better glycemic control at high levels of parental assistance (B=0.58, SE=0.27, p=.03), but not at average or low levels of assistance. In contrast, low EC was associated with better control at low levels of parental support (B=0.60, SE=0.29, p=.04), but not at average or high levels of support. Overall, the model accounted for 31.7% of the variance in child glycemic control.
Findings provide preliminary support for the need to tailor the quality and quantity of parental involvement in pediatric T1DM treatment depending on children’s temperamental reactivity and regulation. Specifically, offering ample parental support may be critical to help children with high negative affectivity maintain healthy glycemic control. Results regarding EC appear mixed and require further investigation. On the one hand, consistent with the hypothesis, children with low EC may particularly benefit from greater behavioral assistance from their parents; on the other hand, they may maintain better glycemic control than those with high EC when receiving low parental support. Results will be replicated in a full sample upon completing recruitment.

Authors

• Anna J Yeo, State University of New York at Albany (SUNY Albany)
  Presenting Author

• Leslie F Halpern, State University of New York at Albany
  Non-Presenting Author

• Betty Lin, State University of New York at Albany (SUNY Albany)
  Non-Presenting Author

• Linda Riddick, Australian Maritime College
  Non-Presenting Author

• Daniela Sima, Australian Maritime College
  Non-Presenting Author

• Kristine M Wohlfahrt, Australian Maritime College
  Non-Presenting Author

• Nancy Jones, Australian Maritime College
  Non-Presenting Author