Associations Between Emotion Expressions, Familism Values, and Physical/Mental Health in Latinx Adolescents with Type 1 Diabetes

• In Event: Acculturation and Cultural Values

Abstract

Adolescents’ emotions are central to effective type 1 diabetes (T1D) management. For example, effective emotional processing and self-control strategies predict better T1D management and less negative affect for adolescents with T1D (Hughes et al., 2012) and those with worse emotion regulation tend to have poorer diabetes management through high diabetes distress (Fisher et al., 2018). Literature is mixed regarding whether Latinx youth have worse diabetes management compared with other ethnic groups (Nicholl et al., 2019). Familism is central to Latinx culture which may be an important factor for T1D management for Latinx adolescents (Fuller & García Coll, 2010). and familism generally has a protective effect on mental health outcomes in Latinx youth (Valdivieso-Mora et al., 2016). However, it is unclear how familism might attenuate associations between adolescent emotional expressions during interactions with their parents and their physical and mental health. We focused on adolescents’ sadness expressions due to the important role of sadness regulation in depression (Millgram et al., 2018) and the expression of sadness as central to support solicitation during interpersonal interactions (Fletcher et al., 2020).
This study examined associations between adolescents’ emotional expressions of sadness displayed during interactions with parents, adolescents’ familism values, and adolescents’ physical and mental health (glycemic control, diabetes self-management, health-related quality of life, and depressive symptoms) in a Latinx sample of adolescents with T1D (N=68, Mage=12.74 years) and their parents. We hypothesized adolescents who expressed more sadness and endorsed lower familism would experience more depressive symptoms and have higher (worse) glycemic control, lower diabetes self-management, and lower health-related quality of life. Parents and adolescents participated in a conflict discussion related to the adolescent’s diabetes management. Adolescents’ emotional expressions during the conversation were coded by using the Coding Expression of Emotions coding system (Cameron & Overall., 2012). Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (Radloff, 1977) and health-related quality of life was measured with the Pediatric Quality of Life Inventory Generic Core Scales (PQOL; Varni et al., 2003). Glycemic control was indexed using glycosylated hemoglobin (HbA1c) obtained from clinic records. Parents and adolescents reported on adolescents’ diabetes self-management (e.g., checking blood glucose) using an adapted version of the Self-Care Inventory (Lewin et al., 2009). Adolescents’ familism was measured with support, respect, and obligation subscales of the Mexican American Cultural Values Scale (Knight et al., 2010).
To test whether associations between adolescents’ sadness and physical/mental health were moderated by adolescents’ familism, 4 hierarchical multiple regression analyses were conducted. Somewhat consistent with hypotheses, results revealed greater sadness expression predicted lower health-related life quality (ß = -.34, p = .00) and parent-reported self-management (ß = -.32, p = .03). Consistent with hypotheses, adolescents who expressed more sadness and endorsed lower familism had higher HbA1c (see Figure 1). Conversely, adolescents who expressed more sadness and endorsed lower familism had higher parent-reported adherence (see Figure 2). Results suggest that there may be benefits of familism for T1D management in Latinx adolescents, though effects vary depending on the type of physical and mental health outcome.

Authors

• Shun Ting Yung, University of California, Merced
  Presenting Author

• Alexandra Main, University of California, Merced
  Non-Presenting Author

• Deborah Wiebe, University of California, Merced
  Non-Presenting Author

• Maria D. Ramirez Loyola, University of California, Merced
  Non-Presenting Author

• Linda Cameron, University of California, Merced
  Non-Presenting Author

• Jennifer Raymond, Children's Hospital Los Angeles
  Non-Presenting Author