The Role of Autonomy and Pubertal Status in Understanding Age Differences in Maternal Involvement in Diabetes Responsibility across Adolescence

• Published in: Journal of pediatric psychology 2004-01, Vol.29 (1), p.35-46
• Main Authors: Palmer, Debra L., Berg, Cynthia A., Wiebe, Deborah J., Beveridge, Ryan M., Korbel, Carolyn D., Upchurch, Renn, Swinyard, Michael T., Lindsay, Rob, Donaldson, David L.
• Format: Article
• Language: English
• Subjects: Adolescent; adolescents; Adult; age; Age Factors; Attitude to Health; autonomy; Biological and medical sciences; Child; diabetes; Diabetes Mellitus - psychology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Male; Management. Various non-drug treatments. Langerhans islet grafts; Maternal Behavior; Medical sciences; Mother-Child Relations; mothers; Personal Autonomy; pubertal status; Puberty - physiology
• ISSN: 0146-8693; 1465-735X
• DOI: 10.1093/jpepsy/jsh005

Objective To examine how autonomy and pubertal status explain age decreases in maternal involvement in type 1 diabetes management across adolescence, how they relate to metabolic control, and the reasons that guide declines in maternal involvement. Methods One hundred twenty-seven children ages 10–15 years with type 1 diabetes and their mothers participated. Data included maternal and child report of diabetes management, child report of autonomy level, maternal report of pubertal status, maternal reports of reasons for transfer of diabetes responsibility, and glycosylated hemoglobin (Hba1c) values. Results Autonomy and pubertal status partially mediated age effects on reports of maternal involvement. Mothers' reasons for transferring responsibility included responding to the child's competence, promoting competence and maturity in their child, and minimizing hassles and conflict. The transfer of diabetes responsibility from mother to child without sufficient autonomy and when pubertal status was low was related to higher Hba1c values. Conclusions The importance of chronological age for changes in maternal involvement suggests the need to examine mothers' and adolescents' developmental expectations for diabetes management. The reasons for transferring responsibility from mother to child suggest many avenues for intervention.