Diabetes-specific friend support in emerging adults with type 1 diabetes: Does satisfaction with support matter?

Youth with type 1 diabetes (T1D) must adhere to a complex treatment regimen to prevent health complications. Friends may provide diabetes-specific support to help youth manage diabetes, but evidence on whether youth benefit from diabetes-specific friend support is inconclusive. The present study first investigated whether satisfaction with friend support was linked to psychological distress and diabetes management. Second, it was investigated whether self-esteem mediated these relations. To this end, 324 Dutch-speaking emerging adults (17-28 years) with T1D completed questionnaires on diabetes-specific friend support, self-esteem, diabetes-specific distress, depressive symptoms, and self-care. HbA1c values were obtained from patients' physicians. Receiving diabetes-specific support from friends was associated with more diabetes-specific distress, but not for youth who were satisfied with the received support. Diabetes-specific friend support was not associated with other outcomes. Self-esteem did not mediate these relations. These results suggest that associations between diabetes-specific friend support and diabetes management are limited and that support satisfaction should be taken into consideration when examining the role of friend support for youth with T1D.

A Person-Centered Perspective on the Role of Peer Support and Extreme Peer Orientation in Youth with Type 1 Diabetes: A Longitudinal Study.

BACKGROUND: Despite clear evidence that peers are crucial for youth development, research on the role of peers for youth with Type 1 diabetes (T1D) is scarce. PURPOSE: The present study identified trajectory classes of perceived peer functioning in youth with T1D, based on peer support and extreme peer orientation (EPO). Further, classes were compared with respect to their trajectories of depressive symptoms, diabetes-specific distress, treatment adherence, and HbA1c values. METHODS: Five hundred and fifty-nine youth (14-25 years) with T1D completed questionnaires at baseline, 1, 2, and 3 years later. Latent class growth analysis identified classes of perceived peer functioning. Multigroup latent growth curve modelling assessed whether these classes were characterized by different trajectories of general and diabetes-specific functioning. RESULTS: A socially normative class (48%) was characterized by trajectories of high support and low EPO over time. A socially reserved class (29%) was characterized by low support and EPO, and a socially oriented class (17%) by high support and EPO. Finally, a socially vulnerable class (6%) was characterized by low support and high EPO. The normative class functioned significantly better over time than the other classes. The vulnerable class functioned significantly worse compared to the reserved class, despite experiencing equally low levels of support. CONCLUSIONS: The results underscore the need to take youths' orientation toward the peer context into account alongside support when tapping into the role of peers, because individuals with low levels of support and EPO functioned substantially better than individuals with similar low levels of support but high levels of EPO.

The Social Context and Illness Identity in Youth with Type 1 Diabetes: A Three-Wave Longitudinal Study.

Youth with type 1 diabetes are confronted with the challenging task of integrating diabetes into their identity. This integration process, referred to as illness identity, may play an important role in how youth with type 1 diabetes cope with normative and illness-specific challenges. In line with socio-ecological theorizing, the present study investigated the longitudinal interplay between illness identity and two important social contexts for youth, the parent and peer contexts. A total of 559 (54.5% female; mean age = 18.8 years) adolescents (14-17 years) and emerging adults (18-25 years) with type 1 diabetes completed questionnaires at three time-points with intervals of one year. A total of 98% of these participants had the Belgian nationality, and all of them spoke Dutch. At each time point, illness identity (i.e., acceptance, enrichment, rejection, and engulfment), peer support, extreme peer orientation, parental responsiveness, parental psychological control, and parental overprotection were self-assessed. The present findings show that overprotective parenting may lead to youth feeling engulfed by their diabetes. Further, when type 1 diabetes becomes adaptively integrated into youth's identity, the data suggest that youth may be better prepared to engage in healthy peer relationships. Thus, the present findings show that illness identity may be affected by the social context, and in turn may have an impact on parent and peer relationships as well. In general, the present findings underscore the importance of adaptive illness integration for youth with type 1 diabetes, and further emphasize the importance of achieving a coherent identity.

Developmental Change in Loneliness and Attitudes Toward Aloneness in Adolescence.

Adolescents are particularly vulnerable to experiencing feelings of loneliness. Changes in different social contexts and the inability to cope with these changes can result in different types of loneliness. According to the multidimensional view on loneliness, loneliness can be experienced in relationships with peers and parents and can be placed in a broader perspective by taking into account attitudes toward aloneness (i.e., positive and negative). However, we do not yet know how loneliness and attitudes toward aloneness develop across adolescence. These developmental trends were examined in two samples of Flemish adolescents consisting of 834 adolescents (61.9% girls, M age = 14.84; Sample 1), and 968 adolescents (58.6% girls, M age = 14.82; Sample 2), respectively. Adolescents filled out the Loneliness and Aloneness Scale for Children and Adolescents (LACA) during regular school hours on three (Sample 1) and four (Sample 2) measurement occasions with a 1-year interval. Latent growth curve modeling (LGCM) was applied. In line with theoretical notions, adolescents' parent-related loneliness and positive attitude toward aloneness were expected to increase, and adolescents' peer-related loneliness and negative attitude toward aloneness were expected to decrease. Clear evidence was found for the hypotheses regarding attitudes toward aloneness. The results regarding peer-related loneliness were inconsistent across samples and parent-related loneliness decreased, which was in contrast with theoretical expectations. In general, the two types of loneliness and attitudes toward aloneness changed in different directions during adolescence, suggesting the added value of a multidimensional view on loneliness.

Co-Brooding and Co-Reflection as Differential Predictors of Depressive Symptoms and Friendship Quality in Adolescents: Investigating the Moderating Role of Gender.

Co-rumination has been shown advantageous for friendship quality, but disadvantageous for mental health. Recently, two components have been distinguished, with co-brooding predicting increases in depressive symptoms and co-reflection decreases. The current study aimed to replicate these findings and investigated whether both components also show differential relations with friendship quality. Gender was investigated as a moderator. Path analyses were used on data of 313 adolescents aged 9-17 (50.5% girls). Co-brooding was related to more concurrent and prospective depressive symptoms in girls. Co-reflection predicted less concurrent and prospective depressive symptoms in girls and higher concurrent positive friendship quality for boys and girls. This study underscores the value of studying co-rumination components and suggests that boys and girls in this context differ in their pathways towards depression.

The Detrimental Effects of Adolescents' Chronic Loneliness on Motivation and Emotion Regulation in Social Situations.

In adolescence, when establishing and maintaining satisfying social relationships is a key developmental task, chronic loneliness is related to a host of negative outcomes. This study aimed at examining motivational and regulatory factors related to chronic loneliness. Specifically, this study investigated chronically lonely adolescents' responses to hypothetical vignettes of social inclusion and exclusion, thereby focusing on (a) adolescents' willingness and motivation to approach social inclusion and (b) emotion regulation strategies to deal with social exclusion. A total of 730 adolescents (Mage = 15.43 years, 72% female) participated in this four-wave study with annual loneliness assessments and hypothetical vignettes of social inclusion and exclusion at the final wave. After each social inclusion vignette, participants rated their willingness to accept the invitation for social inclusion and five types of motivation to approach the situation. After each social exclusion vignette, participants rated nine cognitive emotion regulation strategies. Compared to individuals following other trajectories, chronically lonely adolescents were less likely to accept invitations for social inclusion and the quality of their motivation for accepting such invitations was lower. Further, they were more likely to employ maladaptive emotion regulation strategies. In sum, this study adds significantly to understanding the motivational and regulatory processes that differentiate chronically lonely adolescents from adolescents following other trajectories.

Lonely adolescents exhibit heightened sensitivity for facial cues of emotion.

Contradicting evidence exists regarding the link between loneliness and sensitivity to facial cues of emotion, as loneliness has been related to better but also to worse performance on facial emotion recognition tasks. This study aims to contribute to this debate and extends previous work by (a) focusing on both accuracy and sensitivity to detecting positive and negative expressions, (b) controlling for depressive symptoms and social anxiety, and (c) using an advanced emotion recognition task with videos of neutral adolescent faces gradually morphing into full-intensity expressions. Participants were 170 adolescents (49% boys; Mage = 13.65 years) from rural, low-income schools. Results showed that loneliness was associated with increased sensitivity to happy, sad, and fear faces. When controlling for depressive symptoms and social anxiety, loneliness remained significantly associated with sensitivity to sad and fear faces. Together, these results suggest that lonely adolescents are vigilant to negative facial cues of emotion.

Parent-Adolescent Discrepancies Regarding Adolescents' Peer-Related Loneliness: Associations with Adolescent Adjustment.

Because loneliness is a subjective experience, it is often examined using self-reports. Yet, researchers have started to use other-reports to examine loneliness. As previous research suggests that discrepancies between self- and other views might have important implications for adolescents' mental health, the current study examines discrepancies in multi-informant reports on adolescents' loneliness in relation with prosocial behavior, aggression, and adolescents' parent-related loneliness. The sample consisted of 374 mother-adolescent dyads and 318 father-adolescent dyads (41.80% male, M age = 15.67 years, SD = 1.25). Results indicated that informants used different reference points to assess adolescents' peer-related loneliness, but were otherwise comparable. Moreover, informant discrepancies were associated with greater adolescents' reported parent-related loneliness. The current study did not provide evidence that discrepancies were related to prosocial or aggressive behavior. The current study adds to the notion that other-reports on loneliness show substantial convergence with self-reports. In addition, this study indicates that the discrepancy between other- and self-reports on loneliness holds valuable information for adolescent socio-emotional adjustment.

Loneliness and Attitudes Toward Aloneness in Adolescence: A Person-Centered Approach.

In adolescence, feeling lonely and dealing with time spent alone become particularly salient. The present study examined the co-occurrence of parent- and peer-related loneliness, and positive and negative attitudes toward aloneness, using cluster analysis. In three independent samples, covering about 1800 adolescents (61 % female), six meaningful groups were identified. These groups showed different associations with adolescents' self-esteem and personality, parental responsiveness and psychological control, and peer group functioning and friendships. An adaptive pattern of correlates was found for adolescents in three of the six groups, that is, the Indifference group (with rather low scores on the four constructs), the Moderate group (with moderate scores on the four constructs), and the Negative Attitude Toward Aloneness group. A rather maladaptive pattern of correlates was found for adolescents in the three other groups, that is, the Peer-Related Loneliness group, the Positive Attitude Toward Aloneness group, and the Parent-Related Loneliness group. More specifically, adolescents in the Peer-Related Loneliness and Positive Attitude Toward Aloneness groups may need assistance regarding their relations with their peers, whereas adolescents in the Parent-Related Loneliness group may need assistance regarding their relations with their parents. Implications of these findings for current understanding and optimal measurement of adolescents' loneliness and aloneness are discussed.

Parental support, internalizing symptoms, perceived health status, and quality of life in adolescents with congenital heart disease: influences and reciprocal effects.

Caring for adolescents with congenital heart disease requires attention to physical health but also to psychosocial functioning. Identifying how such psychosocial variables influence one another over time is important for designing health care strategies. The present study examined how depressive symptoms, loneliness, paternal and maternal support, and quality of life predicted one another. A total of 429 mid- to late adolescents with congenital heart disease (53.4 % boys) participated in a three-wave longitudinal study. Cross-lagged analyses indicated that depressive symptoms and loneliness mutually reinforced one another over time and led to relative decreases in quality of life. Paternal- and not so much maternal-support predicted relative decreases in depressive symptoms and loneliness and relative increases in quality of life. Maternal and paternal support, in turn, were negatively predicted by previous levels of adolescent depressive symptoms. In sum, important temporal sequences were uncovered potentially providing information for prevention and intervention targeting psychosocial functioning in adolescents with congenital heart disease.

The development of loneliness from mid- to late adolescence: trajectory classes, personality traits, and psychosocial functioning.

Although loneliness is a common problem across late adolescence, its developmental course has not been investigated in depth in this period of life. The present study aims to fill this gap by means of a five-wave cohort-sequential longitudinal study spanning ages 15 to 20 (N = 389). Both variable-centered (i.e., latent growth curve modeling) and person-centered (i.e., latent class growth analysis) approaches were used. Variable-centered analyses showed that loneliness generally decreased over time. Person-centered analyses pointed to considerable inter-individual differences in the development of loneliness, and identified five trajectory classes (i.e., stable low, low increasing, moderate decreasing, high increasing, and chronically high). These five trajectory classes were differentially related to personality traits at age 15 (i.e., extraversion, agreeableness, and emotional stability) and psychosocial functioning at age 20 (i.e., depressive symptoms, self-esteem, anxiety, and perceived stress). These findings underscore the additional value of studying subgroups regarding the development of loneliness.

Identity and perceived peer relationship quality in emerging adulthood: the mediating role of attachment-related emotions.

Identity formation and the perceived quality of one's peer relationships are theorized to be intimately linked in emerging adulthood. The present study examined the associations between identity styles (i.e., information-oriented, normative, and diffuse-avoidant styles) and the quality of relationships with peers (as indexed by friendship quality and loneliness) in a sample of 343 college students from Belgium. High scores for the information-oriented style were positively related to friendship quality, whereas high scores for the diffuse-avoidant identity style were positively related to loneliness. These direct associations were mediated, at least in part, by attachment-related emotions (i.e., avoidance and anxiety). These associations, both direct and indirect, provide the first evidence linking identity styles and the quality of peer relationships. Suggestions for future research are provided, both at the methodological and the conceptual level.

Identity processes and coping strategies in college students: short-term longitudinal dynamics and the role of personality.

Coping strategies and identity processes are hypothesized to influence one another over time. This three-wave longitudinal study (N = 458; 84.9% women) examined, for the first time, how and to what extent identity processes (i.e., commitment making, identification with commitment, exploration in breadth, exploration in depth, and ruminative exploration) and coping strategies (i.e., problem solving, social support seeking, and avoidance) predicted one another over time. Cross-lagged analyses indicated that processes of identity exploration seemed especially to be intertwined with different coping strategies over time, suggesting that identity exploration may resemble problem-solving behavior on the pathway to an achieved identity. Commitment processes were found to be influenced by certain coping strategies, although identification with commitment also negatively influenced avoidance coping. These temporal sequences remained significant when controlling for baseline levels of Big Five personality traits. Hence, evidence was obtained for reciprocal pathways indicating that coping strategies and identity processes reinforce one another over time in college students.

The interplay of loneliness and depressive symptoms across adolescence: exploring the role of personality traits.

Based on current theories of depression, reciprocal links between loneliness and depressive symptoms are expected to occur. However, longitudinal studies on adolescent samples are scarce and have yielded conflicting results. The present five-wave longitudinal study from mid- to late adolescence (N=428, M age at T1=15.22 years; 47% female) examined the direction of effect between loneliness and depressive symptoms, using cross-lagged path analysis. In addition, the robustness of these prospective associations was tested by examining the role of the Big Five personality traits (i.e., extraversion, conscientiousness, agreeableness, neuroticism, and openness) as explaining factors and moderators. Results indicated that loneliness and depressive symptoms influenced one another reciprocally, and these reciprocal associations were not attributable to their mutual overlap with personality traits. In addition, neuroticism was found to be a moderator, in that the bidirectional effects between loneliness and depressive symptoms were only found in adolescents high in neuroticism. Practical implications are discussed, and suggestions for future research are outlined.

Loneliness and depressive symptoms: the mediating and moderating role of uncontrollable ruminative thoughts.

Although feelings of loneliness often are accompanied by depressive symptoms, little is known about underlying mechanisms in this association. The present study sampled 370 college freshmen and investigated whether rumination (and its components of Uncontrollability, Causal Analysis, and Understanding) functioned as a mediator or moderator in the relationship between 2 types of loneliness (as experienced in the relationship with parents and with peers, respectively) and depressive symptoms. Results indicated that rumination partially mediated the relationship between peer-related loneliness and depressive symptoms and moderated the relationship between parent-related loneliness and depressive symptoms. In addition, the uncontrollable nature, rather than the content, of these ruminative thoughts about parent- and peer-related loneliness was particularly harmful in the development of depressive symptoms. Implications and suggestions for future research are discussed.

Lonely in Different Relationships: Bidirectional Effects between Parent- and Peer-Related Loneliness in Adolescence.

Although it is assumed that loneliness in one relationship might put one at risk of experiencing loneliness in another relationship, this association has rarely been examined as such. In this longitudinal study, we examined the associations between peer- and parent-related loneliness in a sample of 3391 adolescents across three waves (Mage Wave 1 = 14.53; 59.3% female). Using random intercept cross-lagged panel models, parent- and peer-related loneliness were found to be stable over time and were concurrently related to each other. Moreover, the state of peer-related loneliness predicted the state of parent-related loneliness one year later. Thereby, the current study provides limited evidence of a carry-over effect between relation-specific types of loneliness.

Identity styles and conflict resolution styles: associations in mother-adolescent dyads.

Adolescent identity and parent-adolescent conflict have each attracted considerable research interest. However, few studies have examined the important link between the two constructs. The present study examined the associations between adolescent identity processing styles and adolescent conflict resolution styles in the mother-adolescent dyad. Questionnaires about conflict frequency and resolution were completed by 796 adolescents (66% female, mostly Caucasian) and their mothers. Adolescents also completed a measure on identity styles. Each identity style was hypothesized to relate to a specific conflict resolution behavior. Hierarchical regression analyses showed that the information-oriented identity style was positively associated with positive problem solving and negatively with conflict engagement and withdrawal, the normative style was positively associated with compliance, and, finally, the diffuse-avoidant style was positively associated with withdrawal and conflict engagement and negatively with positive problem solving. Our results demonstrated that the way in which adolescents tackle identity-relevant issues is related to the way in which they deal with conflicts with their mothers. Implications and suggestions for future research are discussed.

A typology of coping with Type 1 diabetes in emerging adulthood: associations with demographic, psychological, and clinical parameters.

The present study set out to develop a typology of illness coping (as assessed through tackling spirit, illness integration, passive resignation, and avoidance coping) in a sample of 194 emerging adults (18-30 years) with Type 1 diabetes. Four groups, each with their own unique profile scores on illness coping, were identified through cluster analysis: active integrated, passive avoidant, high generic low integrated, and low generic high integrated coping. These clusters were differentiated on the basis of demographic, psychological (problem areas in diabetes, illness perceptions, depressive symptoms, and self-esteem), and clinical parameters (HbA(1c)-values indexing glycemic control). The active integrated cluster (and, to a lesser extent, the low generic high integrated cluster) evidenced the most optimal profile (i.e., better glycemic control, low depressive symptoms, etc.), the passive avoidant cluster (and, to a lesser extent, the high generic low integrated cluster) the least optimal profile. Implications for the study and practice of coping with a chronic illness are discussed.

Repetitive Negative Thinking outperforms loneliness and lack of social connectedness as a predictor of prospective depressive symptoms in adolescents.

BACKGROUND: Repetitive Negative Thinking (RNT) is a well-established predictor in adolescents of emotional problems, such as depression. Surprisingly little research, however, has looked at the relative importance of RNT vs. more interpersonally relevant variables in the context of depression, such as loneliness and lack of social connectedness. OBJECTIVE: The present study, therefore, set out to examine whether RNT is a significant predictor when taking into account the contribution of loneliness and social connectedness. METHODS: A sample of 135 typically developing adolescents (N = 135; 79.3% girls; M age = 17.5; range 16-21) completed measures of depressive symptoms, RNT, loneliness and social connectedness at two time points with a 3-month interval. RESULTS: Results showed that above and beyond baseline depressive symptoms, RNT was the only other significant predictor of prospective depressive symptoms. CONCLUSIONS: According to these results, RNT seems a relatively more important factor to consider in the context of adolescent depression than factors in the interpersonal or social context. Consequently, targeting RNT might be expected to yield more significant gains in reducing or preventing depressive symptoms in adolescents compared to focusing on feelings of loneliness or social connectedness - a hypothesis that remains to be tested.

Loneliness and social anxiety across childhood and adolescence: Multilevel meta-analyses of cross-sectional and longitudinal associations.

Social relationships are of vital importance for children's and adolescents' development, and disruptions in these relationships can have serious implications. Such disruptions play a central role in both loneliness and social anxiety. Although both phenomena are closely related, they have largely been studied separately, and important questions have remained unanswered concerning how both go together within and across time. Multilevel meta-analyses were performed on 102 cross-sectional studies, published between 1981 and 2016, including 41,776 participants (39% males) with a mean age of 15.59 years. Longitudinal associations were examined in 10 studies, including 3,995 participants (46% males), using a novel technique that enables the examination of such associations even when these were not reported in the original empirical studies. Results indicated a strong, positive cross-sectional association between loneliness and social anxiety symptoms. This associations did not systematically differ in strength across childhood and adolescence. Moreover, results showed that loneliness and social anxiety symptoms were reciprocally associated over time. To conclude, loneliness and social anxiety symptoms are positively associated both within and across time, and across childhood and adolescence. Breaking this vicious cycle is of great importance, as both phenomena may be associated with profound problems in multiple domains of youth development. Moreover, failing to pay attention to both loneliness and social anxiety symptoms might substantially reduce the effectiveness of intervention programs focusing on either of the two. (PsycINFO Database Record (c) 2019 APA, all rights reserved).