Trajectories of Acute Diabetes-Specific Stress in Adolescents With Type 1 Diabetes and Their Caregivers Within the First Year of Diagnosis.

Objectives: Our aims were to describe stress trajectories for newly diagnosed type 1 diabetes (T1D) in adolescents and their parents, explore whether resilience is associated with stress trajectories, and to examine the effects of stress trajectories on diabetes-specific outcomes. Methods: Fifty-nine youth aged 10-18 years with newly diagnosed T1D and a primary caregiver were followed for 12 months. Stress and resilience were assessed using questionnaires every 3 months, and diabetes-specific outcomes (self-care, quality of life, and hemoglobin A1C) at 6 and 12 months. Parent and adolescent stress trajectories were identified using semiparametric group-based modeling. Results: Four stress trajectories emerged for parents and three emerged for adolescents. Adolescent trajectories were stable throughout the 12 months, and those with stable low stress had the highest levels of resilience. Further, the stable low stress group had higher quality of life scores at 12-month postdiagnosis. In contrast, stress for parents changed considerably over the 12-month period, and trajectory groups did not associate with 12-month outcomes. Conclusions: Distinct patterns of stress emerged for both the adolescent and parent cohorts. Resilience at the time of diagnosis was particularly protective for adolescents. These results suggest that stress-reducing and resilience-promoting interventions for newly diagnosed adolescents with T1D may have potential to improve longer-term outcomes.

The association of personal resilience with stress, coping, and diabetes outcomes in adolescents with type 1 diabetes: variable- and person-focused approaches.

This study explored the association between personal resilience and distress, coping, and diabetes outcomes in 50 adolescents with type 1 diabetes. Resilience was defined by a factor score derived from validated instruments measuring self-efficacy, optimism, and self-esteem. Variable- and person-focused methodologies were used to explore these associations. Low resilience was associated with higher distress, poor quality of life, and poor glycemic control. Participants with low resilience used more maladaptive coping strategies and were at greatest risk of poor outcomes. Findings suggest that resilience is a promising candidate for interventions designed to reduce distress and improve outcomes for adolescents with type 1 diabetes.