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Description
Type 1 Diabetes Mellitus (T1DM) is a chronic disease that requires maintaining tight metabolic control through complex behavioral and pharmaceutical regimens. Subtle cognitive impairments and stress response dysregulation may partially account for problems negotiating life changes and maintaining treatment adherence among emerging adults. The current study examined whether young adults with T1DM physiologically respond to psychological stress in a dysregulated manner compared to non-diabetic peers, and if such individuals also demonstrated greater cognitive declines following psychological stress. Participants included 23 young adults with T1DM and 52 non-diabetic controls yoked to T1DM participants based on age, gender, ethnicity, participant education, and maternal education. Participants completed a laboratory-based social stressor, pre- and post-stressor neurocognitive testing, provided fingerstick blood spots (for glucose levels) and salivary samples (for cortisol levels) at five points across the protocol, and completed psychosocial questionnaires. Related measures ANOVAs were conducted to assess differences between T1DM participants and the average of yoked controls on cortisol and cognitive outcomes. Results demonstrated that differences in cortisol reactivity were dependent on T1DM participants' use of insulin pump therapy (IPT). T1DM participants not using IPT demonstrated elevated cortisol reactivity compared to matched controls. There was no difference in cortisol reactivity between the T1DM participants on IPT and matched controls. On the Stroop task, performance patterns did not differ between participants with T1DM not on IPT and matched controls. The performance of participants with T1DM on IPT slightly improved following the stressor and matched controls slightly worsened. On the Trail Making Test, the performance of participants with T1DM was not different following the stressor whereas participants without T1DM demonstrated a decline following the stressor. Participants with and without T1DM did not differ in patterns of performance on the Rey Verbal Learning Task, Sustained Attention Allocation Task, Controlled Oral Word Association Task, or overall cortisol output across participation. The results of this study are suggestive of an exaggerated cortisol response to psychological stress in T1DM and indicate potential direct and indirect protective influences of IPT.
ContributorsMarreiro, Catherine (Author) / Luecken, Linda (Thesis advisor) / Doane, Leah (Thesis advisor) / Barrera, Manuel (Committee member) / Aiken, Leona (Committee member) / Arizona State University (Publisher)
Created2013
Description
Family plays an important yet understudied role in the development of psychopathology during childhood, particularly for children at developmental risk. Indeed, much of the research on families has actually concentrated more on risk processes in individual family members or within-family subsystems. In general, important and complex associations have been found among family-related constructs such as marital conflict, parent-child relationships, parental depression, and parenting stress, which have in turn been found to contribute to the emergence of children's behavioral problems. Research has begun to emerge that certain family system constructs, such as cohesion, organization, and control may influence children's development, but this research has been limited by a focus on parent-reports of family functioning, rather than utilizing observational methods. With notable exceptions, there is almost no observational research examining families of children at developmental risk. This study examined the longitudinal relations among family risk and family system constructs, as well as how family systems constructs mediated the relations between family risk and child outcome. Further, the study examined how developmental risk moderated these relations. The sample followed 242 families of children with and without developmental risk across the transition-to-school period. Family risk factors were assessed at 5 years, using parental reports of symptomatology, parenting stress, and marital adjustment, and observational assessments of the parent-child relationship. Family system constructs (cohesion, warmth, conflict, organization, control) were measured at age 6 using structured observations of the entire family playing a board game. Child behavior problems and social competence were assessed at age 7. Results indicated that families of children with developmental delays did not differ from families of typically developing children on the majority of family system attributes. Cohesion and organization mediated the relations between specific family risk factors and social competence for all families. For families of typically developing children only, higher levels of control were associated with more behavior problems and less social competence. These findings underscore the importance of family-level assessment in understanding the development of psychopathology. Important family effects on children's social competence were found, although the pathways among family risk and family systems attributes are complex.
ContributorsGerstein, Emily Davis (Author) / Crnic, Keith A (Thesis advisor) / Aiken, Leona (Committee member) / Bradley, Robert (Committee member) / Gonzales, Nancy (Committee member) / Arizona State University (Publisher)
Created2012