UNDERSTANDING THE RELATION BETWEEN PROFILES OF ADOLESCENT PEER CONFLICT, SOCIO-DEMOGRAPHIC FACTORS, AND TYPE 1 DIABETES ADAPTATION

Gabrielle Banks

Data is provided by the student.

Abstract

Peer conflict and socio-demographic variables are differentially associated with Type 1 Diabetes (T1D) outcomes in adolescents. The present study determined empirical patterns of the context (friend versus non-friend) and content (diabetes specific versus general) of peer conflict within a broader framework of socio-demographic factors and examined how these patterns relate to adolescents diabetes related adherence, quality of life, and glycemic control). Data were collected from 178 youth with T1D, ages 12-18, receiving treatment in a Mid-Southern outpatient endocrinology clinic. Patients reported adherence and quality of life using the Self-Care Inventory and PedsQL-Diabetes module, respectively. Glycemic control (HbA1c values) and illness duration were obtained from medical chart review. Patients and caregivers reported sex, race, and household income. Patients reported on peer conflict using the Diabetes Peer Conflict Scale (DPCS). Confirmatory Factor Analysis validated a factor structure for the DPCS and Latent Profile Analysis was employed to determine profiles of peer conflict. A four factor structure emerged for the DPCS: general friend conflict, general non-friend conflict, T1D friend conflict, T1D non-friend conflict. Using these factors as indicators, four profiles emerged: profiles characterized by 1) Low Overall Conflict (LOC) and 2) Moderate Overall Conflict (MOC) across all domains, a 3) Non-Friend Conflict (NFC), and a 4) Friend Conflict (FC) profile. Differences were not established between diabetes specific versus general conflict. Socio-demographic variables did not predict class membership. While controlling for the effects of race, sex, income, and illness duration, the LOC profile reported the highest quality of life and the best level of glycemic control relative to the other profiles. The FC profile reported the lowest adherence behaviors compared to the other three profiles. These findings suggest that while low levels of conflict are associated with better glycemic control and quality of life, conflict with friends impacts reports of adherence behaviors above and beyond moderate levels of conflict and conflict with non-friends. Peer conflict uniquely contributes to diabetes adaptation above and beyond socio-demographic and illness factors. Intervention aimed at improving glycemic control and quality of life should focus on reducing overall conflict with peers, however, interventions targeting adherence behaviors should focus more closely on conflict with friends.