Depressive symptoms, daily stress, and adherence in late adolescents with type 1 diabetes.
Depressive symptoms, daily stress, and adherence in late adolescents with type 1 diabetes.
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DOI：
10.1037/hea0000219
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Berg CA
中科院分区：
文献类型：
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作者：
Baucom KJ;Queen TL;Wiebe DJ;Turner SL;Wolfe KL;Godbey EI;Fortenberry KT;Mansfield JH;Berg CA
本研究旨在探究抑郁症状是否与青少年1型糖尿病（T1D）患者更高的日常感知压力相关，以及抑郁症状是否会调节压力严重程度与较差的日常治疗依从性之间的关系。
175名青少年T1D患者在基线实验室评估期间完成了抑郁症状和血糖控制的测量。此次评估之后，开展为期14天的每日日记记录，在此期间，青少年对一般应激事件（GS）和糖尿病特异性应激事件（DSS）的严重程度，以及对糖尿病治疗方案的依从性进行评分。
多层次建模显示，抑郁症状较多的青少年平均报告的日常压力更严重，日常治疗依从性更差，且血糖控制也较差。在DSS较严重（而非GS较严重）的日子里，青少年报告的治疗依从性较差。这种关联受到抑郁症状与两周日记记录中所经历的DSS严重程度平均水平之间的交互作用的调节。在抑郁症状水平较低的青少年中，无论DSS严重程度的平均水平如何，在DSS较严重的日子里，他们报告的治疗依从性都较差。在抑郁症状处于中等或较高水平的青少年中，只有当DSS严重程度的平均水平为中等或较高时，在DSS较严重的日子里，他们才会报告较差的治疗依从性。
抑郁症状与较差的日常治疗依从性和更严重的压力相关，并且与DSS严重程度的平均水平相互作用，调节日常压力与治疗依从性之间的关系。研究结果表明，抑郁症状对于理解青少年晚期压力与治疗依从性之间的关联具有重要意义。
To examine whether depressive symptoms are associated with greater perceived daily stress and moderate the link between stress severity and poorer daily adherence in late adolescents with Type 1 diabetes (T1D). 175 late adolescents with T1D completed measures of depressive symptoms and glycemic control during a baseline laboratory assessment. This assessment was followed by a 14-day daily diary during which adolescents rated the severity of general (GS) and diabetes-specific (DSS) stressful events, as well as adherence to their diabetes regimen. Multilevel modeling revealed that adolescents with more depressive symptoms reported more severe daily stress and poorer daily adherence on average, and had poorer glycemic control. On days with more severe DSS, but not GS, adolescents reported poorer adherence. This association was moderated by an interaction between depressive symptoms and the mean level of DSS severity experienced across the two week diary. In adolescents with low levels of depressive symptoms, poorer adherence was reported on days with more severe DSS across all levels of mean DSS severity. In adolescents with average or high levels of depressive symptoms, poorer adherence was reported on days with more severe DSS only when mean DSS severity was average or high. Depressive symptoms are associated with poorer daily adherence and greater stress severity, and interact with mean DSS severity to moderate the link between daily stress and adherence. The results point to the importance of depressive symptoms for understanding associations between stress and adherence during late adolescence.