Coping with Childhood Diabetes: Sibling Influences

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Diabetes is a chronic disease that affects as many as 16 million Americans. Health care costs for diabetes are estimated to be nearly $100 billion per year in the US (American Diabetes Association). Our long-term goal is to explain why some children with diabetes manage to achieve positive emotional and behavioral adjustment and other children evidence depression and anxiety. We will also determine whether and how siblings factor into the stress-coping process and maintenance of positive adjustment. The specific hypothesis is that children with diabetes that have older siblings who model adaptive coping and provide emotional and instrumental support will demonstrate better psychological functioning. We base that hypothesis on findings that suggest older siblings to be powerful socializing agents for children's cognitive, social, and emotional development. The specific aims are to: 1. Identify illness-related and common developmental stressors among children with diabetes. 2. Delineate typical coping strategies used to deal with these stressors, with particular attention paid to coping that incorporates sibling interaction. 3. Investigate the links between stress, coping and mental health (depression and anxiety) for children with diabetes and their siblings. 4. Identify factors (e.g., sex composition of the sibling dyad, illness history, pubertal development, locus of control, etc.) that modify associations between stress, coping and mental health.We will address these aims by using a family systems framework and by collecting data from 102 children (equally from African American, Hispanic, and non-Hispanic White populations) between the ages of 8 and 14 who have been diagnosed with Type 2 diabetes. These children, along with at least one parent and one older sibling will participate in 90-minute interviews designed to assess mental and physical health, stress, coping, and family interactions. Siblings will also participate in series of 7 follow-up phone calls over a 2-3 week period during which they will report on daily activities, including sibling interactions. Results are expected to have direct implications for effective diabetes intervention.