Coping, Parenting & Maternal-Child Adjustment in Adolescents with Type 1 Diabetes

描述（由申请人提供）：这个指导的以患者为导向的研究职业发展奖（K23）的目标是了解预测青少年适应1型糖尿病（T1 D）的风险和保护因素。患有T1 D的青少年有适应不良的风险，包括生理（即，代谢控制不良）和社会心理结果（例如，抑郁症状，生活质量差）。指导这项研究的总体框架是跨性别压力和应对模型，该模型将慢性疾病视为儿童和家庭试图适应的潜在压力源。儿童适应被认为是介导的儿童和家庭的适应过程和人口和疾病变量的调节。这项研究采用多方法、前瞻性的方法，研究了三大类风险和保护因素对青少年在12个月内对疾病的生理和心理社会适应的预测作用：（主要控制、次要控制和脱离应对）; B）家庭功能（母亲参与，亲子冲突）;和c）母亲适应（抑郁和焦虑的症状）。K23奖将在耶鲁大学进行，由一个多学科的导师团队组成，包括一名初级导师，玛格丽特格雷博士，PH，RN，和两名二级导师，威廉坦博莱恩，医学博士和艾伦德拉马特，博士。这些导师中的每一个都是各自领域的专家，将能够为申请人提供以下方面的额外指导和经验：（1）青少年T1 D的病理生理学;（2）将申请人以前对儿童和青少年风险和保护因素的研究转化为T1 D青少年的纵向研究;和（3）先进的手稿和赠款写作技巧。这些技能的获得将准备申请人建立一个研究职业生涯，重点是开发以家庭为基础的认知行为预防干预儿童和青少年的风险为负面的心理和身体结果，特别是青少年与慢性儿科疾病，如T1 D。相关性（参见说明）：这项研究有可能大大改善慢性病青少年及其家庭的生活质量。预计接下来的研究将是一个试点和可行性研究，以家庭为基础的认知行为预防干预的青少年与TlD和他们的母亲，重点是提高青少年的使用适应性应对，减轻父母的痛苦，并促进最好的养育行为。 公共卫生相关性：这项研究有可能大大改善慢性病青少年及其家庭的生活质量。预计接下来的研究将是一个试点和可行性研究，以家庭为基础的认知行为预防干预的青少年与TlD和他们的母亲，重点是提高青少年的使用适应性应对，减轻父母的痛苦，并促进最好的养育行为。

DESCRIPTION (provided by applicant): The goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to understand the risk and protective factors predicting adolescents' adjustment to type 1 diabetes (T1D). Adolescents with T1D are at risk for poor adjustment, including both physiological (i.e., poor metabolic control) and psychosocial outcomes (e.g., depressive symptoms, poor quality of life). The overarching framework guiding this research is the Transactional Stress and Coping Model, which views chronic illness as a potential stressor to which children and families attempt to adapt. Child adjustment is thought to be mediated by child and family adaptational processes and moderated by demographic and illness variables. The proposed study uses a multi-method, prospective approach to examine the effects of three broad categories of risk and protective factors as predictors of adolescents' physiological and psychosocial adjustment to the illness over 12 months: a) Coping Strategies (primary control, secondary control, and disengagement coping); b) Family Functioning (maternal involvement, parent-child conflict); and c) Maternal Adjustment (symptoms of depression and anxiety). The K23 Award will be conducted at Yale University with a multidisciplinary team of mentors, consisting of a primary mentor, Margaret Grey, Dr.PH, RN, and two secondary mentors, William Tamborlane, MD, and Alan Delamater, PhD. Each of these mentors are experts in their respective fields and will be able to provide the applicant with additional instruction and experience in: (1) the pathophysiology of T1D in adolescents; (2) translating the applicant's previous research on risk and protective factors in children and adolescents to longitudinal research in adolescents with T1D; and (3) advanced manuscript and grant writing skills. The acquisition of these skills will prepare the applicant to build a research career focused on developing family-based cognitive-behavioral preventive interventions for children and adolescents at risk for negative psychosocial and physical outcomes, particularly adolescents with chronic pediatric conditions, such as T1D. RELEVANCE (See instructions): This study has the potential to greatly improve the quality of life in adolescents with chronic illness and their families. It is expected that the study to follow will be a pilot and feasibility study of a family-based cognitive-behavioral preventive intervention for adolescents with Tl D and their mothers, focusing on improving adolescents' use of adaptive coping, relieving parents' distress, and promoting the best parenting behaviors. PUBLIC HEALTH RELEVANCE: This study has the potential to greatly improve the quality of life in adolescents with chronic illness and their families. It is expected that the study to follow will be a pilot and feasibility study of a family-based cognitive behavioral preventive intervention for adolescents with Tl D and their mothers, focusing on improving adolescents' use of adaptive coping, relieving parents' distress, and promoting the best parenting behaviors.