Depressive symptoms, daily stress, and adherence in late adolescents with type 1 diabetes

Katherine J W Baucom, Tara L. Queen, Deborah J. Wiebe, Sara L. Turner, Kristin L. Wolfe, Elida I. Godbey, Katherine T. Fortenberry, Jessica H. Mansfield, Cynthia A. Berg

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Objective: 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). Method: 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. Results: 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 2-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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)522-530
Number of pages9
JournalHealth Psychology
Volume34
Issue number5
DOIs
StatePublished - May 1 2015

Keywords

  • Adolescents
  • Depression
  • Diabetes
  • Diary methods
  • Stress

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology

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