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Attributions of Adolescents With Type 1 Diabetes in Social Situations

Relationship with expected adherence, diabetes stress, and metabolic control

From the University of Wisconsin-Milwaukee, Medical College of Wisconsin, Milwaukee, Wisconsin

Address correspondence and reprint requests to Anthony Hains, Department of Educational Psychology, P.O. Box 413, University of Wisconsin-Milwaukee, Milwaukee, WI 53201. E-mail: aahains{at}uwm.edu

OBJECTIVE—To examine the relationships among negative attributions of friend reactions (NAFRs) within a social context, anticipated adherence difficulties, diabetes stress, and metabolic control.

RESEARCH DESIGN AND METHODS—A sample of 104 adolescents with type 1 diabetes completed instruments measuring demographics, attribution of friend reactions, anticipated adherence, and diabetes stress. Metabolic control was measured by HbA_1c obtained during the clinic visit.

RESULTS—Path analysis demonstrated an excellent fit of a model depicting an indirect relationship between NAFRs and metabolic control through the mechanisms of expected adherence difficulties and diabetes stress.

CONCLUSIONS—Adolescents who make NAFRs are likely to find adherence difficult in social situations and have increased feelings of stress, with the latter associated with poorer metabolic control. Intervention efforts to address negative attributions may impact adherence behavior and feelings of stress, especially if specific contexts of self-care behavior are taken into account.

Abbreviations: AAD, anticipated adherence difficulty • NAFR, negative attribution of friend reaction

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