Agentic and communal traits and health: adolescents with and without diabetes

A systematic review of parental burnout and related factors among parents

BACKGROUND

Parenting is both a complex and stressful endeavor, so parents sometimes experience parenting burnout. The main objective of this study was to provide an overview of factors related to general parental burnout (PB) among parents with at least one child based on the Ecological Systems Theory (EST).

METHODS

PubMed, Web of Science, EBSCO, CNKI and WanFang were systematically searched for studies published from 2010 to July 2023 for peer-reviewed articles using keywords extracted from Medical Subject Headings such as "parenting", "parental", "burnout", "psychological burnout", "burn-out syndrome". Studies were included if they described associations between factors and PB among parents of children aged 0-18 years old in the general population, and published in an English or Chinese language peer-reviewed journal. The Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was employed to assess the risk of bias of included studies.

RESULTS

Of 2037 articles, 26 articles met the inclusion criteria. Based on the Ecological Systems Theory (EST), we found that microsystem-individual factors such as gender, educational level, income, parental personality, internalization of maternal parental motivation, unmitigated communion, self-compassion and concern for others, alexithymia, anxiety and depressive symptoms, parental perfectionism, resilience, low self-esteem and high need for control, mother's attachment style were identified as being associated with parenting burnout. Mesosystem-interpersonal factors involve parent-child relationship and marital satisfaction. The exosystem-organizational or community factors include the number of children in the household, neighborhood and the number of hours spent with children, child's illness, child's behavior problems and social support. The macrosystem-society/policy or culture factors are mainly personal values and cultural values.

CONCLUSIONS

This systematic review found several factors that have been investigated in relation to PB. However, the majority of the factors were reported by one or two studies often implementing a cross-sectional design. Nevertheless, we still recommend that health policymakers and administrators relieve parenting burnout among parents with children by adjusting these modifiable factors.

Topical Review: Youth With Type 1 Diabetes: What Is the Role of Peer Support?

The literature on the role of peer support for psychological well-being and disease management among youth with type 1 diabetes (T1D) is mixed. In this topical review, we use self-determination theory (SDT) as a framework to understand the conditions under which peer support is helpful or unhelpful regarding psychological well-being and diabetes management. We briefly review the literature to support our claim that existing research on peer support is inconsistent. A primary reason for the inconsistency is that previous work largely focuses on diabetes instrumental and informational support from peers, which have the potential to threaten SDT needs for autonomy, competence, and relatedness. Instrumental and informational support may set youth with T1D apart from peers at a time when fitting in with peers is crucial. Instead, we argue that emotional support from and companionship with peers best meet the SDT need of relatedness while not posing direct threats to autonomy or competence. We also note that some youth have extremely high needs for relatedness such that they prioritize connecting with peers over diabetes management. We conclude by calling for more research to adopt a SDT theory approach to examine the role of peer support in the lives of youth with T1D and for health care professionals to expand their focus from the specifics of diabetes to the broader social context.

14-Year Longitudinal Trajectories of Depressive Symptoms Among Youth With and Without Type 1 Diabetes

OBJECTIVE

There is evidence that youth with type 1 diabetes are at risk for depression, and depression is a significant risk factor for subsequent psychological and physical health problems. However, it is not clear if/when this depression risk emerges. The goal of this study was to determine if there are differences in levels of depressive symptoms between youth with and without type 1 diabetes that develop over the course of emerging adulthood. We also examined whether adolescent psychosocial variables predicted depressive symptoms during emerging adulthood.

METHODS

Youth with (n = 132) and without (n = 131) type 1 diabetes were enrolled in the study at average age 12 and followed for 14 years. Depressive symptoms were measured throughout the study. Psychosocial variables of interest were measured during adolescence.

RESULTS

Group differences in depressive symptoms emerged by study end at average age 26. Depressive symptoms appeared to decline over time for youth without diabetes and to increase over time for youth with diabetes. Parent relationship difficulties increased over adolescence as did peer conflict for the entire cohort. Supportive relationships with parent and peers predicted fewer end of study depressive symptoms (controlling for baseline depressive symptoms)-equally so for both groups.

CONCLUSIONS

This study provides evidence that those with type 1 diabetes may be at risk for depressive symptoms many years after diagnosis and after adolescence. Although relational difficulties with parents and peers increase during adolescence, supportive relationships over the course of adolescence may help to mitigate depressive symptoms during young adulthood.

The role of the Big Two in socially responsible behavior during the COVID-19 pandemic: Agency and communion in adolescents' personal norm and behavioral adherence to instituted measures

The outbreak of the COVID-19 virus urged all members of the society to adopt COVID-responsible behavioral patterns and practice them in everyday life. Given the variability in its adoption, it is critical to understand psychological factors associated with socially responsible behavior during the pandemic. This might be even more important among adolescents, who are less endangered by the virus but contribute to its spread. In this article, we focus on adolescent boys' and girls' agency and communion orientations to explain the level of importance they attribute to the instituted measures to contain the spread of the COVID-19 virus (personal norm), as well as their behavioral adherence to those measures. In total, 12,552 adolescents (67.6% girls, Mage = 15.06, SDage = 2.44, age range 10-21) answered inventory assessing adolescents' agentic and communal orientation (GRI-JUG) and items related to personal norm regarding the instituted measures and behavioral adherence to the measures. The results showed a small positive role of communion in both boys' and girls' personal norm and behavioral adherence, whereas agency played a very small negative role in boys' and girls' personal norm and boys' behavioral adherence to measures. Nevertheless, these findings could indicate the importance of enhancing communal traits and behaviors in both genders in order to assure socially responsible behavior during the pandemic.

Psychosocial predictors of diabetes risk factors and complications: An 11-year follow-up

OBJECTIVE

The goal of this study was to use the risk and resistance framework to examine whether a set of psychosocial variables measured at age 12 in youth with Type 1 diabetes would predict the emergence of diabetes risk and complication variables 11 years and 13 years later.

METHOD

We interviewed youth with Type 1 diabetes when they were average age 12 and followed them for 11 years until they were average age 23 and then average age 25. At age 12, we measured personality traits (unmitigated communion, unmitigated agency), relationship variables (parent relationship quality, friend support, friend conflict), indicators of psychological well-being (depressive symptoms, bulimic symptoms, self-worth), and self-care behavior. We used these psychosocial variables assessed at age 12 to predict diabetes risk factors, glycemic control, and the emergence of diabetes complications at follow-up.

RESULTS

Higher unmitigated agency, poor quality parent relationships, higher friend conflict, bulimic symptoms, and lower self-worth predicted one or more diabetes outcomes. When statistical controls for age 12 glycemic control were employed, unmitigated agency emerged as the most robust predictor of diabetes outcomes.

CONCLUSION

Unmitigated agency, which involves an overly inflated view of the self and a cynical view of others, predicted poor diabetes outcomes over an 11-year and 13-year period. The processes by which unmitigated agency could influence health are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A follower-centric approach to the 2016 US presidential election: Candidate rhetoric and follower attributions of charisma and effectiveness

The 2016 US Presidential Campaign was followed worldwide due to the dynamic nature of the candidates and the controversy surrounding them. This study takes a unique look at the candidacy of Donald Trump through the eyes of his followers. Using both qualitative data collected from campaign speeches and quantitative data collected from followers, our study examines (1) the positive/negative valence of the rhetoric used by both presidential candidates and (2) the relationship between follower characteristics, perceived threat of social groups, and attributions of charisma and effectiveness to Donald Trump. The results of this study suggest that Trump’s rhetoric was significantly more negative, hostile, and aggressive than Clinton’s. In addition, quantitative analyses show a direct relationship between followers’ attitudes toward gender and attributions of charisma and effectiveness to Trump. Finally, followers’ perceived threat of social groups mediated relationships between follower self-esteem, romance of leadership, gender attitudes, and attributions of charisma and effectiveness to Trump. Our results shed further light on the important role that follower characteristics and perceptions play in predicting social constructions of leadership and attributions of charisma. Implications for both organizations and scholars of leadership are discussed.

Partner unmitigated communion moderates communal coping benefits in type 2 diabetes

The study goal was to determine whether partner's level of unmitigated communion moderated the relation of partner communal coping to patient health. Couples in which one person was recently diagnosed with type 2 diabetes (n = 123) were interviewed separately and asked to discuss a diabetes-related problem. Communal coping behavior (from videotaped discussions) interacted with partner communal coping, such that partner communal coping was related to lower patient distress, higher patient self-efficacy, and higher patient medication adherence only when partners scored lower on unmitigated communion. The extent to which perceived emotional responsiveness and overprotective behavior mediated these relations was explored.

Implications of supportive and unsupportive behavior for couples with newly diagnosed diabetes

OBJECTIVE

To examine the relation between daily diary reports of diabetes-specific social interactions to patient and partner mood and patient self-care behaviors, and whether relations are moderated by unmitigated communion.

METHOD

Participants were 70 couples in which 1 person had been diagnosed with Type 2 diabetes in the past 3 years. They were interviewed in-person at baseline and completed daily diary reports on an iPad. Daily diary questionnaires measured support, mood, and self-care behavior (patients only). Unmitigated communion, a personality trait characterized by an overinvolvement in others to the exclusion of the self, was measured at baseline.

RESULTS

Multilevel statistical modeling revealed that daily fluctuations in partner emotional support were related to daily fluctuations in happy mood, more exercise, and dietary compliance. Partner controlling behavior was related to poor mood but was unrelated to self-care. Relations of support and controlling behavior to mood were strongest for individuals high (vs. low) in unmitigated communion.

CONCLUSION

Patients newly diagnosed with Type 2 diabetes who felt understood and cared for by partners reported a better mood and were more likely to take care of themselves on a daily basis, whereas patients whose partners were controlling on a daily basis reported poorer mood. Patients characterized by unmitigated communion were most affected by partner supportive and unsupportive behavior. (PsycINFO Database Record

Life Lessons from Women with HIV: Mutuality, Self-Awareness, and Self-Efficacy

Women with HIV in the United States cope with multiple traumas that influence adherence to antiretroviral therapy (ART) and well-being. Narrative themes from three life turning points and a projective story task were compared for two groups of women with HIV (HIV well-managed vs. HIV not well-managed, matched on demographics and narrative word count) to understand predictors of successful outcomes. The well-managed group (n = 10) was virally suppressed and reported ≥95% ART adherence; the not well-managed group (n = 10) had detectable viral load and reported <95% ART adherence. Women were predominantly African American with low socioeconomic status and averaged 46.51 years. A three-stage coding process (with coders blind to group status in stages 1 and 2) involved (1) line by line thematic analyses that generated 155 subthemes reflecting six content areas (interpersonal relationships; culture and community; sense of self; relationship to past, present, and future experiences; self-care; and motivators for change); (2) absence/presence of the 155 subthemes was compared for the two groups; the frequency of 37 subthemes was found to significantly differ; and (3) the 37 differentiating subthemes were conceptually integrated, revealing that the well-managed group's narratives more frequently reflected (a) mutuality (growth-fostering relationships involving reciprocal care and empathy); (b) self-awareness (recognition of personal strengths and weaknesses and multiple factors contributing to life choices and trajectories); and (c) self-efficacy (active coping, self-advocacy, and utilizing resources). Implications for treatment and interconnections among themes are discussed, emphasizing the factors that enable women to care for themselves and others.

Variation in narrative identity is associated with trajectories of mental health over several years

This article presents 2 longitudinal studies designed to assess the relationship between variability in narrative identity and trajectories of mental health over several years. In Study 1, core scenes from 89 late-mid-life adults' life stories were assessed for several narrative themes. Participants' mental health and physical health were assessed concurrently with the narratives and annually for the subsequent 4 years. Concurrent analyses indicated that the themes of agency, redemption, and contamination were significantly associated with mental health. Longitudinal analyses indicated that these same 3 themes were significantly associated with participants' trajectories of mental health over the course of 4 years. Exploratory analyses indicated that narratives of challenging experiences may be central to this pattern of results. In Study 2, similar longitudinal analyses were conducted on a sample of 27 late-mid-life adults who received a major physical illness diagnosis between the baseline assessment and 6 months later and a matched sample of 27 control participants who remained healthy throughout the study. Participants' mental health and physical health were assessed every 6 months for 2 years. In this study, the themes of agency, communion, redemption, and contamination in participants' life narratives collected at baseline (before any participant became sick) were significantly associated with mental health in the group of participants who went on to receive a medical diagnosis, but not in the control group. Taken together, the results of these 2 studies indicate that the way an individual constructs personal narratives may impact his or her trajectory of mental health over time.