Positive Well-Being in Youth With Type 1 Diabetes During Early Adolescence

Identification of psychological constructs for a positive psychology intervention to assist with the adjustment to closed loop technology among adolescents living with type 1 diabetes

Aim

Adolescents have been identified as the group who struggle most with successful adjustment to closed loop technology. This study aims to identify the psychological constructs that should form part of a positive psychology intervention to assist with the adjustment to closed loop technology among adolescents living with type 1 diabetes.

Method

Qualitative document analysis was employed to integrate findings from two documents: a published ongoing intervention study and a recent phenomenological study by the authors. Reflexive thematic analysis was used to identify themes from the documents.

Findings

The following themes were identified as important psychological constructs that aid adjustment: the importance of knowledge and education; the process of positive adjustment to closed loop technology; a positive outlook; and building a relationship with diabetes.

Conclusion

Interventions are needed to assist adolescents in their adjustment to closed loop technology. The psychological constructs identified served as a starting point in designing an effective, evidence-based intervention grounded in data and theory. Knowledge and education, responsibility, identity, positive affect, gratitude, support, and trust are psychological constructs that need to be included in an intervention program.

Significant and persistent improvements in time in range and positive emotions in children and adolescents with type 1 diabetes using a closed-loop control system after attending a virtual educational camp

OBJECTIVE

To evaluate the six-month impact of the advanced automated functions of a closed-loop control (CLC) system (Control-IQ) and a virtual educational camp (vEC) on emotions and time in range (TIR) of children and adolescents with type 1 diabetes.

METHODS

Children and their parents participated in a three-day vEC. Clinical, glucose, and emotion data were evaluated before, just after, and six months after the vEC. Emotions were evaluated using adapted Plutchik's and Geneva Emotion Wheels.

RESULTS

Forty-three children and adolescents (7-16 years) showed significant improvements in positive emotions immediately and six months after the vEC (67% and 65% vs 38%, p < 0.05, respectively), while mixed emotions were reduced (32% and 15% vs 61%, p < 0.05 and p < 0.001, respectively). The median percentage TIR increased from 64% (IQR 54-72) to 75% (IQR 70-82) with Control-IQ (p < 0.001) six months after the vEC.

CONCLUSIONS

Positive emotions (joy, serenity, and satisfaction) significantly improved while mixed emotions were significantly worse six months after the initiation of a CLC system (Control-IQ) and a vEC.

Designing resilience research: Using multiple methods to investigate risk exposure, promotive and protective processes, and contextually relevant outcomes for children and youth

BACKGROUND

Inconsistent, poorly designed research on resilience in the human sciences has contributed to epistemological and ontological ambiguity which has fuelled claims that resilience as a concept is poorly theorized.

OBJECTIVE

Building on research with abused and neglected children around the world, the objective of this paper is to show that studies of resilience must account for: (a) risk exposure (of relevance in different contexts); (b) promotive and protective processes (internal and external resources associated with resilience across systems); and (c) desired outcomes (as privileged by stakeholders in different cultures and contexts).

METHOD

By identifying common aspects of resilience research from a purposeful selection of studies (ones with weak and strong methodologies), this paper identifies three dimensions of well-designed studies of childhood resilience.

RESULTS

Attention to all three dimensions enhances both the empirical validity (in the quantitative research paradigm) and phenomenological trustworthiness (in qualitative research) of resilience research with children and families. Challenges researching resilience can also be resolved by designing studies that account for all three dimensions. These challenges include the lack of systemic thinking to account for contextual factors and other external threats to child wellbeing, and the excessive generalization of findings.

CONCLUSION

This three-part model for resilience research reflects the very best practices among resilience researchers and has the potential to address the definitional and methodological ambiguity that plague studies of resilience.

Test of the modified dual pathway model of eating disorders in individuals with type 1 diabetes

OBJECTIVE

Adolescents and young adults with type 1 diabetes (T1D) demonstrate high rates of disordered eating behaviors (DEBs) and may experience physiological and psychological vulnerabilities not currently included in established risk models of DEBs. This study examined associations among constructs included in the recently proposed T1D-specific modified dual pathway model and examined age as a moderator of these associations.

METHOD

Participants included adolescents (n = 307; age M = 15.71, SD = 1.33), young adults (n = 313; age M = 21.20, SD = 2.10), and adults (n = 198; age M = 30.51, SD = 2.81) recruited via the T1D Exchange Clinic Registry. Data were collected from participants' medical records and from self-report questionnaires assessing dietary regimen, dietary restraint, body dissatisfaction, hunger/satiety, diabetes-specific negative affect, and DEBs. Multiple group path modeling was used to test hypotheses.

RESULTS

Approximately 31% of participants were at risk for an eating disorder. The original modified dual pathway model had poor model fit. The addition of three empirically defensible paths improved model fit. Diabetes-specific dietary regimen, diabetes-specific negative affect, and hunger/satiety disruption all were associated with DEBs. A fully varying multiple group model by age fit best; however, only the dietary restraint to DEBs pathway demonstrated a distinct pattern across age cohort, which attenuated from the adolescent to the adult cohort.

DISCUSSION

This study provides preliminary support for associations proposed in the modified dual pathway model and suggests potential for intervening on disease-specific risk factors of DEBs in a T1D population.