Coping in adolescents with T1D:

different in boys and girls

Nienke Maas- van Schaaijk, PhD

Clinical psychologist,
Catharina hospital Eindhoven, the
Netherlands

nienke.maas@cze.nl
after 1-10-2014

Radboud UMC, Nijmegen, the Netherlands

nienke.maas@radboudumc.nl

Presenter Disclosure Information

Nienke Maas
Disclosed no conflict or duality of interest

ISPAD 2014

Coping in adolescents T1D [1]

Complex disease management tasks
Self-discipline
Interference with developmental goals
dealing with stressors

ISPAD 2014

Definition Coping
The proces of managing stressors
Cognitive, emotional, behavioral strategies of
coping*
3 dimensions of coping

*Kammeyer-Mueller, Judge&Scott (2009)

ISPAD 2014

Dimensions of Coping
1. problem solving (active) coping

ISPAD 2014

Dimensions of Coping
2. emotion-focused coping

ISPAD 2014

Dimensions of Coping
3. avoidance coping

ISPAD 2014

Coping in adolescents T1D [2]:

the relation with HbA1c*
An active coping style had a positive and stable
effect on both metabolic control and quality of life
An emotion-focused coping strategy related to
poorer metabolic control and reduced quality of
life
An avoiding coping style associated with poorer
metabolic control

*Roesch & Weiner (2001), Seiffge-Krenke & Stemmler (2003), Graue, Wentzel-Larsen, Bru,
Hanestad & Svik (2004), Luyckx, Seiffge-Krenke & Hampson (2010) e.g.

ISPAD 2014

Aim of the study

Examine the relationship between coping strategies
and blood glucose regulation (HbA1c) in both
teenage boys and teenage girls with T1D

part of larger study Self perception of psychological functioning and

coping ability of adolescents with type 1 diabetes and their parents
(Maas-van Schaaijk et al. 2012)

ISPAD 2014

Participants
Adolescents with T1D (n=151) of 9 hospitals in the
Netherlands
Age 12-18
65 boys (mean 14.8 1.7 years) and 86 girls (mean
14.9 1.7 years)
No comorbid medical or psychological condition
Approved by the medical ethical committees

ISPAD 2014

Table. Baseline group characteristics

Variable
Age: mean (SD)
Range
Gender
male
female
School level
lower
vocational
higher
pre-university
unknown
Treatment
Injections
Pump
HbA1c (mmol/mol)
Range

T1D (n=151)
14.9 (1.7)
12-18
65 (43%)
86 (57%)
42 (27.8%)
19 (12.6%)
46 (30.5%)
40 (26.5%)
4 (2.6%)

71 (47%)
80 (53%)
67
32- 118

Age at diagnose: mean (SD)

range

9.43 (3.82)
0-18

Years T1DM: mean (SD)

range

5.74 (3.92)
0-15

ISPAD 2014

Measures
Adolescent coping
CODI coping questionnaire for children and
adolescents
29 items (5-point scale, varying from 1 (never) to 5 (always), clustered
in six domains: acceptance, (emotional) avoidance, cognitive
palliative, distance, emotional reaction, and wishful thinking
separate last item Satisfaction, how well do you think you cope with
your illness?

Metabolic control
HbA1c mmol/mol

ISPAD 2014

Analyses
Seperate regression analyses for boys and girls were
performed to examine the relationship between
each coping style and HbA1c and for satisfaction
Model adjusted for age

ISPAD 2014

Coping and HbA1c [1]

In girls an accepting coping style was significantly
related to lower HbA1c values, after adjusting for
age (B=-.49, p=<.00)
In boys none of the different coping styles was
significantly related HbA1c values

ISPAD 2013

Coping and HbA1c [2]

A higher level of satisfaction with their coping ability
was significantly related to lower HbA1c levels in
girls (B=.-.35, p=.00)
In boys no relation was found between satisfaction
with their coping ability and HbA1c values (B=-.11,
p=.41)

ISPAD 2014

Conclusions
Teenage boys and girls differ in their coping with
diabetes, with differentiated impact on
bloodglucose regulation
In girls an accepting coping style and a higher
level of satisfaction with their coping ability were
related to better bloodglucose regulation
In boys none of the coping styles could predict
HbA1c
ISPAD 2014

Implications
For clinical practice it seems relevant to look at the
presentation of the coping strategies, and
differentiate between boys and girls, in both
counselling and treatment

ISPAD 2014

Special thanks to

The participating adolescents

The participating diabetes teams
Utrecht University
Tilburg University
Catharina Hospital
Kidz & Ko
Prof. Dr. A.L. van Baar
R.J.Odink
A.B.C. Roeleveld-Versteegh