Emotional Processing and Self-Control in Adolescents With Type 1 Diabetes Amy E. Hughes, 1 MS, Cynthia A. Berg, 1 PHD, and Deborah J. Wiebe, 2 PHD, MPH 1 Department of Psychology, University of Utah, and 2 Department of Psychiatry—Division of Psychology, University of Texas Southwestern Medical Center All correspondence concerning this article should be addressed to Cynthia A. Berg, 380 S. 1530 E., Department of Psychology, University of Utah, Salt Lake City, UT, 84112, USA. E-mail: Cynthia.berg@psych.utah.edu Received June 22, 2011; revisions received March 15, 2012; accepted March 20, 2012 Objective This study examined whether emotional processing (understanding emotions), self-control (regulation of thoughts, emotions, and behavior), and their interaction predicted HbA1c for adolescents with type 1 diabetes over and above diabetes-specific constructs. Methods Self-report measures of self-control, emotional processing, self-efficacy for diabetes management, diabetes-specific negative affect, and adherence, and HbA1c from medical records were obtained from 137 adolescents with type 1 diabetes (M age ¼ 13.48 years). Results Emotional processing interacted with self-control to predict HbA1c, such that when adolescents had both low emotional processing and low self-control, HbA1c was poorest. Also, both high emotional processing and self-control buffered negative effects of low capacity in the other in relation to HbA1c. The interaction of emotional processing  self-control predicted HbA1c over diabetes-specific self-efficacy, negative affect, and adherence. Conclusions These findings suggest the importance of emotional processing and self-control for health outcomes in adolescents with diabetes. Key words adolescence; diabetes management; emotional processing; self-control; self-regulation. For those with type 1 diabetes, adolescence, compared with middle childhood and adulthood, is marked by strug- gles to maintain sufficient metabolic control (Silverstein et al., 2005). Diabetes management requires self-control, de- fined as the regulation and modulation of thoughts, emo- tions, and behaviors (Finkenauer, Engels, & Baumeister, 2005). However, adolescents lack the self-control maturity of adults (Steinberg, 2010). Furthermore, emotion inten- sity and reactivity increases during adolescence; more effective processing of this emotion (i.e., acknowledging, understanding, and accepting emotion) is related to decreased impulsive behavior and distress, and improved social interaction (Cole, Martin, & Dennis, 2004; Stanton, Parsa, & Austenfeld, 2002; Steinberg, 2010). Diabetes management requires both effective self-control and emotional processing for completion of adherence behav- iors (e.g., checking blood glucose even when feeling angry at your parents for reminding you to do so). Although the importance of self-control of emotions, thoughts, and be- haviors is beginning to be studied in the pediatric literature (Tan & Holub, 2011), the relation of self-control and emo- tional processing to health outcomes in adolescents with type 1 diabetes has not been studied. Self-control and emotional processing interact in predicting cognitive, emotional, and behavioral outcomes, such as effective coping strategies, mood, and impulsive behaviors (Dennis, 2010). Self-control and emotional processing are distinct constructs, with self-control involv- ing regulation of emotion (e.g., reappraising anger in response to your parents reminding you to check blood glucose); while the latter involves understanding and acceptance of emotion (e.g., reappraising that you are angry after your parent gives the reminder). Skill in each is related to increased adaptation and positive psychosocial Journal of Pediatric Psychology 37(8) pp. 925–934, 2012 doi:10.1093/jpepsy/jss062 Advance Access publication April 19, 2012 Journal of Pediatric Psychology vol. 37 no. 8 ß The Author 2012. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com at University of California, Merced on September 30, 2014 http://jpepsy.oxfordjournals.org/ Downloaded from