DOI 10.1515/jpem-2012-0410 J Pediatr Endocr Met 2013; 26(9-10): 867–875 Annett Körner*, Julia Würz, Danielle C. Brosseau, Elmar Brähler, Thomas Kapellen and Wieland Kiess Parental dyadic coping in families of children and adolescents with type 1 diabetes Abstract Background: The strains of type 1 diabetes mellitus in children and adolescents pose a challenge to the minor and his/her parents. Objective: The objective of this study was to identify parental dyadic coping patterns and explore their relation to psychosocial and disease variables. Subjects: Parents (n= 44 dyads) of children/adolescents with type 1 diabetes. Methods: Cluster analysis employing Ward’s method was conducted as a multivariate classification procedure without predetermined cluster centers. Results: Three parental coping clusters were identified and labeled: avoiders, negotiators, and doers. Although not reaching statistical significance, the HbA 1c levels of children/adolescents with parental dyads exhibiting the negotiator coping pattern were consistently lower than the levels of children with parents classified as avoiders or doers. Conclusions: Parental dyads were distinguishable based on their dyadic coping patterns with a substantial pro- portion employing avoidant coping and suboptimal com- munication strategies. These parental dyads may benefit from minimal psychosocial intervention. Keywords: adolescents; children; metabolic control; parental coping; type 1 diabetes mellitus. *Corresponding author: Annett Körner, Department of Educational and Counselling Psychology, McGill University, 3700 rue McTavish, Montréal, Québec, H3A 1Y2 Canada, E-mail: annett.koerner@mcgill.ca Julia Würz and Elmar Brähler: Independent Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany Danielle C. Brosseau: Department of Educational and Counselling Psychology, McGill University, 3700 rue McTavish, Montréal, Québec, H3A 1Y2 Canada Thomas Kapellen and Wieland Kiess: Department of Pediatrics, Medical Center of the University of Leipzig, Leipzig, Germany Introduction The strains, restrictions, and demands of type 1 diabetes mellitus in children and adolescents may pose a chal- lenge to the minor, his/her parents, and the entire family system. Even when coping adaptively through the inte- gration of clear routines of care and self-care, conflicts may arise within the family (1). Steinhausen (2) proposed a holistic model of psychological adaptation to chronic illness in children, which incorporates the following factors: specific aspects of the illness, biography, per- sonality, family, and social environment. Following this model, the family, and parental adaptation in particular, is of pivotal importance given its influence on the expe- rience and adjustment of children with type 1 diabetes. Parental adaptation is particularly vital as it is theorized to have a detrimental or a protective effect on children’s ability to cope. Given the importance of the parental dyad for a child’s well-being, it is essential to understand the factors that influence this dyad’s functioning. Research- ers examining family disease management styles propose that the adoption of a certain disease manage- ment style has positive or negative consequences for the parental dyad. Hauenstein et al. (3) described a process of alienation among couples when the dyad adopted a disease management style in which the mother had the sole responsibility for disease management. This aliena- tion and responsibility split led to tension in the parental relationship. In contrast, among parental dyads already exhibiting healthy communication patterns and high cohesion, both the spousal cohesion and communica- tion have been shown to even further improve while caring for the ill child (4). Similarly, Krause and Peter- mann (5) found that some partners reported increased emotional closeness and higher family cohesion over the course of coping with a chronic illness. Others have also highlighted the pivotal impact of the family system as some researchers have suggested that family climate may even influence a child’s metabolic control (3, 6–8). This is said to occur as psychological stress activates neuroendocrine and other physiological mechanisms, which, in turn, raise blood glucose levels (9). However, Bereitgestellt von | Universitaetsbibliothek Leipzig Angemeldet | 139.18.235.208 Heruntergeladen am | 04.04.14 05:12