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Associations of Disordered Eating Behavior With the Family Diabetes Environment in Adolescents With Type 1 Diabetes

Caccavale, Laura J. MS*; Nansel, Tonja R. PhD; Quick, Virginia PhD, RD; Lipsky, Leah M. PhD; Laffel, Lori M. B. MD, MPH; Mehta, Sanjeev N. MD, MPH

Journal of Developmental & Behavioral Pediatrics: January 2015 - Volume 36 - Issue 1 - p 8–13
doi: 10.1097/DBP.0000000000000116
Original Article
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Objective: To examine associations of disordered eating behaviors with aspects of the family eating and diabetes management environments among adolescents with Type 1 diabetes (T1D).

Methods: Data were collected from 151 adolescents (mean age = 15.6 years) with T1D and their parents. Adolescents and parents completed self-report measures of the family eating environment (priority, atmosphere and structure/rules surrounding family meals, and the presence of restricted and special foods in the household) and diabetes family management environment (diabetes family conflict and responsibility sharing). Adolescents completed measures of parent modeling of healthy eating and disordered eating behaviors. Linear regression models were used to assess the relationship of disordered eating behaviors with aspects of the family eating and diabetes management environments.

Results: In unadjusted models, adolescent, but not parent, report of aspects of the family eating environment was associated with adolescents' disordered eating behaviors. Both adolescent and parent report of diabetes family conflict were positively associated with disordered eating behaviors. The adjusted adolescent model including all family eating and diabetes management variables accounted for 20.8% of the variance in disordered eating behaviors (p < .001, R2 = .208). Factors associated with greater risk of disordered eating included being female (β = .168, p = .029), lower priority placed on family meals (β = −.273, p = .003), less parental modeling of healthy eating (β = −.197, p = .027), more food restrictions in the household β = .223, (p = .005), and greater diabetes family conflict (β = .195, p = .011).

Conclusions: Findings suggest that aspects of the family eating environment and diabetes family conflict may represent important factors for disordered eating risk in adolescents with T1D.

*Department of Psychology, Virginia Commonwealth University, Richmond, VA;

Division of Intramural Population Health Research, NIH, DHHS, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD;

Pediatric, Adolescent and Young Adult Section, Genetics and Epidemiology Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA.

Address for reprints: Laura J. Caccavale, MS, Clinical Psychology Program, Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, PO Box 842018, Richmond, VA 23284-2018; e-mail: caccavalelj@vcu.edu.

Virginia Quick's current affiliation is the Department of Health Sciences, James Madison University, Harrisonburg, VA.

Supported by the intramural research program of the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, contract number HHSN267200703434C.

Disclosure: The authors declare no conflict of interest.

Received April , 2014

Accepted October , 2014

© 2015 by Lippincott Williams & Wilkins