P-181: Emotion regulation skills and treatment engagement support resilience in children living with type 1 diabetes (T1D)
N Kahhan, J Pierce, M Clements, S PattonAbstract
Introduction
Diabetes distress (DD) and resilience are associated in children living with T1D, but the roles that children’s emotion regulation (ER) skills and family treatment engagement play in this association are unknown. ER represents a potentially modifiable skill that may support resilience and family-level engagement, beyond DD alone. Focusing on ER and family-level engagement aligns with strengths-based approaches emphasizing adaptive functioning in T1D.
Objectives
To examine associations among child DD, ER skills, family-level engagement, and resilience in youth with T1D, clarifying the distinct roles of child ER skills and family-level T1D engagement.
Methods
One-hundred eighty-nine families of youth with T1D completed validated child- and parent-reported measures. Child measures included DD, resilience, and ER skills (adaptive and maladaptive); parents reported on family-level T1D engagement and their DD. Bivariate correlations described associations among key variables. A primary linear regression model examined predictors of child resilience, adjusting for child age and T1D duration. Sensitivity analyses examined continuous glucose monitor (CGM) and automated insulin delivery (AID) use and HbA1c.
Results
In bivariate correlations, higher child resilience was associated with lower child and parent DD and higher engagement (p<.01). In the multivariable model, lower parent DD (b=-.07, SE=.03, p<.05) independently predicted higher child resilience, alongside higher engagement (b=.24, SE=.10, p<.05) and lower maladaptive ER skills (b=-.25, SE=.09, p<.01). Child DD, age and T1D duration were not associated. Findings were unchanged for CGM use and HbA1c; AID use attenuated the effects.
Conclusions
Child ER skills and family-level engagement were independently associated with child resilience in youth with T1D. Findings suggest that interventions targeting maladaptive ER skills, alongside efforts to support family-level engagement and address parent DD, may strengthen resilience in children living with T1D.