ABSTRACT
Type 1 Diabetes (T1D) adolescents have higher depression rates than controls. Self-efficacy has been proposed as a mediator of therapeutic changes. Few scales assess emotional self-efficacy in adolescents. None have been validated with T1D youth. We examined the psychometric properties of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA) with 51 T1D youth (aged 12-17 years), enrolled in a depression treatment study. Adolescents and one parent each completed several measures. Youth completed the EADA. We used alpha coefficient to estimate its internal consistency and Pearson correlation to assess its concurrent and construct validity. We found an internal consistency of 0.93 for the EADA total score, with alpha values ranging from 0.71 to 0.85 for its subscales. EADA scores significantly (p ≤ 0.05) diverged from self-reports of depression, hopelessness/helplessness, suicidal ideation, self-esteem/guilt problems, depression-related cognitive alterations, hypoglycemic symptoms, and problems in quality of life. Its scores converged with youth's life satisfaction, self-efficacy for diabetes, self-care behaviors, and perceptions about the quality of group therapy climate and family social support. Our findings document EADA's reliability and validity when used with T1D youth and extend the supporting evidence on its psychometric properties to a clinical sample of Latino adolescents.
ABSTRACT
OBJECTIVE: Family conflict is related to depression, difficulties with treatment adherence and glycemic control, in adolescents with type 1 diabetes (T1D). We examined the psychometric properties of a parent-rated family conflict measure and the most frequent behaviors endorsed by caregivers of these youths. METHODS: Participants were 51 caregivers (86.27% women) of adolescents (aged 12-17) with T1D, recruited during a psychotherapy study for youth depression. Both (caregivers and youths) completed questionnaires during the eligibility evaluation. Caregivers completed the Conflict subscale of the Family Environment Scale, considering to what extent its items described their whole family or its majority. RESULTS: The most frequent indicators of conflict where becoming upset, displaying anger openly, believing that something can be achieved by speaking loudly, and criticizing and fighting, although not physically. Internal consistency for the subscale when rating conflict indicators in a dichotomous format was .69 and .76 when rated in an ordinal format. Conflict scores correlated moderately and significantly (p less than or equal .05) with other measures completed by youths and caregivers. Caregivers of youths with the worst glycemic control reported the highest levels of conflict. The subscale also showed a satisfactory sensitivity to change by reflecting a significant reduction in caregivers' reports of family conflict after adolescent group treatment. CONCLUSION: Our results confirm the frequent occurrence of conflict (especially verbal conflict) in these families and document the psychometric properties of a measure for its assessment, which may be useful in studies that examine the impact of family conflict in both youth depression and diabetes.
