Executive function mediates the link between externalizing behavior and HbA1c in children and adolescents with type 1 diabetes: A cross-national investigation.
Identifieur interne : 000211 ( Main/Exploration ); précédent : 000210; suivant : 000212Executive function mediates the link between externalizing behavior and HbA1c in children and adolescents with type 1 diabetes: A cross-national investigation.
Auteurs : Eveline R. Goethals [Belgique, États-Unis] ; Jurgen Lemiere [Belgique] ; Frank J. Snoek [Pays-Bas] ; Kristina Casteels [Belgique] ; Koen Luyckx [Belgique, Afrique du Sud] ; Maartje De Wit [Pays-Bas]Source :
- Pediatric diabetes [ 1399-5448 ] ; 2020.
Abstract
OBJECTIVE
Externalizing behavior (i.e., conduct problems, hyperactivity) and executive function (EF) problems in children and adolescents with type 1 diabetes (T1D) have been associated with worse diabetes-related and psychosocial outcomes but have not been examined in relationship to each other. We aimed to examine whether externalizing behavior is associated with HbA1c and whether this relationship is mediated by EF problems, specifically metacognition (i.e., ability to initiate, plan, organize and monitor behavior) and behavioral regulation (i.e., impulse control, regulation of emotion and behavior).
RESEARCH DESIGN AND METHODS
Cohorts of Belgian and Dutch parents of children and adolescents (6-18 years) with T1D filled out questionnaires on externalizing behavior (Strengths and Difficulties Questionnaire; SDQ) and EF (Behavior Rating Inventory of Executive Function; BRIEF) composite scales. Treating physicians collected HbA1c values. Mediation analyses were performed separately for the BRIEF composite Metacognition and Behavior Regulation scales, correcting for age, sex and diabetes duration.
RESULTS
The 335 parents of children and adolescents with T1D (mean age 12.3 ± 2.8 SD; mean HbA1c 7.6% ± 1.1 SD [60 mmol/mol ± 12.0 SD]; mean diabetes duration 5.3 ± 3.6 SD; 49.6% female) participated. Analyses showed that the association between externalizing behavior and HbA1c is mediated by metacognition (ab path Point estimate = 0.05 BCa CI 95% 0.02-0.08), and not behavioral regulation.
CONCLUSIONS
Results uncovered the influence externalizing behavior may have on EF problems in the metacognition domain, which in turn seem to influence HbA1c. Clinicians should be mindful of these EF problems when working with children and adolescents displaying externalizing behavior, and not only target behavioral but also cognitive processes.
DOI: 10.1111/pedi.13172
PubMed: 33314616
Affiliations:
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Goethals</name><affiliation wicri:level="1"><nlm:affiliation>School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Harvard Medical School, Joslin Diabetes Center, Boston, Massachusetts, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Harvard Medical School, Joslin Diabetes Center, Boston, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Lemiere, Jurgen" sort="Lemiere, Jurgen" uniqKey="Lemiere J" first="Jurgen" last="Lemiere">Jurgen Lemiere</name><affiliation wicri:level="1"><nlm:affiliation>Pediatrics, University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Pediatrics, University Hospitals Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Snoek, Frank J" sort="Snoek, Frank J" uniqKey="Snoek F" first="Frank J" last="Snoek">Frank J. Snoek</name><affiliation wicri:level="3"><nlm:affiliation>Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Casteels, Kristina" sort="Casteels, Kristina" uniqKey="Casteels K" first="Kristina" last="Casteels">Kristina Casteels</name><affiliation wicri:level="1"><nlm:affiliation>Pediatrics, University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Pediatrics, University Hospitals Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Luyckx, Koen" sort="Luyckx, Koen" uniqKey="Luyckx K" first="Koen" last="Luyckx">Koen Luyckx</name><affiliation wicri:level="1"><nlm:affiliation>School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Unit for Professional Training and Service in the Behavioural Sciences, University of the Free State, Bloemfontein, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Unit for Professional Training and Service in the Behavioural Sciences, University of the Free State, Bloemfontein</wicri:regionArea><wicri:noRegion>Bloemfontein</wicri:noRegion></affiliation></author><author><name sortKey="De Wit, Maartje" sort="De Wit, Maartje" uniqKey="De Wit M" first="Maartje" last="De Wit">Maartje De Wit</name><affiliation wicri:level="3"><nlm:affiliation>Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author></analytic><series><title level="j">Pediatric diabetes</title><idno type="eISSN">1399-5448</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>Externalizing behavior (i.e., conduct problems, hyperactivity) and executive function (EF) problems in children and adolescents with type 1 diabetes (T1D) have been associated with worse diabetes-related and psychosocial outcomes but have not been examined in relationship to each other. We aimed to examine whether externalizing behavior is associated with HbA1c and whether this relationship is mediated by EF problems, specifically metacognition (i.e., ability to initiate, plan, organize and monitor behavior) and behavioral regulation (i.e., impulse control, regulation of emotion and behavior).</p></div><div type="abstract" xml:lang="en"><p><b>RESEARCH DESIGN AND METHODS</b></p><p>Cohorts of Belgian and Dutch parents of children and adolescents (6-18 years) with T1D filled out questionnaires on externalizing behavior (Strengths and Difficulties Questionnaire; SDQ) and EF (Behavior Rating Inventory of Executive Function; BRIEF) composite scales. Treating physicians collected HbA1c values. Mediation analyses were performed separately for the BRIEF composite Metacognition and Behavior Regulation scales, correcting for age, sex and diabetes duration.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The 335 parents of children and adolescents with T1D (mean age 12.3 ± 2.8 SD; mean HbA1c 7.6% ± 1.1 SD [60 mmol/mol ± 12.0 SD]; mean diabetes duration 5.3 ± 3.6 SD; 49.6% female) participated. Analyses showed that the association between externalizing behavior and HbA1c is mediated by metacognition (ab path Point estimate = 0.05 BCa CI 95% 0.02-0.08), and not behavioral regulation.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Results uncovered the influence externalizing behavior may have on EF problems in the metacognition domain, which in turn seem to influence HbA1c. Clinicians should be mindful of these EF problems when working with children and adolescents displaying externalizing behavior, and not only target behavioral but also cognitive processes.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33314616</PMID><DateRevised><Year>2021</Year><Month>02</Month><Day>08</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1399-5448</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Dec</Month><Day>13</Day></PubDate></JournalIssue><Title>Pediatric diabetes</Title><ISOAbbreviation>Pediatr Diabetes</ISOAbbreviation></Journal><ArticleTitle>Executive function mediates the link between externalizing behavior and HbA1c in children and adolescents with type 1 diabetes: A cross-national investigation.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1111/pedi.13172</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Externalizing behavior (i.e., conduct problems, hyperactivity) and executive function (EF) problems in children and adolescents with type 1 diabetes (T1D) have been associated with worse diabetes-related and psychosocial outcomes but have not been examined in relationship to each other. We aimed to examine whether externalizing behavior is associated with HbA1c and whether this relationship is mediated by EF problems, specifically metacognition (i.e., ability to initiate, plan, organize and monitor behavior) and behavioral regulation (i.e., impulse control, regulation of emotion and behavior).</AbstractText><AbstractText Label="RESEARCH DESIGN AND METHODS" NlmCategory="METHODS">Cohorts of Belgian and Dutch parents of children and adolescents (6-18 years) with T1D filled out questionnaires on externalizing behavior (Strengths and Difficulties Questionnaire; SDQ) and EF (Behavior Rating Inventory of Executive Function; BRIEF) composite scales. Treating physicians collected HbA1c values. Mediation analyses were performed separately for the BRIEF composite Metacognition and Behavior Regulation scales, correcting for age, sex and diabetes duration.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The 335 parents of children and adolescents with T1D (mean age 12.3 ± 2.8 SD; mean HbA1c 7.6% ± 1.1 SD [60 mmol/mol ± 12.0 SD]; mean diabetes duration 5.3 ± 3.6 SD; 49.6% female) participated. Analyses showed that the association between externalizing behavior and HbA1c is mediated by metacognition (ab path Point estimate = 0.05 BCa CI 95% 0.02-0.08), and not behavioral regulation.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Results uncovered the influence externalizing behavior may have on EF problems in the metacognition domain, which in turn seem to influence HbA1c. Clinicians should be mindful of these EF problems when working with children and adolescents displaying externalizing behavior, and not only target behavioral but also cognitive processes.</AbstractText><CopyrightInformation>© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Goethals</LastName><ForeName>Eveline R</ForeName><Initials>ER</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-1242-8851</Identifier><AffiliationInfo><Affiliation>School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Harvard Medical School, Joslin Diabetes Center, Boston, Massachusetts, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lemiere</LastName><ForeName>Jurgen</ForeName><Initials>J</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-1575-0889</Identifier><AffiliationInfo><Affiliation>Pediatrics, University Hospitals Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Snoek</LastName><ForeName>Frank J</ForeName><Initials>FJ</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-9563-6762</Identifier><AffiliationInfo><Affiliation>Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Casteels</LastName><ForeName>Kristina</ForeName><Initials>K</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-9690-3551</Identifier><AffiliationInfo><Affiliation>Pediatrics, University Hospitals Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Luyckx</LastName><ForeName>Koen</ForeName><Initials>K</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-8862-5598</Identifier><AffiliationInfo><Affiliation>School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Unit for Professional Training and Service in the Behavioural Sciences, University of the Free State, Bloemfontein, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Wit</LastName><ForeName>Maartje</ForeName><Initials>M</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-6029-5101</Identifier><AffiliationInfo><Affiliation>Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>Belgian American Educational Foundation</Agency><Country></Country></Grant><Grant><GrantID>2011.13.1449</GrantID><Agency>Dutch Diabetes Foundation</Agency><Country></Country></Grant><Grant><Agency>Iacocca Family Foundation</Agency><Country></Country></Grant><Grant><Agency>Vlaamse Vereniging voor Diabetescentra</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>12</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>Denmark</Country><MedlineTA>Pediatr Diabetes</MedlineTA><NlmUniqueID>100939345</NlmUniqueID><ISSNLinking>1399-543X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">adolescents</Keyword><Keyword MajorTopicYN="N">children</Keyword><Keyword MajorTopicYN="N">executive function</Keyword><Keyword MajorTopicYN="N">externalizing behavior</Keyword><Keyword MajorTopicYN="N">glycemic control</Keyword><Keyword MajorTopicYN="N">self-management</Keyword><Keyword MajorTopicYN="N">type 1 diabetes</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>02</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>09</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>11</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>12</Month><Day>14</Day><Hour>11</Hour><Minute>15</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33314616</ArticleId><ArticleId IdType="doi">10.1111/pedi.13172</ArticleId></ArticleIdList><ReferenceList><Title>REFERENCES</Title><Reference><Citation>Beck RW, Bergenstal RM, Laffel LM, Pickup JC. 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Goethals</name></noRegion><name sortKey="Casteels, Kristina" sort="Casteels, Kristina" uniqKey="Casteels K" first="Kristina" last="Casteels">Kristina Casteels</name><name sortKey="Lemiere, Jurgen" sort="Lemiere, Jurgen" uniqKey="Lemiere J" first="Jurgen" last="Lemiere">Jurgen Lemiere</name><name sortKey="Luyckx, Koen" sort="Luyckx, Koen" uniqKey="Luyckx K" first="Koen" last="Luyckx">Koen Luyckx</name></country><country name="États-Unis"><region name="Massachusetts"><name sortKey="Goethals, Eveline R" sort="Goethals, Eveline R" uniqKey="Goethals E" first="Eveline R" last="Goethals">Eveline R. Goethals</name></region></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Snoek, Frank J" sort="Snoek, Frank J" uniqKey="Snoek F" first="Frank J" last="Snoek">Frank J. Snoek</name></region><name sortKey="De Wit, Maartje" sort="De Wit, Maartje" uniqKey="De Wit M" first="Maartje" last="De Wit">Maartje De Wit</name></country><country name="Afrique du Sud"><noRegion><name sortKey="Luyckx, Koen" sort="Luyckx, Koen" uniqKey="Luyckx K" first="Koen" last="Luyckx">Koen Luyckx</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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