Objective

To identify whether changes in pubertal status and self-efficacy for diabetes management are associated with longitudinal declines in parental responsibility for diabetes, and to determine whether these factors moderate associations between declining parental responsibility and deteriorating adherence across adolescence.

Methods

Adolescents (N = 252; 53.6% females) with type 1 diabetes, mothers, and 188 fathers participated in a 2.5-year longitudinal study. Self-reports of pubertal status, adolescent efficacy, parental responsibility, and adherence were completed every 6 months (6 time points).

Results

Latent growth curve modeling revealed that longitudinal increases in efficacy and pubertal maturation were uniquely associated with longitudinal declines in parental responsibility. Declines in parental responsibility were related to deterioration in adherence especially when adolescents did not report concomitant growth in self-efficacy.

Conclusions

Transfer of responsibility for diabetes management across adolescence may be more optimal when adolescents' increased independence is titrated to their changing self-efficacy beliefs.

Developing individuals and their families benefit from a warm and supportive relationship that fosters the development of good self-regulatory skills in the child needed for a host of positive developmental outcomes. Children and parents face special challenges to self-regulation when faced with a child's chronic illness. A developmental model is presented that traces how positive parental involvement is coordinated with a child's self-regulation skills (regulation of cognition, emotion, and behavior) that are essential for positive health management. This involves different temporal patterns of coordination of child and parent (and other close relationships) that lead to accumulating regulatory developments that afford benefits for managing illness. This process begins early in infancy through attachment and develops into childhood and adolescence to involve the coordination of parental monitoring and child disclosure that serves as a training ground for the expansion of social relationships beyond the family during emerging adulthood. The specific case of families dealing with type 1 diabetes is used to illustrate the transactional and dynamic nature of parent-child coordination across development. We conclude that a developmental model of parent-child coordination holds promise for understanding positive health outcomes and offers new methodological and statistical tools for the examination of development of both child and parent.