Executive function and quality of life in children and adolescents with type 1 diabetes: The mediating role of the Child Behavior Checklist Dysregulation Profile

Abstract

Type 1 diabetes (T1D) is a common childhood disease with a complex management that could adversely impact the quality of life of young sufferers. Executive functioning problems and psychopathology are factors that appear to have a detrimental effect on T1D-related quality of life (T1D-QoL). However, research on these factors is limited, and the pathways through which they do so remain unclear. This study aims to replicate the relationship between EF and T1D-QoL and to explore the possible mediating role of the clinical dysregulation profile (CBCL-DP) in this relationship. A total of 68 children and adolescents aged 10-18 living with T1D were recruited for this cross-sectional study. Parents reported on youth executive functioning, T1D-QoL, CBCL-DP, and socio-demographic data. In addition, clinical records of the youth were consulted to collect endocrinological information. Statistical analyses encompassed bivariate correlations, linear regressions, and bootstrap analyses to test the mediation model. Results demonstrate that executive function, CBCL-DP, and T1D-QoL are significantly correlated. The mediation model of the CBCL-DP variable in the relationship between executive function and T1D-QoL is significant. In linear regressions, executive function ceases to be significant on T1D-QoL when CBCL-DP is taken into account. The CBCL-DP significantly accounts for 55% of the variance in T1D-QoL.

Conclusion: This study identifies the CBCL-DP as a full mediator between executive function and T1D-QoL, highlighting the importance of emotional and behavioral regulation for quality of life in youth with T1D. The CBCL-DP scale may be useful in identifying regulatory issues and guiding early interventions to improve outcomes in children and adolescents with T1D.

What is known: • Previous studies have suggested that EF problems may negatively affect T1D-QoL; however, no studies have investigated the underlying mechanisms by which these variables are associated and the mediating role of CBCL-DP.

What is new: •This study suggests that there is an absence of a direct association between EF problems and T1D-QoL and identifies the CBCL-DP as a complete mediator between these variables. Furthermore, the study indicates that clinical dysregulation acts as a risk factor for diminished T1D-QoL in children and adolescents with T1D.