The relation of alexithymia and attachment with type 1 diabetes management in adolescents: a gender-specific analysis

BACKGROUND: Several studies indicate the role of psychosocial factors in the management and control of chronic diseases in adolescents. In this regard, the roles of attachment and alexithymia in the management of type 1 diabetes in adolescents and related gender-specific patterns have rarely been the focus of empirical research. In this study we investigate the gender-specific relationship of alexithymia and attachment with self-care and blood glucose level in adolescents with type1 diabetes. METHODS: This is a cross-sectional study conducted on adolescents aged 12–18 years, with type 1 diabetes. Participants were recruited from diabetes clinics and the Iranian Diabetes Society. Data were collected using the Farsi versions of the Toronto Alexithymia Scale (FTAS-20), the Inventory of Parent and Peer Attachment (IPPA) and the Summary of Diabetes Self-Care Activities Scale (SDSCA). Blood glucose levels were measured by determining HbA1c which were abstracted from medical records. Data were analyzed using SPSS21 software. RESULTS: Participants were 150 adolescents (57% female), mean age 14.97 ± 2.30. Alexithymia (β = 0.10, P = 0.01), difficulty identifying feelings (β = 0.15, P = 0.03) and communication with mothers (β = − 0.08, P = 0.03) predicted HbA1c in girls, whereas no significant relationships were observed for HbA1c with alexithymia and attachment in boys. Factors that predicted self-care in girls were alexithymia (β = − 0.04, P = 0.02), difficulty identifying feelings (β = − 0.06, P = 0.04); in boys however in addition to these two factors predicting self-care [alexithymia (β = − 0.07, P = 0.01) and difficulty identifying feelings (β = − 0.11, P = 0.01)], we also found difficulty describing feelings (β = − 0.16, P = 0.02), communication with mother (β = 0.04, P = 0.04), alienation to mother (β = − 0.06, P = 0.03), to father (β = − 0.06, P = 0.01) and to peers (β = − 0.09, P = 0.03). CONCLUSIONS: Our results suggest that, in a gender-specific pattern, alexithymia and attachment could affect self-care and blood glucose level in adolescents with type 1 diabetes; findings that can be used to facilitate more effective treatment strategies and interventions in this age group.