Physical self-discrepancies and emotional discomfort in adolescents affected by type1-diabetes and controls

Objectives The perception of one’s own body as imperfect and dependent from medical treatments could expose adolescents affected by type1-diabetes (T1D) to negative judgments on their actual body and higher ideals on physical self-concept. Therefore, in line with predictions based on Self-Discrepancy Theory, we hypothesize that in T1D-adolescents the association between actual/ideal-discrepancy (AID) and depression might be stronger than controls. Moreover, T1D-adolescents are commonly required (by parents and doctors) to be particularly responsible for the medical needs of their bodies. However, the normal process of autonomy and individualization from adults might expose T1D-adolescents to high actual/ought-discrepancy (AOD), and stronger associations between AOD and anxiety than controls. Design We performed several sets of regressions using as dependent variables depression and anxiety measures and as independent variables various discrepancy measures. Methods A sample of 170 T1D-adolescents (age range: 11-18; males: 57%) and an equivalent sample of controls (N=172), completed an adaptation of the Selves Questionnaire to the physical self-domain and self-report measures of depression and anxiety. Findings Results showed no difference between T1D-adolescents and controls in relation to the AID/depression association. Regarding the link between AOD and anxiety, in T1D-adolescents, the effect on anxiety was due to discrepancies between actual-self and ought-self according to significant others perspective; whilst in the control group, the effect on anxiety was due to discrepancies between one’s own representations. Conclusions Our study showed a major role of significant others in the formation of AOD for T1D-adolescents. This has implications for psychological programs to support T1D-adolescents and their families