Peer Relationships and Diabetes: Retrospective and Ecological Momentary Assessment Approaches

Objective: To examine the association of positive and negative aspects of friendship to psychological well-being, self-care behavior, and blood glucose control and to determine whether these relations were moderated by gender. Design: Adolescents with Type I diabetes (n = 76) completed baseline measures of friendship quality, depressive symptoms, and self-care. A measure of metabolic control was obtained from medical records. Adolescents also tested blood glucose periodically over the course of 4 days and completed ecological momentary assessments of interpersonal interactions and mood using PDAs. Main Outcome Measures: For between-groups analyses, primary outcomes were depressive symptoms, self-care behavior, and metabolic control. For within-groups analyses, primary outcomes were mood and blood glucose. Results: Results showed baseline reports of peer conflict but not support were associated with outcomes, particularly among girls. Conflict was more strongly related to poor metabolic control for girls than boys. Momentary interaction enjoyment and interaction upset were associated with mood, but were unrelated to blood glucose. Aggregate indices of enjoyable interactions were associated with fewer depressive symptoms and better self-care-especially among girls. Conclusions: These results suggest that the positive and negative aspects of peer relationships are related to the psychological well-being and physical health of adolescents with diabetes.