Date of Award
2-2025
Document Type
Dissertation
Degree Name
Doctor of Psychology (PsyD)
Department
Graduate Department of Clinical Psychology
First Advisor
Carilyn Ellis PsyD, MSCP
Second Advisor
Amber Nelson, PsyD
Third Advisor
Danny Duke, PhD, ABPP
Abstract
This study explores the relationships between youth executive functioning, symptoms of depression, the self-management (self-care) of Type 1 diabetes (T1D), and glycemic control, a proxy for diabetes-related health outcomes. Utilizing archival clinical data from a universityaffiliated pediatric diabetes clinic, the study tested a priori hypothesized associations between depressive symptoms, executive functioning, diabetes self-care, and health outcomes. Parent and youth measures included the Patient Health Questionnaire-9 to assess youth depression, the Diabetes Related Executive Functioning Scale-Short Form to assess youth executive functioning, and the Diabetes Self-Management Profile-Short Form to assess youth diabetes-related self-care behaviors. Hemoglobin A1c (HbA1c) assays were a secondary outcome and a proxy for health outcomes. We hypothesized depressive symptoms would be significantly associated with selfcare behaviors, executive functioning, and HbA1c. We further hypothesized findings would support that executive functioning mediates the relationship between depressive symptoms and self-care behaviors, and depressive symptoms would be significantly associated with executive functioning and HbA1c. Analysis supported our hypotheses that depressive symptoms are significantly associated with executive functioning, self-care behaviors, and HbA1c. Further, longitudinal analysis provided strong support that executive functioning mediates the relationship between depressive symptoms and later diabetes self-care. In addition, depressive symptoms were significantly associated with HbA1c. Findings highlight the critical youth role of executive functioning in helping youth manage T1D self-care. The study concludes that addressing depressive symptoms and associated executive functioning deficits through targeted behavioral and psychosocial interventions can significantly enhance T1D self-care, and associated health outcomes for youth with T1D. Furthermore, these findings emphasize the critical need to integrate behavioral health care into routine diabetes self-care to support optimal outcomes during this vulnerable developmental stage.
Recommended Citation
Vogel, Erin, "Examining the Role of Executive Functioning in Self-Care of Type 1 Diabetes Among Youth" (2025). Doctor of Psychology (PsyD). 577.
https://digitalcommons.georgefox.edu/psyd/577
