Eating disturbances in girls with diabetes: the contribution of adolescent self-concept, maternal weight and shape concerns and mother–daughter relationships

Background. This study examined the relative contribution of adolescent self-concept, maternal weight and shape concerns (WSC), and mother–daughter relationships to eating disturbances among girls with type 1 diabetes mellitus (DM).

Method. Eighty-eight adolescent girls (mean=15·0 years, s.d.=2·2) and their mothers completed self-report measures of disordered eating and weight control behaviours, with teens also reporting on disturbed eating and body attitudes. Based on reported symptoms, adolescents were classified as highly (N=18), mildly (N=30) and non-eating disturbed (N=40). Self-concept was assessed by adolescent self-report. Mother–daughter relationships were assessed by adolescent self-report and by observed mother–daughter interactions that were rated using a macroanalytic coding system that assesses intimacy and autonomy in these relationships.

Results. Hierarchical regressions illustrated that adolescent self-concept deficits, maternal WSC, and impaired mother–daughter relationships significantly predicted eating disturbances in girls with DM, accounting for 57% of the variance. Mothers who engaged in dieting and binge-eating were more impaired in their ability to support their daughters' emerging autonomy. The quality of mother–daughter relationships partly mediated the influence of maternal WSC on adolescent eating disturbances. Moreover, the impact of maternal WSC and mother–daughter relationships on eating disturbances was mediated by adolescent self-concept.

Conclusions. Findings illustrate two pathways through which mother–daughter relationships may impact upon risk of eating disturbances in girls with DM and highlight the need to evaluate family-based interventions specifically tailored for this high-risk population.