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Title: Mentalizing diabetes in the mother-child dyad
Author: Costa Cordella, Stefanella Maria
ISNI:       0000 0004 7965 1577
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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Type 1 diabetes (T1D) is a life-threatening chronic illness, the management of which is demanding for both children and their caregivers. It is widely accepted that psychological aspects play a crucial role in its course. T1D affects and is affected by psychosocial issues, both directly, through behaviour, and indirectly, through the metabolic effects of stress. However, previous studies of T1D have not considered the role of interpersonal and attachment relationships in regulating these effects, despite the valuable understanding such research has offered in the case of other chronic, stress-related conditions. In response, the present PhD thesis aims to develop a theoretical model for the understanding of T1D in children and their caregivers from a contemporary psychodynamic perspective, rooted in attachment and mentalizing approaches, and to empirically test the key assumptions of this model. To this end, three observational, cross-sectional studies were performed. Study 1 investigated the relationship between attachment, mentalizing, stress and diabetes outcomes and self-report measures in a sample of 77 mother-child dyads. In Study 2, initial validation of a measure for testing diabetes-specific Reflective Functioning (RF) was carried out with a sample of 91 mother-child dyads. Study 3 compared levels of maternal and child RF from observer-rated measures in two dyad groups (N=55): one with good and another with poor diabetes control. Overall, both mother and child's mentalizing, attachment and stress appear to have an impact on diabetes outcomes, with important gender differences. However, the mechanisms that mediate the relationship between these factors require further elucidation. Our results support the theoretical model proposed and establish an empirical framework for further research on this topic, while also highlighting the need and feasibility of developing mentalization-based interventions for diabetic children and their caregivers. At the same time, findings from these studies point to important limitations of the proposed theoretical approach, and directions for future research.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available