Carer's Attachment Anxiety, Stressful Life-Events and the Risk of Childhood-Onset Type 1 Diabetes

Anja Turin, Klemen Dovč, Simona Klemenčič, Nataša Bratina, Tadej Battelino, Jasna Klara Lipovšek, Katarina Uršič, Yael Shmueli-Goetz, Maja Drobnič-Radobuljac, Anja Turin, Klemen Dovč, Simona Klemenčič, Nataša Bratina, Tadej Battelino, Jasna Klara Lipovšek, Katarina Uršič, Yael Shmueli-Goetz, Maja Drobnič-Radobuljac

Abstract

Background/Objective: Type 1 diabetes (T1D) is among the most common chronic diseases in children/adolescents, and the incidence continues to rise worldwide. Different environmental factors have been evaluated in the etiology. In the present study, we investigated the role of attachment examining whether insecure attachment to carers or carers' own attachment insecurity was related to a higher risk of T1D in children. Methods: We included 101 children with T1D (mean age 11.8 years), 106 healthy controls (11.6 years), and one of their carers. We assessed children's attachment using the Child Attachment Interview and carers' attachment using the Relationship Structures Questionnaire. We constructed binary multinomial logistic regression models using attachment to mothers, carers' attachment representations, and stressful life-events as T1D predictors. Results: Higher carer attachment anxiety was associated with the child's T1D diagnosis (p < 0.05; R 2 = 0.0613) while security of attachment to mothers showed no significant association. When mothers' education was included in the model, both attachment anxiety in higher educated mothers and stressful life events showed a significant association with the child's T1D (p < 0.001; R 2 = 0.293). Conclusions: Our findings suggest that higher attachment-related anxiety in carers with high education and stressful life events are associated with T1D in children.

Keywords: attachment—a strong affectional bond; child/adolescent; etiology; stress; stressful life events; type 1 diabetes mellitus.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Turin, Dovč, Klemenčič, Bratina, Battelino, Lipovšek, Uršič, Shmueli-Goetz and Drobnič-Radobuljac.

Figures

Figure 1
Figure 1
The consort flow diagram.
Figure 2
Figure 2
The relationship between mothers' education level and children's T1D for different levels of carers' attachment anxiety. The figure shows significant slopes for the three levels of carers' attachment anxiety. The lower the mother's education, the higher the association with T1D for all levels of carers' attachment anxiety. Type 1 diabetes—type 1 diabetes in children; Education—level of mothers' education (−4—finished high school or less, 0—finished university); 25, 50, and 75%—levels of carers' attachment anxiety on ECR-RS (divided in three groups according to quartiles).
Figure 3
Figure 3
The relationship between carers' attachment anxiety and children's T1D for different levels of mothers' education. The figure shows significant slopes for the three levels of mothers' education. In the mothers with higher than secondary education, higher level of carers' attachment-related anxiety was positively associated to T1D in children. This was not the case for mothers with secondary or lower education. Type 1 diabetes—type 1 diabetes in children; Carers' attachment anxiety—carers' ECR-RS general anxiety; 25, 50, and 75%−7 levels of education presented as median and quartiles (25%—finished high school or less, 50%—unfinished or finished college, unfinished university, 75%—university).

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