The role of perceived control in adjustment to diabetes

When are perceptions of control over a threatening event maximally adaptive? In a sample of 43 adolescents with diabetes, we predicted that the relation between personal control and adjustment would be greater (a) when perceptions of control are based in reality, and (b) when the threat is severe. We predicted that health behavior would mediate the relation of personal control to adjustment. We also examined the association of vicarious control (i.e., perceptions that others have control) to adjustment. We interviewed adolescents following a routine physician visit and contacted them by phone four months later. Results confirmed predictions. The relation of personal control to adjustment was mediated by better health behavior but the interpretation of this finding was complicated. We concluded that health behavior was used as a way to manage distress rather than a way to influence the disease. There also was some evidence that vicarious control—specifically, perceiving that parents have control — was maladaptive for a subset of patients.