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- Emotion regulation, fear of hypoglycemia, and diabetes distress in parents of children with type 1 diabetesPublication . Vieira, Anabela; Costa, Vasco; Pais Brandão, Tânia RaquelParents of children and adolescents with type 1 diabetes (T1D) are responsible for intensive daily disease management and often experience high levels of emotional distress. This study examined whether fear of hypoglycemia mediates the association between parents’ emotion regulation strategies and diabetes-related distress. Participants were recruited through Facebook and WhatsApp groups for parents of children and adolescents with T1D, and data was collected via self-report online questionnaires. A total of 102 parents, 92.2% mothers (aged 32–58 years) of children with T1D aged 8–17 years, completed measures of fear of hypoglycemia (Hypoglycemia Fear Survey—Parent Version), diabetes distress (Problem Areas in Diabetes-Parent Revised) and emotion regulation strategies (Emotion Regulation Questionnaire), along with a sociodemographic questionnaire. Four mediation models were tested using PROCESS, including cognitive reappraisal and expressive suppression as predictors and the worry and behavior subscales of fear of hypoglycemia as mediators. Results revealed a significant indirect effect of worry on the relationship between cognitive reappraisal and diabetes distress (indirect effect = −0.15, 95% CI [−0.35, −0.02]), highlighting worry as a potential mediator between these variables, while the direct effect was negative but non-significant. No significant indirect effects were found for expressive suppression on the behavior subscale (indirect effect = 0.12; 95% IC [−0.07; 0.36]) or on the worry subscale (indirect effect = 0.07; 95% IC [−0.08; 0.24]). These findings suggest that cognitive reappraisal may be associated with lower diabetes-related distress through lower levels of excessive worry about hypoglycemia. Clinically, the results highlight fear-related cognition can be a relevant intervention target, alongside emotion regulation skills, in psychosocial support programs for parents of youth with T1D.
