The Impact of Peer Stress on Disordered Eating Behaviors in Youths With Type 1 Diabetes: A Parallel Mediation Effect...

Disordered eating behaviors (DEBs) have been a prevalent issue among youths with type 1 diabetes (T1D), leading to impaired glycemic control, significant short- and long-term complications, and elevated mortality risk. Peer stress plays a critical role in the development of DEBs in adolescents. However, the association between peer stress and DEBs in youths with T1D remains unestablished, and the underlying mechanisms are unclear. This study investigated how peer stress influences DEBs and examined the parallel mediating role of dual-mode self-control-comprising both impulsive and control systems-in this relationship.

This cross-sectional study included 180 youths with T1D who were recruited from two tertiary hospitals in Nanjing, China, between December 2021 and September 2022. Data were collected using the peer stress subscale of the Diabetes Stress Questionnaire for Youths, the Dual-Mode Self-Control Scale, and the Diabetes Eating Problem Survey-Revised. Descriptive analyses and Pearson correlations were conducted in SPSS 22.0. Parallel mediation effects were tested via Model 4 of the PROCESS macro, using bias-corrected bootstrap with 5000 resamples to determine significant mediation.

Peer stress significantly predicted DEBs (B = 0.55, p < 0.001). Only the impulsive system demonstrated partial mediation in the pathway from peer stress to DEBs (indirect effect = 0.13, 95% CI [0.04, 0.25]), accounting for 22.41% of the total effect.

Peer stress directly influences DEBs and indirectly exacerbates DEBs through the activation of the impulsive system. These findings advance theoretical frameworks on peer stress and DEBs, informing interventions targeting peer stress reduction and impulse regulation to mitigate DEBs in youths with T1D.