Structural Relationships between Anxiety and Diabetes Self Management in Adolescents with Type 1 Diabetes: The Mediating Role of Perceived Stress

Amirzadeh, Fatemeh; Jalali, Mohsen; Pourahmadi, Elnaz; Azizi, Seyedeh Leila

Volume 18, Issue 3 (8-2026) IJDO 2026, 18(3): 180-189 | Back to browse issues page

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Amirzadeh F, Jalali M, Pourahmadi E, Azizi S L. Structural Relationships between Anxiety and Diabetes Self Management in Adolescents with Type 1 Diabetes: The Mediating Role of Perceived Stress. IJDO 2026; 18 (3) :180-189
URL: http://ijdo.ssu.ac.ir/article-1-1059-en.html

Structural Relationships between Anxiety and Diabetes Self Management in Adolescents with Type 1 Diabetes: The Mediating Role of Perceived Stress

Fatemeh Amirzadeh

, Mohsen Jalali ^*

, Elnaz Pourahmadi

, Seyedeh Leila Azizi

Assistant Prof of clinical psychology, Faculty of Humanities and Social sciences, Golestan University, Gorgan, Iran.

Abstract: (25 Views)

Objective: Adolescents with type 1 diabetes often face psychological challenges that may interfere with effective disease management. This study aimed to examine the structural links between anxiety and diabetes self-management, with perceived stress tested as a potential mediator.
Materials and Methods: This descriptive correlational study was conducted among adolescents with type 1 diabetes attending diabetes treatment centers in Tehran, Iran, in 2024. A convenience sample of 310 participants completed the Diabetes Self-Management Questionnaire, the Perceived Stress Scale, and the Beck Anxiety Inventory. Path analysis was conducted using AMOS version 24. The adequacy of the proposed model was evaluated through standard goodness-of-fit indices, and the mediating effect of perceived stress was tested using bootstrap confidence intervals.
Results: The structural model showed an acceptable fit to the observed data. Anxiety had a significant positive effect on perceived stress, β= .33, t= 4.61,P< 0.001, and a significant negative effect on diabetes self-management, β= −0.28, t= −3.90, P< 0.001. Perceived stress was also negatively associated with diabetes self-management, β= −0.46, t= −6.20, P< 0.001. Bootstrap analysis confirmed the significant indirect effect of anxiety on diabetes self-management via perceived stress, 95% CI [-0.28, -0.11]. The final model explained 48% of the variance in diabetes self-management.
Conclusion: Anxiety appears to compromise diabetes self-management among adolescents with type 1 diabetes, partly through heightened perceived stress. Integrating anxiety- and stress-focused psychological interventions into routine diabetes care may improve self-management outcomes in this vulnerable population.

Keywords: Anxiety, Perceived stress, Diabetes self management, Type 1 diabetes, Adolescents

Type of Study: Research | Subject: Special
Received: 2026/08/22 | Accepted: 2026/08/19 | Published: 2026/08/19

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