Psychosocial factors in treatment efficacy of dyslipidemic adolescents

Abstract

This study investigated the family dynamics, subjective health rating, value on health, self-efficacy, self-esteem, and depression level of adolescents beginning a dyslipidemia treatment program, and evaluated whether these psychosocial factors predicted treatment efficacy as measured by changes in serum lipid levels. Differences between obese and non-obese dyslipidemic patients were also investigated. New patients in the program were asked to complete surveys measuring the psychosocial constructs at T1, and baseline lipid and body mass index (BMI) levels were obtained. Approximately six to nine months later, the outcome measures of serum lipids and BMI were again measured. Pearson correlation and ANOVA analyses were utilized to investigate relationships between the psychosocial variables and outcome measures.;There were significant, positive correlations between family cohesion and adaptability, subjective health rating and self-esteem, and between subjective health rating, self-efficacy and self-esteem. There were significant, negative correlations between depression and family cohesion, subjective health rating, self-efficacy, and self-esteem. Status in the older age group (13-17 years old) was found to be significantly related to higher self-efficacy. Being female was associated with lower self-esteem and higher depression levels which approached significance. With the exception of non-obese subjects evidencing significantly higher family cohesion, the obese and non-obese subjects did not differ on the psychosocial measures.;There were no significant correlations between T1 psychosocial measures and percent serum lipid change for the total sample. In the younger age group (10-12 years old), higher baseline self-efficacy predicted a significant percent increase in HDL-C, and higher self-esteem predicted a significant percent increase in LDL-C. Status in the older age group was associated with a significantly greater change in LDL-C from T1 to T2. Gender was not independently associated with serum lipid change The total sample experienced mean increases in BMI from T1 to T2. Self-esteem was positively correlated with percent BMI change in the non-obese group, but not in the obese. The findings suggest that age, sex, and obesity status have more impact on lipid outcomes than the psychosocial factors studied. However, trends in the data suggest a need to further explore the role of psychosocial factors in treatment efficacy.