Deconstructing distress: the contribution of cognitive patterns to elevated distress among people with type 2 diabetes
DOI:
https://doi.org/10.1002/edn.72Keywords:
Self-regulation, emotional distress, diabetesAbstract
AbstractBackground: While the prevalence of diabetes-related distress is now well recognised, less is known about how best we might intervene to reduce distress. Effective clinical interventions require a good understanding of the factors responsible for creating elevated distress about diabetes. At present there is a dearth of scientific information in this area.
Aims: The aim of the present study was to identify cognitive patterns that may contribute to elevated distress among people with type 2 diabetes. It was predicted that cognitive illness perceptions would explain variance in diabetes-related distress.
Participants: Research participants were randomly selected from a medical database held in Wellington, New Zealand.
Method: Data was collected via mailed questionnaire survey (n=113).
Results: It was hypothesised that cognitive illness perceptions would account for a significant proportion of the variance in diabetes-related distress. Results supported this hypothesis. Cognitive variables were found to explain approximately 34% of the variability in diabetes distress (p<0.001), when controlling for age.
Conclusions: Research findings highlight two cognitive variables that may play an important role in diabetes distress: (1) a perception that diabetes symptoms fluctuate in cycles, and (2) an expectation that diabetes will have serious life consequences. These findings identify particular cognitive patterns that could form the basis for intervention targets, and might be useful for clinicians and researchers with an interest in reducing the incidence of diabetes-related distress. Findings also highlight the need for careful discussion of diabetes complications in clinical practice.
Downloads
References
Peyrot M, Rubin RR, Lauritzen T, et aL Psychosocial problems and barri-ers to improved diabetes manage-ment results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med 2005; 22: 1379–1385.
Rubin RR, Counselling and psychotherapy in diabetes mellitus. In: Psychology in Diabetes Care, 2nd edn. Snoek FJ, Skinner TC (eds). Chichester: John Wiley Sc Sons, 2005; 171–193.
Scott D, Brown EP. Stories of Life with Diabetes. Palmerston North:Dunmore Press, 1989.
Davis S. The patient's journey: living with diabetes. BMJ 2006; 332: 1018–1020.
Paddison CAM. Psychological Distress Among People with Diabetes. International Behavioural Medicine Society Annual Scientific Meeting 2004, Mainz: 280.
Samuel-Hodge CD, Headen SW, Skelly AH, et al Influences on day-to-day self-management of type 2 dia-betes among African-American women - spirituality, the multi-caregiver role, and other social con-text factors. Diabetes Care 2000; 23: 928–933.
Barnes LC. Cultural Perceptions of Diabetes Mellitus. Doctoral thesis: University of Auckland, 2000.
Keers JC, Links TP, Bouma J, et al. Diabetes-related coping as a determi-nant of success in diabetes rehabilita-tion. 3rd International DAWN Summit 2006, Florence, Italy.
Weinger K, Jacobson AM. Psycho-social and quality of life correlates of glycemic control during intensive treatment of type 1 diabetes. Patient Educ Couns 2001; 42: 123–131.
Tibbetts C. Case study: care coordi-nation and case finding of unde-tected depression in a 72-year-old man with type 2 diabetes. Clin Diabetes 2003; 21: 188–190.
Leventhal H, Diefenbach M, Leventhal EA. Illness cognition: using common sense to understand treatment adherence and affect cog-nition interactions. Cognit Ther Res 1992; 16: 143–163.
Leventhal H, Nerenz DR, Steele DJ, Illness representations and coping with health threats. In: Handbook of Psychology and Health. Baum A, Taylor SE, Singer JE (eds). New Jersey: Lawrence Erlbaum Associates, 1984.
Welch G, Weinger K, Anderson B, et al. Responsiveness of the Problem Areas In Diabetes (PAID) question-naire. Diabet Med 2003; 20: 69–72.
Moss-Morris R, Weinman J, Petrie KJ, et al The revised Illness Perception Questionnaire (IPQ-R). Psychology and Health 2002; 17:1–16.
Loewe R, Schwartzman J, Freeman J, et aL. Doctor talk and diabetes: towards an analysis of the clinical construction of chronic illness. Soc Sci Med 1998; 47: 1267–1276.
Wiebe DJ, Korbel C. Defensive denial, affect, and the self-regulation of health threats. In: The Self-regula-tion of Health and Illness Behaviour. Cameron LD, Leventhal H (eds). London: Routledge, 2003; 184–203.
Garay-Sevilla ME, Malacara JM, Gutierrez-Roa A, et al. Denial of dis-ease in type 2 diabetes mellitus: its influence on metabolic control and associated factors. Diabet Med 1999; 16: 238–244.
Cameron LD. Anxiety, cognition, and responses to health threats. In: The Self-regulation of Health and Illness Behaviour. Cameron LD, Leventhal H (eds). London: Routledge, 2003; 157–183.
Paschalides C, Wearden AJ, Dunkerley R, et aL. The associations of anxiety, depression and personal illness representations with gly-caemic control and health-related quality of life in patients with type 2 diabetes mellitus. J Psychosom Res 2004; 57: 557–564.
Skinner TC, Carey ME, Cradock S, et aL Diabetes education and self-management for ongoing and newly diagnosed (DESMOND): process modelling of pilot study. Patient Educ Counsel 2006; 64: 369–377.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2007 Copyright © 2007 FEND
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
