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Sińska BI, Rzońca E, Kucharska A, Gałązkowski R, Traczyk I, Rzońca P. Factors Influencing the Control of Diabetes Measured via Glycated Hemoglobin Concentrations in Adults with Type 1 Diabetes. Eur J Investig Health Psychol Educ 2023; 13:2035-2045. [PMID: 37887145 PMCID: PMC10606861 DOI: 10.3390/ejihpe13100144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/04/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Numerous complications of type 1 diabetes (T1D) may be prevented through suitable glycemic control. Glycated hemoglobin (HbA1c) may be one of the markers for the early detection of the metabolic imbalance characteristic of the disease. However, optimal control of diabetes is not achieved in a large group of patients. It was demonstrated that numerous factors (sociodemographic, psychological, and clinical) contributed to this condition. The aim of the study was to identify factors influencing the control of diabetes measured via glycated hemoglobin concentrations in people with T1D. Independent factors influencing better diabetes control measured via HbA1c in the study group included higher disease acceptance, higher nutritional adherence, lower BMI, and a lower risk of eating disorders. Describing the determinants will allow for the improvement of the system of care provided to people with T1D and for it to comprise important psychological variables related to self-care and acceptance of the disease.
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Affiliation(s)
- Beata I. Sińska
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland; (A.K.); (I.T.)
| | - Ewa Rzońca
- Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, 00-575 Warsaw, Poland;
| | - Alicja Kucharska
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland; (A.K.); (I.T.)
| | - Robert Gałązkowski
- Department of Emergency Medical Services, Faculty of Health Sciences, Medical University of Warsaw, 00-575 Warsaw, Poland;
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland; (A.K.); (I.T.)
| | - Patryk Rzońca
- Department of Human Anatomy, Faculty of Health Sciences, Medical University of Warsaw, 02-004 Warsaw, Poland;
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Inns SJ, Chen A, Myint H, Lilic P, Ovenden C, Su HY, Hall RM. Comparative Analysis of Body Image Dissatisfaction, Depression, and Health-Related Quality of Life in Adults with Type 1 Diabetes: A Case-Control Study. Nutrients 2023; 15:3938. [PMID: 37764722 PMCID: PMC10534710 DOI: 10.3390/nu15183938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Objective: This case-control study investigated body image dissatisfaction, depression, and health-related quality of life (HRQoL) in adults with type 1 diabetes. (2) Methods: A total of 35 adults with diabetes and an equal number of age- and gender-matched controls were included. Assessment tools used were the Body Image Disturbance Questionnaire (BIDQ), the Hospital Anxiety and Depression Scale (HADS), and the RAND 36-Item Health Survey. Both quantitative and qualitative data were analyzed. (3) Results: Body image dissatisfaction did not differ significantly between the groups. However, adults with diabetes reported higher levels of depression (p = 0.002) and lower scores for physical health (p = 0.015) and general health (p < 0.001) on the HRQoL measure. Qualitative analysis identified common themes related to physical disturbance, effect on activities, and psychosocial concerns. (4) Conclusions: Despite similar body image dissatisfaction, adults with type 1 diabetes exhibited increased depression and reduced HRQoL. These findings emphasize the need to integrate psychological well-being into type 1 diabetes management. They also support further research into the impact of body image dissatisfaction in T1D and potential interventions to address it.
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Affiliation(s)
- Stephen J. Inns
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
- Department of Medicine, University of Otago, P.O. Box 7343, Wellington 6242, New Zealand
| | - Amanda Chen
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Helen Myint
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Priyanka Lilic
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Crispin Ovenden
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Heidi Y. Su
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Rosemary M. Hall
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
- Department of Medicine, University of Otago, P.O. Box 7343, Wellington 6242, New Zealand
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Gu Hong WC, Ferri J, Ampudia-Blasco FJ, Martín-Brufau R, Peiró M, Benito E, Martinez-Hervas S, Sanz MJ, Real JT. Effect of personality on blood glucose control in patients with type 1 diabetes. ENDOCRINOL DIAB NUTR 2022; 69:677-685. [PMID: 36470643 DOI: 10.1016/j.endien.2021.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/04/2021] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The diagnosis of type 1 diabetes mellitus (DM1) has a major impact on young people and their families. Psychosocial factors, patient motivation, participation and acceptance of the disease are essential to achieve good blood glucose control. Our aims were to analyse personality traits and how they are related to blood glucose control in patients with DM1. METHODS Sixty-two patients with DM1 over 18 years of age, with at least one-year disease duration and absence of advanced chronic complications were studied. Clinical, biological and personality parameters were measured. The Millon Index of Personality Styles was administered for personality assessment. RESULTS Significant correlations between different personality variables and glycated haemoglobin (HbA1c) values were found. Individuals with poor blood glucose control had significantly higher scores on the Feeling-guided (53.6±25.7 vs 36.2±26.8, p=0.021), Innovation-seeking (36.7±24.1 vs 21.9±21.4, p=0.025), Dissenting (41.1±24.4 vs 15.6±16.6, p=0.001), Submissive (41.5±25.1 vs 28.3±14.7, p=0.038) and Dissatisfied (37.5±27.5 vs 19.5±20.2, p=0.015) scales. This psychological profile is characterised by greater focus on emotions and personal values (feeling-guided), the tendency to reject conventional ideas (innovation-seeking), an aversion to complying with norms and a preference for autonomy (unconventional/dissenting), labile self-confidence (submissive/yielding) and expressed disagreement with others (dissatisfied/complaining). Factor analysis based on the main components of the variance yielded four factors. Factor characterised as related to rebelliousness or independent judgement and action was correlated with poor blood glucose control (r=0.402, p<0.05). CONCLUSION The rebellious or non-conformist personality type is closely associated with poor blood glucose control in patients with DM1.
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Affiliation(s)
- Wan Chen Gu Hong
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Jordi Ferri
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain; Institute of Health Research of Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Francisco Javier Ampudia-Blasco
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain; Institute of Health Research of Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | | | - Marta Peiró
- Institute of Health Research of Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) [Network Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases], Madrid, Spain
| | - Esther Benito
- Institute of Health Research of Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) [Network Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases], Madrid, Spain
| | - Sergio Martinez-Hervas
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain; Institute of Health Research of Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) [Network Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases], Madrid, Spain.
| | - María Jesús Sanz
- Institute of Health Research of Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) [Network Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases], Madrid, Spain; Department of Pharmacology, University of Valencia, Valencia, Spain
| | - José Tomás Real
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain; Institute of Health Research of Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) [Network Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases], Madrid, Spain
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4
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Gu Hong WC, Ferri J, Ampudia-Blasco FJ, Martín-Brufau R, Peiró M, Benito E, Martinez-Hervas S, Sanz MJ, Real JT. Effect of personality on blood glucose control in patients with type 1 diabetes. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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5
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McCarvill R, Weaver K. Primary care of female adolescents with type 1 diabetes mellitus and disordered eating. J Adv Nurs 2014; 70:2005-2018. [PMID: 24628439 DOI: 10.1111/jan.12384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2014] [Indexed: 11/29/2022]
Abstract
AIM To identify the role of the nurse practitioner in caring for female adolescents with type 1 diabetes mellitus at risk for disordered eating behaviour and to formulate clinical recommendations for nurse practitioners in the primary care setting. BACKGROUND Transition into adulthood can be difficult for female adolescents with type 1 diabetes mellitus. Challenges associated with management of this illness may place adolescent females at an increased risk for disordered eating. DESIGN Discussion paper. DATA SOURCES Sourced literature from 1991-2013, located through CINAHL, Health Source, Proquest, PubMed, PsychInfo, Web of Science and Medline databases. IMPLICATIONS FOR NURSING Nurses involved in the primary care of female adolescents with type 1 diabetes mellitus need to be aware of the increased risk for disordered eating behaviours and develop the competencies to care for both the adolescent and her family to reduce the serious consequences of these behaviours. CONCLUSION Awareness and acquisition of the skills required to intervene will enable nurse practitioners to recognize clients at risk for disordered eating, gain appreciation of the motivation of female adolescents with type 1 diabetes mellitus towards disordered eating behaviours and give optimal opportunity for education, counselling and recovery. Future direction for research includes exploration of the experiences of adolescents with type 1 diabetes mellitus; early interventions in the primary care setting; effective educational, preventative or supportive services for adolescents with this illness and their families; and outcomes to emerging technologies for insulin therapy on disordered eating occurrence.
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Affiliation(s)
| | - Kathryn Weaver
- University of New Brunswick, Fredericton, New Brunswick, Canada
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Roepke SK, Grant I. Toward a more complete understanding of the effects of personal mastery on cardiometabolic health. Health Psychol 2011; 30:615-32. [PMID: 21534674 DOI: 10.1037/a0023480] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE A great deal of research has been devoted to identifying the psychological factors that might be associated with reduced risk for cardiovascular diseases. In particular, coping resources such as personal mastery might attenuate stress-related pathophysiology. The purpose of the present review was to examine the existing literature reporting associations between personal mastery and cardiometabolic health outcomes to determine which outcomes have been studied to date, investigate the extent of inconsistency in the literature, and propose new directions for research. DESIGN Systematic review of articles examining the associations between personal mastery and cardiometabolic health. MAIN OUTCOME MEASURES Studies were included if they examined objective measures of cardiometabolic function, cardiovascular events, and/or mortality. RESULTS Thirty-two studies were identified examining the effect of mastery on the following outcomes: mortality and/or cardiovascular events, psychoneuroendocrine stress systems, cardiovascular reactivity to acute stress, metabolic dysregulation, inflammation/coagulation, and evidence of large vessel disease from imaging methods. CONCLUSIONS Overall, mastery was associated with better cardiometabolic health and reduced risk for disease and/or death, typically with a small-medium effect size. A relatively small proportion of studies reported contradictory findings that higher mastery was associated with poorer cardiometabolic outcomes. The state of the current research suggests that future investigations should focus on 1) clarifying the mediators and moderators most relevant in the association between mastery and downstream disease, 2) testing the association between mastery and biological outcomes longitudinally, 3) examining the physiological impact of mastery-increasing interventions, and 4) studying the relationship between mastery and disease risk in diverse ethnic or sociocultural groups.
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Affiliation(s)
- Susan K Roepke
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, La Jolla, CA 92093-0680, USA
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Cardarelli R, Hogan SA, Fulda KG, Carroll J. The relationship between perceived sense of control and visceral adipose tissue - the North Texas Healthy Heart Study. Biopsychosoc Med 2011; 5:12. [PMID: 21914181 PMCID: PMC3180246 DOI: 10.1186/1751-0759-5-12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 09/13/2011] [Indexed: 11/28/2022] Open
Abstract
Background The purpose of this study was to assess the relationship between one's sense of control and visceral adipose tissue. Methods This cross-sectional study recruited 571 subjects (45 years and older) who were asymptomatic of CHD from Fort Worth, Texas from 2006 to 2008. Subjects completed a questionnaire, body measurements, a multi-slice computed tomography scan to assess for visceral adipose tissue (VAT) centered at the L4L5 spinal interspace, and serum chemistries. The natural log of L4L5 VAT (lnVAT) was used in all analyses to achieve normality of the data with final analyses including 506 participants. Linear regression was used to estimate unadjusted and adjusted beta-coefficients and standard errors for the association between sense of control and lnVAT. Results A total of 506 participants were used in the data after adjusting for normality of the data. An increase in sense of control was associated with a decrease in lnVAT in the unadjusted (p < 0.001) and adjusted (p = 0.03) models. Other factors significantly associated with lnVAT in the adjusted model include age, BMI, male gender, non-Hispanic African American, and diet. Conclusions Sense of control remained as an independent factor associated with visceral adiposity despite adjusting for traditional cardiovascular risk factors, including BMI. Future studies should focus on establishing a causal relationship between sense of control and visceral adiposity.
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Affiliation(s)
- Roberto Cardarelli
- Department of Behavioral and Community Health, School of Public Health, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA.
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Abstract
OBJECTIVE To test the moderating role of the extent of fast-food restaurants in one's immediate environment in the association between mastery and metabolic risk. Higher sense of mastery (perceived control over one's circumstances) has been associated with better metabolic outcomes. Mastery may be instrumental in resisting unhealthful environmental food cues when these become ubiquitous, resulting in a greater health impact of mastery. METHODS Blood samples were obtained from 344 individuals (50% men), aged 18 to 57 years (mean, 34.9 years), sampled from seven census tracts representing the spectrum of census tract-level socioeconomic status and language (French/English) in Montreal. Risk factors based on standards for high-density lipoprotein and total cholesterol, waist circumference, body mass index, triglycerides, and glycated hemoglobin were summed to obtain a cumulative metabolic risk score. Mastery was self-reported, using a validated scale. The proportion of restaurants classified as fast-food within 500 m of participants' residences was determined, using a geographic information system. Main and interactive effects were tested with Poisson regression, accounting for clustering of observations and participants' age, gender, education, and income. RESULTS Mastery interacted with fast-food exposure in relation to metabolic risk (p = .03). Higher mastery was significantly associated with lower metabolic risk for participants surrounded by a high proportion of fast food (relative risk, 0.80; 95% confidence interval, 0.76-0.84; p < .0001), but not for those living in areas with low proportion of fast-food restaurants (relative risk, 0.94; 95% confidence interval, 0.82-1.08; p = .37). CONCLUSIONS A positive relationship between mastery and lower metabolic risk was most apparent in environments with higher fast-food exposure.
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Abstract
It has been suggested that anxious individuals are more prone to feel that negative outcomes are particularly extreme and to interpret ambiguous outcomes as negative compared to nonanxious individuals. Previous studies have demonstrated that the feedback negativity (FN) component of event-related brain potential (ERP) is sensitive to outcome evaluation and outcome expectancy. Hence, we predicted that the FN should be different between high trait-anxiety (HTA) and low trait-anxiety (LTA) individuals. To test our hypothesis, the ERPs were recorded during a simple monetary gambling task. The FN was measured as a difference wave created across conditions. We found that the amplitude of the FN indicating negative versus positive outcomes was significantly larger for LTA individuals compared to HTA individuals. However, there was no significant difference in the FN between groups in response to ambiguous versus positive outcomes. The results indicate that there is a relationship between the FN and individual differences in anxiety. We suggest that these results reflect the impact of anxiety on outcome expectation. Our results challenge the reinforcement learning theory of error-related negativity, which proposes that ERN and FN reflect the same cognitive process.
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Affiliation(s)
- Ruolei Gu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
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Manjarrez-Gutierrez G, Marquez RH, Mejenes-Alvarez SA, Godinez-Lopez T, Hernandez-R J. Functional change of the auditory cortex related to brain serotonergic neurotransmission in type 1 diabetic adolescents with and without depression. World J Biol Psychiatry 2010; 10:877-83. [PMID: 19277928 DOI: 10.1080/15622970902717032] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of this study was to determine whether diabetic patients who were depressed present a decrease of brain serotonergic activity compared to diabetic patients without depression or patients with depression but without diabetes. Determination was made with plasma free fraction of L-tryptophan (FFT) and intensity-dependent auditory-evoked potentials (IDAEPs). Thirty-seven adolescents were studied (20 type 1 diabetic subjects: nine with depression, 11 without depression), nine controls and eight subjects with only depression. FFT, glucose, glycated haemoglobin, free fatty acids, albumin and IDAEPs were determined. All diabetic patients showed a significant decrease of FFT. The group diabetic subjects with depression presented a steeper slope of the amplitude-intensity function of N1/P2 component, suggesting a higher reactivity of the auditory cortex in comparison to diabetic subjects without depression, subjects with only depression, and controls. This was associated with lower plasma FFT. Diabetic subjects with depression had a deficiency of metabolic control due to poor treatment adherence. These findings suggest an enhanced deterioration of brain serotonergic neurotransmission in diabetic subjects with depression with abnormal responses of the auditory cortex. The N1/P2 component of IDAEP is proposed as a non-invasive indicator of brain serotonergic tone that differentiates depressed from non-depressed diabetic patients.
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Affiliation(s)
- Gabriel Manjarrez-Gutierrez
- Laboratory of Molecular Pathology, Cardiology Hospital, National Medical Center (CMN-SXXI), Mexican Institute of Social Security, Mexico City, Mexico.
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Young-Hyman DL, Davis CL. Disordered eating behavior in individuals with diabetes: importance of context, evaluation, and classification. Diabetes Care 2010; 33:683-9. [PMID: 20190297 PMCID: PMC2827531 DOI: 10.2337/dc08-1077] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Deborah L Young-Hyman
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Augusta, Georgia, USA.
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Kichler JC, Foster C, Opipari-Arrigan L. The Relationship between Negative Communication and Body Image Dissatisfaction in Adolescent Females with Type 1 Diabetes Mellitus. J Health Psychol 2008; 13:336-47. [DOI: 10.1177/1359105307088138] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Maladaptive eating attitudes and behaviors are common in adolescent females with Type 1 Diabetes Mellitus (T1DM). This research assessed potential pathways through which individual and familial factors relate to treatment adherence and glycemic control. Seventy-five females with T1DM (aged 11—17 years) and their mothers completed questionnaires regarding communication, diabetes management, and eating attitudes and behaviors. Hierarchical regression analyses found that body image dissatisfaction moderates the relationship between negative communication and maladaptive eating attitudes and behaviors. Treatment adherence mediates the relationship between maladaptive eating attitudes and behaviors and glycemic control. None of the participants endorsed omitting insulin for the purposes of weight management. This study highlights the need to address familial and individual factors along with treatment adherence within this population.
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Affiliation(s)
- Jessica C. Kichler
- University of Michigan Health System & C. S. Mott Children's Hospital, USA,
| | - Carol Foster
- University of Michigan Health System & C. S. Mott Children's Hospital, USA
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Sense of control and diabetes mellitus among U.S. adults: a cross-sectional analysis. Biopsychosoc Med 2007; 1:19. [PMID: 17971217 PMCID: PMC2151060 DOI: 10.1186/1751-0759-1-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Accepted: 10/30/2007] [Indexed: 11/10/2022] Open
Abstract
Background Little is known about the influence of psychosocial factors on diabetes mellitus. The aim of this study was to improve understanding of the association between two psychosocial factors- sense of control and social support- and diabetes mellitus. Methods The authors analyzed data from 2,592 U.S. households in the 1995 survey of the Aging, Status, and the Sense of Control study. Logistic regression analyses were conducted to examine whether sense of personal control and social support were associated with DM and whether gender, race, and Hispanic ethnicity modified these associations. Results After adjusting for age, obesity, and socioeconomic position, a one point increase in sense of control (i.e., a stronger sense of control) was associated a significant reduction in risk of diabetes mellitus (odds ratio = 0.67, 95% confidence interval: 0.47, 0.95). A weak social support system was associated with a non-significant risk of diabetes (odds ratio = 1.32, 95% confidence interval: 0.93, 1.89). No effect modification was detected. Conclusion Sense of control deserves greater attention as a predictor of diabetes mellitus. Further studies of the contribution of psychosocial factors to diabetes mellitus should assess the temporal nature of this relationship.
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Grylli V, Wagner G, Hafferl-Gattermayer A, Schober E, Karwautz A. Disturbed eating attitudes, coping styles, and subjective quality of life in adolescents with Type 1 diabetes. J Psychosom Res 2005; 59:65-72. [PMID: 16186000 DOI: 10.1016/j.jpsychores.2005.02.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2004] [Revised: 02/02/2005] [Accepted: 02/02/2005] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluate coping styles and quality of life in youth with Type 1 diabetes with and without eating disorders and to identify relationships between these variables in each group. METHODS Adolescents were evaluated for eating disorders with a two-stage diagnostic procedure. Adolescents with and without eating disorders then provided data on coping styles and on subjective well-being. RESULTS Adolescents with Type 1 diabetes and disordered eating behavior reported more often blaming themselves and resorting to wishful thinking and poorer physical and psychosocial quality of life than do adolescents with Type 1 diabetes without disordered eating behavior. Specific coping strategies were also positively linked with quality of life and metabolic control. CONCLUSIONS Eating disorders and disordered eating behavior in adolescents with Type 1 diabetes seem to be associated with certain negative and avoidant coping strategies and with impeded physical and bio-psychosocial well-being.
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Affiliation(s)
- Vasileia Grylli
- Eating Disorders Unit, University Clinic of Neuropsychiatry of Childhood and Adolescence, General Hospital of Vienna, Medical University Vienna, Austria
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Lee S, Chan YYL, Kwok K, Hsu LKG. Relationship between control and the intermediate term outcome of anorexia nervosa in Hong Kong. Aust N Z J Psychiatry 2005; 39:141-5. [PMID: 15701062 DOI: 10.1080/j.1440-1614.2005.01535.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine the relationship between control and the intermediate term outcome of Chinese patients with anorexia nervosa. METHOD 88 patients who fulfilled the DSM-III-R criteria for typical (fat phobic, n=63) and atypical (non-fat phobic, n=25) anorexia nervosa were contacted 9 years after the onset of illness. They completed the Morgan-Russell Outcome Assessment Schedule, Shapiro Control Inventory, and Eating Disorder Inventory-I. RESULTS 62.2%, 32.4% and 5.4% of patients had good, intermediate, and poor outcome. Outcome was positively correlated with the overall general and specific sense of control, positive sense of control, and negatively with negative sense of control. Patients with good outcome exhibited the least negative modes of control and had the least desire for control. Typical and atypical patients showed similar but not identical control profiles. CONCLUSION Healthier control was associated with better outcome of anorexia nervosa but their causal relationship was far from clear because of the cross-sectional nature of the present study. The Shapiro Control Inventory is a potentially useful instrument for studying control in eating disorders.
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Affiliation(s)
- Sing Lee
- Department of Psychiatry and Hong Kong Eating Disorders Center, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Maharaj S, Daneman D, Olmsted M, Rodin G. Metabolic control in adolescent girls: links to relationality and the female sense of self. Diabetes Care 2004; 27:709-15. [PMID: 14988290 DOI: 10.2337/diacare.27.3.709] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study investigated whether intimacy and autonomy in mother-daughter interactions and relational aspects of the self are associated with metabolic control in adolescent girls with type 1 diabetes. RESEARCH DESIGN AND METHODS This cross-sectional study included 88 girls with diabetes (mean age 14.9 +/- 2.2 years, diabetes duration 7.1 +/- 3.9 years, and HbA1c 8.9 +/- 1.6%) from the Diabetes Clinic at the Hospital for Sick Children in Toronto and their mothers. Teens completed a self-report measure assessing self-concept in eight domain-specific areas. Mothers and daughters engaged in a 7-min, videotaped, problem-solving task involving a diabetes-related conflict issue. Interactions were rated using a macroanalytic rating system to assess intimacy and autonomy in parent-teen relationships. Metabolic control was measured using HbA1c. RESULTS Self-concept in domains of perceived behavioral conduct (P=0.003), social acceptance (P=0.03), romantic appeal (P=0.03), and close friendships (P=0.04) independently predicted HbA1c levels, together accounting for 30% of the variance. Also, the experience of emotional closeness (i.e., intimacy) rather than separateness (i.e., autonomy) in mother-daughter relationships was associated with lower HbA1c (P=0.03). CONCLUSIONS Relational aspects of the self and the experience of emotional closeness in relationships are associated with metabolic control in adolescent girls. Efforts to improve metabolic control in girls should include enhancing the self-concept and the experience of relatedness in familial, peer, and patient-caregiver relationships.
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Affiliation(s)
- Sherry Maharaj
- Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
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Abstract
Diabetes mellitus (DM) presents itself in two forms: insulin-dependent (type 1 DM) and non-insulin-dependent (type 2 DM). Although type 2 DM usually has an adult onset, in recent years there has been a significant rise in the number of children diagnosed with type 2 DM in the United States. Reasons for this increased frequency are believed to be a larger percentage of children who are overweight, a family history of diabetes, and a considerable increase in the use of psychotropic medication in children. The diagnosis of DM is a significant stressor not only for patients but also for their environment. Children with DM are sometimes stigmatized by their peers and relatives who do not understand the illness or are frightened by it. Some children also may need to alter several of their customary routines and are often scared to participate in activities in which they were previously engaged. The family's response to the diagnosis of DM may have a negative effect on glycemic control. Differences have been found in the way patients with type 1 DM and type 2 DM cope with and adapt to their diagnosis.
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Affiliation(s)
- David Szydlo
- Yale Child Study Center, National Center for Children Exposed to Violence, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06520, USA.
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