Behavioral self-regulation in adolescents with Type I diabetes: Negative affectivity and blood glucose symptom perception.

Wiebe, Deborah J.; Alderfer, Melissa A.; Palmer, Steven C.; Lindsay, Robert; Jarrett, Lucie

doi:10.1037/0022-006x.62.6.1204

Cited by 54 publications

(35 citation statements)

References 45 publications

(56 reference statements)

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“…Wiebe et al (9) reported that "negative affectivity," which was also described as a tendency to experience negative emotions, was related to worse glycemic control in a sample of adolescents with type 1 diabetes. The evidence was an observed interaction between measures of trait anxiety and "internal focus" based on a brief self-report measure of how much attention was paid to internal versus external cues for information about blood glucose levels.…”

Section: Discussionmentioning

confidence: 99%

Personality correlates of glycemic control in type 2 diabetes.

et al. 2000

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Abbreviations: NEO-PI-R, NEO Personality Inventory, Revised; SMBG, self-monitoring of blood glucose. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Personality Correlates of Glycemic Control in Type 2 Diabetes O R I G I N A L A R T I C L EOBJECTIVE -To determine whether traits of normal personality are associated with variations in glycemic control in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS -A longitudinal cohort study was conducted using data from 105 type 2 diabetic patients in a clinical trial of a stress management intervention. Before treatment assignment, patients completed the NEO Personality Inventory, Revised, which is a questionnaire inventory measuring 5 major domains of normal personality and 30 important traits that define these domains. Glycemic control was assessed by measures of HbA 1c and average blood glucose levels based on 7 days of self-monitoring at baseline and at 6 and 12 months. Relationships between personality traits and measures of glycemic control were examined by correlation and linear regression models that were adjusted for age, sex, race, duration of diabetes, medication status, and experimental treatment.RESULTS -Lower average blood glucose values at baseline were associated with higher scores for the personality domain of neuroticism and several specific traits including anxiety, angry hostility, depression, self-consciousness, and vulnerability but were associated with lower scores for the trait of altruism. Results were similar for HbA 1c but were not as strong. Followup results were similar but were less consistent.CONCLUSIONS -Personality traits may offer new insights into variations in glycemic control in patients with type 2 diabetes undergoing standard management. The relative tendency to experience fewer negative emotions and to focus on the needs of others instead of oneself could prove to be a risk factor for poor glycemic control.

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Section: Discussionmentioning

confidence: 99%

Personality correlates of glycemic control in type 2 diabetes.

et al. 2000

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“…Anxiety may also have more subtle effects on specific aspects of diabetes management. Individuals with T1DM who are high in trait anxiety show a tendency to misattribute bodily symptoms to hypoglycemia, which can lead to unnecessary treatment and hyperglycemia (Wiebe et al, 1994). In addition, needle phobias and fear of self-injecting/testing, which have an obvious potential impact on diabetes management, persist undetected in some patients long after diagnosis (Snoek, Mollema, Heine, Bouter, & van der Ploeg, 1997).…”

Section: Individual Variablesmentioning

confidence: 99%

Diabetes and behavioral medicine: The second decade.

Gönder-Frederick¹,

Cox²,

Ritterband³

2002

Journal of Consulting and Clinical Psychology

166

144

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Diabetes management depends almost entirely on behavioral self-regulation. Behavioral scientists have continued a collaboration with other health systems researchers to develop a holistic approach to this disease. The authors summarized the literature in 4 major areas: self-management of diabetes, psychosocial adjustment and quality of life, neuropsychological impact, and psychobehavioral intervention development. Progress made in each of these areas over the past decade is highlighted, as are important issues that have not yet received sufficient scientific attention. Emerging areas likely to become central in behavioral research, such as diabetes prevention, are introduced. The future of behavioral medicine in diabetes is also discussed, including topics such as the changing role of psychologists in diabetes care, the urgent need for more and better intervention research, the growing importance of incorporating a health system-public health perspective, and obstacles to the integration of psychobehavioral approaches into routine health care delivery.A profound event in diabetes management during the past decade was the release of the 1993 report of the National Institutes of Health (NIH) funded Diabetes Control and Complications Trial (DCCT; DCCT Research Group, 1993), which radically altered both the goals and the philosophy of treatment of this disease. The DCCT was a controlled, prospective trial following more than 1,400 adults and adolescents with Type 1 diabetes (T1DM) over an average of 6.5 years. The results provided strong evidence that the use of intensive treatment regimens to maintain tighter glucose control can delay or prevent the development of at least some of the devastating long-term complications of diabetes, including retinopathy and nephropathy. Subsequent studies replicated these findings and demonstrated the benefits of maintaining tighter metabolic control for patients with Type 2 diabetes (T2DM; Ohkubo et al., 1995;Reichard, Nilsson, & Rosenqvist, 1993;Turner, Cull, & Holman, 1996).It is almost impossible to overestimate the impact of the DCCT on diabetes treatment and research. Seemingly overnight, large numbers of patients were expected to follow a demanding, intensive treatment regimen that previously had been recommended only for those who were most highly motivated and diligent in their diabetes self-management. Health care practitioners were also expected to know how to help patients achieve these lofty treatment goals. In addition to problems in implementing intensive treatment, questions arose concerning the effects of these regimens on quality of life (QOL) for patients. Intensive regimens also posed new dilemmas for health care practitioners and patients, not the least of which was the dramatic increase in risk for episodes of severe hypoglycemia when patients attempted to lower blood glucose (BG) levels. It quickly became clear that the greatest challenge to contemporary diabetes treatment was overcoming the many psychobehavioral and social-environmental barriers to optimal ...

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“…For example, Wiebe, Alderfer, Palmer, Lindsay, and Jarrett (1994) found that trait anxiety significantly influenced symptom perception and interpretation among adolescents with Type 1 diabetes. These findings suggest that further study of personality dimensions in the management and progression of chronic illness in adolescence is warranted.…”

Section: Developmental Perspective On Chronic Illness During Adolescencementioning

confidence: 99%

Adolescent health psychology.

Williams¹,

Holmbeck²,

Greenley³

2002

Journal of Consulting and Clinical Psychology

256

184

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In this article, a biopsychosocial model of adolescent development is used as an organizing framework for a review of primary, secondary, and tertiary prevention research with adolescent populations. During adolescence many critical health behaviors emerge, affecting future disease outcomes in adulthood. In addition, most of the predominant causes of morbidity and mortality in adolescence are unique to this period of development, indicating that health-focused interventions must be tailored specifically to adolescents. Moreover, it is during adolescence that lifelong patterns of self-management of and adjustment to chronic health conditions are established. Thus, an increased focus on adolescence in health psychology research is important both to improve the health of adolescents per se and to optimize health trajectories into adulthood.Adolescence has historically been a developmental period of relative neglect with respect to research on both mental and physical health intervention and outcome. Perhaps such neglect has occurred because, from a health perspective, morbidity and mortality rates are quite low during adolescence compared with other developmental periods (Holden & Nitz, 1995). However, as we argue in this article, adolescence is a pivotal period of development with respect to health and illness. First, it is during adolescence that many positive health behaviors (e.g., diet and exercise) are consolidated and important health risk behaviors (e.g., smoking, alcohol and drug use, and unsafe sexual practices) are first evident; thus, adolescence is a logical time period for primary prevention intervention. Second, the predominant causes of morbidity and mortality in adolescence are quite different from adults, indicating that early identification and treatment of adolescent health problems must be directed toward a unique set of targets in this age group. Moreover, because of the particular developmental issues that characterize adolescence, intervention efforts designed for adults are often inappropriate or ineffective in an adolescent population. Finally, even when chronic illnesses are congenital or begin in childhood (e.g., spina bifida, Type 1 diabetes), the manner in which the transition from childhood to adolescence to young adulthood is negotiated has important implications for disease outcomes throughout the remainder of the life span.Given the unique developmental challenges of adolescence, we argue that an effective and theoretically sound approach to adolescent health psychology research and treatment must be firmly grounded in a developmental framework. We present a biopsychosocial model of adolescent development as one such framework that can inform primary, secondary, and tertiary prevention research and interventions targeting adolescents. This article is organized around the three levels of health-related prevention as they apply to adolescence. Within these levels, we include discussion of the adolescent-focused aspects of what Smith and Ruiz (1999) characterize as the predominant res...

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Behavioral self-regulation in adolescents with Type I diabetes: Negative affectivity and blood glucose symptom perception.

Cited by 54 publications

References 45 publications

Personality correlates of glycemic control in type 2 diabetes.

Personality correlates of glycemic control in type 2 diabetes.

Diabetes and behavioral medicine: The second decade.

Adolescent health psychology.

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