No worries, no impact? A systematic review of emotional, cognitive, and behavioural responses to the diagnosis of type 2 diabetes

Abstract

Previous research suggests that patients with type 2 diabetes quickly adjust to their diagnosis, but most studies tend to focus on emotional outcomes. This systematic review also examines patients' cognitive and behavioural responses in the first year after diagnosis, based on empirical studies published between 1993 and 2008. A total of 24 studies are presented in order from most to least rigorous design. A further distinction is made between being diagnosed in the context of a screening programme and other forms of diagnoses. This review confirms that the diagnosis of type 2 diabetes has limited longterm emotional impact, if at all, regardless of how patients are detected. Examination of cognitive and behavioural responses indicate that most patients underestimate the seriousness of their diabetes, overestimate their ability to control it and show limited engagement in the management of their disease. The results also indicate considerable variations in adjustment to the illness. These are related to symptom experience, prior knowledge, and information provision and treatment. Overall, this review shows that a lack of emotional distress does not necessarily indicate a successful adjustment but may instead reflect patients' tendency to avoid dealing with and managing their diabetes until the first signs and symptoms appear, potentially undermining the effectiveness of early detection and treatment.

Life satisfaction and happiness among young adults with schizophrenia

“…This aligns with research showing the fluidity of well-being, whereby adverse events lower well-being acutely, however individuals adjust to their new circumstances and find happiness and meaning in these (Luhmann et al, 2012). Even individuals with chronic illnesses have been found to adjust to their new circumstances and experience a quality of life similar to that of healthy people Thoolen et al, 2008;Barak and Achiron, 2009). Of the clinical variables examined, only depressive symptoms and motivational deficits demonstrated independent predictive value for determining subjective well-being in schizophrenia.…”

“…Schizophrenia is often framed as a severe and debilitating chronic illness, characterized by a multitude of signs and symptoms such as positive (e.g., delusions, hallucinations) and negative (e.g., amotivation, blunted affect) symptoms (van Os and Kapur, 2009). Despite the burden of symptoms and associated functional impairments, many individuals with schizophrenia report being satisfied with their lives (Fervaha et al, 2013b(Fervaha et al, , 2015a.…”

Examining inequities in children’s environmental health: results of a survey on the risk perceptions and protective actions of new mothers

“…In the risk literature, lower income is commonly found to be associated with higher risk perception (Ho, Davidson, and Ghea 2005;Lee et al 2005;Lemyre et al 2006;Thoolen et al 2008), explained by the fact that low SES respondents may feel powerless when it comes to managing risks (Vaughan and Dunton 2007). Correspondingly, in the descriptive data, the most commonly reported factors preventing participants from taking protective action were financial constraints and lack of control.…”

“…using a precautionary approach when purchasing and consuming organic food and non-toxic household products). Therefore, even though health problems associated with environmental exposures may be largely preventable in principle, people who face seemingly insurmountable barriers may be unable to take the actions necessary to reduce risks (CPCHE 2005;Ho, Davidson, and Ghea 2005;Mackendrick, forthcoming;Thoolen et al 2008). The amount of worry associated with risks can also influence protective behaviours; while some worry may encourage protective action, too little or too much worry can have the opposite effect (Thirlaway and Heggs 2005;Wood and Della-Monica 2011).…”

Self-regulation theory and self-monitoring of blood glucose behavior in type 2 diabetes mellitus.

“…The psychological, "nonconscious" processes are an important next step for SMBG research. In health psychology literature, these processes have been consistently shown to contribute to goal selection, goal pursuit and other self-care decisions and behaviors in many illnesses (Aarts, 2007), including diabetes (Thoolen, Ridder, Bensing, Gorter, & Rutten, 2008). The clearest understanding of the utility of SMBG in T2DM will come from research grounded in a theoretical framework, through which to explain psychological factors that are associated with its successful use are explained, and upon which expectations for change are based.…”