Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development

Abstract

Most patients with type 2 diabetes (T2D) have suboptimal adherence to recommended diet, physical activity, and/or medication. Current approaches to improve health behaviors in T2D have been variably effective, and successful interventions are often complex and intensive. It is therefore vital to develop interventions that are simple, well-accepted, and applicable to a wide range of patients who suffer from T2D. One approach may be to boost positive psychological states, such as positive affect or optimism, as these constructs have been prospectively and independently linked to improvements in health behaviors. Positive psychology (PP) interventions, which utilize systematic exercises to increase optimism, well-being, and positive affect, consistently increase positive states and are easily delivered to patients with chronic illnesses. However, to our knowledge, PP interventions have not been formally tested in T2D. In this paper, we review a theoretical model for the use of PP interventions to target health behaviors in T2D, describe the structure and content of a PP intervention for T2D patients, and describe baseline data from a single-arm proof-of-concept (N = 15) intervention study in T2D patients with or without depression. We also discuss how PP interventions could be combined with motivational interviewing (MI) interventions to provide a blended psychological-behavioral approach.

Physical symptom complaints, cognitive emotion regulation strategies, self‐compassion and diabetes distress among adults with Type 2 diabetes

“…comorbid chronic illnesses and chronic pain) in relation to diabetes distress. Finally, our results suggest that negative cognitive emotion regulation strategies may have a more potent role than positive strategies in relation to diabetes distress, which suggests that positive psychology interventions, often involving a focus on increasing positive coping strategies may be less effective than those that focus on reducing use of negative/maladaptive strategies. However, because so few prior studies have distinguished between positive and negative aspects of coping with stress, this remains an important area for future research.…”

Association between poor psychosocial conditions and diabetic nephropathy in Japanese type 2 diabetes patients: A cross‐sectional study

“…Unfortunately, we did not collect information about the lifestyle factors, such as dietary habit, physical activity and good medication compliance, and thus, could not assess whether these factors might have confounded the association between positive psychosocial factors and DN found in the present study. However, it has been reported that the patients with positive psychosocial factors understood the importance of good health behavior, and felt that maintaining a healthy lifestyle was less troublesome as compared with the patients without positive psychosocial factors 29,30 . Optimists understood their disease more correctly, and had more motivation for a healthy life as compared with pessimists 4,29 .…”

Randomized controlled trial of a positive affect intervention for people newly diagnosed with HIV.

“…Researchers have begun to demonstrate the efficacy of interventions that specifically target positive affect for people living with chronic physical and mental health conditions (Boutin-Foster et al, 2016; Caponigro et al, 2013; Carrico et al, 2015; Cohn et al, 2014; Huffman et al, 2015; Huffman et al, 2011; Krentzman et al, 2015; Ogedegbe et al, 2012; Peterson et al, 2012; Seligman et al, 2005). Although most of these studies have been small pilot feasibility and preliminary efficacy studies, Charlson and colleagues have conducted larger-scale randomized trials of a positive affect intervention in samples of people with chronic illness and hypothesized that the intervention would have beneficial effects on health behaviors (Mancuso et al, 2012; Ogedegbe et al, 2012; Peterson et al, 2012).…”