The Relationship between Type 2 Diabetes, Differentiation of Self, and Emotional Distress: Jews and Arabs in Israel

Type 2 diabetes mellitus (T2DM) is considered a global epidemic, and is constantly on the rise. In Israel, the percentage of diabetics in the Arab population is twice that found in the Jewish population (12% and 6.2%, respectively). Findings suggest that low differentiation of self (DoS: emotional reactivity+ fusion with others, I-position, emotional cutoff) may raise vulnerability to certain physiological pathologies by increasing susceptibility to psychological distress. The major goal of this study was to test differences in DoS and emotional distress (anxiety and depressive symptoms) between diabetic and healthy participants. The second aim was to examine cultural differences within these metrics. Another purpose was to examine the relationship between DoS and emotional distress among healthy and diabetic participants. The sample included 261 participants, of whom 154 were healthy and 107 were diabetic. Diabetics reported more severe depressive symptoms, higher levels of anxiety and emotional cutoff and lower levels of I-position than healthy individuals. The groups did not differ in their levels of emotional reactivity + fusion with others. Arabs demonstrated higher levels of emotional cutoff, anxiety and depressive symptoms and lower levels of I-position than Jews. However, Arabs and Jews did not differ in their levels of emotional reactivity + fusion with others. Emotional reactivity + fusion with others contributed the most to diabetes among Arabs, while depressive symptoms contributed the most among Jews. Finally, among Jewish participants, age was positively correlated with emotional cutoff and depressive symptoms. Emotional cutoff was positively correlated with anxiety and depressive symptoms. Emotional reactivity + fusion with others was positively correlated with anxiety. Among Arab participants, age was positively correlated with emotional cutoff, anxiety and depressive symptoms. I-position was negatively correlated with all study variables. Emotional cutoff was positively correlated, anxiety and depressive symptoms. Emotional reactivity + fusion with others was positively correlated with anxiety and depressive symptoms.

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Depressive Symptoms Mediate the Relationship between Emotional Cutoff and Type 2 Diabetes Mellitus

International Journal of Behavioral Medicine ◽

10.1007/s12529-019-09816-0 ◽

2019 ◽

Vol 26 (6) ◽

pp. 591-599 ◽

Cited By ~ 2

Author(s):

Ami Cohen ◽

Ora Peleg ◽

Amira Sarhana ◽

Shany Lam ◽

Iris Haimov

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Depressive Symptoms ◽

Emotional Cutoff ◽

The Relationship

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The Relationship Between the Severity of Depressive Symptoms and Diabetes-Related Emotional Distress in Patients with Type 2 Diabetes

Internal Medicine ◽

10.2169/internalmedicine.51.5768 ◽

2012 ◽

Vol 51 (3) ◽

pp. 263-269 ◽

Cited By ~ 15

Author(s):

Takumi Hosoya ◽

Masato Matsushima ◽

Kazutaka Nukariya ◽

Kazunori Utsunomiya

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

Emotional Distress ◽

The Relationship

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Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocv082 ◽

2015 ◽

Vol 23 (1) ◽

pp. 12-18 ◽

Cited By ~ 46

Author(s):

Lyndsay A Nelson ◽

Shelagh A Mulvaney ◽

Tebeb Gebretsadik ◽

Yun-Xian Ho ◽

Kevin B Johnson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

Medication Adherence ◽

Health Literacy ◽

Low Income ◽

Mhealth Intervention ◽

Lower Health ◽

The Relationship ◽

Lower Health Literacy

Abstract Objective Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM). Materials and Methods Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform. Participants received daily text messages addressing and assessing medication adherence, and weekly interactive automated calls with adherence feedback and questions for problem solving. Longitudinal repeated measures analyses assessed the relationship between participants’ baseline characteristics and the probability of engaging with texts and calls. Results On average, participants responded to 84.0% of texts and participated in 57.1% of calls. Compared to Whites, non-Whites had a 63% decreased relative odds (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI], 0.19-0.73) of participating in calls. In addition, lower health literacy was associated with a decreased odds of participating in calls (AOR = 0.67, 95% CI, 0.46-0.99, P = .04), whereas older age ( Pnonlinear = .01) and more depressive symptoms (AOR = 0.62, 95% CI, 0.38-1.02, P = .059) trended toward a decreased odds of responding to texts. Conclusions Racial/ethnic minorities, older adults, and persons with lower health literacy or more depressive symptoms appeared to be the least engaged in a mHealth intervention. To facilitate equitable intervention impact, future research should identify and address factors interfering with mHealth engagement.

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Relationship Between Social Capital and Depressive Symptoms Among Type 2 Diabetes Mellitus Patients in Northwest China: A Mediating Role of Sleep Quality

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.725197 ◽

2021 ◽

Vol 12 ◽

Author(s):

Liqun Wang ◽

Jiangping Li ◽

Yuqi Dang ◽

Haiyu Ma ◽

Yang Niu

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Depressive Symptoms ◽

Sleep Quality ◽

Northwest China ◽

Mediating Role ◽

The Relationship

Objective: There are few studies about the relationship between social capital (SC) and depression among type 2 diabetes mellitus (T2DM) patients, and the mechanism explaining how SC leads to decreased depression is unclear. The current study aims to explore the relationship between SC and depressive symptoms among the T2DM patients in northwest China, with a particular focus on the mediating role of sleep quality.Methods: A cross-sectional study of 1,761 T2DM patients from Ningxia Province was conducted. The Center for Epidemiological Survey Depression Scale (CES-D) and self-report sleep quality questionnaire coupled with the SC scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model.Results: The prevalence of depressive symptoms among T2DM patients was 24.8%. After controlling for covariates, the SC (r = −0.23, p < 0.001) was negatively correlated with CES-D score; the sleep quality was also negatively correlated with CES-D score (r = −0.31, p < 0.001); and the SC was positively correlated with sleep quality (r = 0.10, p < 0.001). Logistic regression analysis showed that SC was inversely related to the risk of depressive symptoms. Meanwhile, sleep quality was negatively associated with depressive symptoms. Sleep quality has mediated the relationship between SC and depressive symptoms among T2DM patients (explaining 12.6% of the total variance).Conclusions: We elucidated how SC interacted with depressive symptoms through the mediation pathway of sleep quality using a representative sample of the Chinese diabetes patients. The findings indicate that the improvement of SC and sleep quality may help in maintaining mental health among T2DM patients. Hence, clinicians can suggest that patients communicate more with others to improve the SC and, in turn, maintain their health.

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The Mediating Role of Diabetes Distress and Depressive Symptoms in Type 2 Diabetes Medication Adherence Gender Differences

Health Education & Behavior ◽

10.1177/1090198119885416 ◽

2019 ◽

Vol 47 (3) ◽

pp. 474-482 ◽

Cited By ~ 1

Author(s):

Benjamin D. Aronson ◽

Kelley J. Sittner ◽

Melissa L. Walls

Keyword(s):

Type 2 Diabetes ◽

Gender Differences ◽

Depressive Symptoms ◽

Medication Adherence ◽

American Indian ◽

Diabetes Distress ◽

Computer Assisted ◽

Moderating Effects ◽

The Relationship

Background. Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes. Method. The Maawaji idi-oog mino-ayaawin (Gathering for Health) study was a community-based participatory research collaboration with five American Indian tribes. Participants, randomly recruited from clinic records, shared information during computer-assisted personal interviews. This study includes the 166 participants who reported using medications to treat their diabetes. The relationship between gender, DD, DS, and medication adherence are explored. Possible mediating and moderating effects on medication were tested using regression and path analysis. Results. Females had higher levels of DD and DS and lower levels of medication adherence. Higher levels of DD and DS were both associated with lower medication adherence. No evidence was found that gender moderates the relationship between DD or DS and medication adherence. Instead, DD and DS mediated the relationship between gender and medication adherence. Conclusions. Medication adherence differences in male and female patients may be attributable to DD and DS. The present research highlights both DD and DS as targets for clinicians and researchers alike.

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The role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in adults with type 2 diabetes

Journal of Advanced Nursing ◽

10.1111/jan.12682 ◽

2015 ◽

Vol 71 (9) ◽

pp. 2164-2175 ◽

Cited By ~ 12

Author(s):

Chun-Ja Kim ◽

Elizabeth A. Schlenk ◽

Dae Jung Kim ◽

Moonsun Kim ◽

Judith A. Erlen ◽

...

Keyword(s):

Social Support ◽

Type 2 Diabetes ◽

Depressive Symptoms ◽

Medication Adherence ◽

Self Care ◽

Relationship Of ◽

The Relationship

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Clinical variables associated with depression in patients with type 2 diabetes

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.61.04.336 ◽

2015 ◽

Vol 61 (4) ◽

pp. 336-340 ◽

Cited By ~ 4

Author(s):

Mari Cassol Ferreira ◽

Camila Piaia ◽

Ana Carolina Cadore ◽

Marinez Amabile Antoniolli ◽

Geni Portela Gamborgi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

Peripheral Neuropathy ◽

Metabolic Control ◽

Antidepressant Treatment ◽

Clinical Impact ◽

Control Group ◽

Increased Risk ◽

The Relationship

SummaryBackground:the aim of the study was to evaluate the relationship between type 2 diabetes (T2DM), depression and depressive symptoms and their clinical impact on T2DM.Methods:the authors evaluated 214 outpatients, 105 with diabetes (T2DM group) and 109 non-diabetics (control group), with ages ranging between 50 and 75 years (T2DM group 65.1 ± 5.6 years, control group 63.4 ± 5.8 years). Use of antidepressant treatment or score ≥ 16 on the Beck depression inventory (BDI) was considered depression. Complications of diabetes and total symptom score (TSS) for peripheral neuropathy were reported by patients.Results:diabetes group had a higher frequency of depression (35.2%) compared to controls (21.1%) (p=0,021), with 2.4 times increased risk of depression. The presence of depressive symptoms was also higher in T2DM group (mean BDI 9.5 ± 8.8 versus 6.9 ± 6.2; p=0.039). Symptoms of diabetic neuropathy were higher in depressed subjects. The metabolic control and presence of complications in T2DM group were not associated with depression.Conclusion:T2DM led to an increased risk of depression, but this did not influence the metabolic control or the presence of other complications.

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