Emotional regulation ‘meaningfully linked’ to diabetes distress
medwireNews: Negative emotional experience and skill at regulating emotions are associated with diabetes distress in adults with type 1 or type 2 diabetes, researchers report.
Therefore, diabetes distress and glycemic control “may be improved” by targeting emotional regulation, “especially in those with diabetes and difficulties with emotionality,” suggest Emil Coccaro (The Ohio State University Wexner Medical Center, Columbus, USA) and co-investigators.
The study included 298 people with type 1 (n=125) or type 2 (n=173) diabetes with an average age of 49.5 years who underwent psychologic assessment for issues relevant to diabetes and further evaluation using measures of negative emotional experience (ER-Exp) and skill at regulating negative emotions (ER-Skill). In all, 64.4% of participants reported having at least one of six diabetes distress screen items at a “moderate” level.
Coccaro et al report in Diabetes Care that diabetes distress “correlated uniquely” with two variables reflecting ER-Exp and two variables reflecting ER-Skill. Specifically, a multiple regression model showed that diabetes distress was significantly associated with negative intensity on the Affect Intensity Measure questionnaire and with anxiety and depression on the Affect Lability Scale questionnaire, and there was a significant negative correlation between diabetes distress and two emotional skill subscale scores on the Trait Meta-Mood (TMM) Scale, these being TMM Clarity and TMM Repair.
When these variables were combined into composite ER-Exp and composite ER-Skill variables, the researchers say that the correlation coefficients for the association with diabetes distress were “similar and in the modest range,” at 0.28 and –0.25, respectively. However, combining both variables and accounting for the opposite directions of association gave rise to “a stronger relationship […] of medium-size,” with a correlation coefficient of 0.45.
Inclusion of variables related to diabetes self-care and perceived psychologic stress in the model only attenuated this association by 18%, and the team says that the association between diabetes distress and the combination of ER-Exp and ER-Skill was “considerably stronger than that with perceived psychological stress or diabetes self-care.” Diabetes distress was significantly associated with both of these variables, but the correlation coefficients were “modest or small,” at 0.15 and –0.09, respectively.
Together, “[t]hese data suggest that [diabetes distress] is meaningfully linked with negative emotionality and skill at emotional regulation in adults with diabetes,” say Coccaro and colleagues.
“This is not surprising, given that the nature of [diabetes distress] is characterized by negative emotionality related to having diabetes and that skill at reducing such emotions would be relatively low,” they add.
And considering these study findings in the context of previous data suggesting that cognitive behavioral intervention can reduce both diabetes distress and glycated hemoglobin levels, they suggest “it is also likely that treating suboptimal emotional regulation, in itself, can reduce blood glucose levels.”
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