Associations Between Coping Strategies and Mental Health in Individuals With Type 2 Diabetes: Prospective Analyses
Associations Between Coping Strategies and Mental Health in Individuals With Type 2 Diabetes: Prospective Analyses
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DOI：
10.1037/hea0000250
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发表时间：
2016-01-01
影响因子：
4.2
通讯作者：
Schmitz, Norbert
中科院分区：
文献类型：
--
作者：
Burns, Rachel J.;Deschenes, Sonya S.;Schmitz, Norbert
目的：与没有2型糖尿病的人相比，2型糖尿病患者更容易出现一些心理健康状况，包括抑郁、焦虑和糖尿病相关的痛苦。横断面研究表明，一些应对策略可能会增加糖尿病患者心理健康状况的风险，而另一些则可能具有保护作用。本研究以前瞻性研究扩展了横断面证据基础。方法：每年从1742名2型糖尿病成人社区样本中收集数据，为期2年。在基线时测量应对策略，在每个时间点用自我报告症状测量评估心理健康状况。为了比较，我们进行了横断面和前瞻性分析。结果：横断面分析表明，任务导向的应对与心理健康状况的可能性呈负相关，情绪导向的应对与心理健康状况的可能性呈正相关，回避导向的应对与心理健康状况的可能性无相关。前瞻性分析显示，在基线时没有抑郁症状升高的个体中，只有情绪导向的应对预测了随访期间发展为重度抑郁综合征的可能性。在焦虑症状升高和糖尿病相关的痛苦中也观察到类似的结果模式。结论：横断面结果与前瞻性结果不同。只有情绪导向的应对似乎在抑郁症状、焦虑症状和糖尿病相关痛苦的发展中起作用。结果强调了研究前瞻性关联的重要性，并表明针对特定应对策略的干预可能会缓解2型糖尿病患者的心理健康问题。
Objective: Individuals with type 2 diabetes are at greater risk of developing a number of mental health conditions, including depression, anxiety, and diabetes-related distress, than individuals without type 2 diabetes. Cross-sectional studies suggest that some coping strategies may increase the risk of mental health conditions in individuals with diabetes, whereas others may be protective. This study extends the cross-sectional evidence base with a prospective study. Methods: Data were collected annually for 2 years from a community sample of 1,742 adults with type 2 diabetes. Coping strategies were measured at baseline and mental health conditions were assessed at each time point with self-report symptom measures. For comparison, cross-sectional and prospective analyses were conducted. Results: Cross-sectional analyses demonstrated that task-oriented coping was negatively associated with the likelihood of each of the mental health conditions, emotion-oriented coping was positively associated with the likelihood of each condition, and avoidance-oriented coping showed no association. Prospective analyses revealed that among individuals who did not have elevated depressive symptoms at baseline, only emotion-oriented coping predicted the likelihood of developing major depression syndrome during follow-up. Similar patterns of results were observed for elevated anxiety symptoms and diabetes-related distress. Conclusions: Cross-sectional results differed from prospective results. Only emotion-oriented coping appears to play a role in the development of depressive symptoms, anxiety symptoms, and diabetes-related distress. Results underscore the importance of examining prospective associations and suggest that interventions targeting specific coping strategies might alleviate mental health problems in individuals with type 2 diabetes.