Positive affect and clinical outcomes in type 2 diabetes

描述（由申请人提供）：最近在各种慢性病和健康样本中进行的研究的惊人发现表明，积极的影响与显著降低的死亡风险相关。在糖尿病患者中，抑郁情绪很常见，与血糖控制较差、症状和并发症增加、对运动和饮食建议的依从性较差、医疗保健支出增加甚至死亡率有关。关于糖尿病的积极影响的工作要少得多，尽管我们研究小组的分析表明，积极影响与死亡率降低风险有独特的相关性，独立于消极影响。在广泛的层面上，这些适应性效应与弗雷德里克森的Broketness和Build模型以及Cacioppo的评价空间理论等理论是一致的。然而，人们对将积极影响与改善健康和心理结果联系起来的特定认知，行为和生理途径知之甚少。我们的总体目标是建立积极影响在2型糖尿病管理中的益处，并根据对该现象的时间过程、预测因素和作用机制的理解，制定有针对性的心理社会干预措施。在本提案中，我们描述了一项前瞻性观察性研究，以记录50名参与者在诊断2型糖尿病后9个月内积极情绪的发生和临床后果。该研究的具体目的是：（1）通过检查积极情绪与血糖控制、血压和血脂的独特并发和前瞻性关联，记录诊断为2型糖尿病后积极情绪的适应性生理功能;（2）探索积极情绪的潜在行为和心理影响，包括糖尿病自我管理（例如，饮食、锻炼、药物治疗、血糖自我监测和参加推荐的医疗保健预约）、与压力相关的应对资源和应对反应。研究结果将为2型糖尿病患者制定基于积极影响的干预措施提供证据和方向。 公共卫生相关性：积极的情感与糖尿病患者的死亡风险降低有独特的相关性。然而，临床，行为和心理途径连接积极的影响和糖尿病患者的健康状况较差是未知的。这项拟议的研究将记录50名参与者在诊断为2型糖尿病后9个月内积极情绪的临床后果。这项研究的结果将为心理社会干预的发展提供证据和方向，其中包括关注2型糖尿病患者的积极影响。

DESCRIPTION (provided by applicant): Striking findings from recent studies in a variety of chronically ill and healthy samples demonstrate that positive affect is associated with significantly lower risk of mortality. In people with diabetes, depressive mood is common and is associated with poorer glycemic control, increased symptoms and complications, poorer adherence to exercise and diet recommendations, increased health care expenditures, and even mortality. Much less work has been done on positive affect in diabetes, even though analyses from our research team indicate that positive affect is uniquely associated with lower risk of mortality, independently of negative affect. On a broad level, these adaptive effects are consistent with theories such as Fredrickson's Broaden and Build Model and Cacioppo's Evaluative Space theory. However, very little is known about the specific cognitive, behavioral, and physiological pathways that link positive affect with improved health and psychological outcomes. Our overarching aim is to establish the benefits of positive affect in the management of type 2 diabetes, and to develop a targeted psychosocial intervention based on an understanding of the phenomenon's time-course, predictors, and mechanisms of action. In this proposal we describe a prospective observational study to document the occurrence and clinical consequences of positive affect during the 9 months after diagnosis of Type 2 diabetes in a sample of 50 participants. The specific aims of the study are to: (1) Document the adaptive physiologic functions of positive affect following a diagnosis of Type 2 diabetes by examining its unique concurrent and prospective associations with glycemic control, blood pressure, and lipids; and (2) Explore potential behavioral and psychological effects of positive affect including diabetes self management (e.g., diet, exercise, medication, self monitoring of blood glucose, and attendance at recommended health care appointments), stress-related coping resources, and coping responses. Findings will provide evidence and direction for the development of positive-affect based interventions for people with type 2 diabetes. PUBLIC HEALTH RELEVANCE: Positive affect is uniquely associated with lower risk of mortality in people with diabetes. However, the clinical, behavioral, and psychological pathways linking positive affect and poorer health in people with diabetes are unknown. The proposed study will document the clinical consequences of positive affect during the 9 months after diagnosis of Type 2 diabetes in a sample of 50 participants. Findings from the proposed study will provide evidence and direction for the development of psychosocial interventions that include a focus on positive affect for people with type 2 diabetes.