Stress and blood glucose in type II diabetes mellitus

Six adults with non-insulin dependent diabetes mellitus participated in a laboratory procedure to determine the effects of an acute Stressor, mental arithmetic, on blood glucose, cardiovascular, and subjective indices of stress. They then completed 12 days home monitoring of stressful events, subjective stress, and blood glucose. Diet and activity were controlled to evaluate the direct effects of stress on blood glucose in the natural environment. Laboratory results showed significant increases in blood glucose, cardiovascular (HR and SBP), and subjective stress ratings during the mental arithmetic task when compared to a resting condition. Home monitoring data were consistent with the laboratory findings; blood glucose range tended to be greater on high vs low stress days, especially when the difference between high and low stress was greatest. These findings suggest that the laboratory stress induction procedure was externally valid and that in the natural environment, stress has a hyperglycemic effect on blood glucose.     

Correlates of hypoglycemic fear in type I and type II diabetes mellitus.

We examined whether fear of hypoglycemia in insulin-dependent diabetes mellitus was associated with (a) higher levels of trait anxiety and general fearfulness, (b) difficulty in differentiating symptoms of anxiety and hypoglycemia, and (c) past experience with hypoglycemia. Joslin Diabetes Center outpatients with Type I and Type II diabetes (N = 232), all requiring insulin, were surveyed. Type I patients experienced significantly more fear of hypoglycemia than Type II patients. For the Type I and Type II groups, higher scores on the Worry subscale of the Hypoglycemia Fear Survey (HFS-W) were associated with higher levels of trait anxiety and fear. Higher scores on the Behavior subscale (HFS-B) were associated with higher levels of fear. Among Type I subjects only, HFS-W scores were also positively associated with past hypoglycemic experience and with difficulty in differentiating anxiety and hypoglycemic symptoms. These latter relations remained significant even after the variance resulting from trait anxiety and fear was removed. Other significant associations with HFS-B scores were not observed.     

Associations of blood glucose control with self-efficacy and rated anxiety/depression in type II diabetes mellitus patients

We investigated the possible relations of hemoglobin A1c (HbA1c) level, a parameter of blood glucose control with scores on anxiety, depression, and self-efficacy for 113 outpatients (55 men and 58 women) with type II diabetes mellitus. The relation between the HbA1c level and the self-efficacy scores as well as with the ratings of anxiety and depression was evaluated. A significant relation was found for the HbA1c level with the scores; however, self-efficacy and anxiety and depression showed no association. These results suggest that HbA1c can be maintained at better levels by increasing self-efficacy of diabetic patients.     

A test of theory of planned behavior in type II diabetes adherence: The leading role of perceived behavioral control

Current Psychology - Diabetes mellitus is a health complication that millions of people suffer from all over the world. Type II (non-insulin dependent) diabetes requires many changes in the daily...     

Psychosocial adjustment to and control of diabetes mellitus: differences by disease type and treatment

The relationship of diabetic patients' psychosocial adjustment to disease type, treatment mode, and indexes of control was examined in a representative community population. The psychometric properties of the Diabetes Educational Profile (DEP) and its application to psychosocial research in diabetes were also investigated. Findings support the reliability and validity of the DEP. Various measures of psychosocial adjustment were related to diabetes control but the specific relationships depended on the particular aspect of adjustment, the specific measure of diabetes control, and the type of disease and treatment. The findings suggest that analyses that aggregate dissimilar patient groups are subject to misinterpretation due to ecological masking and supressor effects. The results indicate that clinicians and researchers must recognize that patients with different disease types and treatment modes have different norms for psychological adjustment and diabetes control. Further, the particular aspects of psychosocial adjustment associated with diabetes control differ across patient groups.     

The effectiveness of cognitive behavioral group intervention on depression and anxiety in patients with type II diabetes

IntroductionDepression and anxiety are important risk factors for diabetes and high blood pressure.ObjectiveThis study investigated the effectiveness of the Cognitive-Behavioral Group Intervention for Diabetes Disease (CBGI-DD) in reducing depression and anxiety in female patients with type 2 diabetes (T2D).MethodThe CBGI-DD program includes 12 weekly 2.5 h sessions, spread weekly over the course of 3 months. The present study was semi-experimental and controlled, with assessments at pre-test and post-test. It included diagnostic criteria for the diagnosis of T2D in the patient's medical records by a diabetes specialist. Participants (62 female volunteers aged 25 to 75 years) were randomly allocated to a control or test group. Both groups responded to the Second edition of the Beck Depression Inventory (BDI-II) and the Beck Anxiety Inventory (BAI) before (pretest) and immediately after the intervention (posttest). Participants in the test group received CBGI-DD (from April up to the end of September 2018) at Mashhad Diabetes Center. The control group received only medical care during this period.ResultsAn analysis of covariance showed that compared to the control group, the test group had a significant reduction in anxiety and depression from pre-test to post-test (p < 0.05). It was compared post-test scores between the two groups, controlling for pre-test scores.ConclusionThe CBGI-DD program seems to be effective in reducing anxiety and depression in female patients with T2D. However, further research exploring the potential for long-term improvements in depression and anxiety is needed.     

Diminished weight loss and behavioral compliance during repeated diets in obese patients with type II diabetes.

Compared weight losses during first and second bouts of a very low calorie diet (VLCD) and examined whether decreased compliance might in part explain the decrease in weight loss during the second bout. Forty-five Type II diabetic patients participated in a year-long behavioral weight-reduction program that incorporated a VLCD (400 to 500 kcal/day) during Weeks 1 to 12 and 28 to 40. Weight losses decreased dramatically from the first to the second VLCD (15.54 vs. 1.42 kg, p less than .0001). There was also markedly diminished adherence as assessed by weeks ketonuric, attendance, and completeness of self-monitoring records. The percentage of weeks subjects were in ketosis dropped from 61% during VLCD 1 to 13% during VLCD 2 (p less than .0001). Similarly, subjects attended significantly fewer treatment meetings during VLCD 2 and self-monitored less during VLCD 2 than during VLCD 1. Weeks ketonuric and initial weight accounted for 63% of the variance in weight loss during VLCD 1 (p less than .0001); weeks ketonuric and attendance predicted weight loss during VLCD 2 (p less than .0001), accounting for 54% of the variance. These results suggest the importance of behavioral factors in explaining poorer performance on a repeated diet.     

Adolescent vulnerability: A framework for behavioral interventions

A general framework is offered for characterizing behavioral risks in a way that might help coordinate behavioral interventions. It is demonstrated in terms of adolescents' vulnerability, arising from the life situations confronting teens, from teens' understanding of those situations, and from the beliefs of those entrusted with helping them (parents, educators, psychologists, etc.). The framework provides a rationale for identifying opportunities to reduce adolescent vulnerability, based on research regarding the genesis and control of risks. It provides a common language for characterizing alternative theoretical approachs to these issues and a systematic way to integrate their results. It is illustrated with results from research on the role of information in determining adolescent vulnerability.     

On the longevity of behavioral interventions for challenging behavior

The capacity for a treatment to maintain its effects over time may be the most critical component of behavioral interventions for challenging behavior as treatments that fail to persist are likely to be of little value to society. We reviewed the quality and quantity of different types of post-intervention data for the treatment of challenging behavior in studies published over the last 7 years. We found that for the majority of participants at least one measure of maintenance, fading, or follow-up was reported but with limited information regarding the quality of those measures. Reports of secondary variables related to post-intervention data (e.g., latency to measurement) were also uncommon. We discuss possible explanations for the paucity of post-intervention data, barriers to obtaining post-intervention data, strategies for obtaining these data, and implications for the external validity of behavioral interventions for challenging behavior. We provide recommendations for increasing the probability that post-intervention data are included in applied research on challenging behavior.     

Neurocognitive correlates of type 1 diabetes mellitus in childhood.

Type 1 Diabetes Mellitus (T1DM) is one of the most prevalent chronic health conditions in children under the age of 18 years. Complications of the disease include hypo- and hyperglycemia, which can have an impact on children's performance in assessment situations, in the clinic, and in school. Because there is no cure for this disease, there is a need to understand the cognitive deficits associated with some of its complications, as this knowledge will impact on the choice of treatment regimens as well as educational interventions. This paper provides a comprehensive review of the relevant literature on the neurocognitive outcome of T1DM. In particular, disease- and treatment-related variables that are associated with poor performance on cognitive domains will be reviewed. Specifically, age of onset, duration, pubertal effects, and presence of hypoglycemia or hyperglycemia will be examined. These findings are not without controversy, and limitations to conclusions will also be presented. Where relevant, recommendations for future research directions will be provided.     

Using an Apple II microcomputer for real-time control in a behavioral laboratory

This report describes the hardware and software developed to implement an Apple II (48 KB) as a real-time control device for operant experiments. The hardware has a straightforward design, so that it is readily understandable and can be built by individuals with only minimal experience in the use of integrated circuits and other electronic components. The software routines listed below represent an approach to controlling and handling the data generated by an operant experiment. Using these routines, we are able to record each response and experimental event, the time of the occurrence, and the conditions at that time.     

Polyneuropathy and residual insulin secretion in diabetes mellitus type I

In 145 patients suffering from type-I-diabetes with or without signs or symptoms of polyneuropathy basal and glucose-glucagon-induced secretion of insulin was determined. Patients without remaining insulin secretion exhibited somewhat more often polyneuropathies, slowing of nerve conduction, or reduced respiratory heart arrhythmia. If diabetes lasts for more than 10 years, insulin secretion ist reduced to such a low level that its may not have any significant preventive capability with respect to polyneuropathy.     

Preliminary study of psychological factors affecting clinic attendance and glycemic control of Japanese patients with type 2 diabetes mellitus

We studied 50 Japanese patients who were first diagnosed with type 2 diabetes mellitus. Psychological functioning was assessed by using the Rorschach test and the Yatabe-Guilford Personality test. Analysis indicated that patients who discontinued clinic attendance during the 2-yr. study period had more depression, lower general activity and less extraversion, more negative self-attitudes, and more concern about being helpless than those who continued having regular followups. This study also found that patients who had worse glycemic control 2 yr. after being first diagnosed reported more inferiority feelings, lower general activity, more need for closeness to others, and more emotional demands than those who had better glycemic control. In conclusion, understanding the psychological functioning would be helpful in the management of Japanese patients with type 2 diabetes mellitus.     

A methodology for describing and decomposing complex psychosocial and behavioral interventions

This article presents a comprehensive conceptual framework and methodology for characterizing multidimensional psychosocial and behavioral interventions for family caregivers of people with Alzheimer's disease. The methodology involved conducting a detailed task analysis of the interventions, and the application of the analytical hierarchy process. The authors were able to achieve high levels of consistency and reliability using this methodology to decompose and describe the interventions according to a complex conceptual framework comprising 3 dimensions: target domain, functional domain, and delivery system characteristics. Application of this methodology will enhance the ability to describe and measure interventions consistently, make comparisons across studies, isolate causal factors that achieve desired outcomes, and more generally elevate the science of psychosocial intervention research.     

Differential effects of social support and social network on physiological and social outcomes in men and women with type II diabetes mellitus

Patients with non-insulin-dependent diabetes mellitus (NIDDM) were advised to comply with a complex behavioral regimen of diet and exercise. The relationship between social support satisfaction and social support network size was evaluated using the Social Support Questionnaire for 32 men and 44 women with a confirmed diagnosis of NIDDM. Control of diabetes, as measured by the glycosylated hemoglobin assay, was significantly correlated with social support satisfaction for women but negatively correlated with social support satisfaction for men. Social support network size differentially predicted success in a program for men and women. For women, network size was significantly correlated with failure to attend sessions and with failure to complete a diary. For these women, network size was not significantly correlated with weight loss, which was the goal of the program. For men, network size was correlated with increases in weight, cholesterol, and triglycerides over an 18-month period. We conclude that social support network size and satisfaction have different functions for men and women faced with a serious chronic illness. Network size adversely affects success in a program, whereas social support satisfaction has some benefits for women. The direction of the influence of social network may be determined by the similarity or dissimilarity of network norms to the desired behavior.     

Benefits of adding precision teaching to behavioral interventions for students with autism

Students with autism have a variety of learning characteristics that can provide challenges to teachers. Precision Teaching, a method providing frequent assessment of performance, facilitation of curricular decisions, and techniques for developing fluency, can help teachers enhance educational outcomes for students with autism. Teachers can use the techniques found in Precision Teaching to augment their current instructional methods. This article purposes to examine the potential benefits of adding Precision Teaching to behavioral interventions for children with autism. This paper will define Precision Teaching, and review its guidelines within the context of a hypothetical case study. Copyright © 2002 John Wiley & Sons, Ltd.     

A review of behavioral interventions to enhance sports performance

Research on applied behavior analysis and sports performance has become an increasingly popular subject. It involves using behavioral measures to assess the utility of numerous interventions to enhance athletic performance. We identified 101 studies published since the late 1960s focusing on behavioral interventions to enhance sports performance. To determine the breadth of the current research, we identified each sport and the different interventions used to improve performance. Of the studies included in this review, research has investigated 23 interventions with 21 sports. The purpose of this paper is to review the current literature regarding what procedures have been evaluated, the results of this research, some of the limitations, and future directions of behavioral research on sports performance enhancement. In doing so, this review will allow readers to easily browse the current literature by the sport or intervention of interest.