Diabetes Distress, Depressive Symptoms, and Cardiovascular Health in Adults With Type 1 Diabetes.

BACKGROUND: The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. OBJECTIVES: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors. METHODS: This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores. RESULTS: Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c. DISCUSSION: This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.

The Combined Influence of Psychological Factors on Biomarkers of Renal Functioning in African Americans.

OBJECTIVE: African Americans are disproportionately affected by chronic kidney disease (CKD). Recent research has documented that psychological-factors have a significant influence on the progression and treatment of CKD. However, extant evidence exists that has examined the link between psychological factors and renal function in African Americans. The purpose of the study was to determine if psychological factors were associated with several biomarkers of renal functioning in this group. PARTICIPANTS: 129 African American participants, with a mean age of 44.4 years (SD = 12.25). DESIGN AND SETTING: Data were analyzed from a cross-sectional study entitled Stress and Psychoneuroimmunological Factors in Renal Health and Disease. MAIN PREDICTOR MEASURES: Participants completed the Beck Depression Inventory-II, Cook Medley Scale, and Perceived Stress Scale-10. MAIN OUTCOME MEASURES: Systolic blood pressure, as well as blood and urine samples, were collected and served as biomarkers of renal functioning. RESULTS: Our findings indicated that psychological factors were not associated with renal functioning. Age, sex, and systolic blood pressure emerged as significant predictors of renal functioning. CONCLUSIONS: Depressive symptomatology, perceived stress, and hostility did not influence renal functioning in this sample. This unexpected finding may be attributed to the fact that this sample population was not elevated on depressive symptoms, perceived stress, or hostility. Elevated levels of these psychological factors, as well as other psychological factors associated with the CKD, may be more influential on renal functioning in African Americans.

Coping with perceived racism: a significant factor in the development of obesity in African American women?

BACKGROUND: African American women have the highest rates of obesity in the United States. The prevalence of obesity in this group calls for the identification of psychosocial factors that increase risk. Psychological stress has been associated with obesity in women; however, there is scant literature that has explored the impact of racism on body mass index (BMI) in African American women. OBJECTIVE: The current study aimed to determine whether emotional responses and behavioral coping responses to perceived racism were associated with BMI in African American women. METHODS: A sample of 110 African American women participated in a community-based study. Height and weight measurements were taken to calculate BMI and participants completed the Perceived Racism Scale and the Perceived Stress Scale. RESULTS: Hierarchical regression analyses demonstrated a significant relationship between BMI and behavioral coping responses to perceived racism. Findings for emotional responses to perceived racism and appraisal of one's daily life as stressful were nonsignificant. Mean comparisons of BMI groups showed that obese African American women used more behavioral coping responses to perceived racism as compared to normal-weight and overweight women in the sample. CONCLUSION: Findings suggest that behavioral coping responses better explained increased risk for obesity in African American women. A biobehavioral pathway may explain this finding with a stress-response process that includes cortisol reactivity. Maladaptive behavioral coping responses may also provide insight into obesity risk. Future research is needed to determine which behavioral coping responses place African American women at greater risk for obesity.