OBJECTIVE: Evidence indicates that depression is linked to the development and worsening of diabetes, but the mechanisms underlying this link are not well understood. The authors examined the hypothesis that diabetes-related symptoms mediate the effect of both behavioral adherence and body mass index (BMI) on depression. In addition, they examined whether a prior finding that self-efficacy mediates the effect of behavioral adherence and BMI on depression would replicate with a larger sample size (W. P. Sacco, K. J. Wells, C. A. Vaughan, A. Friedman, S. Perez, & R. Morales, 2005). Also, the relative contributions of diabetes-related symptoms and self-efficacy to depression were evaluated. DESIGN AND PARTICIPANTS: Cross-sectional design involving adults diagnosed with Type 2 diabetes (N = 99). MAIN OUTCOME MEASURES: The primary outcome measure was depression (Patient Health Questionnaire: Nine Symptom Depression Checklist). Predictors of depression were diet and exercise adherence (Summary of Diabetes Self-Care Activities Questionnaire), diet and exercise self-efficacy (Multidimensional Diabetes Questionnaire), diabetes symptoms (Diabetes Symptom Checklist), and BMI (based on height and weight data from medical records). RESULTS: Path and mediation analyses indicated that adherence and BMI each contributed to depression indirectly, via their effects on self-efficacy and diabetes-related medical symptoms. CONCLUSION: Results provide evidence consistent with two independent pathways by which BMI and adherence could increase depression in people with Type 2 diabetes. The first pathway indicates that the effects of higher BMI and poor adherence on depression are mediated by lower self-efficacy perceptions. The second pathway indicates that the effect of higher BMI on depression is mediated by increased diabetes symptoms. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
OBJECTIVE: Evidence indicates that depression is linked to the development and worsening of diabetes, but the mechanisms underlying this link are not well understood. The authors examined the hypothesis that diabetes-related symptoms mediate the effect of both behavioral adherence and body mass index (BMI) on depression. In addition, they examined whether a prior finding that self-efficacy mediates the effect of behavioral adherence and BMI on depression would replicate with a larger sample size (W. P. Sacco, K. J. Wells, C. A. Vaughan, A. Friedman, S. Perez, & R. Morales, 2005). Also, the relative contributions of diabetes-related symptoms and self-efficacy to depression were evaluated. DESIGN AND PARTICIPANTS: Cross-sectional design involving adults diagnosed with Type 2 diabetes (N = 99). MAIN OUTCOME MEASURES: The primary outcome measure was depression (Patient Health Questionnaire: Nine Symptom Depression Checklist). Predictors of depression were diet and exercise adherence (Summary of Diabetes Self-Care Activities Questionnaire), diet and exercise self-efficacy (Multidimensional Diabetes Questionnaire), diabetes symptoms (Diabetes Symptom Checklist), and BMI (based on height and weight data from medical records). RESULTS: Path and mediation analyses indicated that adherence and BMI each contributed to depression indirectly, via their effects on self-efficacy and diabetes-related medical symptoms. CONCLUSION: Results provide evidence consistent with two independent pathways by which BMI and adherence could increase depression in people with Type 2 diabetes. The first pathway indicates that the effects of higher BMI and poor adherence on depression are mediated by lower self-efficacy perceptions. The second pathway indicates that the effect of higher BMI on depression is mediated by increased diabetes symptoms. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Authors: Jared R Anderson; Joshua R Novak; Matthew D Johnson; Sharon L Deitz; Ann Walker; Allison Wilcox; Virginia L Lewis; David C Robbins Journal: J Behav Med Date: 2016-09-30
Authors: Lisa L Sumlin; Theresa J Garcia; Sharon A Brown; Mary A Winter; Alexandra A García; Adama Brown; Heather E Cuevas Journal: Diabetes Educ Date: 2014-06-17 Impact factor: 2.140