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Adherence, body mass index, and depression in adults with type 2 diabetes: the mediational role of diabetes symptoms and self-efficacy.
Health Psychol. 2007 Nov; 26(6):693-700.HP

Abstract

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.

Authors+Show Affiliations

Department of Psychology, University of South Florida, 4202 East Fowler Avenue, Tampa, FL 33620, USA. sacco@cas.usf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18020841

Citation

Sacco, William P., et al. "Adherence, Body Mass Index, and Depression in Adults With Type 2 Diabetes: the Mediational Role of Diabetes Symptoms and Self-efficacy." Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, vol. 26, no. 6, 2007, pp. 693-700.
Sacco WP, Wells KJ, Friedman A, et al. Adherence, body mass index, and depression in adults with type 2 diabetes: the mediational role of diabetes symptoms and self-efficacy. Health Psychol. 2007;26(6):693-700.
Sacco, W. P., Wells, K. J., Friedman, A., Matthew, R., Perez, S., & Vaughan, C. A. (2007). Adherence, body mass index, and depression in adults with type 2 diabetes: the mediational role of diabetes symptoms and self-efficacy. Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, 26(6), 693-700.
Sacco WP, et al. Adherence, Body Mass Index, and Depression in Adults With Type 2 Diabetes: the Mediational Role of Diabetes Symptoms and Self-efficacy. Health Psychol. 2007;26(6):693-700. PubMed PMID: 18020841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adherence, body mass index, and depression in adults with type 2 diabetes: the mediational role of diabetes symptoms and self-efficacy. AU - Sacco,William P, AU - Wells,Kristen J, AU - Friedman,Andrea, AU - Matthew,Rebecca, AU - Perez,Sylvia, AU - Vaughan,Christine A, PY - 2007/11/21/pubmed PY - 2008/2/6/medline PY - 2007/11/21/entrez SP - 693 EP - 700 JF - Health psychology : official journal of the Division of Health Psychology, American Psychological Association JO - Health Psychol VL - 26 IS - 6 N2 - 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. SN - 0278-6133 UR - https://www.unboundmedicine.com/medline/citation/18020841/Adherence_body_mass_index_and_depression_in_adults_with_type_2_diabetes:_the_mediational_role_of_diabetes_symptoms_and_self_efficacy_ L2 - http://content.apa.org/journals/hea/26/6/693 DB - PRIME DP - Unbound Medicine ER -