Motivala S J, Hurwitz B E, LaGreca A M, Llabre M M, Marks J B, Skyler J S, Schneiderman N
Behavioral Medicine Research Center, Department of Psychology, University of Miami, FL 33124, USA.
Int J Behav Med. 1999;6(1):78-94. doi: 10.1207/s15327558ijbm0601_6.
In a previous study, a subgroup of asymptomatic insulin-dependent diabetic individuals (termed IDDM-2) were identified on the basis of diminished parasympathetic cardiac input and elevated heart rate at rest. When compared to another group of asymptomatic IDDM participants (termed IDDM-1), and a nondiabetic healthy control group, the IDDM-2 group displayed elevated blood pressure, supported by elevated total peripheral resistance. Measures of psychological regulation were also taken in this study, and form the basis of this article, which examined whether these IDDM-2 patients differed from the other two groups on these measures. The possible role of glycemic control, IDDM duration, and number of somatic complaints among group differences in psychological regulation was also examined. The IDDM-2 group reported increased psychological distress, as reflected by increased dysphoric or depressive symptoms, trait anxiety, perceived stress, and cynical hostility, as well as decreased optimism and interpersonal, but not family, social support. Glycemic control did not account for any of the group differences in psychological regulation. However, group differences in dysphoria and anxiety were accounted for by differences in somatic complaints, whereas differences in interpersonal social support were accounted for by IDDM duration. Moreover, none of the variables investigated accounted for the diminished optimism of the IDDM-2 group. Therefore, in individuals with IDDM, who would otherwise be considered, after medical examination, as no different from other asymptomatic IDDM individuals, the combination of diminished parasympathetic cardiac input and elevated heart rate was associated with aberrant alterations of both hemodynamic and psychological functioning; the increased psychological distress in these individuals may be influenced, in part, by increased diabetes duration and number of somatic symptoms.
在之前的一项研究中，根据副交感神经对心脏的输入减少以及静息心率升高，识别出了一组无症状的胰岛素依赖型糖尿病个体（称为IDDM - 2）。与另一组无症状的IDDM参与者（称为IDDM - 1）以及非糖尿病健康对照组相比，IDDM - 2组的血压升高，总外周阻力升高支持了这一点。本研究还进行了心理调节测量，并构成了本文的基础，本文研究了这些IDDM - 2患者在这些测量指标上是否与其他两组不同。还研究了血糖控制、IDDM病程以及躯体不适数量在心理调节组间差异中的可能作用。IDDM - 2组报告心理困扰增加，表现为烦躁或抑郁症状增加、特质焦虑、感知压力和愤世嫉俗的敌意增加，以及乐观主义和人际（而非家庭）社会支持减少。血糖控制并未解释心理调节方面的任何组间差异。然而，烦躁和焦虑的组间差异由躯体不适的差异解释，而人际社会支持的差异由IDDM病程解释。此外，所研究的变量均未解释IDDM - 2组乐观主义的降低。因此，在经医学检查原本被认为与其他无症状IDDM个体无异的IDDM个体中，副交感神经对心脏的输入减少和心率升高的组合与血流动力学和心理功能的异常改变相关；这些个体心理困扰的增加可能部分受到糖尿病病程延长和躯体症状数量增加的影响。
