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D型人格、健康行为欠佳与成年糖尿病患者的情绪困扰:荷兰糖尿病MILES研究结果

Type D personality, suboptimal health behaviors and emotional distress in adults with diabetes: results from Diabetes MILES-The Netherlands.

作者信息

Nefs G, Speight J, Pouwer F, Pop V, Bot M, Denollet J

机构信息

Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands.

The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia-Vic, 570 Elizabeth Street, Melbourne 3000, VIC, Australia; Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood 3125, VIC, Australia; AHP Research, 16 Walden Way, Hornchurch, UK.

出版信息

Diabetes Res Clin Pract. 2015 Apr;108(1):94-105. doi: 10.1016/j.diabres.2015.01.015. Epub 2015 Jan 20.

Abstract

AIMS

Type D personality - defined as high negative affectivity (NA) and high social inhibition (SI) - has been associated with adverse cardiovascular prognosis. We explored the differential associations of Type D personality and its constituent components with health behaviors, emotional distress and standard biomedical risk factors as potential risk mechanisms in adults with diabetes.

METHODS

3314 Dutch adults with self-reported type 1 or 2 diabetes completed an online survey, including the DS14 Type D Scale. AN(C)OVAs and X(2) tests were used to compare participants scoring (i) low on NA and SI; (ii) high on SI only; (iii) high on NA only; (iv) high on NA and SI (Type D).

RESULTS

Participants with Type D personality (29%) were less likely to follow a healthy diet or to consult healthcare professionals in case of problems with diabetes management than those scoring high on neither or only one component. They also reported more barriers surrounding medication use, diabetes-specific social anxiety, loneliness and symptoms of depression and anxiety. There were no differences in standard biomedical risk factors (body mass index, blood pressure, cholesterol, HbA1c). After adjustment for demographics, clinical characteristics, NA, and SI in multivariable logistic regression analyses, Type D personality was independently associated with 2 to 3-fold increased odds of suboptimal health behaviors and over 15-fold increased odds of general emotional distress.

CONCLUSIONS

Type D personality was not related to standard biomedical risk factors, but was associated with unhealthy behaviors and negative emotions that are likely to have adverse impact on adults with diabetes.

摘要

目的

D型人格(定义为高消极情感性(NA)和高社交抑制(SI))与不良心血管预后相关。我们探讨了D型人格及其组成成分与健康行为、情绪困扰和标准生物医学风险因素之间的差异关联,这些因素可能是糖尿病成年人的潜在风险机制。

方法

3314名自我报告患有1型或2型糖尿病的荷兰成年人完成了一项在线调查,包括DS14 D型人格量表。采用方差分析(AN(C)OVA)和卡方检验来比较以下参与者:(i)NA和SI得分低的;(ii)仅SI得分高的;(iii)仅NA得分高的;(iv)NA和SI得分高的(D型人格)。

结果

D型人格的参与者(29%)与那些在两个成分上都得分不高或仅在一个成分上得分高的参与者相比,不太可能遵循健康饮食,在糖尿病管理出现问题时也不太可能咨询医疗保健专业人员。他们还报告了更多与药物使用、糖尿病特异性社交焦虑、孤独以及抑郁和焦虑症状相关的障碍。在标准生物医学风险因素(体重指数、血压、胆固醇、糖化血红蛋白)方面没有差异。在多变量逻辑回归分析中,对人口统计学、临床特征、NA和SI进行调整后,D型人格与次优健康行为的几率增加2至3倍以及一般情绪困扰的几率增加超过15倍独立相关。

结论

D型人格与标准生物医学风险因素无关,但与可能对糖尿病成年人产生不利影响的不健康行为和负面情绪相关。

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