Gonder-Frederick L A, Cox D J, Bobbitt S A, Pennebaker J W
Behavioral Medicine Center, Blue Ridge Hospital, University of Virginia Medical Center, Charlottesville 22901.
Health Psychol. 1989;8(1):45-59. doi: 10.1037//0278-6133.8.1.45.
Individuals with insulin-dependent diabetes mellitus (IDDM) and their healthcare practitioners believe that extreme blood glucose (BG) fluctuations are characterized by changes in subjective mood states and emotional behavior, as well as physical symptoms. This study examined relationships between BG levels and self-reported mood in a group of 34 IDDM adults. The method followed a within-subject, repeated-measures design employed in previous studies of physical symptoms associated with diabetic glucose. Four times each day, participants completed a mood/symptom checklist just prior to a self-measurement of BG until 40 checklists had been completed. Half the items on the checklist described physical symptoms and half described mood states. In addition, half the mood items described negative states and half described positive states. Within-subject correlations and regressions showed that moods were related to BG for the majority of participants and that, like physical symptoms, mood-BG relationships were highly idiosyncratic. Low BG levels tended to be associated with negative mood states, primarily self-reported "nervousness." Positive mood items were almost always associated with high BG. High BG levels also frequently correlated with negative mood states, although the negative mood items that tended to relate to high glucose (anger, sadness) differed from those that tended to relate to low BG. The implications of these findings for self-treatment and glucose perception in the IDDM individual are discussed.
胰岛素依赖型糖尿病(IDDM)患者及其医护人员认为,血糖(BG)的剧烈波动表现为主观情绪状态和情感行为的变化以及身体症状。本研究调查了34名成年IDDM患者的血糖水平与自我报告情绪之间的关系。该方法采用了之前关于糖尿病血糖相关身体症状研究中使用的受试者内重复测量设计。参与者每天四次在自我测量血糖之前完成一份情绪/症状清单,直至完成40份清单。清单上一半的项目描述身体症状,一半描述情绪状态。此外,情绪项目中一半描述消极状态,一半描述积极状态。受试者内相关性和回归分析表明,大多数参与者的情绪与血糖有关,并且与身体症状一样,情绪与血糖的关系具有高度特异性。低血糖水平往往与消极情绪状态相关,主要是自我报告的“紧张”。积极情绪项目几乎总是与高血糖相关。高血糖水平也经常与消极情绪状态相关,尽管与高血糖相关的消极情绪项目(愤怒、悲伤)与与低血糖相关的不同。讨论了这些发现对IDDM个体自我治疗和血糖感知的影响。