Date of Award

10-2024

Document Type

Doctoral Research Project

Degree Name

Master of Science (MS)

Department

Psychology

First Advisor

Patrick J. Aragon, Psy.D.

Second Advisor

Vida L. Tyc, Ph.D.

Third Advisor

Siddhartha Bhattacharyya, Ph.D.

Fourth Advisor

Lisa A. Steelman, Ph.D.

Abstract

The United States faces a growing Type 2 Diabetes (T2D) epidemic, with the CDC estimating that 38.4 million Americans are affected by diabetes, a number projected to exceed 54.9 million by 2030. T2D constitutes over 90% of cases, with lifestyle factors and poor treatment adherence playing critical roles in this increase. While research has explored psychosocial and biomedical explanations for treatment non-adherence, cognitive factors, particularly cognitive distortions, have received less attention. This study investigated the relationship between Adverse Childhood Experiences (ACEs), cognitive distortions, and diabetes self-management behaviors in a sample of 331 adults with T2D. Participants completed the ACE-Q, PHQ-9, DSMQ, and CD-Quest measures. Results indicated that 49.8% of participants reported a significant ACE score (≥ 4), and 63.4% exhibited clinical levels of depression. A significant association was found between ACEs and depressive symptoms; however, ACEs were not significantly associated with diabetes self-management. Cognitive distortions, by contrast, were significantly associated with diabetes self-management behaviors. Specifically, Jumping to Conclusions was more frequently endorsed by those with poorer self-management. Additionally, logistic regression analyses revealed that the interaction between ACEs and cognitive distortions significantly predicted diabetes self-management, with cognitive distortions having a more substantial impact on females than males. These findings suggested the importance of addressing cognitive distortions, particularly Jumping to Conclusions, in interventions for T2D patients. The results underscore the necessity of integrating trauma-informed care and mental health interventions into Type 2 Diabetes management, particularly for patients with Adverse Childhood Experiences (ACEs) and cognitive distortions, to improve both psychological and physical health outcomes. Future research should explore these cognitive factors further to improve treatment adherence in this population.

Available for download on Tuesday, May 09, 2028

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