Abstract
Background: Although various forms of anger have been found to influence the psychological and physical health in many chronic illness populations, little is known about the effects of anger in diabetes patients. Purpose: Associations between anger coping style, diabetes-related psychological distress, and glycosylated hemoglobin (HbA1c) were examined in 100 diabetes patients. Method: Participants completed the Problem Areas in Diabetes and Coping Styles questionnaires, and had HbA1c assessments at study entry (Time 1 = T1), six months (T2), and 12 months after T1 (T3). Results: Linear regression analyses revealed T1 anger coping associated with T3 HbA1c (β = .22, p < .05), but T1 HbA1c did not associate with T3 anger coping (β = .13, p = NS). After controlling for significant covariates (of gender, age, education, type and duration of diabetes), regression analyses revealed that T2 diabetes-related psychological distress partially mediated this association. Conclusion: These results suggested that higher levels of anger coping may promote poorer glycemic control in diabetes patients by provoking greater diabetes-related distress. Areas of future research on this topic are discussed.
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Attari, A., Sartippour, M., Amini, M., & Haghighi, S. (2006). Effect of stress management training on glycemic control in patients with type 1 diabetes. Diabetes Research and Clinical Practice, 73, 23–28.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.
Bradshaw, B. G., Richardson, G. E., Kumpfer K., Carlson, J., Stanchfield, J., Overall, J., Brooks, A. M., & Kulkarni, K. (2007). Determining the efficacy of a resiliency training approach in adults with type 2 diabetes. Diabetes Educator, 33, 650–659.
Coon, D. W., Thompson, L., Steffan, A., Sorocco, K., & Gallagher-Thompson, D. (2003). Anger and depression management: Psychoeducational skill training interventions for women care-givers of a relative with dementia. The Gerontologist, 43, 678–689.
De Sonnaville, J. J., Snoek, F. J., Colly, L. P., Deville, W., Wijkel, D., & Heine, R. J. (1998). Well-being and symptoms in relation to insulin therapy in type 2 diabetes. Diabetes Care, 21, 919–924.
Diabetes Control and Complications Trial. (1993). The effect of intensive treatment of diabetes on the development and progressions of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine, 329, 977–986.
Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study Research Group. (2007). Long-term effect of diabetes and its treatment on cognitive function. New England Journal of Medicine, 356, 1842–1852.
Gallegos, E. C., Ovalle-Berumen, F., & Gomez-Meza, M. V. (2006). Metabolic control of adults with type 2 diabetes mellitus through education and counseling. Journal of Nursing Scholarship, 38,344–351.
Golden, S. H., Williams, J. E., Ford, D. E., Yeh, H. C., Sanford, C. P., Nieto, F. J., & Brancati, F. L. (2006). Anger temperament is modestly associated with the risk of type 2 diabetes mellitus: The atherosclerosis risk in communities study. Psychoneuroen-docrinology, 31, 325–332.
Gross, J. J., Carstensen, L. L., Pasupathi, M., Tsai, J., Skorpen, C. G., & Hsu, A. Y. (1997). Emotion and aging: Experience, expression, and control. Psychology & Aging, 12, 590–599.
Lustman, P. J., Frank, B. L., & McGill, J. B. (1991). Relationship of personality characteristics to glucose regulation in adults with diabetes. Psychosomatic Medicine, 53, 305–312.
McCrimmon, R. J., Ewing, F. M., Frier, B. M., & Deary, I. J. (1999). Anger state during acute insulin-induced hypoglycemia. Physiology and Behavior, 67, 35–39.
Merbis, M. A., Snoek, F. J., Kanc, K., & Heine, R. J. (1996). Hypoglycemia induces emotional disruption. Patient Education and Counseling, 29, 117–122.
Moreland, E. C., Volkening, L. K., Lawlor, M. T., Chalmers, K. A., Anderson, B. J., & Laffel, L. M. (2006). Use of a blood glucose monitoring manual to enhance monitoring adherence in adults with diabetes: A randomized controlled trial. Archives of Internal Medicine, 166, 689–695.
Nakahara, R., Yoshiuchi, K., Kumano, H., Hara, Y., Suematsu, H., & Kuboki, T. (2006). Prospective study on influence of psychosocial factors on glycemic control in Japanese patients with type 2 diabetes. Psychosomatics, 47, 240–246.
Paschalides, C., Wearden, A. J., Dunkerley, R., Bundy, C., Davies, R., & Dickens, C. M. (2004). The associations of anxiety, depression, and personal illness representations with glycemic control and health-related quality of life in patients with type 2 diabetes. Journal of Psychosomatic Research, 57, 557–564.
Peyrot, M. F., & McMurry, J. F. (1985). Psychosocial factors in diabetes control: Adjustment of insulin-treated adults. Psychosomatic Medicine, 47, 542–557.
Peyrot, M. F., & McMurry, J. F. (1992). Stress buffering and glycemic control. Diabetes Care, 15, 842–846.
Peyrot, M. F., McMurry, J. F., & Kruger, D. F. (1999). A biopsy-chosocial model of glycemic control in diabetes: Stress, coping, and regimen adherence. Journal of Health and Social Behavior, 40, 141–158.
Phillips, L. H., Henry, J. D., Hosie, J. A., & Milne, A. B. (2006). Age, anger regulation, and well-being. Aging & Mental Health, 10, 250–256.
Polonsky, W. H., Anderson, B. A., Lohrer, P. A., Welch, G. W., & Jacobson, A. M. (1995). Assessment of diabetes-related emotional distress. Diabetes Care, 18, 754–760.
Schieman, S. (1999). Age and anger. Journal of Health & Social Behavior, 40, 273–289.
Siegler, I. C., Peterson, B. L., Barefoot, J. C., & Williams, R. B. (1992). Hostility during late adolescence predicts coronary risk factors at mid-life. American Journal of Epidemiology, 136, 146–154.
Stewart, S. M., Lee, P. W. H., Waller, D., Hughes, C. W., Low, L. C. K., Kennard, B. D., Cheng, A., & Huen, K. F. (2003). A follow-up study of adherence and glycemic control among Hong Kong youths with diabetes. Journal of Pediatric Psychology, 28, 67–79.
Suinn, R. M. (2001). The terrible twosfl Anger and anxiety. American Psychologist, 56, 27–36.
Sultan, S., & Heurtier-Hartemann, A. (2001). Coping and distress as predictors of glycemic control in diabetes. Journal of Health Psychology, 6, 731–739.
Thomas, P. D., & Miceli, R. (2006). Evaluation of the “Know Your Health” program for type 2 diabetes mellitus and hypertension in a large employer group. American Journal of Managed Care, 12(Speco), SP33–39.
Vitaliano, P. P., Scanlan, J. M., Zhang, J., Savage, M. V., Hirsch, I. B., & Siegler, I. C. (2002). A path model of chronic stress, the metabolic syndrome, and coronary heart disease. Psychosomatic Medicine, 64, 418–435.
Weinger, K., & Jacobson, A. M. (2001). Psychosocial and quality of life correlates of glycemic control during intensive treatment of type 1 diabetes. Patient Education and Counseling, 42,123–131.
Weinger, K., Jacobson, A. M., Draelos, M. T., Finkelstein, D. M., & Simonson, D. C. (1995). Blood glucose estimation and symptoms during hyperglycemia and hypoglycemia in patients with insulin-dependent diabetes mellitus. American Journal of Medicine, 98, 22–31.
Welch, G. W., Jacobson, A. M., & Polonsky, W. H. (1997). The problem areas in diabetes scale: An evaluation of its clinical utility. Diabetes Care, 20, 760–766.
Welch, G. W., Weinger, K., Anderson, B. A., & Polonsky, W. H. (2003). Responsiveness of the problem areas in diabetes (PAID) questionnaire. Diabetic Medicine, 20, 69–72.
Wiebe, D. J., Alderfer, A. M., Palmer, S. C., Lindsay, R., & Jarrett, L. (1994). Behavioral self-regulation in adolescents with type 1 diabetes: Negative affectivity and blood glucose symptom perception. Journal of Consulting and Clinical Psychology, 62, 1204–1212.
Wilson, J. F., Moore, R. W., Randolph, S., & Hanson, B. J. (1982). Behavioral preparation of patients for gastrointestinal endoscopy: Information, relaxation, and coping style. Journal of Human Stress, 8, 13–23.
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This research was supported by the National Science Foundation (National Science Foundation Graduate Research Fellowship Grant), the National Institute of Mental Health (R01 MH57663), and the Harvard Medical School Priscilla White Fellowship, National Institute of Diabetes and Digestive and Kidney Diseases (R01 NIDDK24315, R01 NIDDK60115). The authors gratefully acknowledge the reviewers’ thoughtful suggestions and comments, as well as Stephanie Horton, Scarlett Mai, Alexandra Toner, and Brent Tatsuno for their assistance.
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Yi, J.P., Yi, J.C., Vitaliano, P.P. et al. How does anger coping style affect glycemic control in diabetes patients?. Int. J. Behav. Med. 15, 167–172 (2008). https://doi.org/10.1080/10705500802219481
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DOI: https://doi.org/10.1080/10705500802219481