Thesis (Ph. D.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains viii, 170 p. Includes abstract. Includes bibliographical references (p. 108-157).

Thesis (MA)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: Individuals diagnosed with diabetes mellitus are at an increased risk for developing depression. According to the literature, depression in diabetes mellitus has been associated with a poorer quality of life, poorer regimen adherence, poorer adjustment to diabetes, poorer glycaemic control, and an increased risk of developing diabetes related complications. While the role of certain psychosocial determinants in the onset and maintenance of depression has been investigated, mental health professionals and researchers have neglected the task of conceptualizing the relationship between depression and diabetes from a psychological perspective. This assignment presents a psychological conceptualization of the relationship between diabetes and depression, using Beck's (1967, 1979) cognitive model of depression as a framework. This conceptualization may serve as a means of theoretically understanding the relationship between these two conditions and as a framework in directing future research on this relationship. / AFRIKAANSE OPSOMMING: Individue wat met diabetes mellitus gediagnoseer word, toon 'n verhoogde risiko om depressie te ontwikkel. Volgens die literatuur word depressie in diabetes mellitus geassosieer met 'n swakker lewensgehelte, swakker nakoming van behandeling, swakker aanpassing by diabetes, swakker glisemie-kontrole, en 'n verhoogde risiko om diabetes verwante komplikasies te ontwikkel. Hoewel die rol van bepaalde psigososiale verandelikes in die ontstaan en instandhouding van depressie reeds ondersoek is, is min nog gedoen oor 'n konseptualisering van die assosiasie tussen diabetes en depressie. Hierdie werkstuk handeloor 'n konseptualisering van die verband tussen diabetes en depressie, gebaseer op Beck (1967, 1979) se kognitiewe model van depressie. Die konseptualisering dien as 'n naamwerk om hierdie verband te verstaan en toekomstige narvorsing hieroor te rig.

About 8.3% of individuals diagnosed with diabetes mellitus (DM) are diagnosed with comorbid depression, a higher rate than the general adult population. This project examined the differences of depression symptoms experienced between diabetic and matched non-diabetic individuals and the relationship of daily activity and nutrition behaviors with depression between these groups. The 2005-2006 National Health and Nutrition Examination Survey (NHANES) was utilized to assess: depression symptoms, diabetic glycemic control as measured by glycoginated hemoglobin (HbA1c), amount of physical activity, percentage of macronutrients, daily frequencies of foods consumed, and the use of nutritional food labels to make food choices. A sample of diabetic (n = 451) and non-diabetic individuals (n = 451) were matched to on age, gender, ethnicity, and education. The diabetic individuals experienced greater depression on both continuous and ordinal diagnostic variables. Counter to expectation, there was no relationship observed between depression and HbA1c in diabetic individuals, r = .04, p > .05.

Objective: To identify whether perceived stress is a risk-factor for higher cortisol levels and greater insulin resistance in Type 2 diabetic patients, using data from participants with and without diabetes in the National Survey of Midlife Development in the United States (MIDUS), specifically MIDUS II, Project 4. The following hypotheses were tested: (H1a) greater perceived stress would be associated with higher cortisol for Type 2 diabetic participants, (H1b) the perceived stress/cortisol relationship would be stronger for people with Type 2 diabetes than for those without it, (H2) greater perceived stress would be associated with higher Homeostatic Model Assessment-Insulin Resistance (HOMA-IR, insulin-resistance) for Type 2 diabetic participants, (H3a) subjective well-being would moderate the perceived stress/insulin resistance relationship for Type 2 diabetic participants, and (H3b) depression would moderate the perceived stress/insulin resistance relationship for Type 2 diabetic participants. Method: MIDUS, a longitudinal study of over 7,000 American adults, explores biopsychosocial factors that could contribute to variance in mental/physical health. Only complete data were utilized. Type 2 participants (n=115) consisted of 54 males and 62 females ranging in age from 36 to 81 years. Non-diabetic participants (n=1097) consisted of 470 males and 627 females ranging in age from 34 to 84 years. Results: None of the predicted relationships were statistically significant. Waist to hip ratio was significantly related to insulin resistance (r = .31, p = .001). Conclusions: Future studies should collect information about the type and duration of stressors in addition to perceptions about stress for those with Type 2 diabetes.