Diabetes mellitus affects 7.8% of the American population. National health statistic data and other research shows that racial/ethnic disparities exist in terms of prevalence and treatment outcomes. The present study investigated the role of patient health beliefs (i.e., locus of control, self-efficacy) and the doctor-patient relationship (e.g., satisfaction and collaboration with health care provider), as relative predictors of diabetic control (i.e., HbA1c levels) and overall satisfaction with diabetes care, in older adult participants with diabetes. Demographic, psychosocial, and diabetes-related data from the Health and Retirement Study (HRS) 2003 Diabetes Study were analyzed to compare treatment outcomes among non-Hispanic White, non-Hispanic Black, and Hispanic individuals with various types of diabetes. Non-Hispanic White individuals exhibited better diabetic control than their minority counterparts (F(2, 592) = 7.60, p < .001); however, no significant group differences were noted in terms of psychosocial factors. Diabetic control was best predicted by time since diagnosis (&#946; = -.21, p < .001), satisfaction with diabetes self-care (&#946; = .19, p < .001) and age (&#946; = .12, p < .01). In addition, satisfaction with provider care was best predicted by perceived collaboration with provider (&#946; = .44, p < .001), satisfaction with diabetes self-care (&#946; = .22, p < .001) and diabetes self-efficacy (&#946; = .08, p < .05). Recommendations for future research were discussed.

Researchers have examined psychosocial risk variables (e.g., hostility) related to high resting blood pressure (BP), with the majority of findings suggesting that hostility is associated with increased resting BP. Additionally, it has been proposed that constructive verbal anger expression is a protective factor for hypertension (Davidson, MacGregor, Stuhr, Dixon, & MacLean, 2000; Davidson, MacGregor, Stuhr, & Gidron, 1999), while others have hypothesized that humor promotes physical health (i.e., the humor-health hypothesis) (Martin, Puhlik-Doris, Larsen, Gray, & Weir, 2003; McClelland & Cheriff, 1997). The primary purpose of the present study is to examine the relations between hostility, humor styles, constructive verbal anger, and resting BP, with an emphasis on the humor-health hypothesis. One hundred and ninety nine undergraduate university participants had six resting blood pressure measurements taken at three-minute intervals. Participants then completed the following questionnaires online in a randomized order: Cook-Medley Hostility Scale (CMH), Constructive Anger Behaviour-Verbal Scale (CAV), Humor Styles Questionnaire (HSQ), and a health and demographic questionnaire. A series of hierarchical regressions were conducted to test the hypotheses with resting systolic BP (SBP) and resting diastolic BP (DBP). Two health and demographic variables, age and body mass index (BMI), were entered into step 1 of all the regressions analyzed as covariates. In step 2 of each regression model, the respective psychosocial variables were independently entered. Comparisons were conducted between the various psychosocial variables entered into step 2 to determine which variable accounts for the most unique variance in resting SBP and DBP. Small to moderate positive correlations were observed between age and resting BP, as well as BMI and resting BP. Regarding psychosocial variables, small positive correlations were observed between affiliative humor and resting SBP, and between self-enhancing humor and resting BP. Multiple regression analyses revealed that after controlling for age and BMI, adaptive humor styles uniquely predicted higher resting SBP, while no psychosocial variables predicted resting DBP. The present investigation provides evidence suggesting that psychosocial risk factors are not associated with resting BP while also contradicting the humor-health hypothesis, suggesting that adaptive humor is associated with increased resting BP.

Introduction: The current study examined the psychosocial predictors (Type D personality, anxiety, depression & social support) in patients following MI. It further assessed the influence of these psychosocial predictors on quality of life of MI patients. Methods: In this prospective cohort study, 300 patients with definite myocardial infarction were recruited and assessed at baseline (2 -8 weeks) post MI (time 1). Out of 300 participants 191 completed assessments at 9 months follow up (time 2). Type D personality was evaluated with Distress scale 14(DS-14). Depression and anxiety were assessed with Hospital anxiety and depression scale (HADS). Social support was measured with Social support scale (SSS), while quality of Life was assessed with WHO quality of life scale (WHOQOL-BREF) at time 1 and time 2. Results: Analysis revealed that a significantly high percentage of MI patients had Type D personality characteristics, high levels of anxiety, depression and low level of social support. Type D personality and depression emerged as most significant predictors of quality of life after controlling for sociodemographic and clinical variables at time 1 and time 2 assessments. Discussion & Conclusion: This research emphasized the importance of Type D personality, anxiety, depression, and lack of social support in risk stratification for adverse outcomes such as impaired quality of life. This research highlighted the need for a more personalized approach to therapeutic interventions along with medical treatment for the management and rehabilitation of MI patients.

The cost of health care continues to increase. Based on the biopsychosocial model of heath care, it has been shown that the treatment of psychological and social problems can have a cost offset effect on the cost of medical care. While this offset effect has been shown in an MFT population, there are no known studies that have looked at predictors of the change in medical use by those that receive marital and family therapy. This study looked at psychological and social measures of individuals who received marital and family therapy. These measures were evaluated based on the change from intake to one year post intake using best subsets multiple regression. The model for males showed variables that could be affected using a cognitive or cognitive-behavioral model of therapy. The model for females showed variables that could be affected using the emotionally focused model of therapy. The implications of this study are that a therapist could be the most effective in conjoint therapy if they apply concepts from both cognitive and emotionally focused therapeutic models.

Introduction: The current study examined the psychosocial predictors (Type D personality, anxiety, depression & social support) in patients following MI. It further assessed the influence of these psychosocial predictors on quality of life of MI patients. Methods: In this prospective cohort study, 300 patients with definite myocardial infarction were recruited and assessed at baseline (2 -8 weeks) post MI (time 1). Out of 300 participants 191 completed assessments at 9 months follow up (time 2). Type D personality was evaluated with Distress scale 14(DS-14). Depression and anxiety were assessed with Hospital anxiety and depression scale (HADS). Social support was measured with Social support scale (SSS), while quality of Life was assessed with WHO quality of life scale (WHOQOL-BREF) at time 1 and time 2. Results: Analysis revealed that a significantly high percentage of MI patients had Type D personality characteristics, high levels of anxiety, depression and low level of social support. Type D personality and depression emerged as most significant predictors of quality of life after controlling for sociodemographic and clinical variables at time 1 and time 2 assessments. Discussion & Conclusion: This research emphasized the importance of Type D personality, anxiety, depression, and lack of social support in risk stratification for adverse outcomes such as impaired quality of life. This research highlighted the need for a more personalized approach to therapeutic interventions along with medical treatment for the management and rehabilitation of MI patients. / Fatima Jinnah Women University of Pakistan and The Higher Education Commission

No description available.

Poorly controlled diabetes is common among the majority of youth with type 1 diabetes and can lead to adverse health outcomes at an early age. There is a need to change this to minimise the risk of negative long-term consequences. The onset of complications from diabetes can be prevented or delayed with good management as demonstrated by blood glucose being kept close to or within the normal range. Diabetes control is challenging for young people due to a combination of physiological and psychological factors. Diabetes control needs to be monitored both at an individual level and also at a population level, in order to optimise health outcomes and provide important information for health service provision. There are gaps in knowledge relating to the current level of diabetes control at a population level and of the epidemiological characteristics of youth with type 1 diabetes in the Canterbury region in New Zealand. There has been no research of this nature in the Canterbury region since 2003. There are also gaps in knowledge and a lack of national and international research that investigates psychosocial characteristics of youth with type 1 diabetes and the impact these may have on diabetes control. There is a potentially promising intervention, namely, Motivational Interviewing (MI), that although previous research investigating it with diabetes has shown some promise, methodological problems have limited the conclusions that can be drawn. This thesis, within the New Zealand context, addresses some of these gaps and adds to the body of knowledge of research concerning diabetes control and youth with type 1 diabetes, and investigates MI intervention for youth with poorly controlled diabetes. The thesis encompasses three studies. The first study is an audit that provides up-to-date information on epidemiological characteristics and clinical outcomes for the youth population with type 1 diabetes residing in the Canterbury region. The second study is a cross-sectional study that investigates the relationship between glycaemic control and key psychosocial characteristics: illness beliefs, self-efficacy, and quality of life in youth with type 1 diabetes in Canterbury. The third study is a longitudinal study that investigates the efficacy of MI as an intervention for youth with poorly controlled type 1 diabetes, and explores its impact on diabetes outcomes using statistical and clinical analyses. The first study showed that from 2003 to 2010 the prevalence of adolescents and young adults with type 1 diabetes in Canterbury has increased; there is therefore an increased demand on health resources. In addition, in 2010 glycaemic control at a population level was in the poorly controlled diabetes range and this had remained unchanged since 2003. This suggests the need for more intensive interventions. The second study found that poor diabetes control in youth with type 1 diabetes is influenced by a number of factors, including negative views on diabetes, lower perceived personal control, higher diabetes-related concerns, and lower levels of worry about complications. These findings provide a new understanding of the importance of balancing worries about diabetes complications and the perception of diabetes as a threatening condition. The third study showed that the MI intervention was generally successful in improving diabetes outcomes – clinical, psychosocial, and behavioural changes were observed. Statistically and clinically significant positive changes were found across multiple variables: glycated haemoglobin (HbA1c), glycaemic variability, adherence, and psychosocial functioning. Taken together, the findings of the three studies indicate that majority of youth with type 1 diabetes in the Canterbury region had poor glycaemic control, which suggests that additional interventions may be required to improve management of their condition, especially interventions targeting psychosocial functioning (e.g., illness perceptions) and diabetes self-management. Motivational Interviewing may be a viable option, and therefore further research into this approach is recommended.