Type2 Diabetes Clinical Trial
Official title:
An Emotion-Focused Psychosocial Intervention for Improved Glycemic Control in T2D Patients: A Pilot Study
The primary aim of this proposed project is to collect pilot data using an Emotion-Focused CBT Psycho-social Intervention i individuals with T2D to obtain the effect sizes on hypothesized changes in Negative Emotionality, Diabetes Distress, and HbA1c values that will be needed for a more appropriately sized clinical trial for an RO1 submission to the National Institutes of Health.
Our interest in aberrant Emotional Regulation / Emotional Intelligence in Type 2 Diabetes
stems from observations that while many patients with Type 2 Diabetes have greater incidence
of mood and anxiety (and even anger) disorders than controls, targeting psychiatric
conditions, such as depression, is not sufficient to improve glycemic control in patients
with diabetes. Thus, the key issue for such patients is not what specific psychiatric
disorder they have, but the presence of an impairment in the fundamental regulation of
emotional regulation and in how such individuals modulate their emotional response to
aversive events in their lives (e.g., emotional intelligence), now suggested by a recent
study. As part of a new study, we examined the relationship between glycemic control (HbA1c)
and Emotional Experience (ER-Exp) and Skill at Emotional Regulation (ER-Skill) in 100 adult
patients with Type 2 Diabetes. We found significant relationships between ER-Exp and ER-Skill
and HbA1c levels that accounted for nearly 24% of the variance in HbA1c levels. These
relationships with HbA1c levels remained even after accounting for other relevant behavioral
variables such as depression/anxiety scores and diabetes self-care/literacy scores.
Accordingly, the tendency of an individual to have intense emotional responses (higher scores
on ER-Exp), and/or to have a reduced ability to understand/modulate one's emotions in order
to cope with daily stresses/threats (lower scores on ER-Skill), may well be linked with poor
glycemic control (HbA1c) in adult patients with Type 2 Diabetes. If so, it will be important
to develop psycho-social methods to improve ER-Exp and DR-Skill in Type 2 Diabetes patients
to determine if one can improve aberrant Emotional Regulation (ER-Exp/ER-Skill), Diabetes
Distress (DD), and HbA1c (A1c) levels as suggested by treatment studies showing that such
treatment can improve ER-Skill with a sustained reduction in A1c levels in Type 2 Diabetes
for up to nine months. Supporting these findings are data from a recent study showing that
increasing positive emotion reduces (and increasing negative emotion increases) blood glucose
levels, especially in those with poor emotion regulation skills.
Specific Study Objectives:
- Develop an integrated Emotion - Focused Psycho-social EF-CBT) from three (3) existing
sources that contain elements to improve ER-Exp and ER-Skill.
- Conduct a pilot study in 10 patients with Type 2 Diabetes with aberrant
ER-ER-Exp/ER-Skill and compare treatment outcomes in emotionality, diabetes distress,
and in A1c levels with 10 patients with Type 2 Diabetes undergoing treatment as usual
(TAU).
;
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