Skip to main content

Advertisement

Log in

The Relationship Between Mindfulness, Depression, Diabetes Self-Care, and Health-Related Quality of Life in Patients with Type 2 Diabetes

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

In this cross-sectional study, we examined the relationships between dispositional mindfulness, depression, diabetes self-care, and health-related quality of life in patients with type 2 diabetes. Seventy-five participants (mean age = 63.4, SD = 10.2) completed the Beck Depression Inventory-II, the Five Facets of Mindfulness Questionnaire, the Summary of Diabetes Self-Care Activities, and the Short-Form-12v2 Health Survey. We used correlational analyses and hierarchical regression analyses. Mindfulness was not correlated with diabetes self-care. However, mindfulness was negatively correlated with depression and positively correlated with mental health-related quality of life. In a hierarchical multiple regression analysis, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience were significant predictors of lower depression scores and better mental health-related quality of life scores after controlling for age and medical comorbidities. Dispositional mindfulness and, in particular, the ability to accept and respond to moment-to-moment experiences in a nonreactive way is associated with better mental health in type 2 diabetes. Longitudinal studies linking changes in various mindfulness facets over time, with and without training, to changes in diabetes outcomes are needed to further understand the role of mindfulness in this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Ali, S., Stone, M. A., Peters, J. L., Davies, M. J., & Khunti, K. (2006). The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabetic Medicine, 23(11), 1165–1173.

    Article  PubMed  Google Scholar 

  • Ali, S., Stone, M., Skinner, T.C., Robertston, N., Davies, M., & Khunti, K. (2010). The association between depression and health-related quality of life in people with type 2 diabetes: a systematic literature review. Diabetes/Metabolism Research and Reviews, 26(2), 75–89. doi:10.1002/dmrr.1065.

  • Arch, J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behaviour Research and Therapy, 44(12), 1849–1858.

  • Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143. doi:10.1093/clipsy/bpg015.

  • Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.

    Article  PubMed  Google Scholar 

  • Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., & Williams, J. M. G. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342. doi:10.1177/1073191107313003.

  • Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

  • Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., & Devins, G. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241. doi:10.1093/clipsy.bph077.

  • Bränström, R., Duncan, L. G., & Moskowitz, J. T. (2011). The association between dispositional mindfulness, psychological well-being, and perceived health in a Swedish population-based sample. British Journal of Health Psychology, 16(2), 300–316. doi:10.1348/135910710X501683.

  • Bruce, D. G., Davis, W. A., Starkstein, S. E., & Davis, T. M. E. (2005). A prospective study of depression and mortality in patients with type 2 diabetes: the Fremantle Diabetes Study. Diabetologia, 48(12), 2532–2539.

    Article  PubMed  Google Scholar 

  • Danaei, G., Finucane, M. M., Lu, Y., Singh, G. M., Cowan, M. J., Paciorek, C. J., et al. (2011). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet, 378(9785), 31–40. doi:10.1016/S0140-6736(11)60679-X.

  • Ditto, B., Eclache, M., & Goldman, N. (2006). Short-term autonomic and cardiovascular effects of mindfulness body scan meditation. Annals of Behavioral Medicine, 32(3), 227–234.

    Article  PubMed  Google Scholar 

  • Gonzalez, J. S., Safren, S. A., Cagliero, E., Wexler, D. J., Delahanty, L., Wittenberg, E., & Grant, R. W. (2007). Depression, self-care, and medication adherence in type 2 diabetes relationships across the full range of symptom severity. Diabetes Care, 30(9), 2222–2227.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gregg, J. A., Callaghan, G. M., Hayes, S. C., & Glenn-Lawson, J. L. (2007). Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 75(2), 336–343.

  • Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: a meta-analysis. Journal of Psychosomatic Research, 57(1), 35–43.

  • Hartmann, M., Kopf, S., Kircher, C., Faude-Lang, V., Djuric, Z., Augstein, F., & Nawroth, P. P. (2012). Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients design and first results of a randomized controlled trial (the Heidelberger diabetes and stress-study). Diabetes Care, 35(5), 945–947. doi:10.2337/dc11-1343.

  • IBM Corp. Released. (2011). IBM SPSS Statistics for Windows, Version 20.0 [Software]. Armonk, NY: IBM Corp.

  • International Society for Quality of Life Research. (2015). What is health-related quality of life research? Retrieved from http://www.isoqol.org/about-isoqol/what-is-health-related-quality-of-life-research.

  • Jakobsson, U., Westergren, A., Lindskov, S., & Hagell, P. (2012). Construct validity of the SF-12 in three different samples. Journal of Evaluation in Clinical Practice, 18(3), 560–566.

    Article  PubMed  Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Bantam Dell.

  • Katon, W. J., Rutter, C., Simon, G., Lin, E. H., Ludman, E., Ciechanowski, P., & Von Korff, M. (2005). The association of comorbid depression with mortality in patients with type 2 diabetes. Diabetes Care, 28(11), 2668–2672.

    Article  PubMed  Google Scholar 

  • Kim, M. H., Mazenga, A. C., Devandra, A., Ahmed, S., Kazembe, P. N., Yu, X., & Sharp, C. (2014). Prevalence of depression and validation of the beck depression inventory-II and the Children’s depression inventory-short amongst HIV-positive adolescents in Malawi. Journal of the International AIDS Society, 17(1), 18965. doi:10.7448/IAS.17.1.18965.

  • Knol, M. J., Twisk, J. W. R., Beekman, A. T. F., Heine, R. J., Snoek, F. J., & Pouwer, F. (2006). Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia, 49(5), 837–845.

    Article  PubMed  Google Scholar 

  • Lee, H. J., Chapa, D., Kao, C. W., Jones, D., Kapustin, J., Smith, J., & Friedmann, E. (2009). Depression, quality of life, and glycemic control in individuals with type 2 diabetes. Journal of the American Academy of Nurse Practitioners, 21(4), 214–224. doi:10.1111/j.1745-7599.2009.00396.x.

  • Lin, E. H., Katon, W., Von Korff, M., Rutter, C., Simon, G. E., Oliver, M., & Young, B. (2004). Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care, 27(9), 2154–2160.

    Article  PubMed  Google Scholar 

  • Matousek, R. H., Dobkin, P. L., & Pruessner, J. (2010). Cortisol as a marker for improvement in mindfulness-based stress reduction. Complementary Therapies in Clinical Practice, 16(1), 13–19. doi:10.1016/j.ctcp.2009.06.004.

  • McCracken, L. M., & Vowles, K. E. (2008). A prospective analysis of acceptance of pain and values-based action in patients with chronic pain. Health Psychology, 27(2), 215–220. doi:10.1037/0278-6133.27.2.215.

  • McCracken, L. M., Gutierrez-Martinez, O., & Smyth, C. (2013). Decentering reflects psychological flexibility in people with chronic pain and correlates with their quality of functioning. Health Psychology, 32(7), 820–823. doi:10.1037/a0028093.

  • Miller, C. K., Kristeller, J. L., Headings, A., Nagaraja, H., & Miser, W. F. (2012). Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a pilot study. Journal of the Academy of Nutrition and Dietetics, 112(11), 1835–1842. doi:10.1016/j.jand.2012.07.036.

  • Nichols, G. A., & Brown, J. B. (2003). Unadjusted and adjusted prevalence of diagnosed depression in type 2 diabetes. Diabetes Care, 26(3), 744–749.

    Article  PubMed  Google Scholar 

  • Nouwen, A., Winkley, K., Twisk, J., Lloyd, C. E., Peyrot, M., Ismail, K., & Pouwer, F. (2010). Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia, 53(12), 2480–2486. doi:10.1007/s00125-010-1874-x.

  • Paul, N. A., Stanton, S. J., Greeson, J. M., Smoski, M. J., & Wang, L. (2013). Psychological and neural mechanisms of trait mindfulness in reducing depression vulnerability. Social Cognitive and Affective Neuroscience, 8(1), 56–64. doi:10.1093/scan/nss070.

  • Poole, H., Bramwell, R., & Murphy, P. (2006). Factor structure of the Beck Depression Inventory-II in patients with chronic pain. The Clinical Journal of Pain, 22(9), 790–798.

    Article  PubMed  Google Scholar 

  • Redekop, W. K., Koopmanschap, M. A., Stolk, R. P., Rutten, G. E. H. M, Wolffenbuttel, B. H. R., & Niessen, L. W. (2002). Health-related quality of life and treatment satisfaction in dutch patients with type 2 diabetes. Diabetes Care, 25 (3), 458–463.

  • Rosenkranz, M. A., Davidson, R. J., MacCoon, D. G., Sheridan, J. F., Kalin, N. H., & Lutz, A. (2013). A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation. Brain Behavior and Immunity, 27(1), 174–184. doi:10.1016/j.bbi.2012.10.013.

  • Rosenzweig, S., Reibel, D. K., Greeson, J. M., Edman, J. S., Jasser, S. A., McMearty, K. D., & Goldstein, B. J. (2007). Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: a pilot study. Alternative Therapies in Health and Medicine, 13(5), 36–38.

  • Rubin, R. R., & Peyrot, M. (1999). Quality of life and diabetes. Diabetes/Metabolism Research and Reviews, 15(3), 205–218. doi:10.1002/(SICI)1520-7560(199905/06)15:3<205::AID-DMRR29>3.0.CO;2-O.

  • Rustad, J. K., Musselman, D. L., & Nemeroff, C. B. (2011). The relationship of depression and diabetes: Pathophysiological and treatment implications. Psychoneuroendocrinology, 36(9), 1276–1286. doi:10.1016/j.psyneuen.2011.03.005.

  • Safran, J. D., & Segal, Z. V. (1990). Interpersonal process in cognitive therapy. New York, NY: Basic Books.

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York, NY: Guilford Press.

  • Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373–386.

  • Shapiro, S. L., Brown, K. W., Thoresen, C., & Plante, T. G. (2011). The moderation of mindfulness-based stress reduction effects by trait mindfulness: results from a randomized controlled trial. Journal of Clinical Psychology, 3(3), 267–277. doi:10.1002/jclp.20761.

  • Toobert, D.J., & Glasgow, R.E. (1994). Assessing diabetes self-management: the summary of diabetes self-care activities questionnaire. Handbook of Psychology and Diabetes, 351–375.

  • Toobert, D. J., Hampson, S. E., & Glasgow, A. R. (2000). The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care, 23(7), 943–950.

    Article  PubMed  Google Scholar 

  • United Kingdom Prospective Diabetes Study Group (1999). Quality of life in type 2 diabetic patients is affected by complications but not by intensive policies to improve blood glucose or blood pressure control (UKPDS 37). Diabetes Care, 22(7), 1125–1136. doi:10.2337/diacare.22.7.1125.

  • Van Son, J., Nyklíček, I., Pop, V. J., Blonk, M. C., Erdtsieck, R. J., Spooren, P. F., & Pouwer, F. (2013). The effects of a mindfulness-based intervention on emotional distress, quality of life, and HbA1c in outpatients with diabetes (DiaMind) a randomized controlled trial. Diabetes Care, 36(4), 823–830. doi:10.2337/dc12-1477.

  • Veehof, M. M., Peter, M., Taal, E., Westerhof, G. J., & Bohlmeijer, E. T. (2011). Psychometric properties of the Dutch five facet mindfulness questionnaire (FFMQ) in patients with fibromyalgia. Clinical Rheumatology, 30(8), 1045–1054. doi:10.1007/s10067-011-1690-9.

  • Ware, J. E., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.

    Article  PubMed  Google Scholar 

  • Young, B. A., Lin, E., Von Korff, M., Simon, G., Ciechanowski, P., Ludman, E., Everson-Stewart, S., Kinder, L., Oliver, M., Boyko, E., & Katon, W. J. (2008). Diabetes complications severity index and risk of mortality, hospitalization, and health care utilization. American Journal of Managed Care, 14(1), 15–24.

  • Young, L. A., Cappola, A. R., & Baime, M. J. (2009). Mindfulness based stress reduction: effect on emotional distress in diabetes. Practical Diabetes International, 26(6), 222–224. doi:10.1002/pdi.1380.

Download references

Funding

The study received funding from The University of Ottawa Department of Family Medicine.

Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Myka B. Caluyong.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Caluyong, M.B., Zambrana, A.F., Romanow, H.C. et al. The Relationship Between Mindfulness, Depression, Diabetes Self-Care, and Health-Related Quality of Life in Patients with Type 2 Diabetes. Mindfulness 6, 1313–1321 (2015). https://doi.org/10.1007/s12671-015-0401-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-015-0401-z

Keywords

Navigation