The role of anxiety and depression on acceptance and action, considering emotional schemas in diabetics of Birjand (Iran)
Keywords:
Diabetes Mellitus; Depressive Disorder; Anxiety DisordersAbstract
Background: Diabetes is one of the most common noncommunicable diseases around the world that accompanies assorted psychiatric disorders including anxiety and depression due to being chronic.
Objective: The aim of this study was to evaluate the effect of anxiety and depression on acceptance and action, considering emotional schemas of diabetics referring to diabetes clinics of health centers in Birjand, Iran.
Methods: This study was conducted in 2016 and was a correlational study with a structural equation modeling approach. The statistical population of this study were all men and women with type 2 diabetes in Birjand, with an active health record in health centers of this county. To collect data, Depression, Anxiety, and Stress Scale (DASS-21), Acceptance and Action Questionnaire-II (AAQ-II) and Leahy Emotional Schema Scale (LESS) were employed. Using SPSS19 and LISREL, data were analyzed via multiple regression and modeling at p≤0.05.
Results: In general, 350 subjects entered the study, most of whom were between 50 and 60 years of age and of whom, (47.7%) were women. Results show that depression has had a negative contribution in predicting quality of life (p=0.0001). In addition, results demonstrated the negative relation of anxiety and depression in predicting no emotional avoidance (flexibility) (p=0.0001). Anxiety and rumination had a positive effect and emotional unawareness had a negative effect on predicting no emotional avoidance (p=0.0001).
Conclusion: Results of this study showed that by reducing adaptive emotional schemas, emotions reduce psychological flexibility and increase emotional avoidance. In addition, by increasing non-adaptive emotional schemas, it increases no flexibility and emotional avoidance that finally reduces quality of life as well as acceptance and action.
References
Izadi Tameh A, Naderi Far M, Naderi Far A, Nikbakht R. Depression in patiens with Diabetes: A Review
Article. Journal of Diabetes Nursing. 2014; 2(2): 77-83.
Moayedi F, Zare S, Nikbakht A. Anxiety and depression in diabetic patient referred to Bandar Abbas
diabetes clinic. Hormozgan Medical Journal. 2015; 18(1): 65-71.
Lee HJ, Chapa D, Kao CW, Jones D, Kapustin J, Smith J, et al. Depression, quality of life, and glycemic
control in individuals with type 2 diabetes. J Am Acad Nurse Pract. 2009; 21(4): 214-24. doi:
1111/j.1745-7599.2009.00396.x. PMID: 19366380.
Lustman PJ, Clouse RE. Depression in diabetic patients: the relationship between mood and glycemic
control. J Diabetes Complications. 2005; 19(2): 113-22. doi: 10.1016/j.jdiacomp.2004.01.002. PMID:
Mosaku K, Kolawole B, Mume C, Ikem R. Depression, Anxiety and Quality of Life among Diabetic
Patients: A Comparative Study. J Natl Med Assoc. 2008; 100(1): 73-8. doi: 10.1016/S0027- 9684(15)31178-0. PMID: 18277812.
Leahy RL. A model of emotional schemas. Cognitive and Behavioral Practice. 2002; 9(3): 177-90. doi:
1016/S1077-7229(02)80048-7.
Izard CE. Basic Emotions, Natural Kinds, Emotion Schemas, and a New Paradigm. Perspect Psychol Sci.
; 2(3): 260-80. doi: 10.1111/j.1745-6916.2007.00044.x. PMID: 26151969.
Chew BH, Shariff-Ghazali S, Fernandez A. Psychological aspects of diabetes care: Effecting behavioral
change in patients. World J Diabetes. 2014; 5(6): 796-808. doi: 10.4239/wjd.v5.i6.796. PMID: 25512782,
PMCID: PMC4265866.
Ashraff S, Siddiqui MA, Carline TE. The Psychosocial Impact of Diabetes in Adolescents: A Review.
Oman Med J. 2013; 28(3): 159-62. doi: 10.5001/omj.2013.46. PMID: 23772279, PMCID: PMC3679608.
Mohammadkhani S, Soleimani H, Seyd Ali Naghei SA. The Role of Emotional Schemas in Resilience of
People living with HIV. Knowledge & Health. 2014; 9(3): 1-10.
Kuttner MJ, Delamater AM, Santiago JV. Learned helplessness in diabetic youths. J Pediatr Psychol. 1990;
(5): 581-94. doi: 10.1093/jpepsy/15.5.581. PMID: 2283568.
Ghaednia Jahromi A. The effectiveness of procedural emotion regulation strategies in temptation, cope
cognitive, emotional schemas and the impulsivity of people with substance abuse. Tehran: Tarbiat Moallem
University; 2014.
Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary Psychometric
Properties of the Acceptance and Action Questionnaire-II: A Revised Measure of Psychological
Inflexibility and Experiential Avoidance. Behav Ther. 2011; 42(4): 676-88. doi:
1016/j.beth.2011.03.007. PMID: 22035996.
Rajabi S, Yazdkhasti F. The Effectiveness of Acceptance and Commitment Group Therapy on Anxiety and
Depression in Women with MS Who Were Referred to the MS Association. Journal of Clinical Psycology.
; 21(1): 29-38.
Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression
Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;
(3): 335-43. doi: 10.1016/0005-7967(94)00075-U. PMID: 7726811.
Samani S, Jowkar B. Validity and reliability of the short form of Depression Anxiety Stress Scales. Journal
of Social Sciences and Humanities of Shiraz University. 2008; 26(3): 65-77.
Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-
item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample.
Psychological Assessment. 1998; 10(2): 176-81. doi: 10.1037/1040-3590.10.2.176.
Mirzaee Garakani M, Asgharnejad Farid AA, Fathali Lavasani F, Ahadian Fard P. Comparison of
Emotional Schemas and Study of the Relationship between anxiety, worry and Emotional Schema in
Patients with Obsessive-compulsive Disorder, Social Anxiety Disorder and in Normal Group. Journal of
Research in Psychological Health. 2014; 8(1): 21-30.
Bayazi MH, Gohari Z, Hojjat SK, Behrad A. Relationship between emotional schemas and anxiety,
depression and coping stress styles in patients with coronary artery disease. Journal of North Khorasan
University of Medical Sciences. 2014; 5(5): 1091-8.
Daneshmandi S, Izadikhah Z, Kazemi H, Mehrabi HA. The Effectiveness of Emotional Schema Therapy
on Emotional Schemas of Female Victims of Child Abuse and Neglect. J Shahid Sadoughi Univ Med Sci.
; 22(5): 1481-94.
Noorbakhsh Amiri F, Yaghubi A, Abbasi Asfajir AA. A Study on Negative Schemas and Resiliency of the
Quality of Life for Patients with Diabetes. J Life Sci Biomed. 2015; 5(4): 91-6.
Bagheri Nezhad M, Salehi Fedardi J, Tabatabaee M. Relationship between rumination and depression in a
sample of Iranian students. Studies in Education & Psychology. 2010; 11(1): 21-38. doi:
22067/fe.v11i1.2246.
Calvete E. Emotional abuse as a predictor of early maladaptive schemas in adolescents: contributions to the
development of depressive and social anxiety symptoms. Child Abuse Negl. 2014; 38(4): 735-46. doi:
1016/j.chiabu.2013.10.014. PMID: 24252743.
Bamelis LL, Evers SM, Spinhoven P, Arntz A. Results of a multicenter randomized controlled trial of the
clinical effectiveness of schema therapy for personality disorders. Am J Psychiatry. 2014; 171(3): 305-22.
doi: 10.1176/appi.ajp.2013.12040518. PMID: 24322378.
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