Behavioral Risk Factors in Type-2 Diabetes; Associations with Cognitive Appraisal Type and Psychological Distress

Grant Winners

  • Jeffrey Kibler, Ph.D. – Center for Psychological Studies
  • Charnette Munroe, M.S. – Center for Psychological Studies
  • Gisela Robles, Pharm.D. – College of Pharmacy


  • Karen Grosby – Center for Psychological Studies
  • Andrés Malavé – College of Pharmacy


While type-2 diabetes has a genetic component, managing diabetes is lifestyle-dependent and prognosis is associated with obesity, smoking, and other behavioral factors. These behavioral risk factors remain barriers to wellness despite significant efforts of healthcare providers to educate diabetic patients about preventative care. Emotional distress (e.g., depression) is one variable that may interfere with adherence. Additionally, perceptions of illness and stressors may impact both emotional regulation and health behaviors. Given the high rates of depressive and anxiety among patients with diabetes, and that cognitions (thought patterns) are associated with emotional distress, research is needed to examine the relevance of cognitions to behavioral health risks. The proposed study is an examination of relationships of cognitive appraisals with emotional functioning and health behaviors in type-2 diabetes. In addition, we propose to examine whether experimentally varying the type of prevention message influences illness-related cognitive appraisals and expectancies about engaging in healthy behaviors.

Participants will be 100 men and women ages 21-55, with type-2 diabetes. The study protocol will entail a one-time assessment of physical health-risk measures (e.g., blood sugar, central body mass, cholesterol) and self-report questions regarding demographics, cognitive appraisals, emotional regulation, health risks, and expectancies about adhering to healthy behaviors. Half of the participants will be randomly assigned to each of two prevention message vignettes (one emphasizing dangerous/threatening aspects of non-adherence, and one reinforcing patient abilities to avoid health risks). Diabetes knowledge and severity will be controlled for in each analysis. A series of correlations will assess relationships among cognitive appraisals, emotional distress, and health risks. T-tests will be utilized to assess the effects of prevention message on illness-related cognitive appraisals and expectancies about engaging in healthy behaviors. Results of the proposed project will inform efforts to increase patient adherence and enhance primary and secondary prevention of behavioral health risks.