Cognitive self-regulation strategies and resilience in patients with type 2 diabetes mellitus

Background: Medical, economic, socio-demographic, psychological consequences of T2DM justify the need for the development of an interdisciplinary program of clinical and psychological support of patients with T2DM. Aim. This paper aims to study cognitive self-regulation strategies and resilience in patients with T2DM taking into account the duration of the disease, its perception as a severe threat, as well as analysis of the correlation between cognitive self-regulation strategies and resilience components, to clarify the targets of psychotherapeutic interventions in T2DM patients. Materials and methods: An experimental study has been conducted. The study involved 30 patients with a clinical diagnosis of type 2 diabetes (ICD-10 code E11). The clinical psychological method has been used in the study namely psychodiagnostic (controlled, partially standardized) interview and the analysis of medical documentation. The experimental psychological method involves the use of psychodiagnostic techniques: the Adult’s Resilience test, the Brief Illness Perception Questionnaire, the Cognitive Representations of Illness Questionnaire, the Types of Attitude toward Disease technique. For statistical analysis, the following methods have been used: descriptive statistics, comparative statistics (Mann-Whitney criteria, Spearman's rank correlation method). All calculations were performed using the StatSoft STATISTICA 10.0 software package for Windows. Results. It has been revealed that the cognitive representation transforms according to the disease duration and its perception as a severe threat. In T2DM patients, the structural organization of resilience alters with increasing duration of disease. Components of resilience (persistence, self-efficacy, internal locus of control, family and social relationships, spirituality) contribute to cognitive reappraisal of the aversive nature of T2DM. The targets of psychotherapeutic interventions in patients with T2DM are reduction of helplessness-hopelessness construct and an increase of acceptance cognition; transformations of the structure of cognitive representations and cognitive reappraisal strategies occur through increasing links with the components of resilience. Conclusion: cognitive representations about T2DM and components of resilience transform in patients as the disease develops. With an increase in the duration of T2DM, the cognitive helplessness construct remains stable. It has been found that groups of patients with a perception of T2DM as a severe and moderate threat significantly differ both in the components of cognitive perceptions and in the valence of cognitive reevaluation. The targets of psychotherapeutic interventions in patients with type 2 diabetes are formulated.