The Role of Psychological Flexibility and Self-Compassion in Predicting Depression, Anxiety and Stress in Patients with Type 2 Diabetes

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Psychology, School of Literature, Lorestan University, Khorramabad, Iran

2 PhD Student, Department of Psychology, School of Literature, Lorestan University, Khorramabad, Iran

3 Department of Psychology, School of Humanities, Borujerd Branch, Islamic Azad University, Borujerd, Iran

Abstract

Background: Considering high prevalence of psychiatric disorders in patients with type 2 diabetes, this study aimed to investigate the predicting role of psychological flexibility and self-compassion against depression, anxiety, and stress in patients with type 2 diabetes in Khorramabad City, Iran.Methods: In this periodical quantitative study, participants consisted of 102 men and women with type 2 diabetes selected from clinics using convenient sampling method. To collect the data, Neff Self-Compassion Scale-Short Form, Acceptance and Action Questionnaire-II, and Depression, Anxiety and Stress Scale-21 (DASS-21) were used. Data were analyzed using Pearson correlation coefficient and stepwise regression tests via SPSS software.Findings: There was a significant negative correlation between psychological flexibility and self-compassion with variables such as depression, anxiety, and stress (P < 0.050 for all). In addition, self-compassion determined stress and anxiety variables better, and psychological flexibility only determined depression variable better.Conclusion: In general, individuals with high self-compassion and psychological flexibility have less stress, anxiety, and depression. So, it is recommended to exercise suitable practices to increase self-compassion and flexibility in patients with type 2 diabetes.

Keywords


  1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011; 94(3): 311-21.
  2. Rehman A, Kazmi SF. Prevalence and level of depression, anxiety and stress among patients with type-2 diabetes mellitus. Ann Pak Inst Med Sci 2015; 11(2): 81-6.
  3. Larejani B, Zahedi F. Epidemiology of diabetes mellitus in Iran. Iran J Diabetes Lipid Disord 2001; 1(1): 1-8. [In Persian].
  4. Friis AM, Consedine NS, Johnson MH. Does kindness matter? Diabetes, depression, and self-compassion: A selective review and research agenda. Diabetes Spectr 2015; 28(4): 252-7.
  5. Degmecic D, Bacun T, Kovac V, Mioc J, Horvat J, Vcev A. Depression, anxiety and cognitive dysfunction in patients with type 2 diabetes mellitus--a study of adult patients with type 2 diabetes mellitus in Osijek, Croatia. Coll Antropol 2014; 38(2): 711-6.
  6. Marshall EJ, Brockman RN. The relationships between psychological flexibility, self-compassion, and emotional well-being. J Cogn Psychother 2016; 30(1): 60-72.
  7. Bryan CJ, Ray-Sannerud B, Heron EA. Psychological flexibility as a dimension of resilience for posttraumatic stress, depression, and risk for suicidal ideation among Air Force personnel. J Contextual Behav Sci 2015; 4(4): 263-8.
  8. Masuda A, Tully EC. The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample. J Evid Based Complementary Altern Med 2012; 17(1): 66-71.
  9. Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self-compassion program. J Clin Psychol 2013; 69(1): 28-44.
  10. Neff KD, Costigan AP. Self-compassion, wellbeing, and happiness. Psychologie in Osterreich 2017; 2(3): 114-9.
  11. Yadavaia JE, Hayes SC, Vilardaga R. Using acceptance and commitment therapy to increase self-compassion: A randomized controlled trial. J Contextual Behav Sci 2014; 3(4): 248-57.
  12. Bhat SA, Shah SA. Self compassion and mental health: A study on young adults. International Journal of Research in Applied, Natural and Social Sciences 2015; 3(4): 49-54.
  13. Neff KD, Kirkpatrick KL, Rude SS. Self-compassion and adaptive psychological functioning. J Res Pers 2007; 41(1): 139-54.
  14. Raes F. Rumination and worry as mediators of the relationship between self-compassion and depression and anxiety. Pers Individ Dif 2010; 48(6): 757-61.
  15. Krieger T, Berger T, Holtforth MG. The relationship of self-compassion and depression: Cross-lagged panel analyses in depressed patients after outpatient therapy. J Affect Disord 2016; 202: 39-45.
  16. Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy: The process and practice of mindful change. 2nd ed. New York, NY: Guilford Press; 2011. p. 64-6.
  17. Hayes SC, Pistorello J, Levin ME. Acceptance and Commitment Therapy as a unified model of behavior change. The Counseling Psychologist 2012; 40(7): 976-1002.
  18. Woodruff SC, Glass CR, Arnkoff DB, Crowley KJ, Hindman RK, Hirschhorn EW. Comparing self-compassion, mindfulness, and psychological inflexibility as predictors of psychological health. Mindfulness 2014; 5(4): 410-21.
  19. Masuda A, Hayes SC, Lillis J, Bunting K, Herbst SA, Fletcher LB. The relation between psychological flexibility and mental health stigma in Acceptance and Commitment Therapy: A preliminary process investigation. Behav Soc Issues 2009; 18(25): 40.
  20. Delavar A. Research method in psychology and educational sciences. Tehran, Iran: Virayesh; 2016. p. 113. [In Persian].
  21. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother 2011; 18(3): 250-5.
  22. Shahbazi M, Rajabi G, Maghami E, Jelodari A. Confirmatory factor analysis of the persian version of the self-compassion rating scale-revised. Journal of Psychological Models and Methods 2015; 6(19): 31-46. [In Persian].
  23. 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.
  24. Imani M. Investigating the factor structure of Acceptance and Action Questionnaire-II in Students. Journal of Teaching and Learning 2016; 8(1): 162-81. [In Persian].
  25. Zare H, Solgi Z. Investigation of the relationship between cognitive emotion regulation strategies and depression, anxiety and stress in students. Journal of Research in Psychological Health 2012; 6(3): 19-29. [In Persian].
  26. Sahebi A, Asghari MJ, Salari RS. Validation of Depression Anxiety and Stress Scale (DASS-21) in Iranian population. Developmental Pscychology 2005; 1(4): 299-310. [In Persian].
  27. Allen AB, Leary MR. Self-compassion, stress, and coping. Soc Personal Psychol Compass 2010; 4(2): 107-18.
  28. Kashdan TB, Ciarrochi JV. Mindfulness, acceptance, and positive psychology: The seven foundations of well-being. Oakland, CA: Context Press; 2013.
  29. p. 94-5.
  30. Fledderus M, Bohlmeijer ET, Fox JP, Schreurs KM, Spinhoven P. The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial. Behav Res Ther 2013; 51(3): 142-51.
  31. Morris R. Psychological flexibility as a mediator of the relationship between self-compassion and mental health [Thesis]. Queensland, Australia: School of Psychology, The University of Queensland; 2015.