Assessing and addressing psychosocial and physiological risk factors of type 2 diabetes, by combining a novel lifestyle modification programme with low intensity CBT

Abstract

Common mental health issues and various psychosocial factors are implicated in increasing the risk for type 2 diabetes (T2DM). As yet, there are deficits in knowledge as no studies have examined prevalence of mental health (MH) issues in at risk populations or how MH is assessed in diabetes prevention programmes (DPPs). Furthermore, examination of psychosocial factors en-masse among aforementioned populations has not been attempted within non-clinical samples, with the express intent of addressing said factors via lifestyle improvement programmes (LMPs).

The thesis contained herein aimed to attend to these deficits and contribute to new knowledge by assessing and addressing psychosocial and physiological determinates of T2DM, using Low Intensity CBT (LI-CBT). To achieve this, a
systematic narrative review (chapter 3) was conducted, identifying the most common MH assessment measures utilised within DPPs. The review further identified the prevalence rates of MH among DPP participants, identifying potential relationships between physical and MH in DPPs. A cross sectional survey (chapter 5) assessed psychosocial variables correlated with risk and found significant relationships (social support, physical activity, pre-existing health conditions, binge eating, and sleep quality), with hierarchical regression yielding a predictive explanatory model, with binge eating and depression being the most unique risk predictors. To address identified psychosocial determinants, the first study of its kind in NI evaluated an obesity pilot that included LI-CBT support (chapter 6), findings illustrated that psychotherapeutic support was beneficial in improving health related behaviours and MH symptomology, with significant participant endorsement for LI-CBT. An additional qualatitave study assessed the impact of COVID-19 restrictions on the health and wellbeing of those at elevated T2DM risk. Outcomes revealed there were unintended consequences of restrictions in terms of health and wellbeing. This thesis has highlighted the significant role of psychosocial factors in T2DM risk and how LICBT can successfully attend to these.

Date of Award	May 2022
Original language	English
Supervisor	Karen Kirby (Supervisor), John Mallett (Supervisor), Noel Brick (Supervisor) & Orla Mc Devitt-Petrovic (Supervisor)