Harrison, A;
Zaremba, N;
Brown, J;
Allan, J;
Hopkins, D;
Treasure, J;
Ismail, K;
(2021)
A cognitive behavioural model of the bidirectional relationship between disordered eating and diabetes self‐care in people with type 1 diabetes mellitus.
Diabetic Medicine
, 38
(7)
, Article e14578. 10.1111/dme.14578.
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Abstract
AIMS: This qualitative study aimed to develop the first cognitive-behavioural-therapy model outlining the development and maintenance of disordered eating in type 1 diabetes and report on recovery strategies and resilience factors to improve previous theoretical models of type 1 diabetes and disordered eating. METHODS: Twenty-three women (n=9 with type 1 diabetes and disordered eating, n=5 with type 1 diabetes recovering from disordered eating, and n=9 with type 1 diabetes without disordered eating) participated in semi-structured interviews. Data were analysed using grounded theory and individual cognitive-behavioural formulations were developed for each participant to inform the development/maintenance and resilience models. RESULTS: The development/maintenance model summarises commonly experienced vicious cycles of thoughts, feelings and behaviours in type 1 diabetes and disordered eating. The resilience model summarises strategies/knowledge acquired by those with type 1 diabetes in recovery from disordered eating and individuals with type 1 diabetes who did not develop disordered eating. Early adverse life events, past psychiatric history, perfectionist personality traits, difficult experiences around type 1 diabetes diagnosis and its relentless daily management sensitise individuals to eating, weight and shape cues. Alongside physical symptoms/complications, unhelpful interpersonal reactions and inadequate healthcare, vicious cycles of thoughts, feelings and behaviours develop. "Good enough" psychological adaptation to type 1 diabetes, integrating type 1 diabetes into one's identity, self-care and compassion around eating, weight and shape were key protective/post-traumatic resilience factors. CONCLUSIONS: This first cognitive-behavioural-therapy model of type 1 diabetes and disordered eating informed by personal experience will inform an intervention for type 1 diabetes and disordered eating.
| Type: | Article |
|---|---|
| Title: | A cognitive behavioural model of the bidirectional relationship between disordered eating and diabetes self‐care in people with type 1 diabetes mellitus |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/dme.14578 |
| Publisher version: | https://doi.org/10.1111/dme.14578 |
| Language: | English |
| Additional information: | © 2021 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Type 1 diabetes mellitus, cognitive behavioural therapy, disordered eating, qualitative |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Psychology and Human Development |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10126087 |
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