The role of illness representations and metacognitive beliefs on mood in people with type 2 diabetes: A study from the covid-19 period

Abstract

Objective: Diabetes poses a significant global health threat due to its increasing prevalence and associated comorbidities, straining healthcare systems worldwide. Depression and anxiety are frequent comorbidities in individuals with diabetes, and their underlying mechanisms have been a subject of research. This study investigated the influence of metacognitions and metacognitions about symptom control (MaSC) on depression and anxiety in people with type 2 diabetes (T2D), specifically examining their effects beyond illness representations. Method: Conducted during the COVID-19 pandemic, this study involved 153 T2D patients. Participants completed the Hospital Anxiety and Depression Scale (HADS), Brief Illness Perception Questionnaire (B-IPQ), Metacognitions Questionnaire-30 (MCQ-30), Metacognitions about Symptom Control Scale-Revised (MaSCS-R), and the Protection Motivation Theory Scale for COVID-19 Preventive Behaviors. Results: Hierarchical regression analysis showed that after controlling for socio-demographic variables, fear of COVID-19, and illness representations, negative metacognitions about symptom control predicted 2% of anxiety and 4% of depression; metacognitions predicted 10% of anxiety and 9% of depression. Conclusion: Metacognitions predicted both depression and anxiety, supporting the Self-Regulatory Executive Function (S-REF) model. Metacognitive therapy could be an alternative for managing emotional distress in T2D patients and may contribute to future research.