Diabetes Distress, Emotional Dysregulation, and Depressive Symptoms among Black Adults with Type 2 Diabetes

The daily demands of diabetes self-management can be distressing, causing greater depressive symptomatology. Further, diabetes distress is positively associated with feelings of frustration and worry, causing increased emotional dysregulation that may further explain the association between diabetes distress and depressive symptomology. The current study used cross-sectional data to assess the role of emotional dysregulation as a mediator of the association between diabetes distress and depressive symptoms in Black adults with type 2 diabetes. Participants (n = 284, 72% female, 62±11 years old, mean diabetes diagnosis duration 11±9 years) were recruited through local churches and completed self-report measures of diabetes distress, emotional dysregulation, and depressive symptoms. Path analyses were performed using Mplus 8 MODEL INDIRECT. Bootstrapping was used to establish robust point estimates. There was a significant direct effect between diabetes distress and depressive symptoms (β = .12, p = .02). A significant indirect effect was also found between diabetes distress and depressive symptoms through emotional dysregulation (β = .30, p < .001). The overall association between diabetes distress and depressive symptoms, including both direct and indirect effects, was β = .42, p < .001. Thus, the positive association between diabetes distress and depressive symptoms was mediated by emotional dysregulation. These findings suggest that strategies aimed at enhancing emotional regulation along with strategies to reduce diabetes distress may decrease depressive symptoms among Black adults with type 2 diabetes.