Effects of stress management and relaxation training on the relationship between diabetes symptoms and affect among Latinos

Abstract

Objective: Stress management and relaxation (SMR) interventions can reduce symptoms of chronic disease and associated distress. However, there is little evidence that such interventions disrupt associations between symptoms and affect. This study examined whether SMR dampened the link between symptoms of hyperglycemia and proximal levels of affect. We predicted that during periods of increased hyperglycemia, individuals receiving SMR training, relative to controls, would demonstrate smaller increases in negative affect.

Design: Fifty-five adult Latinos with type 2 diabetes were randomised to either one group session of diabetes education (DE-only; N = 23) or diabetes education plus eight group sessions of SMR (DE + SMR; N = 32). After treatment, participants reported five diabetes symptoms and four affective states twice daily for seven days using a bilingual telephonic system.

Results: Mean age = 57.8 years, mean A1c = 8.4%, and ¾ was female with less than a high school education. Individuals receiving DE + SMR, compared to DE-only, showed a weaker positive within-person association between daily diabetes symptoms and nervous affect. Groups also differed on the association between symptoms and enthusiasm. Age moderated these associations in most models with older individuals showing less affect reactivity to symptoms.

Conclusions: Findings provide partial support for theorised mechanisms of SMR.

Keywords:

• daily process
• affect-reactivity
• diabetes symptoms
• stress management
• Latinos

Acknowledgements

The authors thank Grace Damio, Sofia Segura-Perez, and their staff at the Hispanic Health Council, Hartford, Connecticut, for the field implementation of the study protocols.

Notes

1. Only 56 out of the 738 daily observations were beyond the planned seven reporting days (7.5% of the daily reports). The majority of these observations (86%) was reported on the 8th day and the remainder on the following day. The majority of the sample (78%) did report beyond the 7th day and there were no associations between having reporting extra-reporting days and any of the study variables, i.e. age, baseline anxiety and depression, treatment condition or any of the aggregate daily variables. Finally, exclusion of the extra reporting intervals did not alter any of the findings.