Chronic Illness as Loss of Good Self: Underlying Mechanisms Affecting Diabetes Adaptation

Francesco Marchini, Andrea Caputo, Angela Napoli, Jerilyn Tan Balonan, Gabriella Martino, Valentina Nannini, Viviana Langher


The aim of the present study is to investigate the role of emotional variables in diabetes adaptation. This is in order to develop and test a conceptual model simultaneously involving emotional variables consistent with a conceptual framework looking at chronic illness as a loss of good self. A convenience sample of 59 participants with a diagnosis of type 1 (n= 26) and type 2 (n=33) diabetes mellitus (Mean age= 57.17, SD=16.82) completed measures of diabetes distress, psychological adjustment to diabetes, diabetes self-care (as outcomes of diabetes adaptation) and depression, alexithymia and damaged ego-related strategies (as emotional variables). Correlation analyses among the examined measures were performed; as well, regression analyses were used to test the role of such emotional variables (as potential predictors) in accounting for diabetes adaptation outcomes. The results overall suggest that lower depression and higher mania contribute to diabetes adaption to a statistically significant extent, despite mania not being associated with self-care behaviors. The study raises a controversial debate about the meaningfulness of the psychological process of adjustment to diabetes without considering the role of underlying symbolic and less conscious dynamics.


Chronic illness; Psychodynamic; Depression; Alexithymia; Diabetes

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