Choose one of the chronic illness above and explain how personality, emotions, stress, coping styles, and/or lifestyle factors play a part in the development and management of the specific illness that you have selected. Please feel free to describe any personal experiences that you may have had with this topic.
Given the current pressure to reform US health care and contain its costs, how might health psychologists and/or research in the field of health psychology be helpful during the development of future policy? Also, how could/will you use the information you learned in this course to shape your own health practices?
Type 2 Diabetes Mellitus and Psychological Factors (Continued)
2. Management of T2DM
Coping Styles and Personality: Effective T2DM management (monitoring blood glucose, adhering to medication, diet, and exercise) requires consistent self-efficacy and proactive coping.
Avoidant coping (e.g., denying the illness, ignoring symptoms, avoiding clinic visits) leads to poor adherence, resulting in severe complications like neuropathy, retinopathy, and kidney failure.
Stress and Emotions (Diabetes Distress): Once diagnosed, T2DM creates its own stress, often called "diabetes distress." This distress stems from the constant mental burden of self-management, fear of complications, and feeling judged. High levels of diabetes distress predict poor glycemic control (higher $\text{HbA}_{1c}$ levels), as individuals become overwhelmed and disengage from care.
Personal Experience: I have observed how chronic stress directly impacts blood sugar. A family member with well-controlled T2DM experienced a sharp, sustained spike in their $\text{HbA}_{1c}$ level (a measure of average blood sugar over three months) following a period of significant family crisis and emotional strain. Even though their medication and basic diet were maintained, the psychological stress clearly overwhelmed their physiological ability to regulate glucose. This demonstrated that no amount of medication can fully compensate for chronic psychological stress.
Health Psychology and Healthcare Policy
Health psychology is uniquely positioned to inform and shape future U.S. healthcare policy, focusing on prevention, cost containment, and patient engagement.
1. Impact on Policy Development
Integrating Behavioral Economics for Prevention: Health psychologists can advise on policies that use "nudge theory" and behavioral science to encourage healthier choices. For example, rather than solely funding expensive treatment for obesity and T2DM, policy could focus on:
Designing public spaces to encourage walking (reducing sedentary behavior).
Structuring insurance plans to offer significant co-pay reductions for demonstrated adherence to preventive behaviors (e.g., maintaining a target $\text{HbA}_{1c}$).
Addressing Social Determinants of Health (SDOH): Health psychology research highlights how stress (due to poverty, discrimination, or unstable housing) directly impacts chronic illness development. Policy could shift funding to integrate mental health support, stable housing, and access to fresh food as essential components of medical care for high-risk populations, recognizing that treating the environment prevents the disease.
Cost Containment through Adherence: Non-adherence to treatment is a major driver of high healthcare costs (emergency room visits, hospitalizations for complications). Health psychologists specialize in motivational interviewing and behavior change models. Policy could mandate and fund behavioral health specialists (health psychologists) to work in primary care settings specifically to improve medication and lifestyle adherence for chronic conditions like T2DM, demonstrating a significant return on investment (ROI) by preventing costly downstream complications.