Associations Between Coping Strategies and Mental Health in Individuals With Type 2 Diabetes: Prospective Analyses

Objective: Individuals with type 2 diabetes are at greater risk of developing a number of mental health conditions, including depression, anxiety, and diabetes-related distress, than individuals without type 2 diabetes. Cross-sectional studies suggest that some coping strategies may increase the risk of mental health conditions in individuals with diabetes, whereas others may be protective. This study extends the cross-sectional evidence base with a prospective study. Methods: Data were collected annually for 2 years from a community sample of 1,742 adults with type 2 diabetes. Coping strategies were measured at baseline and mental health conditions were assessed at each time point with self-report symptom measures. For comparison, cross-sectional and prospective analyses were conducted. Results: Cross-sectional analyses demonstrated that task-oriented coping was negatively associated with the likelihood of each of the mental health conditions, emotion-oriented coping was positively associated with the likelihood of each condition, and avoidance-oriented coping showed no association. Prospective analyses revealed that among individuals who did not have elevated depressive symptoms at baseline, only emotion-oriented coping predicted the likelihood of developing major depression syndrome during follow-up. Similar patterns of results were observed for elevated anxiety symptoms and diabetes-related distress. Conclusions: Cross-sectional results differed from prospective results. Only emotion-oriented coping appears to play a role in the development of depressive symptoms, anxiety symptoms, and diabetes-related distress. Results underscore the importance of examining prospective associations and suggest that interventions targeting specific coping strategies might alleviate mental health problems in individuals with type 2 diabetes.