Amfiana Gherman*1
*amfiana.gherman@ubbcluj.ro
1Babeş-Bolyai University, Cluj-Napoca, Romania
Abstract
The main goal of this study was the construction of a scale that measures functional and dysfunctional beliefs about insulin from the perspective of Rational Emotive and Behavioral Therapy. Beliefs about Insulin Scale (BIS) has two major subscales, specific dysfunctional beliefs (absolute demands, awfulizing, low frustration tolerance, negative global evaluation about oneself), and functional beliefs about insulin (realistic wishes, high frustration tolerance, and contextual self-evaluation). An exploratory Factor Analysis was performed in order to check the internal structure of the scale and the constructs measured by comparing it to other general dysfunctional beliefs scales and also to another psychological insulin resistance scale. Statistical analysis indicated that the dysfunctional subscales of the Beliefs about Insulin Scale (BIS) have good psychometric qualities (including high reliability and good construct validity), and can be used to measure dysfunctional beliefs and cognitive distortions about insulin treatment. From a practical point of view, clinicians could use BIS to assess the types of beliefs that patients hold about insulin treatment. If dysfunctional beliefs are identified, clinicians could use empirically validated cognitive-behavioral strategies (e.g., REBT) to attempt to restructure these dysfunctional evaluations, and in turn to reduce psychological insulin resistance. Thus, the ability to keep people adherent to their insulin regimen requires a good understanding of their beliefs and it is our hope that the BIS will help clinicians achieve these goals.
Keywords: psychological insulin resistance, irrational beliefs
Published online: 2016/09/01
Published print: 2016/09/01
References
Ahmed, U. S., Junaidi, B., Ali, A. W., Akhter, O., Salahuddin, M., & Akhter, J. (2010). Barriers in initiating insulin therapy in a South Asian Muslim community. Diabetic Medicine: A Journal of the British Diabetic Association, 27(2), 169–174. http://doi.org/10.1111/j.1464-5491.2009.02904.x
Alford, B. A., & Beck, A. T. (1998). The Integrative Power of Cognitive Therapy. Guilford Press.
Bernard, M. E. (1998). Validation of the General Attitude and Belief Scale. J Ration Emot Cogn Behav Ther, 16(3), 183–196. http://doi.org/10.1023/A:1024911014579
Blonde, L. (2007). Easing the transition to insulin therapy in people with type 2 diabetes. The Diabetes Educator, 33 Suppl 7, 232S–240S. http://doi.org/10.1177/0145721707305695
Bogatean, M. P., & Hâncu, N. (2004). People with type 2 diabetes facing the reality of starting insulin therapy: factors involved in psychological insulin resistance. Practical Diabetes International, 21(7), 247–252. http://doi.org/10.1002/pdi.670
Brod, M., Kongsø, J. H., Lessard, S., & Christensen, T. L. (2009). Psychological insulin resistance: patient beliefs and implications for diabetes management. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 18(1), 23–32. http://doi.org/10.1007/s11136-008-9419-1
Cronbach, L. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16(3), 297–334. http://doi.org/10.1007/BF02310555
David, D., Lynn, S., & Ellis, A. (2009). Rational and Irrational Beliefs: Research, Theory, and Clinical Practice. Oxford University Press US.
David, D., Schnur, J. B., & Belloiu, A. (2002). Another Search for the “Hot” Cognitions: Appraisal, Irrational Beliefs, Attributions, and Their Relation to Emotion. J Ration Emot Cogn Behav Ther, 20(2), 93–131.
Demaria, T. P., Kassinove, H., & Dill, C. A. (1989). Psychometric properties of the Survey of Personal Beliefs: a rational-emotive measure of irrational thinking. Journal of Personality Assessment, 53(2), 329–341.
Ellis, A. (1994). Reason and emotion in psychotherapy. Carol Pub. Group.
Gherman, A., & Alionescu, A. (2015). Depression and Dysfunctional Beliefs. Predictors of Negative Appraisal of Insulin Treatment. Journal of Evidence-Based Psychotherapies, 15(2), 207–218.
Hollon, S. D., & Kendall, P. C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4(4), 383–395. http://doi.org/10.1007/BF01178214
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … European Association for the Study of Diabetes (EASD). (2012). Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, 35(6), 1364–1379. http://doi.org/10.2337/dc12-0413
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … Matthews, D. R. (2015). Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia, 58(3), 429–442. http://doi.org/10.1007/s00125-014-3460-0
Karter, A. J., Subramanian, U., Saha, C., Crosson, J. C., Parker, M. M., Swain, B. E., … Marrero, D. G. (2010). Barriers to insulin initiation: the translating research into action for diabetes insulin starts project. Diabetes Care, 33(4), 733–735. http://doi.org/10.2337/dc09-1184
Kline, D. T. J. B. (2005). Psychological Testing: A Practical Approach to Design and Evaluation (1st ed.). Sage Publications, Inc.
Meece, J. (2006). Dispelling myths and removing barriers about insulin in type 2 diabetes. The Diabetes Educator, 32(1 Suppl), 9S–18S. http://doi.org/10.1177/0145721705285638
Mollema, E. D., Snoek, F. J., Pouwer, F., Heine, R. J., & van der Ploeg, H. M. (2000). Diabetes Fear of Injecting and Self-Testing Questionnaire: a psychometric evaluation. Diabetes Care, 23(6), 765–769.
Petrak, F., Stridde, E., Leverkus, F., Crispin, A. A., Forst, T., & Pfützner, A. (2007). Development and validation of a new measure to evaluate psychological resistance to insulin treatment. Diabetes Care, 30(9), 2199–2204. http://doi.org/10.2337/dc06-2042
Peyrot, M., Rubin, R. R., Kruger, D. F., & Travis, L. B. (2010). Correlates of insulin injection omission. Diabetes Care, 33(2), 240–245. http://doi.org/10.2337/dc09-1348
Peyrot, M., Rubin, R. R., Lauritzen, T., Skovlund, S. E., Snoek, F. J., Matthews, D. R., … Kleinebreil, L. (2005). Resistance to insulin therapy among patients and providers: results of the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) study. Diabetes Care, 28(11), 2673–2679.
Snoek, F. J., Skovlund, S. E., & Pouwer, F. (2007). Development and validation of the insulin treatment appraisal scale (ITAS) in patients with type 2 diabetes. Health and Quality of Life Outcomes, 5, 69. http://doi.org/10.1186/1477-7525-5-69
Tsilidis, K. K., Kasimis, J. C., Lopez, D. S., Ntzani, E. E., & Ioannidis, J. P. A. (2015). Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies. BMJ (Clinical Research Ed.), 350, g7607.
