The role of attachment trauma, mentalization deficits, and defense mechanisms in diabetes self-management and glycosylated hemoglobin

Articles in Press

Document Type : Original Article

Authors

1 Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran

2 Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Mahdishahr, Semnan, Iran.

3 Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Mahdishahr, Semnan, Iran

Abstract

Introduction: Type 2 diabetes is one of the most prevalent chronic diseases, in which self-management and control of glycosylated hemoglobin (HbA1C) play a pivotal role in mitigating its complications. The present study aimed to investigate the impact of factors such as attachment trauma, mentalization deficits, and defense mechanisms on self-management and HbA1C levels in patients with type 2 diabetes.
Methods: This cross-sectional correlational study was conducted with 347 patients with type 2 diabetes referred to health centers in Kerman in 2024. Sampling was performed using a convenience sampling. Data were collected using the Early Trauma Inventory (Monte et al., 2020), the Defense Mechanisms Rating Scale (Di Giuseppe et al., 2020), the Revised Diabetes Self-Management Scale (Schmitt et al., 2013), and the Fonagy Mentalization Scale (Derogar & Ashtiani, 2020). Data were analyzed using hierarchical regression analysis in SPSS-26 software.
Results: The findings indicated that defense mechanisms and mentalization were significant predictors of self-management, and defense mechanisms were an important predictor of HbA1C levels (p<0.001). Defense mechanisms were associated with reduced self-management (β=-0.35, p<0.001) and increased HbA1C levels (β=0.17, p<0.001), while mentalization was associated with improved self-management (β=0.11, p=0.03). Attachment trauma did not significantly predict self-management or HbA1C levels (p>0.05).
Conclusion: The defense mechanisms and mentalization can predict self-management, and defense mechanisms can predict glycosylated hemoglobin concentration in type 2 diabetic patients. This result has implications for future research and the development of tailored interventions. It is suggested that the role of attachment trauma be examined in mediation models.

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Journal of Clinical Psychology

Articles in Press, Accepted Manuscript
Available Online from 30 June 2025

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History

  • Receive Date: 28 May 2025
  • Revise Date: 24 June 2025
  • Accept Date: 10 June 2025

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