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

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.

Keywords

Main Subjects

References

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Journal of Clinical Psychology
Volume 17, Issue 3 - Serial Number 67
September 2025
Pages 95-109

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History

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

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