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Volume 24, Issue 155 (12-2025)
Journal of Psychological Science 2025, 24(155): 329-345 |
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mehdiabadi H, azamoudeh M, eghbali A, rezaei A. (2025). Modeling the Causal Relationships of Depression based on Self-Management Behaviors Mediated by Self-Compassion in Patients with Type2 Diabetes. Journal of Psychological Science. 24(155), 329-345. doi:10.61186/jps.24.155.20
URL: http://psychologicalscience.ir/article-1-3423-en.html
URL: http://psychologicalscience.ir/article-1-3423-en.html
Department Of Psychology, Tabriz Branch, Islamic Azad University, Tabriz, Iran. , mas_azemoudeh@iaut.ac.ir
Abstract: (140 Views)
Background: Depression is one of the common problems among patients with type 2 diabetes, which can negatively affect the clinical outcomes of the disease. Therefore, understanding the underlying causal mechanisms associated with depression is of great importance. Self-management behaviors are key determinants of patients’ health; however, the nature of their association with depression has not yet been fully elucidated. In this context, self-compassion as a mediating emotional process may play a critical role in the relationship between self-management behaviors and depression; thus, examining the causal model of these relationships appears essential.
Aims: The main purpose of the research was to model the causal relationships among self-management behaviors, depression, and self-compassion in patients with type 2 diabetes.
Methods: This study applied in terms of its objective and employs a descriptive-survey approach with a structural equation modeling (SEM) strategy in terms of its methodology. The statistical population comprised all patients diagnosed with type 2 diabetes who visited the specialized diabetes treatment center affiliated with the Endocrine and Metabolism Research Institute of Tehran University during the first half of 2025. The sample size consisted of 300 participants selected through purposive voluntary sampling. The instruments were depression, anxiety and stress questionnaire (Lovibond, Lovibond, 1995), Diabetes Self-Management Questionnaire-Revised (hussain Zadeghan et al, 2022), and Self-Compassion Scale questionnaire (Raes et al, 2011). For data analysis, structural equation modeling was used along with Smart PLS 3 software.
Results: The findings of the study indicated that self-management behaviors had a direct and statistically significant effect on levels of depression and self-compassion. Specifically, patients who demonstrated better performance in self-management behaviors—such as blood glucose monitoring and engagement in regular physical activity—reported lower levels of depression and higher levels of self-compassion. Furthermore, self-compassion was found to have a statistically significant effect on depression (p<0.05).
Conclusion: The results suggest that self-management behaviors contribute significantly and positively to the reduction of depression among patients with type 2 diabetes through the enhancement of self-compassion. Therefore, incorporating training in self-management behaviors and strengthening self-compassion within therapeutic and psychological intervention programs may lead to improvements in the mental health of these patients.
Aims: The main purpose of the research was to model the causal relationships among self-management behaviors, depression, and self-compassion in patients with type 2 diabetes.
Methods: This study applied in terms of its objective and employs a descriptive-survey approach with a structural equation modeling (SEM) strategy in terms of its methodology. The statistical population comprised all patients diagnosed with type 2 diabetes who visited the specialized diabetes treatment center affiliated with the Endocrine and Metabolism Research Institute of Tehran University during the first half of 2025. The sample size consisted of 300 participants selected through purposive voluntary sampling. The instruments were depression, anxiety and stress questionnaire (Lovibond, Lovibond, 1995), Diabetes Self-Management Questionnaire-Revised (hussain Zadeghan et al, 2022), and Self-Compassion Scale questionnaire (Raes et al, 2011). For data analysis, structural equation modeling was used along with Smart PLS 3 software.
Results: The findings of the study indicated that self-management behaviors had a direct and statistically significant effect on levels of depression and self-compassion. Specifically, patients who demonstrated better performance in self-management behaviors—such as blood glucose monitoring and engagement in regular physical activity—reported lower levels of depression and higher levels of self-compassion. Furthermore, self-compassion was found to have a statistically significant effect on depression (p<0.05).
Conclusion: The results suggest that self-management behaviors contribute significantly and positively to the reduction of depression among patients with type 2 diabetes through the enhancement of self-compassion. Therefore, incorporating training in self-management behaviors and strengthening self-compassion within therapeutic and psychological intervention programs may lead to improvements in the mental health of these patients.
Type of Study: Research |
Subject:
Special
Received: 2025/11/17 | Accepted: 2025/12/22 | Published: 2025/12/26
Received: 2025/11/17 | Accepted: 2025/12/22 | Published: 2025/12/26
References
1. اصغری مقدم، محمدعلی؛ ساعد، فواد؛ دباغ نیا، پروین؛ زنگنه، جعفر (1387). مقیاس پیش آزمون استرس، اضطراب در نمونه های غیربالینی. روانشناسی بالینی و شخصیت، 6(2)، 38-38. https://doi.org/10.1016/j.jad.2009.71.146
2. پارسا، کوروش؛ نیک منش، زهرا؛ و جناآبادی، حسین (۱۳۹۹). تاثیر فراهیجان بر تمایزیافتگی خود با واسطه گری خود شفقتی دانش آموزان. جامعه شناسی آموزش و پرورش، ۶(۲)، ۱۱۴-۱۲۴. https://doi.org/10.2020/dev7006130
3. چوبگین قادری، علیرضا؛ سلیمانی، فرزاد؛ و رسولاخوندزاده، مجید (۱۳۹۷). نقش فاکتورهای روانشناختی آسیب زا (تیپ شخصیتی D، افسردگی، اضطراب و استرس) بر میزان فشار خون و قند خون ناشتا در بیماران مبتلا به دیابت نوع دو. فصلنامه دانش انتظامی چهارمحال و بختیاری، (۲۳)، ۹۱-۱۰۶.https://journals.pnu.ac.ir/article_10165.html
4. حسین زادگان، فریبا؛ عظیم زاده، رقیه؛ پریزاد، ناصر؛ اسماعیلی، رقیه؛ علی نژاد، وحید؛ و همتی مسلک پاک، معصومه (۱۴۰۰). روان سنجی پرسشنامه خودمدیریتی دیابت در بیماران مبتلا به دیابت. مجله دانشکده پرستاری و مامایی ارومیه، ۱۹(۲ (پی در پی ۱۳۹))، ۱۰۹-۱۱۸. https://doi.org/10.3389/fpsyg.2022.12757789
5. خانجانی، سجاد؛ فروغی، علیاکبر؛ صادقی، خیرالله؛ و بحرینیان، سیدعبدالمجید (۱۳۹۵). ویژگیهای روانسنجی نسخهی ایرانی پرسشنامهی شفقت به خود (فرم کوتاه). پژوهنده، ۲۱(۵)، ۲۸۲-۲۸۹. . http://pajoohande.sbmu.ac.ir/article-1-2292-fa.html
6. شجاعیان، مریم؛ صبحی قراملکی، ناصر؛ و ابراهیمی مقدم، حسین (۱۴۰۳). نقش میانجی تحمل پریشانی در رابطه بین اضطراب و افسردگی با عملکرد جنسی در زنان یائسه مبتلا به دیابت نوع دو: یک مطالعه توصیفی. مجله دانشگاه علوم پزشکی رفسنجان، ۲۳(۶)، ۵۱۱-۵۲۳ . https://doi.org/10.2389/fpsyg.2025.1265159
7. قاسم زاده، مهدی؛ معتمدی، عبدالله؛ سهرابی، فرامرز (1398). اثربخشی درمان متمرکز بر شفقت بر بهبود سازگاری اجتماعی و گذشت در زنان مطلقه. پژوهشنامه زنان، 10(27)، 117-139. 10.30465/ws.2019.4041
8. کاهنی، غزاله (۱۴۰۱). بررسی تاثیر آموزش برنامه های خود مراقبتی در دانش آموزان. مجله پیشرفت های نوین در روانشناسی، علوم تربیتی و آموزش و پرورش، سال پنجم، شماره ۵۳ . https://www.noormags.ir/view/en/articlepage/1982841/
9. عبادی، مریم؛ آزموده، معصومه؛ اقبالی، علی؛ چلبیانلو، غلامرضا (1404). معادلات ساختاری رابطه شفقت به خود با کیفیت زندگی و نقش میانجی خودکارآمدی در افراد مبتلا به دیابت نوع ۲: یک مطالعه توصیفی. مجله دانشگاه علوم پزشکی رفسنجان، ۲۴ (۶) :۵۵۵-۵۷۰. http://journal.rums.ac.ir/article-۱-۷۷۲۸-fa.html
10. زارعی، لیلا؛ صالح، رائد؛ آرزویی، اسماعیل؛ الغزلی، مؤید؛ محمودیونو، تریاس؛ پیری، نگار؛ شکری، سمیرا؛ هولدانی، هولدانی (1400). بررسی عوامل موثر بر رفتارهای خودمراقبتی در بیماران دیابتی: مروری نظام مند. https://doi.org/10.4081/jbr.2022.102611
11. سامانی، سیامک؛ جوکار. بهرام. (1385). ارزیابی روانسنجی نسخه فارسیِ مقیاس افسردگی، اضطراب و استرسDASS-21) ). مجله روانشناسی بالینی ایران، 12(3)، 45-60. https://scholar.google.com
12. چوبفروشزاده، آزاده؛ شیروی، الهه؛ خسرویلاریجانی، ماجده (1402). اثربخشی مداخله مبتنی بر درمان شفقت بهخود بر سلامتروان و خودمدیریتی در بیماران مبتلا به دیابت نوع دو. فصلنامه پرستاری دیابت، ۱۱ (۴) : ۲۳۰۱-۲۳۱۲. http://jdn.zbmu.ac.ir/article-1-557-fa.html
13. Abrahamian, H., Kautzky-Willer, A., Rießland-Seifert, A., Lebherz-Eichinger, D., Ebenbichler, C., Kautzky, A., & Toplak, H. (2023). Mental disorders and diabetes mellitus (Update 2023). Wiener Klinische Wochenschrift. https://doi.org/10.1007/s00508-022-02117-9
14. Ahmad, F., Joshi, S. H. (2023). Self-Care Practices and Their Role in the Control of Diabetes: A Narrative Review. Cureus, 15(7), e41409. https://doi.org/10.7759/cureus.41409
15. American Diabetes Association. (2023). Standards of Medical Care in Diabetes-2023. Diabetes Care, 46(Supplement_1), S1–S291.
16. Asghari Moghadam, M. A., Saed, F., Debag nia, P., Zanganeh, J. (2009). pre - test anxiety, stress and stress scales (dass) in non - clinical samples. Clinical Psychology and Personality, 6(2), 38-38. https://doi.org/10.1016/j.jad.2009.71.146 (in presian)
17. Cao, X., Feng, M., Ge, R., Wen, Y., Yang, J., Li, X. (2023). Relationship between self-management of patients with anxiety disorders and their anxiety level and quality of life: A cross-sectional study. PLoS One, 18(5): e0284121. https://doi.org/10.1371/journal.pone.0284121
18. CHobgin Ghaderi, A. R., Solimani, F., Rasoulkhanzadeh, M. (2018). The role of psychological factors (personality type d, depression, anxiety and stress) on blood pressure and fasting blood glucose in patients with type ii diabetes. Journal of law enforcement of chahar mahal va bakhtiari, (23) .91–106. https://journals.pnu.ac.ir/article_10165.html (in Persian)
19. Choobforush-zadeh A, Shirovi E, Khosravi-larijani M. Effectiveness of Self-Compassion-Based Intervention on Mental Health and Self-Management in Patients with Type II Diabetes. J Diabetes Nurs 2023; 11 (4) :2301-2312 URL: http://jdn.zbmu.ac.ir/article-1-557-fa.html
20. Ebadi M, Azemoudeh M, Eghbali A, Chalabianloo Gh. Relationship between Positive and Negative Components of
21. Evans, D. L., Rynn, M. A., Ellison, K. (2023). Understanding Depression. In If Your Adolescent Has Depression: An Essential Resource for Parents. Oxford Academic. https://doi.org/10.1093/medpsych/9780197636060.003.0002
22. GHasem zadeh, M., Motamedi, A., Sohrabi, F. (2019). the effectiveness of concentrated therapy on compassion on social adjustment and forgiveness in divorced women. Women Research, 10(27), 117-139.10.30465/ws.2019.4041
23. Gilbert, P., Simos, G. (2022). The evolved functions of caring connections as a basis for compassion. https://doi.org/10.4324/9781003035879-4
24. Ginting, A., Dewi Simanullang, M. S., & Surbakti, N. K. (2022). Description Behavior Care Self (Self Care) Sufferer Hypertension at the Health Center Kutalimbaru Deli Serdang Regency 2022. Science Midwifery. https://doi.org/10.35335/midwifery.v10i5.596
25. Gonzalez, J. S. (2023). Depression, self-care behaviors, and longitudinal glycemic control in type 2 diabetes: The Diabetes MILES Study. Journal of Behavioral Medicine, 46(1): 1-12. https://doi.org/10.2023/dev0110539
26. Gonzalez, J. S., Tanenbaum, M. L., & Commissariat, P. V. (2022). Psychosocial factors and diabetes outcomes: beyond self-management. Current Diabetes Reports, 22(4), 145–154.https://link.springer.com/article/10.1007/s11892-022-01454-0
27. Hardy, S. (2021). Recognising and treating psychological issues in people with diabetes mellitus. Nursing Standard, 36(5), 61–66. https://doi.org/10.7748/ns.2021.e11682
28. Holt, R. I. (2024). The management of mental health problems in people with diabetes: NICE guidelines 2024 update. Diabetic Medicine, 41(1), e15241. https://doi.org/41.1816/j.ijer.2024.1521010
29. Hussain Zadeghan, F., Azimzadeh, R., Pareizad, N., Esmali, R., Alinejad, V., Hemati, M. (2022). Self-management questionnaire of diabetes in patients with diabetes. Lournal of Nursing and Midwifery School, 19(139), 109-118. https://doi.org/10.3389/fpsyg.2022.12757789 (in presian)
30. International Diabetes Federation. (2023). IDF Diabetes Atlas, 10th edition.
31. Kaheni, GH. (2022). Study the effect of training self - care programs on students. Journal of New Developments in Psychology, Educational Sciences and Education, 5(53). https://www.noormags.ir/view/en/articlepage/1982841/ (in presian)
32. KHanjani, S., Foroghi, A. K., Sadeghi, KH., Bahrenian, A. (2017). The psychometric properties of the iranian version questionnaire (short form). The Researcher, 21 (5): 282 – 289. http://pajoohande.sbmu.ac.ir/article-1-2292-fa.html (in presian)
33. Knyahnytska, Y., Williams, C., Dale, C., & Webster, F. (2018). Changing the Conversation: Diabetes Management in Adults with Severe Mental Illnesses and Type 2 Diabetes. Canadian Journal of Diabetes, 42(6), 595-602. https://doi.org/10.1216/j.jad.2018.01.067
34. Lindekilde, N., Rutters, F., Erik Henriksen, J., Lasgaard, M., Schram, M. T., Rubin, K. H., Kivimäki, M., Nefs, G., Pouwer, F. (2021). Psychiatric disorders as risk factors for type 2 diabetes: An umbrella review of systematic reviews with and without meta-analyses. Diabetes Research and Clinical Practice, 176, 108855. (https://search.crossref.org/
35. Lovibond, P. F., Lovibond, SH. (1995). The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behavior Research and Therapy, 33: 335-342. https://doi.org/10.1995/dev0470538
36. Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–102.
37. Neff, K. D. (2023). Self-Compassion: Theory, Method, Research, and Intervention. Annual Review of Psychology, 74, 1-28.
38. Nefs, G., Pouwer, F., Denollet, J., et al. (2020). Suboptimal diabetes self care in people with type 2 diabetes: The role of depressive symptoms. Diabetes Research and Clinical Practice, 162, 108088. https://doi.org/10.1016/j.diabres.2020.108088
39. Oliveira, E. M. S., Ribeiro, A., Silva, D., & Nunes, E. (2020). Physical training on glycemia and oxidative in type 2 diabetes: a systematic review. Revista Brasileira de Medicina do Esporte, 26(1), 70–76. https://doi.org/10.1536/j.jad.20201.08.013
40. Parsa, k., nickmanesh, Z., Jena Abadi, H. (2020). The effect of self - differentiation on self - differentiation through self-mediated compassion of students. The Society of Education, 2(6): 124-114. https://doi.org/10.2020/dev7006130 (in presian)
41. Powers MA, Bardsley J, Cypress M. (2023). Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report. Diabetes Care, 43(7):1636–1649.DOI: 10.2337/dci20-0020
42. Raes, F., Pommier, E., Neff, K. D., Van Gucht, D. (2011). Construction and factorial validation of a short form of the Self-Compassion Scale. Clinical Psychology & Psychotherapy. 18: 250-255. https://doi.org/10.1016/j.jad.2011.08.041
43. Samani, H., & Jojkar, M. (2007). Psychometric evaluation of the Persian version of the Depression Anxiety Stress Scales (DASS-21). Iranian Journal of Clinical Psychology, 12(3), 45–60. https://scholar.google.com (in pesian)
44. Sapra, R., Gupta, M., Sapra, R. L. (2018). Prevalence of obesity and awareness about diabetes among adolescents of schools of Delhi. Current Medicine Research and Practice, 8(2): 45-51. https://doi.org/10.1816/j.ijer.2018.1523410
45. Schmitt, A., Reimer, A., Hermanns, N., et al. (2021). Depression is linked to poor self management in people with type 2 diabetes. Diabetic Medicine, 38(3), e14409. https://doi.org/10.1111/dme.14409
46. Sen, Z. D., Danyeli, L. V., Woelfer, M., Lamers, F., Wagner, G., Sobanski, T., & Walter, M. (2021). Linking atypical depression and insulin resistance-related disorders via low-grade chronic inflammation: Integrating the phenotypic, molecular and neuroanatomical dimensions. Brain, Behavior, and Immunity, 93, 335–352. https://doi.org/10.1016/j.bbi.2020.12.020
47. Shojaeean, M., Sobhi gharamaleki, N., ebrahimi moghadam, H. (2025). The mediating role of distress tolerance in the relationship between anxiety and depression with sexual function in postmenopausal women with type 2 diabetes: a descriptive study. Rafsanjan University of Medical Sciences. 23(6): 511-523. https://doi.org/10.2389/fpsyg.2025.1265159 (in presian)
48. Taylor, S. E. (2018). Health Psychology. Tenth Edit. New York: McGraw Hill Education. https://doi.org/10.1476/j.jad.2018.01.067
49. Velten, j; bieda, a; scholten, s; wannemuller, a; margraf, j. (2018). Lifestyle chices and mental helth: a longitudinal survey with german and Chinese students. BMC Public Helth, (18): 632. https://doi.org/10.2018/dev0110538
50. Wang, Z., Cheng, Y., Li, Y., Han, J., Yuan, Z., Li, Q., Zhong, F., Wu, Y., Fan, X., Bo, T., & Gao, L. (2022). The relationship between obesity and depression is partly dependent on metabolic health status: A nationwide inpatient sample database study. Frontiers in Endocrinology. https://doi.org/10.3389/fendo.2022.880230
51. World Health Organization. (2023). Global report on diabetes: Psychological care for people with diabetes. Geneva: WHO. https://doi.org/10.3345/.2023.884830
52. Zarei, L., Saleh, R. O., Arziev, I. A., Al-Gazally, M. E., Mahmudiono, T., Piri, N., Shokri, S., & Huldani, H. (2022). Investigating the factors affecting self-care behaviors in diabetic patients: A systematic review. https://doi.org/10.4081/jbr.2022.102611(in presian)
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