every stage from being able to set more realistic goals, to an increased ability to recover from a lapse. By implication, shame is likely to interfere with self-regulation. has consistently been associated with depression (Andrews et al., 2002; Cheung et al., 2004). As noted above, both are promoted by similar attribution styles. One longitudinal study highlighted shame-related schemas as being predictive of severity of depression nine years later, suggesting that a belief about oneself that evokes shame may pre-date depression (Halvorsen et al., 2010). Therefore, as well as shame having a potentially direct effect on condition self-management as noted above, it may also be that depressive affect mediates the relationship between shame and self-care. For example, shame-related depressive affect might decrease motivation and produce problems with memory. It might also increase risk of hyperglycaemia through the physiological effects of stress (Diabetes.co.uk, Diabetes Digital Media ltd, 2014). For those who are already prone to experiencing shame, adjusting to diabetes self-management may be a perfect storm, inducing shame related affect and cognitions, which in turn enhances negative affect and reduces, both directly and indirectly the chances of engaging in condition self-management. Summary Consistent self-care is vital to maintaining good health and quality of life for people with diabetes, as well as avoiding life-limiting conditions. The emerging adult years are important for laying down the foundations for lifelong management. Independent diabetes self-care can be challenging for young people. Evidence suggests depression impacts on diabetes self-care, but research into why this might be, or what might influence this is lacking. Shame is a complex emotional and cognitive experience that has been consistently linked with depression, and may arise in young
every stage from being able to set more realistic goals, to an increased ability to recover from a lapse. By implication, shame is likely to interfere with self-regulation. has consistently been associated with depression (Andrews et al., 2002; Cheung et al., 2004). As noted above, both are promoted by similar attribution styles. One longitudinal study highlighted shame-related schemas as being predictive of severity of depression nine years later, suggesting that a belief about oneself that evokes shame may pre-date depression (Halvorsen et al., 2010). Therefore, as well as shame having a potentially direct effect on condition self-management as noted above, it may also be that depressive affect mediates the relationship between shame and self-care. For example, shame-related depressive affect might decrease motivation and produce problems with memory. It might also increase risk of hyperglycaemia through the physiological effects of stress (Diabetes.co.uk, Diabetes Digital Media ltd, 2014). For those who are already prone to experiencing shame, adjusting to diabetes self-management may be a perfect storm, inducing shame related affect and cognitions, which in turn enhances negative affect and reduces, both directly and indirectly the chances of engaging in condition self-management. Summary Consistent self-care is vital to maintaining good health and quality of life for people with diabetes, as well as avoiding life-limiting conditions. The emerging adult years are important for laying down the foundations for lifelong management. Independent diabetes self-care can be challenging for young people. Evidence suggests depression impacts on diabetes self-care, but research into why this might be, or what might influence this is lacking. Shame is a complex emotional and cognitive experience that has been consistently linked with depression, and may arise in young
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