Exploring the Association between Diabetes Distress and Personality Traits: Insights from the Alternative DSM-5 Model for Personality Disorders.

Abstract

Objective: Little is known about the association between subjectively experienced levels of diabetes distress (DD) and personality traits (PTs), even when levels of DD appear stable over time. This study aimed to use the Alternative Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Model for Personality Disorders (AMPD) to associate specific maladaptive PTs with experienced DD and to describe differences in the constellation of PTs between people with type 1 diabetes (PWT1D) and type 2 diabetes (PWT2D).

Methods: A total of 358 participants with diabetes mellitus (DM) (56.2% female, mean age 42.33 years, standard deviation (SD) = 14.33) were evaluated using the Diabetes Distress Scale (DDS) and the shortened 160-item version of the Personality Inventory for DSM-5 (PID-5). Psychometric properties of the DDS were evaluated first, then the association between DDS and PID-5 scores, and the differences between groups based on diabetes type and DD level, were analyzed.

Results: Strong associations were found between the PID-5 Negative Affectivity (NEF) domain and the emotional burden (β = 0.852, p _Holm < 0.001) and regimen distress (β = 0.435, p _Holm = 0.006) DDS subscale scores. PWT1D had a higher level of personality pathology than PWT2D, as did participants with elevated levels of DD across most domains and facets of PID-5.

Conclusions: Our findings suggest that attention should be paid to the level of NEF among people with diabetes in relation to their emotional burden and perception of regimen distress. We recommend a distinction between people based on their diabetes type. Implications for clinical practice and interventions for DD perceived through the lens of the dimensional DSM-5 PT model are discussed.