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Anxious Temperament and Disease Progression at Diagnosis: The Case of Type 2 Diabetes

From the Departments of Kinesiology (P.A.H.) and Psychology (M.J.C., P.A.H.), University of Waterloo, Ontario, Canada, and the Department of Psychology and Diabetes Education Centre (T.M.V.), Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada.

Address correspondence and reprint requests to Peter A. Hall, Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada. E-mail: pahall{at}healthy.uwaterloo.ca

Objective: To examine the association between anxious temperament and disease progression at diagnosis for individuals with Type 2 diabetes mellitus (T2DM).

Methods: A sample of 204 individuals, newly diagnosed with T2DM, completed the Behavioral Inhibition and Activation Scales (BIS/BAS) and provided an A1C reading. Regression analyses were used to predict A1C levels from individual differences in BIS and BAS.

Results: Individual differences in BIS were inversely related to A1C at diagnosis in the sample as a whole, and this association remained strong after controlling for demographic variables and body mass index. Most importantly, temperamentally anxious individuals had low A1C levels at diagnosis in all age groups, in contrast to their nonanxious counterparts who showed increasing A1C at diagnosis as a function of decreasing age. BAS scores were unrelated to A1C.

Conclusions: Although older age is generally associated with lower disease progression at diagnosis, high BIS individuals show uniformly lower disease progression across all age groups. High levels of temperamental anxiety may facilitate early diagnosis of T2DM, particularly among younger individuals who are not subject to routine screening.

Key Words: diabetes • temperament • anxiety • secondary prevention • personality

Abbreviations: A1C = glycated hemoglobin; BAS = Behavioral Approach System; BIS = Behavioral Inhibition System; BMI = body mass index; RST = Reinforcement Sensitivity Theory; T2DM = Type 2 diabetes mellitus.