A meta-synthesis of the lived experience of adolescents with type 1 diabetes, and an empirical study of the impact of ways of coping on power of the anorexic voice

Holt, Jordan 2023. A meta-synthesis of the lived experience of adolescents with type 1 diabetes, and an empirical study of the impact of ways of coping on power of the anorexic voice. ClinPsy Thesis, Cardiff University. Item availability restricted.

Preview	PDF (DClinPsy Thesis) - Accepted Post-Print Version Download (2MB) | Preview
	PDF (Cardiff University Electronic Publication Form) - Supplemental Material Restricted to Repository staff only Download (119kB)

Abstract

Paper 1 is a qualitative systematic review of the literature regarding adolescents lived experience of Type 1 Diabetes Mellitus (T1DM). T1DM is a chronic health condition where the bodies natural ability to produce insulin is disrupted. Without insulin, blood glucose (sugar) is not metabolised and can build up within the blood stream, which can lead to life-threatening health complications. Diabetes is described as requiring management 24/7, 365 days a year and individuals effectively act as their pancreas. They must continually monitor their blood glucose levels and administer insulin throughout the day and in response to food and drink consumption. This is a substantial burden, and for adolescents, living with T1DM can be difficult to handle. Research has shown that adolescents with T1DM have worse metabolic control, increased hospital admissions and are less likely to attend appointments as they transition to adult services. Understanding the demands faced by adolescents with T1DM is vital if healthcare services want to provide the appropriate support to improve health outcomes for young people. Whilst there has been some exploration of the experiences of children and adults with T1DM, there is a gap in the literature for adolescents. Several databases were systematically searched for qualitative papers that explored the lived experiences of adolescents with T1DM. In total 10 papers were identified for inclusion in this review, reflecting the experiences of over 200 adolescents across five different countries. Thematic synthesis was used to develop codes and themes within and across papers, which resulted in four over-arching themes: 1) Diabetes is exhausting and overwhelming, 2) Nothing is untouched by diabetes, 3) I will always be different because of diabetes and 4) Ways of coping with the burden of diabetes. Adolescents described feeling distressed and overwhelmed by the burden of diabetes and the way it impacted every aspect of their life, from school to friendships and family life. T1DM made them stand out and feel different at a time where fitting in was extremely important. In order to cope with these difficult feelings, many adolescents avoided thinking about their diabetes, or disengaged from treatment altogether. Being able to accept diabetes as part of them helped to reduce feelings of distress, but this was a process that took place over time. The findings of this systematic review highlight the importance of healthcare services looking out for and asking adolescents about diabetes distress and supporting them to find adaptive ways of coping with the burden of management. Paper 2 was concerned with exploring the impact of voice suppression on the power of the anorexic voice. The anorexic voice is a phenomenon described across eating disorders as a critical and powerful internal voice that comments on food, shape, and weight. Individuals with eating disorders have described how initially the voice starts out as encouraging and supportive, but over time it becomes more negative and hostile. What is not yet known is why the anorexic voice becomes more powerful over time. One possible mechanism is the use of metacognitive control strategies, which are ways of coping with thoughts and feelings that we experience. Some strategies, such as voice suppression, are less helpful as it actually increases the frequency of thoughts and levels of distress. Research has shown that voices perceived as malevolent are likely to be resisted and individuals with eating disorders are more likely to use control strategies like voice suppression. It may be that failure to suppress the anorexic voice leads to its increasing power over time. This research study asked a group of participants with current experience of an anorexic voice to complete a series of questionnaires regarding their beliefs about their anorexic voice and to rate topographical features of it, such as its power, volume, frequency. Then, participants were asked to either suppress or accept the experience of their anorexic voice for a short period of time and to rate their anorexic voice again. The results were interesting and showed that engaging in thinking about the anorexic voice, whether through voice suppression or acceptance, increased its power. It was also found that the anorexic voice is perceived to be both benevolent and malevolent and individuals are simultaneously willing to engage with it and try to resist it. This has implications for therapy and may explain why recovery outcomes are so poor for individuals with eating disorders.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	9 October 2023
Last Modified:	09 Oct 2023 14:52
URI:	https://orca.cardiff.ac.uk/id/eprint/163053

Actions (repository staff only)

Edit Item