Mary de Groot

Permanent URI for this collection

https://hdl.handle.net/1805/11673

One in four patients with diabetes will experience depression in their lifetime which is associated with poorer outcomes, greater functional disability, and early mortality. Dr. Mary de Groot is a clinical psychologist whose research is focused on examining the mechanisms that link diabetes and depression as well as the development of accessible interventions to treat depression among adults and socio-economically and culturally diverse populations with diabetes.

Dr. de Groot’s Program ACTIVE (Adults Coming Together to Increase Vital Exercise) is a research study funded by the National Institute of Diabetes, Digestive Diseases and Kidneys within the National Institutes of Health. The study looks at a combination of cognitive behavioral therapy and exercise for individuals with type 2 diabetes to be used as a model of an interdisciplinary approach to the treatment of depression in diabetes.

Dr. de Groot has contributed more than 80 articles and presentations on the psychosocial aspects of type 1 and type 2 diabetes.

Dr. de Groot’s work on treatment of depression for those with diabetes is another example of how IUPUI faculty are TRANSLATING RESEARCH INTO PRACTICE.

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Now showing 1 - 10 of 13

Psychological Conditions in Adults With Diabetes.
(APA, 2016-10) de Groot, Mary; Golden, Sherita Hill; Wagner, Julie; Department of Medicine, IU School of Medicine
Type 1 (T1D) and Type 2 diabetes (T2D) represent a demanding set of biopsychosocial challenges for patients and their families, whether the age of disease onset occurs in childhood, adolescence, or adulthood. Psychological conditions, defined as syndromes, disorders, and diabetes-specific psychological issues affect a larger proportion of individuals with T1D and T2D compared to the general population. In this review, we summarize the prevalence, impact and psychological treatments associated with the primary categories of psychological conditions that affect adults with T1D and T2D: depressive symptoms and syndromes, anxiety disorders, eating behaviors and disorders and serious mental illness. The implications of the literature for psychologists are discussed, and priorities for future research to advance the science of psychological conditions for adults with T1D and T2D are identified.
Experiential Learning in Kinesiology: A Student Perspective
(SAGE Publications, 2015-09-01) de Groot, Mary; Alexander, Kisha; Culp, Brian; Keith, NiCole; Department of Medicine, IU School of Medicine
OVERVIEW: Service learning is a form of experiential learning that pairs academic educational experiences and community organizations to promote training, civic engagement, and meaningful service by students to their community. Kinesiology programs have moved toward increasing experiential and service learning options in health promotion for their students, but few have evaluated the student perceptions of these programs. PURPOSE: The purpose of the current study was to conduct a qualitative evaluation of a service learning course for Kinesiology majors located in a low-income urban area. METHODS: Ten recent graduates of a department of Kinesiology were enrolled in focus groups, stratified by gender, facilitated by a graduate research assistant not affiliated with their school. Focus group discussions were audiotaped, transcribed and analyzed for themes. RESULTS: Nine themes were identified including: (1) Personal and professional experience, (2) decision to participate, (3) location decision, (4) self-efficacy, (5) perceptions of program members, (6) social interaction, (7) personal and program communication, (8) physical facilities and (9) program outcomes. Students positively evaluated the learning experience as valuable to their personal and professional development; noted changes in their perceptions of low-income communities and increases to self-efficacy and skill acquisition from the beginning to the end of the course; and observed significant needs and improvements in physical, emotional and social outcomes of community members. CONCLUSIONS: This study demonstrated multiple and varied benefits of a service learning program for Kinesiology students. On-going evaluation of service learning programs in health promotion is needed to enhance student and community outcomes.
Factors Motivating Individuals to Consider Genetic Testing for Type 2 Diabetes Risk Prediction
(PloS One, 2016) Wessel, Jennifer; Gupta, Jyoti; de Groot, Mary; Department of Medicine, IU School of Medicine
The purpose of this study was to identify attitudes and perceptions of willingness to participate in genetic testing for type 2 diabetes (T2D) risk prediction in the general population. Adults (n = 598) were surveyed on attitudes about utilizing genetic testing to predict future risk of T2D. Participants were recruited from public libraries (53%), online registry (37%) and a safety net hospital emergency department (10%). Respondents were 37 ± 11 years old, primarily White (54%), female (69%), college educated (46%), with an annual income ≥$25,000 (56%). Half of participants were interested in genetic testing for T2D (52%) and 81% agreed/strongly agreed genetic testing should be available to the public. Only 57% of individuals knew T2D is preventable. A multivariate model to predict interest in genetic testing was adjusted for age, gender, recruitment location and BMI; significant predictors were motivation (high perceived personal risk of T2D [OR = 4.38 (1.76, 10.9)]; family history [OR = 2.56 (1.46, 4.48)]; desire to know risk prior to disease onset [OR = 3.25 (1.94, 5.42)]; and knowing T2D is preventable [OR = 2.11 (1.24, 3.60)], intention (if the cost is free [OR = 10.2 (4.27, 24.6)]; and learning T2D is preventable [OR = 5.18 (1.95, 13.7)]) and trust of genetic testing results [OR = 0.03 (0.003, 0.30)]. Individuals are interested in genetic testing for T2D risk which offers unique information that is personalized. Financial accessibility, validity of the test and availability of diabetes prevention programs were identified as predictors of interest in T2D testing.
Diabetes and Depression
(Springer US, 2014-06) Holt, Richard I. G.; de Groot, Mary; Golden, Sherita Hill; Department of Medicine, IU School of Medicine
Diabetes and depression occur together approximately twice as frequently as would be predicted by chance alone. Comorbid diabetes and depression are a major clinical challenge as the outcomes of both conditions are worsened by the other. Although the psychological burden of diabetes may contribute to depression, this explanation does not fully explain the relationship between these 2 conditions. Both conditions may be driven by shared underlying biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors. Depression is frequently missed in people with diabetes despite effective screening tools being available. Both psychological interventions and antidepressants are effective in treating depressive symptoms in people with diabetes but have mixed effects on glycemic control. Clear care pathways involving a multidisciplinary team are needed to obtain optimal medical and psychiatric outcomes for people with comorbid diabetes and depression.
Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study
(Springer International Publishing, 2014-02) Marrero, D.; Pan, Q.; Barrett-Connor, E.; de Groot, M.; Zhang, P.; Percy, C.; Florez, H.; Ackermann, R.; Montez, M.; Rubin, R. R.; DPPOS Research Group; Department of Medicine, IU School of Medicine
Purpose The purpose of this study is to assess if diagnosis of type 2 diabetes affected health-related quality of life (HRQoL) among participants in the Diabetes Prevention Program/Diabetes Prevention Program Outcome Study and changes with treatment or diabetes duration. Methods 3,210 participants with pre-diabetes were randomized to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB). HRQoL was assessed using the SF-36 including: (1) 8 SF-36 subscales; (2) the physical component (PCS) and mental component summary (MCS) scores; and (3) the SF-6D. The sample was categorized by diabetes free versus diagnosed. For diagnosed subgroup, mean scores in the diabetes-free period, at 6 months, 2, 4 and 6 years post-diagnosis, were compared. Results PCS and SF-6D scores declined in all participants in all treatment arms (P <.001). MCS scores did not change significantly in any treatment arm regardless of diagnosis. ILS participants reported a greater decrease in PCS scores at 6 months post-diagnosis (P <.001) and a more rapid decline immediately post-diagnosis in SF-6D scores (P = .003) than the MET or PLB arms. ILS participants reported a significant decrease in the social functioning subscale at 6 months (P <.001) and two years (P <.001) post-diagnosis. Conclusions Participants reported a decline in measures of overall health state (SF-6D) and overall physical HRQoL, whether or not they were diagnosed with diabetes during the study. There was no change in overall mental HRQoL. Participants in the ILS arm with diabetes reported a more significant decline in some HRQoL measures than those in the MET and PLB arms that developed diabetes.
NIDDK International Conference Report on Diabetes and Depression: Current Understanding and Future Directions
(2014-08) Holt, Richard I G.; de Groot, Mary; Lucki, Irwin; Hunter, Christine M.; Sartorius, Norman; Golden, Sherita Hill
Comorbid diabetes and depression are a major clinical challenge as the outcomes of each condition are worsened by the other. This article is based on the presentations and discussions during an international meeting on diabetes and depression convened by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in collaboration with the National Institute of Mental Health and the Dialogue on Diabetes and Depression. While the psychological burden of diabetes may contribute to depression in some cases, this explanation does not sufficiently explain the relationship between these two conditions. Shared biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, autonomic dysfunction, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors, are important to consider in understanding the link between depression and diabetes. Both individual psychological and pharmacological depression treatments are effective in people with diabetes, but the current range of treatment options is limited and has shown mixed effects on glycemic outcomes. More research is needed to understand what factors contribute to individual differences in vulnerability, treatment response, and resilience to depression and metabolic disorders across the life course and how best to provide care for people with comorbid diabetes and depression in different health care settings. Training programs are needed to create a cross-disciplinary workforce that can work in different models of care for comorbid conditions.
Status of Diabetes Care: “It Just Doesn’t Get Any Better . . . or Does It?”
(2014-07) Cefalu, William T.; Tamborlane, William V.; Moses, Robert G.; Greene, Eddie L.; Bakris, George; Rosenstock, Julio; Blonde, Lawrence; Riddle, Matthew C.; Golden, Sherita Hill; Reynolds, Lyn; de Groot, Mary
Genetic Testing and Type 2 Diabetes Risk Awareness
(2014-03) de Groot, Mary; Wessel, Jennifer
Purpose The purpose of this study was to examine the motivational, attitudinal, and behavioral predictors of interest in genetic testing (GT) in those with and without awareness of their risk for type 2 diabetes (T2DM). Methods A convenience sample of adults visiting emergency departments, libraries, or an online research registry was surveyed. Responses from adults without diabetes who reported 1 or more risk factors for T2DM (eg, family history, body mass index > 25) were included in the analyses (n = 265). Results Participants were 37 ± 11 years old, white (54%), and female (69%), with some college education (53%) and an annual income below $25 000 (44%). Approximately half (52%) expressed interest in GT for T2DM. Individuals were stratified by perceived risk for T2DM (risk aware or risk unaware). Among the risk aware, younger age (P < .04) predicted greater interest in GT. Among the risk unaware, family history of T2DM (P < .008) and preference to know genetic risk (P < .0002) predicted interest in GT. Both groups identified the need for low-cost GT. Conclusions GT is an increasingly available and accurate tool to predict T2DM risk for patients. In this sample, GT was a salient tool for those with and without awareness of their T2DM risk. Financial accessibility is critical to use of this tool for both groups.
Racial and Ethnic Disparities in Diabetes Complications in the Northeastern United States: The Role of Socioeconomic Status
(2013) Osborn, Chandra Y.; de Groot, Mary; Wagner, Julie A.
The role of socioeconomic status (SES) in explaining racial/ethnic disparities in diabetes remains unclear. We investigated disparities in self-reported diabetes complications, and the role of macro (e.g., income, education) and micro (e.g., ‘owning a home’ or ‘having a checking account’) SES indicators in explaining these differences. The sample included individuals with a diagnosis of diabetes (N=795) who were on average 55 years old, and 55.6% non-Hispanic White, 25.0% African American, and 19.4% Hispanic. Approximately 8% reported nephropathy, 35% reported retinopathy, and 16% reported cardiovascular disease. There were significant disparities in the rates of complications among non-Hispanic White, African American and Hispanic participants, with Hispanics having the highest rates of nephropathy, retinopathy, and cardiovascular disease. Macro SES indicators (e.g., income) mediated racial differences (i.e., non-Hispanic Whites vs. African Americans) in self-reported retinopathy, a combination of macro and more micro SES indicators (e.g., education, income, and ‘owning a home’ or ‘having a checking account’) mediated racial/ethnic differences (i.e., non-Hispanic Whites vs. Hispanics) in self-reported cardiovascular disease, and only micro SES indicators (e.g., ‘owning a home’ or ‘having a checking account’) mediated differences between lower income SES racial/ethnic minority groups (i.e., African Americans vs. Hispanics) in self-reported retinopathy and cardiovascular disease. Findings underscore that indicators of SES must be sensitive to the outcome of interest and the racial/ethnic groups being compared.
Depression and poverty among African American women at risk for type 2 diabetes
(2003-06) de Groot, Mary; Auslanden, Wendy; Williams, James Herbert; Sherraden, Michael; Haire-Joshu, Debra
Poverty is associated with negative health outcomes, including depression. Little is known about the specific elements of poverty that contribute to depression, particularly among African American women at risk for type 2 diabetes. This study examined the relationships of economic and social resources to depression among African American women at high risk for the development of type 2 diabetes (N = 181) using the Conservation of Resources theory as a conceptual framework. Women were assessed at 3 time points in conjunction with a dietary change intervention. At baseline, 40% of women reported clinically significant depression, and 43.3% were below the poverty line. Depressed women reported fewer economic assets and greater economic distress than nondepressed peers. Multivariate logistic regression analyses indicated that nonwork status, lack of home ownership, low appraisal of one’s economic situation, low self-esteem, and increased life events were significantly associated with depression at baseline. Longitudinal multivariate logistic regression models indicated that income, home ownership, future economic appraisal, life events, and self-esteem predicted depression trajectories at Time 3. These results speak to the multifaceted sources of stress in the lives of poor African American women. Interventions that address the economic and social factors associated with depression are needed.

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