Psychology Ph.D. Dissertations


The Role of Mindfulness, Perceived Discrimination, and Diabetes-Related Distress in Predicting Health Behaviors and Glycemic Control

Date of Award


Document Type


Degree Name

Doctor of Philosophy (Ph.D.)



First Advisor

William Hayes O'Brien (Advisor)

Second Advisor

Abby Braden (Committee Member)

Third Advisor

Howard Casey Cromwell (Committee Member)

Fourth Advisor

David A. Tobar (Other)


For persons with diabetes, adherence to treatment recommendations, such as medication adherence and following diet and exercise guidelines, is often difficult and subject to multiple influences, including psychological well-being and social stressors. Such influences include self-reported microaggressions, mindfulness, depressive symptoms, self-care behaviors, and glycemic control. A model of relationships between these variables was proposed for testing through structural equation modeling. 337 Participants over the age of 18 years with diagnoses of diabetes were recruited from Amazon’s Mechanical Turk website to take a survey of measures assessing these variables. Tests of the hypothesized model indicated poor fit, and the model was respecified to remove diet and exercise behaviors, which resulted in satisfactory fit. Between-groups differences were assessed to investigate potential differences in the model between participants. Findings were generally consistent with hypotheses that better psychological well-being and less frequent microaggressions would be associated with improved self-care behaviors, including diet, exercise, and taking medication regularly. Some differences were noted in the magnitude of relationships between participants from the United States or India, but, the models were generally similar between groups. Limitations included possible misrepresentation of participant character, lack of health literacy, and use of cross-sectional data. This study informs future research on interventions for improvements in treatment adherence for people with diabetes, including interventions for improving mindfulness skills and interventions for decreasing impact of microaggressions.