Intelligence, Personality, and Severe Hypoglycemia in Diabetes

  • Ian J. Deary
Part of the Perspectives on Individual Differences book series (PIDF)


The purpose of this chapter is to describe in detail an area of medical research in which intelligence and personality variables play key, integrated roles. In research on diabetes mellitus, personality and intelligence have been posited as predictors of outcomes related to self-care. Personality and intelligence are also the object of interest as outcome variables in themselves, because there is concern that they might be altered by the illness. The aspect of the illness that much of this interest focuses upon is the phenomenon of severe hypoglycemia, which is described in more detail below. It is largely because the research on personality and intelligence may be centered upon this phenomenon that severe hypoglycemia offers an opportunity to deal with aspects of personality and intelligence in an integrated way as they affect a health-related issue. Moreover, the physiological effects of severe hypoglycemia are relatively well understood and thereby offer a chance to discover the mechanisms that integrate psychological and medical factors in this condition.


Hypoglycemia Episode Necker Cube Diabetic Personality National Adult Reading Test Severe Hypo 
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  1. Bale, R. N. (1973). Brain damage in diabetes mellitus. British Journal of Psychiatry, 122, 337–341.PubMedCrossRefGoogle Scholar
  2. Berger, W. G., Keller, U., Honegger, B., & Jaeggi, E. (1989). Warning symptoms of hypoglycaemia during treatment with human and porcine insulin in diabetes mellitus. Lancet, 1, 1041–1044.PubMedCrossRefGoogle Scholar
  3. Booth-Kewley, S., & Friedman, H. S. (1987). Psychological predictors of heart disease: A quantitative review. Psychological Bulletin, 101, 343–362.PubMedCrossRefGoogle Scholar
  4. Brownlee-Dufeck, M., Paterson, L., Simonds, J. F., Goldstein, D., Kilo, C., & Hoette, S. (1987). The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. Journal of Consulting and Clinical Psychology, 55, 139–144.CrossRefGoogle Scholar
  5. Cox, D., Gonder-Frederick, L., Nowacek, G., & Butterfield, J. (1987). Quantifying fear of hypoglycemia: A preliminary report. Diabetes Care, 10, 617–621.PubMedCrossRefGoogle Scholar
  6. Crawford, J. R. (1989). Estimation of premorbid IQ: A review of recent developments. In J. R. Crawford & D. M. Parker (Eds.), Developments in clinical and experimental neuropsychology. (pp. 55–74 ). New York: Plenum.Google Scholar
  7. Crawford, J. R., Stewart, L. E., Parker, D. M., Besson, L. A. O., & Cochrane, R. H. B. (1989). Estimation of premorbid intelligence: Combining psychometric and demographic approaches improves predictive accuracy. Personality and Individual Differences, 10, 793–796.CrossRefGoogle Scholar
  8. DCCT Research Group. (1991). Epidemiology of severe hypoglycaemia in the Diabetes Control and Complications Trial. American Journal of Medicine, 90, 450–459.Google Scholar
  9. Deary, I. J. (1991). Personality. In F. G. R. Fowkes (Ed.), Epidemiology of peripheral vascular disease. (pp. 217–226 ). Berlin: Springer.CrossRefGoogle Scholar
  10. Deary, I. J. (1992). Diabetes, hypoglycaemia and cognitive performance. In A. P. Smith & D. M. Jones (Eds.), Handbook of human performance. (Vol. 2, pp. 243–259 ). London: Academic Press.Google Scholar
  11. Deary, I. J., Capewell, S., Hajducka, C., & Muir, A. L. (1991). The effects of captopril versus atenolol on memory, information processing and mood. British Journal of Clinical Pharmacology, 32, 347–353.PubMedCrossRefGoogle Scholar
  12. Deary, I. J., Crawford, J. R., Hepburn, D. A., Langan, S. J., Blackmore, L. M., & Frier, B. M. (1993). Severe hypoglycaemia and intelligence in adult patients with insulin-treated diabetes. Diabetes, 42, 341–344.PubMedCrossRefGoogle Scholar
  13. Deary, I. J., Fowkes, F. G. R., Donnan, P. T., & Housley, E. (1994). Hostile personality and risks of peripheral arterial disease in the general population. Psychosomatic Medicine, 56, 197–202.PubMedGoogle Scholar
  14. Deary, I. J., & Frier, B. M. (1992). Intensified conventional insulin treatment and neuropsychological impairment [Letter]. British Medical Journal, 304, 447.PubMedCrossRefGoogle Scholar
  15. Deary, I. J., Hepburn, D. A., MacLeod, K. M., & Frier, B. M. (1993). Partitioning the symptoms of hypoglycaemia using multi-sample confirmatory factor analysis. Diabetologia, 36, 771–777.PubMedCrossRefGoogle Scholar
  16. Deary, I. J., Langan, S. J., Graham, K. S., Hepburn, D., & Frier, B. M. (1992). Recurrent severe hypoglycemia, intelligence, and speed of information processing. Intelligence, 16, 337–359.CrossRefGoogle Scholar
  17. Deary, I. J., MacLullich, A. M. J., & Mardon, J. (1991). Reporting of minor physical symptoms and family incidence of hypertension and heart disease-relationships with personality and Type A behavior. Personality and Individual Differences, 12, 747–751.CrossRefGoogle Scholar
  18. Dejgaard, A., Gade, A., Larsson, H., Balle, V., Parving, A., & Parving, H. (1990). Evidence for diabetic encephalopathy. Diabetic Medicine, 8, 162–167.CrossRefGoogle Scholar
  19. Dunn, S. M., & Turtle, J. R. (1981). The myth of the diabetic personality. Diabetes Care, 4, 640–646.PubMedGoogle Scholar
  20. Egan, V., & Goodwin, G. M. (1992). HIV and AIDS. In A. P. Smith & D. M. Jones (Eds.), Handbook of human performance. (Vol. 2, pp. 219–242 ). London: Academic Press.Google Scholar
  21. Fonagy, P., Morgan, C. S., Lindsay, M. K. M., Kurtz, A. B., & Brown, R. (1987). Psychological adjustment and diabetic control. Archives of Disease in Childhood, 62, 1009–1013.PubMedCrossRefGoogle Scholar
  22. Fowkes, F. G. R., Leng, G. C., Donnan, P. T., Deary, I. J., Riemersma, R. A., & Housley, E. (1992). Serum cholesterol, triglycerides, and aggression in the general population. Lancet, 340, 995–998.PubMedCrossRefGoogle Scholar
  23. Franceschi, M., Cecchetto, R., Minicucci, F., Smizne, S., Baio, G., & Canal, N. (1984). Cognitive processes in insulin-dependent diabetes. Diabetes Care, 7, 228–231.PubMedCrossRefGoogle Scholar
  24. Frier, B. M. (1993). Hypoglycaemia in the diabetic adult. In A. Aynsley-Green & J. Gregory (Eds.), Balliere’s clinical endocrinology and metabolism. (Vol. 7 ). London: Balliere Tindall.Google Scholar
  25. Frier, B. M., & Hepburn, D. A. (1989). Plasma noradrenalin, human insulin, and hypoglycaemia [Letter]. Lancet, 2, 1269.Google Scholar
  26. Gold, A. E., Deary, I. J., O’Hare, J. P., Reckless, J. P. D., & Frier, B. M. (1993). Changes in personality and cognitive function following recurrent severe hypoglycaemia in patients with type 1 diabetes. Manuscript in preparation.Google Scholar
  27. Gordon, D., Fisher, S. G., Wilson, M., Fergus, E., Paterson, K. R., & Semple, C. G. (1993). Psychological factors and their relationship to diabetes control. Diabetic Medicine, 10, 530–534.PubMedCrossRefGoogle Scholar
  28. Heine, R. J., van der Heyden, E. A. P., & van der Veen, E. A. (1989). Responses to human and porcine insulin in healthy subjects. Lancet, 2, 946–949.PubMedCrossRefGoogle Scholar
  29. Hepburn, D. A., Deary, I. J., & Frier, B. M. (1992). Classification of symptoms of hypoglycaemia in insulin-treated diabetic patients using factor analysis: Relationship to hypoglycaemia unawareness. Diabetic Medicine, 9, 70–75.PubMedCrossRefGoogle Scholar
  30. Hepburn, D. A., Deary, I. J., Frier, B. M., Patrick, A. W., Quinn, J. D., & Fisher, B. M. (1991). Symptoms of acute insulin-induced hypoglycaemia in humans with and without IDDM: A factor analysis approach. Diabetes Care, 14, 949–957.PubMedCrossRefGoogle Scholar
  31. Hepburn, D. A., & Frier, B. M. (1989). Hypoglycaemia unawareness and human insulin [Letter]. Lancet, 1, 1394.CrossRefGoogle Scholar
  32. Hepburn, D. A., MacLeod, K. M., Deary, I. J., & Frier, B. M. (1992). Fear of hypoglycaemia, personality and hypoglycaemia unawareness in patients with insulin-treated diabetes [Abstract]. Diabetic Medicine, 9 (Suppl. 2), S43.Google Scholar
  33. Ingersoll, G. M., Orr, D. P., Herold, A. J., & Golden, M. P. (1986). Cognitive maturity and self-management among adolescents with insulin dependent diabetes mellitus. Journal of Paediatrics, 108, 620–623.CrossRefGoogle Scholar
  34. Irvine, A. A., Cox, D., & Gonder-Frederick, L. (1992). Fear of hypoglycemia: Relationship to physical and psychological symptoms in patients with insulin-dependent diabetes mellitus. Health Psychology, 11, 135–138.PubMedCrossRefGoogle Scholar
  35. Lane, J. D., Stabler, B., Ross, S. L., Morris, M. A., Litton, J. C., & Surwit, R. S. (1988). Psychological predictors of glucose control in patients with IDDM. Diabetes Care, 11, 790–800.Google Scholar
  36. Langan, S. J., Deary, I. J., Hepburn, D. A., & Frier, B. M. (1991). Cumulative cognitive impairment following recurrent severe hypoglycaemia in adult patients with insulin-treated diabetes mellitus. Diabetologia, 34, 337–344.PubMedCrossRefGoogle Scholar
  37. Lawson, J. S., Erdahl, D. L. W., Monga, T. N., Bird, C. E., Donald, M. W., Surridge, D. H. C., & Letemendia, E J. J. (1984). Neuropsychological function in diabetic patients with neuropathy. British Journal of Psychiatry, 145, 263–268.PubMedCrossRefGoogle Scholar
  38. MacLeod, K. M., Hepburn, D. A., Deary, I. J., Ebmeier, K., Goodwin, G., & Frier, B. M. (1992). Variations in regional cerebral blood flow in patients with Type 1 diabetes: Effects of diabetes and a history of recurrent severe hypoglycaemia [Abstract]. Diabetic Medicine, 9 (Suppl. 2), S11.Google Scholar
  39. Mann, A. H. (1977). Psychiatric morbidity and hostility in hypertension. Psychological Medicine, 7, 653–659.PubMedCrossRefGoogle Scholar
  40. Mann, A. H. (1986). The psychological aspects of essential hypertension. Journal of Psychosomatic Research, 30, 527–541.PubMedCrossRefGoogle Scholar
  41. Matthews, K. A. (1988). Coronary heart disease and Type A behaviors: Update on and alternative to the Booth-Kewley and Friedman (1987) quantitative review. Psychological Bulletin, 104, 373–380.PubMedCrossRefGoogle Scholar
  42. Mazze, R. S., Lucido, D., & Shamoon, H. (1984). Psychological and social correlates of glycaemic control. Diabetes Care, 7, 360–366.PubMedCrossRefGoogle Scholar
  43. Pennebaker, J. W., Cox, D. J., Gonder-Frederick, L., Wunsch, M. G., Evans, W. S., & Pohl, S. (1981). Physical symptoms related to blood glucose in insulin-dependent diabetics. Psychosomatic Medicine, 43, 489–500.PubMedGoogle Scholar
  44. Phillips, K. (1991). Essential hypertension. In M. Pitts & K. Phillips (Eds.), The psychology of health.(pp. 171–186 ). London: Routledge.Google Scholar
  45. Pramming, S., Thorsteinsson, B., Theilgaard, A., Pinner, E. M., & Binder, C. (1986). Cognitive function during hypoglycaemia in Type 1 diabetes mellitus. British Medical Journal, 292, 647–650.PubMedCrossRefGoogle Scholar
  46. Reichard, P., Berglund, A., Britz, A., Levander, S., & Rosenqvist, U. (1991). Hypoglycaemic episodes during insulin treatment: Increased frequency but no effect on cognitive function. Journal of Internal Medicine, 229, 9–16.PubMedCrossRefGoogle Scholar
  47. Reichard, P., Britz, A., & Rosenqvist, U. (1991). Intensified conventional insulin treatment and neuropsychological impairment. British Medical Journal, 303, 1439–1442.PubMedCrossRefGoogle Scholar
  48. Richardson, J. T. E. (1990). Cognitive function in diabetes mellitus. Neuroscience and Behavioural Reviews, 14, 385–388.CrossRefGoogle Scholar
  49. Robinson, J. O. (1964). A possible effect of selection on the test scores of a group of hypertensives. Journal of Psychosomatic Research, 8, 239–243.PubMedCrossRefGoogle Scholar
  50. Ryan, C. M. (1988). Neurobehavioural complications of Type 1 diabetes: Examination of possible risk factors. Diabetes Care, 11, 86–93.PubMedCrossRefGoogle Scholar
  51. Skenazy, J. A., & Bigler, E. D. (1984). Neuropsychological findings in diabetes mellitus. Journal of Clinical Psychology, 40, 246–258.PubMedCrossRefGoogle Scholar
  52. Smith, T. W., & Williams, P. G. (1992). Personality and health: Advantages and limitations of the five-factor model. Journal of Personality, 60, 395–423.PubMedCrossRefGoogle Scholar
  53. Spergel, P., Ehrlich, G. E., & Glass, D. (1978). The rheumatoid arthritic personality: A pseudodiagnostic myth. Psychosomatics, 19, 79–86.PubMedGoogle Scholar
  54. Starr, J. M., Whalley, L. J., Inch, S., & Schering, P. A. (1993). Blood pressure and cognitive function in healthy old people. Journal of the American Geriatrics Society, 41, 753–756.PubMedGoogle Scholar
  55. Stone, S. V., & Costa, P. T. (1990). Disease-prone personality or distress-prone personality? The role of neuroticism in coronary heart disease. In H. S. Friedman (Ed.), Personality and disease. (pp. 178–200 ). Chichester, England: Wiley.Google Scholar
  56. Suls, J., & Rittenhouse, J. D. (1990). Models of linkages between personality and disease. In H. S. Friedman (Ed.), Personality and disease.(pp. 38–64 ). Chichester, England: Wiley.Google Scholar
  57. Tattersall, R. B. (1981). Psychiatric aspects of diabetes: A physician’s view. British Journal of Psychiatry, 139, 485–493.PubMedCrossRefGoogle Scholar
  58. Van Heck, G. L., Bonaiuto, P., Deary, I. J., & Nowack, W. (Eds.). (1994). Personality psychology in Europe. (Vol. 4 ). Tilburg, Netherlands: Tilburg University Press.Google Scholar
  59. Vernon, P. A. (Ed.). (1993). Biological approaches to the study of human intelligence. Norwood, NJ: Ablex.Google Scholar
  60. Waal-Manning, H. J., Knight, R. G., Spears, G. F., & Paulin, J. M. (1986). The relationship between blood pressure and personality in a large unselected adult sample. Journal of Psychosomatic Research, 30, 361–368.PubMedCrossRefGoogle Scholar
  61. Wilson, W., Ary, D. V., Biglan, A., Glasgow, R. E., Toobert, D. J., & Campbell, R. C. (1986). Psychosocial predictors of self-care behaviours (compliance) and glycemic control in non-insulin-dependent diabetes mellitus. Diabetes Care, 9, 614–622.PubMedCrossRefGoogle Scholar
  62. Wredling, R., Levander, S., Adamson, U., & Lins, P. E. (1990). Permanent neuropsychological impairment after recurrent episodes of severe hypoglycaemia in man. Diabetologia, 33, 152–157.PubMedCrossRefGoogle Scholar
  63. Wredling, R. A. M., Theorell, R. G. T., Roll, H. M., Lins, P. E. S., & Adamson, U. K. C. (1992). Psychosocial state of patients with IDDM prone to recurrent episodes of severe hypoglycaemia. Diabetes Care, 15, 518–521.PubMedCrossRefGoogle Scholar
  64. Zuckerman, M. (1991). Psychobiology of personality. Cambridge, England: Cambridge University Press.Google Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Ian J. Deary
    • 1
  1. 1.Department of PsychologyUniversity of EdinburghEdinburghScotland

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