Skip to main content

A Pathways Approach to the Metabolic Syndrome

  • Chapter
  • First Online:
Integrative Pathways

Abstract

Psychosocial factors interact with genetics, environment, and lifestyle to increase risk for the metabolic syndrome (essential hypertension, Type 2 diabetes, hyperlipidemia, and obesity). Patients with the metabolic syndrome often suffer from anxious and depressive symptoms, negatively affecting motivation for self-management. A biopsychosocial approach is important in the care of patients such as Carmella, the case described in this chapter. Treatment of this multifaceted chronic disorder is complex and is best coordinated among multiple specialists and in addition requires the active participation of the patient. Based on the Pathways Model, the mental health provider’s role is to empower the patient in effective self-management. Psychophysiological therapies offer the opportunity for regulation of physiological stress responses, engaging the relaxation response. Patients learn to make daily decisions which benefit their short- and long-term health. The psychotherapies, particularly cognitive behavioral therapy are consistent with the theme of self-awareness, patient choices, and significant changes in behavior. One of the complementary therapies, Reiki is also utilized by Carmella to achieve her goal of better metabolic control.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    In health care research, this factor of early adversity is operationalized as adverse childhood experiences (ACE) and recognized as a significant contributor to negative adult physical and mental health outcomes (American Academy of Pediatrics, 2014).

References

  • Aguilar, M., Bhuket, T., Torres, S., Liu, B., & Wong, R. J. (2015). Prevalence of the metabolic syndrome in the United States, 2003-2012. Journal of the American Medical Association, 313(19), 1973–1974.

    Article  Google Scholar 

  • Aikens, J. E. (2012). Prospective associations between emotional distress and poor outcomes in type 2 diabetes. Diabetes Care, 35(12), 2472–2478. https://doi.org/10.2337/dc12-0181

    Article  PubMed  PubMed Central  Google Scholar 

  • American Diabetes Association (ADA). (2015a). Diagnosis and classification of diabetes mellitus. Diabetes Care, 38(Suppl. 1), S8–S16.

    Article  Google Scholar 

  • American Diabetes Association (ADA). (2015b). Standards of medical care in diabetes. Diabetes Care, 38(Suppl. 1), S1–S93.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Book  Google Scholar 

  • American Academy of Pediatrics (2014). Adverse childhood experiences and the lifelong consequences of trauma. https://www.aap.org/en-us/Documents/ttb_aces_consequences.pdf.

  • Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychological Science Practicum, 10(2), 125–143.

    Article  Google Scholar 

  • Black, D., O’Reilly, G., Olmstead, R., Breen, E., & Irwin, M. (2015). Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: A randomized clinical trial. JAMA Internal Medicine, 175(4), 494–501.

    Article  Google Scholar 

  • Branth, S., Ronquist, G., Stridsberg, M., Hambraeus, L., Kindgren, E., Olsson, R., et al. (2007). Development of abdominal fat and incipient metabolic syndrome in young healthy men exposed to long-term stress. Nutrition, Metabolism, and Cardiovascular Diseases, 17, 427–435.

    Article  Google Scholar 

  • Brook, R. D., Appel, L. J., Rubenfire, M., Ogedegbe, G., Bisognano, J. D., Elliott, W. J., et al. (2013). Beyond medications and diet: Alternative approaches to lowering blood pressure. Hypertension, 61(6), 1360–1383.

    Article  Google Scholar 

  • Capuron, L., Su, S., Miller, A. H., Bremner, J. D., Goldbery, J., Vogt, G. J., et al. (2008). Depressive symptoms and metabolic syndrome: Is inflammation the underlying link? Biological Psychiatry, 64(10), 896–900.

    Article  Google Scholar 

  • Carnethon, M., & Craft, L. (2008). Autonomic regulation of the association between exercise and diabetes. Exercise and Sport Sciences Reviews, 36(1), 12–18.

    Article  Google Scholar 

  • Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., et al. (2016). 2016 ESC/EAS guidelines for the management of dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis, 253, 281–344. https://doi.org/10.1016/j.atherosclerosis.2016.08.018

    Article  PubMed  Google Scholar 

  • Chandola, T., Brunner, E., & Marmot, M. (2006). Chronic stress at work and the metabolic syndrome: Prospective study. British Medical Journal, 332, 521–525.

    Article  Google Scholar 

  • Davies, S. J. C., Hood, S. D., Christmas, D., & Nutt, D. J. (2008). Psychiatric disorders and cardiovascular disease anxiety, depression and hypertension. In L. Sher (Ed.), Psychological factors and cardiovascular disorders: The role of psychiatric pathology and maladaptive personality features (pp. 69–96). Hauppauge, NY: Nova Scotia Publishers Inc..

    Google Scholar 

  • Davis, M., Eshelman, E., & McKay, M. (2008). The relaxation & stress reduction workbook (6th ed.). Oakland, CA: New Harbinger.

    Google Scholar 

  • Dixon, M. R., Lik, N. M. K., Green, L., & Myerson, J. (2013). Delay discounting of hypothetical and real money: The effect of holding reinforcement rate constant. Journal of Applied Behavior Analysis, 46(2), 512–517.

    Article  Google Scholar 

  • Froy, O. (2010). Metabolism and circadian rhythms—Implications for body weight. The Open Neuroendocrinology Journal, 3, 28–37.

    Google Scholar 

  • Gillespie, E., Gillespie, B. W., & Stevens, M. J. (2007). Painful diabetic neuropathy: Impact of an alternative approach. Diabetes Care, 30(4), 999–1001. https://doi.org/10.2337/dc06-1475

    Article  PubMed  Google Scholar 

  • Goldbacher, E. M., & Matthews, K. A. (2007). Are psychological characteristics related to risk of the metabolic syndrome?: A review of the literature. Annals of Behavioral Medicine, 34(3), 240–252.

    Article  Google Scholar 

  • Gonzalez, J. S., Peyrot, M., McCarl, L. A., Collins, E. M., Serpa, L., Mimiaga, M. J., et al. (2008). Depression and diabetes treatment nonadherence: A meta-analysis. Diabetes Care, 31(12), 2398–2403. https://doi.org/10.2337/dc08-1341

    Article  PubMed  PubMed Central  Google Scholar 

  • Gonzalez, J. S., Shreck, E., Psaros, C., & Safren, S. A. (2015). Distress and Type-2 diabetes-treatment adherence: A mediating role for perceived control. Health Psychology, 34(5), 505–513.

    Article  Google Scholar 

  • Hamer, M., Taylor, A., & Steptoe, A. (2006). The effect of acute aerobic exercise on stress related blood pressure responses: A systematic review and meta-analysis. Biological Psychology, 71(2), 183–190.

    Article  Google Scholar 

  • Healthy Lifestyles. (2016, January). 6th. Retrieved from https://www.icsi.org/guidelines__more/catalog_guidelines_and_more/catalog_guidelines/catalog_prevention__screening_guidelines/healthy_lifestyles/

  • High Blood Pressure (Hypertension): Tests and Diagnosis. (2016, September 9). Retrieved from http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/tests-diagnosis/con-20019580

  • Ho, F. Y. Y., Chung, K. F., Yeung, W. F., Ng, T. H., Kwan, K. S., Yung, K. P., et al. (2015). Self-help cognitive-behavioral therapy for insomnia: A meta-analysis of randomized controlled trials. Sleep Medicine Reviews, 19, 17–28.

    Article  Google Scholar 

  • James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., et al. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth Joint National Committee (JNC 8). JAMA, 311(5), 507–520.

    Article  Google Scholar 

  • Kim, K. H. C., Bursac, Z., DiLillo, V., White, D. B., & West, D. S. (2009). Stress, race, and body weight. Health Psychology, 28(1), 131–135.

    Article  Google Scholar 

  • Knutson, K., & Van Cauter, E. (2008). Associations between sleep loss and increased risk of obesity and diabetes. Annals of the New York Academy of Sciences, 1129, 287–304.

    Article  Google Scholar 

  • Kyrou, I., Chrousos, G. P., & Tsigos, C. (2006). Stress, visceral obesity, and metabolic complications. In G. P. Chrousos & C. Tsigos (Eds.), Stress, obesity, and metabolic syndrome: Annals of the New York Academy of Sciences (Vol. 1083, pp. 77–110). Boston, MA: Wiley-Blackwell.

    Google Scholar 

  • Linden, W., & McGrady, A. V. (2016). Essential hypertension. In M. S. Schwartz & F. Andrasik (Eds.), Biofeedback: A practitioner’s guide (pp. 383–399). New York: The Guilford Press.

    Google Scholar 

  • Lundahl, B., & Burke, B. L. (2009). The effectiveness and applicability of motivational interviewing: A practice-friendly review of four meta-analyses. Journal of Clinical Psychology, 65(11), 1232–1245.

    Article  Google Scholar 

  • Matthews, K. A., & Gallo, L. C. (2011). Psychological perspectives on pathways linking socioeconomic status and physical health. Annual Review of Psychology, 62, 501–530. https://doi.org/10.1146/annurev.psych.031809.130711

    Article  PubMed  PubMed Central  Google Scholar 

  • Maty, S. C., Lynch, J. W., Raghunathan, T. E., & Kaplan, G. A. (2008). Childhood socioeconomic position, gender, adult body mass index, and incidence of type 2 diabetes mellitus over 34 years in the Alameda County Study. American Journal of Public Health, 98(8), 1486–1494.

    Article  Google Scholar 

  • McGinnis, R. A., McGrady, A., Cox, S. A., & Grower-Dowling, K. A. (2005). Biofeedback-assisted relaxation in type 2 diabetes. Diabetes Care, 28(9), 2145–2149.

    Article  Google Scholar 

  • McGrady, A., & Lakia, D. (2016). Diabetes mellitus. In M. S. Schwartz & F. Andrasik (Eds.), Biofeedback: A practitioner’s guide (4th ed., pp. 400–421). New York: The Guilford Press.

    Google Scholar 

  • McIntyre, R. S., Soczynski, J. K., Konarski, J. Z., Woldeyohannes, H. O., Law, C. W. Y., Miranda, A., et al. (2007). Should depressive syndromes be reclassified as “metabolic syndrome type II?”. Annals of Clinical Psychiatry, 19(4), 257–264.

    Article  Google Scholar 

  • McSharry, J., Moss-Morris, R., & Kendrick, T. (2011). Illness perceptions and glycaemic control in diabetes: A systematic review with meta-analysis. Diabetic Medicine, 28, 1300–1310. https://doi.org/10.1111/j.1464-5491.2011.03298.x

    Article  Google Scholar 

  • Moskowitz, J. T., Epel, E. S., & Acree, M. (2008). Positive affect uniquely predicts lower risk of mortality in people with diabetes. Health Psychology, 27(1 Suppl), S73–S82.

    Article  Google Scholar 

  • National Center for Complementary and Alternative Medicine. (2015). Reiki: An introduction. Retrieved from http://nccam.nih.gov/health/reiki/introduction.htm

  • Ogden, C. L., Carroll, M. D., Curin, L. R., McDowell, M. A., Tabak, C. J., & Flegal, K. M. (2006). Prevalence of overweight and obesity in the United States, 1999-2004. Journal of the American Medical Association, 295, 1549–1555.

    Article  Google Scholar 

  • Patel, S. R. (2009). Reduced sleep as an obesity risk factor. Obesity Reviews, 2(10), 61–68.

    Article  Google Scholar 

  • Petry, N. M., Cengiz, E., Wagner, J. A., Hood, K. K., Carria, L., & Tamborlane, W. V. (2013). Incentivizing behavior change to improve diabetes care. Diabetes, Obesity, and Metabolism, 15(12), 1071–1076.

    Article  Google Scholar 

  • Rice, B. I. (2007). Clinical benefits of training patients to voluntarily increase peripheral blood flow. Diabetes Educator, 33(3), 442–454.

    Article  Google Scholar 

  • Simon, G. E., Ludman, E. J., Linde, J. A., Operskalski, B. H., Ichikawa, L., Rohde, P., et al. (2008). Association between obesity and depression in middle-aged women. General Hospital Psychiatry, 30, 32–39.

    Article  Google Scholar 

  • Steptoe, A., O’Donnell, K., Marmot, M., & Wardle, J. (2008). Positive affect and psychosocial processes related to health. British Journal of Psychology, 99, 211–227. https://doi.org/10.1348/000712607X218295

    Article  PubMed  Google Scholar 

  • Thrane, S., & Cohen, S. M. (2014). Effect of Reiki therapy on pain and anxiety in adults: An in-depth literature review of randomized trials with effect size calculations. Pain Management Nursing, 15(4), 897–908. https://doi.org/10.1016/j.pmn.2013.07.008

    Article  PubMed  PubMed Central  Google Scholar 

  • West, D. S., DiLillo, V., Bursac, Z., Gore, S. A., & Greene, P. G. (2007). Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care, 30, 1081–1087.

    Article  Google Scholar 

  • Wickrama, K., O’Neal, C. W., Lee, T. K., & Wickrama, T. (2015). Early socioeconomic adversity, youth positive development, and young adults’ cardio-metabolic disease risk. Health Psychology, 34(9), 905–914.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McGrady, A., Moss, D. (2018). A Pathways Approach to the Metabolic Syndrome. In: Integrative Pathways. Springer, Cham. https://doi.org/10.1007/978-3-319-89313-6_10

Download citation

Publish with us

Policies and ethics