IDF21-0549 Social Identity As a Coping Resource Against Type 2 Diabetes Surrounding Stigma

Background: People with type 2 diabetes experience significant levels of stigma due to their disease. Previous studies have shown that the perception of stigma negatively affects the metabolic compensation, quality of life, and mental health of this group of patients. Recent evidence suggests that social identity could be a resource to coping with stigma. Social identity refers to the part of our self-concept that derives from our belonging to different social groups. Patients with type 2 diabetes constitute a social group, and the perceptions which people diagnosed with this disease have about it can influence their perception of stigma. Two components of social identity have been proposed. One of them, centrality, is a cognitive component that refers to the degree and frequency in which people think about their group membership. The other, an affective component, corresponds to the evaluation people make of the ingroup. The role of social identity as a resource to face stigma in patients with diabetes has not been studied. Aim: This research analyzes the role of the cognitive and affective components of social identity as a resource to coping with stigma in patients with type 2 diabetes. Method: An observational cross-sectional study was carried out. We recruited 501 persons with type 2 diabetes in the city of Barranquilla, Colombia. Each participant answered a Spanish version of the Diabetes Assessment Stigma Scale 2 and the Cameron social identification scale. First, Spearman's correlations between stigma and identity components (affectivity and centrality) were estimated. Then, we used linear regression models with perception of stigma as a dependent variable, and social identification (cognitive and affective) as independent variable. Each regression model was adjusted for sociodemographic variables (i.e., age, educational level), clinical antecedents (i.e., years since diagnosis, use of insulin, presence of complications), and psychosocial variables (i.e., self-esteem and self-efficacy) which could affect the level of stigma. Confidence intervals were estimated using bootstrap bias correct procedure. In all cases, a level of significance of p < 0.05 was accepted. Results: The correlation between stigma and ingroup affect was rs = 0.31 (p < 0.001), while the correlation between stigma and centrality was rs = −0.31 (p < 0.001). In the regression model adjusted for covariates, the affective component maintained a significant association (B = −0.31, CI95% [−0.49, −0.14], p < 0.001), this model explained 27% of the variance of stigma (R2 = 0.27, F (9,482) = 21.33, p < 0.001). In the case of centrality, the model adjusted for covariates showed a significant and positive association (B = 0.21, CI95% [0.01,0.42], p = 0.046]). This model explained 27% of the variability of stigma (R2 = 0.26, F (9,482) = 19.86, p < 0.001). Discussion: A differentiated pattern of correlations with stigma was observed for the cognitive and affective components. Positive evaluation of the group of patients with type 2 diabetes is associated with lower levels of stigma, while more in group centrality is associated with higher levels of stigma. The implications of this results will be discussed in the presentation.