Relationships Among Adverse Childhood Experiences, Delay Discounting, Impulsivity, and Diabetes Self-Management

Lindsey M. Shain, Mai Nguyen, Amy L. Meadows

Research output: Contribution to journalArticlepeer-review


Objective: Adverse childhood experiences (ACEs) have been linked to risky health behaviors, as well as the development of chronic health conditions such as both type 1 and type 2 diabetes mellitus. A connection between ACEs and diabetes self-management has not yet been established. The current study aims to investigate the relationships among ACEs, delay discounting, impulsivity, and diabetes self-management. Method: A total of 227 adults aged 18 to 77 with type 1 diabetes, type 2 diabetes, and prediabetes were recruited to complete an online survey via Amazon’s mechanical Turk. Participants completed validated measures of diabetes self-care, delay discounting, and impulsivity, as well as questions regarding diabetes history and financial strain. Results: In the overall sample and controlling for financial strain, increased number of ACEs was significantly associated with poorer diabetes management (r = -.15, p <.05). Higher delay discounting was associated with fewer ACEs (r = -.31, p <.05) and better diabetes care (r =.42, p <.01), as well as increased number of diabetes-related complications (r =.33, p <.01), controlling for financial strain. Participants who use insulin to manage their diabetes had significantly better diabetes self-care scores (t(225) = 8.19, p <.01), higher levels of delay discounting (t(101) = 3.15, p <.01), and fewer reported ACEs (t(224) = -2.19, p,.05). Conclusions: ACEs are associated with poorer diabetes self-management later in life.

Original languageEnglish
Pages (from-to)566-571
Number of pages6
JournalHealth Psychology
Issue number8
StatePublished - 2022

Bibliographical note

Funding Information:
This project was supported by the University of Kentucky Scientist-Clinician (Scholar) Career Development Program and the National Institutes of Health National Center for Advancing Translational Sciences through Grant UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have no known conflict of interest to disclose.

Publisher Copyright:
© 2022. American Psychological Association


  • Adherence
  • Adverse childhood experiences
  • Diabetes
  • Impulsivity

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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