{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:37:13Z","timestamp":1785375433994,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["CS\u20102017\u201017\u2010023"],"award-info":[{"award-number":["CS\u20102017\u201017\u2010023"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000764","name":"King's College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000764","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009362","name":"South London and Maudsley NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>This qualitative study aimed to develop the first cognitive behavioural therapy model outlining the development and maintenance of disordered eating in type 1 diabetes and report on recovery strategies and resilience factors to improve previous theoretical models of type 1 diabetes and disordered eating.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010three women (<jats:italic>n<\/jats:italic>\u00a0=\u00a09 with type 1 diabetes and disordered eating,<jats:italic>n<\/jats:italic>\u00a0=\u00a05 with type 1 diabetes recovering from disordered eating, and<jats:italic>n<\/jats:italic>\u00a0=\u00a09 with type 1 diabetes without disordered eating) participated in semi\u2010structured interviews. Data were analysed using grounded theory and individual cognitive\u2013behavioural formulations were developed for each participant to inform the development\/maintenance and resilience models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The development\/maintenance model summarises commonly experienced vicious cycles of thoughts, feelings and behaviours in type 1 diabetes and disordered eating. The resilience model summarises strategies and knowledge acquired by those with type 1 diabetes in recovery from disordered eating and individuals with type 1 diabetes who did not develop disordered eating. Early adverse life events, past psychiatric history, perfectionist personality traits, difficult experiences around type 1 diabetes diagnosis and its relentless daily management sensitise individuals to eating, weight and shape cues. Alongside physical symptoms\/complications, unhelpful interpersonal reactions and inadequate healthcare, vicious cycles of thoughts, feelings and behaviours develop. \u2018<jats:italic>Good enough<\/jats:italic>\u2019 psychological adaptation to type 1 diabetes, integrating type 1 diabetes into one's identity, self care and compassion around eating, weight and shape were key protective\/post\u2010traumatic resilience factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This first cognitive behavioural therapy model of type 1 diabetes and disordered eating informed by personal experience will inform an intervention for type 1 diabetes and disordered eating.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14578","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T07:09:38Z","timestamp":1617347378000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["A cognitive behavioural model of the bidirectional relationship between disordered eating and diabetes self care in people with type 1 diabetes mellitus"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3771-9735","authenticated-orcid":false,"given":"Amy","family":"Harrison","sequence":"first","affiliation":[{"name":"Diabetes Research Group Weston Education Centre King's College London London UK"},{"name":"Department of Psychology and Human Development University College London London UK"},{"name":"Department of Psychological Medicine Institute of Psychiatry, Psychology and Neuroscience King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1720-1621","authenticated-orcid":false,"given":"Natalie","family":"Zaremba","sequence":"additional","affiliation":[{"name":"Diabetes Research Group Weston Education Centre King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennie","family":"Brown","sequence":"additional","affiliation":[{"name":"Diabetes Research Group Weston Education Centre King's College London London UK"},{"name":"Institute of Diabetes, Endocrinology and Obesity King's Health Partners London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Allan","sequence":"additional","affiliation":[{"name":"Diabetes Research Group Weston Education Centre King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7205-285X","authenticated-orcid":false,"given":"Emmanouela","family":"Konstantara","sequence":"additional","affiliation":[{"name":"Diabetes Research Group Weston Education Centre King's College London London 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