Psychological Resilience Profiles and Their Association with Socioemotional Health and HbA1c Among African American Adults with Type 2 Diabetes: A Latent Profile Analysis

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OBJECTIVE: We used a cross-sectional design with baseline data from a Type 2 diabetes (T2D) clinical trial to (1) identify resilience profiles among African American adults with T2D and (2) examine the profiles' associations with perceived social support, diabetes distress, depressive symptoms, and Hemoglobin A1c (HbA1c) levels. METHODS: Participants (n = 284, 72% women, 62 ± 11 years) recruited through churches in Central Texas completed a questionnaire assessing perceived psychological resilience, social support, diabetes distress, and depressive symptoms. HbA1c was obtained via finger-stick blood samples. We used latent profile analysis to identify resilience profiles and multinomial logistic regression to examine associations of profile classification with outcomes using relative risk ratios (RRR). RESULTS: Distinct resilience profiles emerged: low (12.0% of sample), moderate (48.4%), and high (39.6%). Participants with lower perceived social support (RRR = 0.60 [95% confidence interval = 0.44-0.80], p < .001) and higher diabetes distress (RRR = 1.95 [1.35-2.82], p < .001) and depressive symptoms (RRR = 1.21 [1.11-1.31], p < .001) were more likely to be classified in the low vs. high resilience profile. Classification into the low vs. high resilience profile was also associated with clinically elevated depressive symptoms (RRR = 9.11 [3.40-24.42], p < .001) and clinically elevated HbA1c (RRR = 3.45 [1.20-9.93], p < .05). CONCLUSIONS: Psychological resilience clustered into distinct subgroups, with individuals in the low resilience profile exhibiting greater socioemotional and glycemic vulnerability. Findings support incorporating resilience-enhancing content into diabetes self-management programs to better assist vulnerable individuals and reduce diabetes-related disparities.

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