Date of Conferral



Doctor of Psychology (Psy.D.)




Anthony R. Perry


Endemic Type-2 Diabetes Mellitus (T2DM) is one of the leading causes of mortality among American Indian/Alaska Natives (AI/ANs). Trauma and stress have been shown to impact the progression of diabetes that could negatively impact health-related behaviors. Previous studies have not examined the relationship between historical and contemporary trauma and T2DM self-management among AI/AN women. The purpose of this research was to examine the relationship between historical loss, historical loss associated symptoms, stressful life events, microaggressions (microinsults and microinvalidations), and T2DM self-management (glucose management, dietary control, physical activity, healthcare use) among AI/AN women with diabetes. Historical trauma theory was the basis of this study and explained the consequences of colonization resulting in contemporary trauma that affects physical and mental health. A cross-sectional survey design included data from a convenience sample of 209 AI/AN adult woman. Multiple regression analyses showed that greater experiences with microinvalidations predicted poorer glucose management, less physical activity, less healthcare use, and poorer overall T2DM self-management. The study demonstrated that contemporary trauma (stressful life events and microinvalidations) had a significant and negative impact on T2DM self-management among AI/AN women. These results could improve T2DM self-management and the high levels of mortality, morbidity, costs, and quality of life among AI/AN women. The findings may also be used by educators and healthcare providers to promote positive social change by integrating cultural-sensitive approaches to the treatment of AI/AN groups.