Date of Conferral



Doctor of Psychology (Psy.D.)




Rachel Piferi


The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse practitioners who treated T2DM patients were interviewed. The clinicians were interviewed regarding their screening experience for T2DM for depression. Interviews were recorded, transcribed and analyzed using thematic analysis. Three themes emerged from the data to explain clinicians' screening of T2DM patients for depression: 1) clinicians' focus on treating the physical disease of diabetes rather than comorbid depression, 2) T2DM depression screening is accepted as a standard of care or part of the clinical assessment process, and 3) there is favorable perception of peer approval for T2DM depression screening. Implications for social change relate to the need for those with T2DM to receive effective and efficient screening and treatment for depression. The role of diabetes clinicians could provide a consistent point of care for screening and referral for filling this need. Development of best practice guidelines and relevant education supporting this role could be pivotal in addressing the complication of depression in T2DM.