Type 2 diabetes (T2D) is a common, chronic condition. People with T2D often report poor mental wellbeing and treatment engagement, especially when stressed. Coping mechanisms may help manage stress, but it is crucial to identify which strategies are most common and (mal)adaptive. Using a psychometrically-informed approach and a series of pilot studies (n = 570) to develop and test the structural validity of a final item pool of coping strategies, a final study recruited 503 people with T2D through Prolific. Participants reported on coping, mental wellbeing (stress, anxiety and depressive symptoms), and treatment engagement (adherence, self-efficacy, A1C). All seven coping strategies (humor, self-blame, avoidance, support-seeking, positive mindset, religion/spirituality, and accessing resources) were psychometrically distinct and were associated with at least one indicator of treatment engagement, but fewer with wellbeing. After controlling for other variables, self-blame, avoidance, and positive mindset were the most robust predictors of both wellbeing and treatment engagement.
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