title: Psychological correlates of gluten-free diet adherence in adults with celiac disease.
abstract: OBJECTIVE
  To determine whether personality traits and psychological characteristics are related to gluten-free diet (GFD) adherence in an adult population diagnosed with celiac disease (CD).
  
  
  BACKGROUND
  Little research has examined psychological correlates of adherence to the GFD.
  
  
  METHODS
  One hundred fifty-seven adults with biopsy-confirmed CD on the GFD for >3 months completed measures of personality and self-reported GFD adherence, provided a blood sample, and participated in an evaluation of GFD adherence conducted by an expert dietician at a clinical care center in a major teaching hospital in Boston, MA.
  
  
  RESULTS
  An expert evaluation of GFD adherence remained the "gold standard" for measuring GFD adherence when compared with self-report and serology. Logistic regression results indicated that the following were independently associated with GFD adherence: conscientiousness (B=-0.04, SE=0.01, P<0.00), values (B=-0.10, SE=0.05, P<0.05), other food intolerances [odds ratio=0.28, 95% confidence interval=0.10-0.78], and CD symptoms (B=0.05, SE=0.02, P<0.03). A model accounting for these associations effectively predicted whether a participant was adherent or nonadherent on the basis of psychological and demographic/disease-specific factors. Successful prediction rates of GFD adherence for the final model were 75.8% for those rated to be adherent with the GFD and 54.5% for those rated to be nonadherent with the GFD.
  
  
  CONCLUSIONS
  The model of psychological and demographic/disease-specific characteristics developed can be used to identify patients who may be at risk for poor dietary adherence to provide additional support, education, and encouragement to individuals with CD.
authors.affiliation: Department of Gastroenterology, Beth Israel Deaconess Medical Center (BIDMC), The Celiac Center, Harvard Medical School, Northeastern University, Boston, MA02215-5491 , USA. jgeorge1@bidmc.harvard.edu
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Edwards George
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Leffler
authors.forename: Melinda D
authors.initials: MD
authors.lastname: Dennis
authors.forename: Debra L
authors.initials: DL
authors.lastname: Franko
authors.forename: Jessica
authors.initials: J
authors.lastname: Blom-Hoffman
authors.forename: Ciaran P
authors.initials: CP
authors.lastname: Kelly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D055050:Diet, Gluten-Free / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005512:Food Hypersensitivity; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D055815:Young Adult