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Zhang Z, Robinson L, Campbell I, Irish M, Bobou M, Winterer J, Zhang Y, King S, Vaidya N, Broulidakis MJ, van Noort BM, Stringaris A, Banaschewski T, Bokde ALW, Brühl R, Fröhner JH, Grigis A, Garavan H, Gowland P, Heinz A, Hohmann S, Martinot JL, Martinot MLP, Nees F, Orfanos DP, Paus T, Poustka L, Sinclair J, Smolka MN, Walter H, Whelan R, Schumann G, Schmidt U, Desrivières S. Distinct personality profiles associated with disease risk and diagnostic status in eating disorders. J Affect Disord 2024; 360:146-155. [PMID: 38810783 DOI: 10.1016/j.jad.2024.05.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 05/13/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Personality traits have been associated with eating disorders (EDs) and comorbidities. However, it is unclear which personality profiles are premorbid risk rather than diagnostic markers. METHODS We explored associations between personality and ED-related mental health symptoms using canonical correlation analyses. We investigated personality risk profiles in a longitudinal sample, associating personality at age 14 with onset of mental health symptoms at ages 16 or 19. Diagnostic markers were identified in a sample of young adults with anorexia nervosa (AN, n = 58) or bulimia nervosa (BN, n = 63) and healthy controls (n = 47). RESULTS Two significant premorbid risk profiles were identified, successively explaining 7.93 % and 5.60 % of shared variance (Rc2). The first combined neuroticism (canonical loading, rs = 0.68), openness (rs = 0.32), impulsivity (rs = 0.29), and conscientiousness (rs = 0.27), with future onset of anxiety symptoms (rs = 0.87) and dieting (rs = 0.58). The other, combined lower agreeableness (rs = -0.60) and lower anxiety sensitivity (rs = -0.47), with future deliberate self-harm (rs = 0.76) and purging (rs = 0.55). Personality profiles associated with "core psychopathology" in both AN (Rc2 = 80.56 %) and BN diagnoses (Rc2 = 64.38 %) comprised hopelessness (rs = 0.95, 0.87) and neuroticism (rs = 0.93, 0.94). For BN, this profile also included impulsivity (rs = 0.60). Additionally, extraversion (rs = 0.41) was associated with lower depressive risk in BN. LIMITATIONS The samples were not ethnically diverse. The clinical cohort included only females. There was non-random attrition in the longitudinal sample. CONCLUSIONS The results suggest neuroticism and impulsivity as risk and diagnostic markers for EDs, with neuroticism and hopelessness as shared diagnostic markers. They may inform the design of more personalised prevention and intervention strategies.
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Affiliation(s)
- Zuo Zhang
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Lauren Robinson
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Iain Campbell
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Madeleine Irish
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Marina Bobou
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Jeanne Winterer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany; Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Yuning Zhang
- Psychology Department, B44 University Rd, University of Southampton, Southampton SO17 1PS, United Kingdom
| | - Sinead King
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom; School of Medicine, Center for Neuroimaging, Cognition and Genomics, National University of Ireland (NUI) Galway, Ireland; Beaumont Hospital, Royal College of Surgeons, Ireland
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany
| | - M John Broulidakis
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Department of Psychology, College of Science, Northeastern University, Boston, MA, USA
| | - Betteke Maria van Noort
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197 Berlin, Germany
| | - Argyris Stringaris
- Division of Psychiatry and Department of Clinical, Educational & Health Psychology, University College London, United Kingdom
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, VT, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Andreas Heinz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U 1299 "Trajectoires développementales & psychiatrie", University Paris-Saclay, CNRS, Ecole Normale Supérieure Paris-Saclay, Centre Borelli, Gif-sur-Yvette, and AP-HP, Sorbonne University, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany; Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
| | | | - Tomáš Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Julia Sinclair
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany; Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Ulrike Schmidt
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sylvane Desrivières
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom.
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2
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Jiretorn L, Engström M, Laursen C, Ramos Salas X, Järvholm K. 'My goal was to become normal'-A qualitative investigation of coping with stigma, body image and self-esteem long-term after bariatric surgery. Clin Obes 2024; 14:e12657. [PMID: 38549516 DOI: 10.1111/cob.12657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 05/14/2024]
Abstract
Improved self-esteem and body image, as well as reduced experiences of weight stigma are important patient-reported obesity treatment outcomes. However, more knowledge is needed about how individuals who have undergone metabolic and bariatric surgery (MBS) perceive themselves and their bodies and use different coping strategies in relation to body image and self-esteem long-term after MBS. In this qualitative study body image, self-esteem, weight stigma and coping strategies were explored among 18 individuals who underwent MBS more than 10 years ago when interviewed. Using reflexive thematic analysis, two primary themes were identified: 'Experiences of living with a stigmatised body' and 'Coping with weight stigma, body image and self-esteem', and eight sub-themes. Findings capture frequent experiences of weight stigma before bariatric surgery, the need for coping with stigma and body dissatisfaction before and after MBS, and how different coping strategies are related to participants' perceptions of their bodies and self-concepts. More adaptive coping strategies, such as confrontation and cognitive restructuring may facilitate more positive body image outcomes, than more ruminative and avoidant strategies. Understanding adaptive coping strategies can be useful to develop interventions to reduce negative consequences of weight stigma on body image and self-esteem.
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Affiliation(s)
- Linda Jiretorn
- Department of Psychology, Lund University, Lund, Sweden
- Department of Child and Adolescent Psychiatry, Region Östergötland, Linköping, Sweden
| | - My Engström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | - Kajsa Järvholm
- Department of Psychology, Lund University, Lund, Sweden
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Brancart X, Rossi G, Dierckx E, De Vos I, De Raedt R. Temperament Based Personality Types in Community-Dwelling Older Adults: A Latent Profile Analysis. Psychol Belg 2024; 64:24-41. [PMID: 38618169 PMCID: PMC11012024 DOI: 10.5334/pb.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/08/2024] [Indexed: 04/16/2024] Open
Abstract
Three adaptive trait-based personality types have been replicated across ages, cultures, clinical problems and clustering methods: Resilient, Undercontrolled and Overcontrolled type (RUO). Recently there is growing interest in and importance of biopsychosocial transdiagnostic factors underlying personality types, such as temperamental reactivity and self-regulation. Latter can be understood in terms of Behavioural Inhibition (BIS), Behavioural Activation Systems (BAS) and Effortful Control (EC). The occurrence of temperament based RUO types has not yet been confirmed in older adults with or without a mental disorder. Therefore, based on a person-centered approach, the current study investigates whether RUO types can be corroborated in older adults based on the aforementioned temperamental factors. Latent profile analysis yielded two distinct personality profiles in community-dwelling over-60s, which we tentatively labeled a resilient (n = 167) and overcontrolled/inhibited type (n = 241). Compared to the resilient type, the overcontrolled/inhibited type scored lower on EC and higher on BIS. We could not corroborate an undercontrolled type (profiles scored equally on BAS). Group comparisons revealed that overcontrolled/inhibited older adults demonstrated significantly more clinical symptoms, higher emotional instability, lower scores on adaptive traits, less resilience and were significantly more likely to use passive and avoidant coping styles, compared to resilient older adults.
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Affiliation(s)
- Xenia Brancart
- Xenia Brancart Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology research group (PEPS), Brussels, Belgium
- Ghent University (UG), Department of Experimental Clinical and Health Psychology, Ghent, Belgium
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
| | - Gina Rossi
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
- Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology research group (PEPS), Brussels, Belgium
| | - Eva Dierckx
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
- Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology research group (PEPS), Brussels, Belgium
- Alexianen Zorggroep Tienen (AZT), Psychiatric Hospital, Tienen, Belgium
| | - Indra De Vos
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
| | - Rudi De Raedt
- Ghent University (UG), Department of Experimental Clinical and Health Psychology, Ghent, Belgium
- VUB-UG alliance research group Personality and Information Processing in Older Adults, PIPO, Belgium
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Berengüí R, Castejón MA. Personality Traits and Risk of Eating Disorders in Men: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2910. [PMID: 37958054 PMCID: PMC10649439 DOI: 10.3390/healthcare11212910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Eating disorders (EDs) have been understudied and misunderstood in men. Among the relevant factors in the risk, onset, and maintenance of EDs, personality stands out. Therefore, the aim of the study was to analyze the relationships between personality traits and risk variables for the development of EDs in men. A total of 443 male university students (mean = 22.16 years) who completed the Spanish versions of the Eating Disorder Inventory-3 (EDI-3) and the NEO Five-Factor Inventory (NEO-FFI) participated. Correlation analyses were performed, and in order to determine the predictive role of personality traits on risk scales, a hierarchical multiple regression was performed. The results showed that neuroticism was positively associated with drive for thinness, being its main predictor variable. In bulimia, the main relationships were positively associated with neuroticism and negatively with conscientiousness. As for body dissatisfaction, the main predictor variables were neuroticism and, in a negative sense, extraversion and openness to experience. In conclusion, personality traits are related to the risk of developing EDs in male university students, with neuroticism being the main associated trait.
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Affiliation(s)
- Rosendo Berengüí
- Faculty of Education, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
| | - María A. Castejón
- Faculty of Education, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
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Montorio I, Izal M, Bellot A, Rodríguez J, de Iceta M. Personality Profiles Associated with Long-Term Success in Bariatric Surgery: 24-Month Follow-Up. Behav Sci (Basel) 2023; 13:797. [PMID: 37887447 PMCID: PMC10603863 DOI: 10.3390/bs13100797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
(1) Background: Bariatric surgery (BS) is highly effective for treating severe obesity in the long term. However, studies investigating predictors and personality profiles linked to BS success yield inconsistent results due to varying methodologies and limited research. This paper aims to identify personality profiles associated with BS success. (2) Method: The study involved 67 patients undergoing bariatric surgery, evaluated through clinical and personality measures. Weight loss was monitored at 6, 12, and 24 months post-surgery. Hierarchical case cluster analysis and iterative k-means cluster analysis identified distinct groups based on excess body mass index loss (%EBL) at these intervals. ANOVA was employed to compare personality profiles between groups. (3) Results: Average weight loss after 24 months was 67.2%. Two success profiles emerged: 46.5% showed very good success, achieving 90% EBL in 24 months, while 55% in the second cluster had less than 40% EBL throughout follow-up. The successful profile correlated with greater self-efficacy and improved emotional adjustment. (4) Conclusions: Successful BS outcomes were linked to personality traits promoting sustained weight loss post-surgery.
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Affiliation(s)
- Ignacio Montorio
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - María Izal
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - Ana Bellot
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - Javier Rodríguez
- Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, 28702 Madrid, Spain
| | - Mariano de Iceta
- Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, 28702 Madrid, Spain
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Attanasio M, Giuliani A, Romano L, Laidò C, Di Poggiovalle G, Le Donne I, Di Fonzo V, Tiberti S, Valenti M, Mazza M. Psychopathological factors and personality dimensions on dysfunctional eating behaviors in a sample of individuals with obesity. Front Psychol 2023; 14:1140890. [PMID: 37794917 PMCID: PMC10546769 DOI: 10.3389/fpsyg.2023.1140890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Obesity and eating disorders are considered to be part of a broad spectrum of disorders associated with weight issues and maladaptive eating styles. Several studies show that psychopathological and personality characteristics contribute to the development and maintenance of obesity and dysfunctional eating behaviors, showing a bidirectional relationship. The purpose of this study was to understand the role of psychopathological factors and personality dimensions on dysfunctional eating behaviors in a sample of individuals with obesity. Methods The study was conducted with 96 individuals with obesity (31 males and 65 females) who underwent psychological assessment. The instruments administered included the Cognitive Behavioral Assessment 2.0 - Primary Scales, the Minnesota Multiphasic Personality Inventory-2, and the Eating Disorder Inventory. Relationships between dysfunctional eating behaviors and personality and psychopathological factors were explored through mediation analysis. Results and discussion Our results showed that difficulties related to impulse control and behavior, along with negative and dysphoric emotions, may be associated with difficulties in eating behavior. Mediation analysis showed that the combination of depressive and obsessive-compulsive symptomatology may exacerbate or contribute to the occurrence of eating disorders. These psychopathological aspects should be taken into account during the assessment of patients who decide to undergo bariatric surgery and should be targets of specific psychological interventions.
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Affiliation(s)
- Margherita Attanasio
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Antonio Giuliani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Surgery, San Salvatore Hospital, L'Aquila, Italy
| | - Lucia Romano
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Surgery, San Salvatore Hospital, L'Aquila, Italy
| | - Cristina Laidò
- Istituto Romano di psicoterapia e psicodinamica integrata, Rome, Italy
| | - Gilda Di Poggiovalle
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Ilenia Le Donne
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Valentina Di Fonzo
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Sergio Tiberti
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Marco Valenti
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
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Hinnen C, Hermens M. A Lifestyle Group Intervention Aimed at Losing Sufficient Weight After Laparoscopic Roux-en-Y Gastric Bypass May Be Helpful for a Small Group of Patients. Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2021.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chris Hinnen
- Leids University Medical Center, Leiden, The Netherlands
| | - Mark Hermens
- Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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8
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An Z, Kim KH, Kim M, Kim YR. Negative emotion-related eating behaviours in young women with underweight status, overweight status, anorexia nervosa, and bulimia nervosa in Korea. EUROPEAN EATING DISORDERS REVIEW 2022; 30:401-411. [PMID: 35384144 DOI: 10.1002/erv.2900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/22/2022] [Accepted: 03/17/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study aimed at investigating the negative emotion-related eating behaviours of young women with extreme weights or eating disorders (EDs). METHOD A total of 808 young women participated including 144 with underweight (UW), 364 with normal-weight (NW) and 137 with overweight (OW; including 27 with obesity) from universities, and 63 patients with anorexia nervosa (AN), and 100 patients with bulimia nervosa (BN) from a hospital. Participants were interviewed and completed questionnaires on eating behaviours related to negative emotions. RESULTS While both OW and BN groups ate more in response to negative emotions, UW and AN groups ate less compared to NW group. Negative feelings after overeating were prominent in OW group and patients with ED. In negative emotions, patients with EDs preferred sweet tastes, but BN group preferred spicy tastes less. Patients with EDs had increased external eating, and BN group also showed increased restrained eating. Neuroticism had indirect impacts on OW status via emotional eating unlike BN. CONCLUSIONS The results suggest that UW and OW status were on the spectrum of emotional eating, and AN and BN were on the extremes of external eating, which may be integrated into the development of interventions targeting each status.
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Affiliation(s)
- Zhen An
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Kyung Hee Kim
- Department of Food and Nutrition, Duksung Women's University, Seoul, Republic of Korea
| | - Mirihae Kim
- Department of Psychology, Duksung Women's University, Seoul, Republic of Korea
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea.,Department of Neuropsychiatry, Seoul Paik Hospital, Inje University, Seoul, Republic of Korea
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Plasonja N, Brytek-Matera A, Décamps G. Psychological Profiles of Treatment-Seeking Adults with Overweight and Obesity: A Cluster Analysis Approach. J Clin Med 2022; 11:jcm11071952. [PMID: 35407559 PMCID: PMC8999798 DOI: 10.3390/jcm11071952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Overweight and obesity are associated with depression and well-being. Some psychological characteristics play a role in explaining well-being and depression in obesity and in identifying specific patient profiles. However, subtyping individuals with overweight/obesity based on variables like self-esteem or stress has not often been done. Therefore, our objective was to explore the psychological profiles of treatment-seeking individuals overweight or with obesity and to compare their depression and well-being. METHODS Data regarding eating self-efficacy, well-being, depression, physical hunger, self-esteem, body satisfaction and perceived stress in individuals with overweight/obesity were collected from the ESTEAM cohort. Hierarchical cluster analysis and mean comparisons were performed on female (n = 1427) and male samples (n = 310). RESULTS Three psychological profiles were identified in both samples. The "High psychological concerns" profile and the "Low psychological concerns" profile were identical in both samples. The third profile, "Bodily concerns", differed by sex and was characterized by appearance dissatisfaction for women and by appearance and eating concerns for men. The "Low psychological concerns" profile presented the highest well-being and the lowest depression scores in both samples. DISCUSSION The findings support the hypothesis of the heterogeneity of individuals with overweight and obesity and suggest sex-related therapeutic approaches.
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Affiliation(s)
- Natalija Plasonja
- Department of Human Sciences, Faculty of Psychology, Université de Bordeaux, LabPsy, EA 4139, F-33000 Bordeaux, France;
- Correspondence:
| | | | - Greg Décamps
- Department of Human Sciences, Faculty of Psychology, Université de Bordeaux, LabPsy, EA 4139, F-33000 Bordeaux, France;
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McGarrity LA, Terrill AL, Martinez PL, Ibele AR, Morrow EH, Volckmann ET, Smith TW. The Role of Resilience in Psychological Health Among Bariatric Surgery Patients. Obes Surg 2022; 32:792-800. [PMID: 35091900 DOI: 10.1007/s11695-021-05855-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Many individuals who undergo bariatric surgery have experienced repeated unsuccessful diet attempts and negative messages from healthcare providers, family, and others about their weight. Research pre- and post-operatively has taken a pathological or risk-based approach, investigating psychiatric problems and disordered eating. In contrast, the current study explores resilience in this population. METHODS Participants were 148 bariatric surgery patients. Participants completed measures pre-operatively and 1.5-3 years post-operatively, including the Binge Eating Scale, Eating Disorder Examination Questionnaire, Patient Health Questionnaire, Generalized Anxiety Questionnaire, Impact of Weight on Quality of Life, Coping Responses Inventory, and Duke Social Support and Stress Scales. The Connor-Davidson Resilience Scale was measured post-operatively. RESULTS Correlations demonstrated a significant association between post-operative resilience and lower symptoms of binge eating, disordered eating, depression, anxiety, and impact of weight on quality of life. Resilience was also associated with greater social support and less social stress, and greater use of approach coping strategies. Resilience was significantly associated with improvements in symptoms of binge eating, disordered eating, depression, anxiety, and impact of weight on quality of life from pre- to post-operative assessments. In regression models, associations remained significant after controlling for psychosocial variables at baseline (e.g., binge eating symptoms pre-operatively) and demographic covariates. CONCLUSIONS Psychological resilience has been under-studied in the literature on obesity and bariatric surgery, with a primary focus on risk factors for poor outcomes. This study was among the first to investigate associations between resilience and post-operative psychological outcomes. Results suggest the field would benefit from consideration of patient resilience in psychological assessments and interventions.
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Affiliation(s)
- Larissa A McGarrity
- University of Utah, Salt Lake City, UT, 84103, USA. .,Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, 84103, USA.
| | - Alexandra L Terrill
- University of Utah, Salt Lake City, UT, 84103, USA.,Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT, 84103, USA
| | - Paige L Martinez
- University of Utah, Salt Lake City, UT, 84103, USA.,Department of Surgery, University of Utah, Salt Lake City, UT, 84103, USA
| | - Anna R Ibele
- University of Utah, Salt Lake City, UT, 84103, USA.,Department of Surgery, University of Utah, Salt Lake City, UT, 84103, USA
| | - Ellen H Morrow
- University of Utah, Salt Lake City, UT, 84103, USA.,Department of Surgery, University of Utah, Salt Lake City, UT, 84103, USA
| | - Eric T Volckmann
- University of Utah, Salt Lake City, UT, 84103, USA.,Department of Surgery, University of Utah, Salt Lake City, UT, 84103, USA
| | - Timothy W Smith
- University of Utah, Salt Lake City, UT, 84103, USA.,Department of Psychology, University of Utah, Salt Lake City, UT, 84103, USA
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11
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Psychosocial and behavioral correlates of weight loss 12 to 15 years after bariatric surgery. J Behav Med 2021; 45:252-259. [PMID: 34773537 DOI: 10.1007/s10865-021-00263-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
While significant weight loss occurs post-bariatric surgery, partial weight regain is common. Psychological and dispositional variables have been examined as predictors of weight change, but most studies have focused on the relationship of preoperative constructs to shorter-term postoperative outcomes. The goal of the current study was to examine associations between weight loss and postoperative psychosocial and behavioral factors up to an average of 13.7 years after surgery. The current study was conducted at a large bariatric center in a Midwestern U.S. city. The sample was comprised of 125 adult patients who participated in the second wave of a long-term bariatric surgery outcome study, examining weight history, physical activity, and psychological health and functioning. Correlations between percent total weight loss (%TWL) and psychosocial and behavioral variables were examined. The variables that had significant correlations with %TWL were used in stepwise linear regressions to determine their contribution to %TWL. These same variables were tested to determine differences among those in the highest and lowest weight loss quartiles. Life satisfaction, conscientiousness, positive affect, and regular exercise were positively associated with weight loss in the entire sample and were significantly higher among those in the highest versus the lowest weight-loss quartile. Experiencing a stressful event and food addiction symptoms were negatively associated with weight loss. Positive affect, fewer food addiction symptoms, and regular exercise significantly predicted weight loss, accounting for 23% of the variance in %TWL. Long-term weight loss maintenance after bariatric surgery may be related to positive affect, conscientiousness, regular physical activity, and an addictive-type relationship with food. Future studies should explore these relationships and develop approaches to deal with the interaction between dispositional tendencies and lifestyle factors.
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12
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Godoy-Izquierdo D, Lara R, Ogallar A, Rodríguez-Tadeo A, Ramírez MJ, Navarrón E, Arbinaga F. Psychosocial and Diet-Related Lifestyle Clusters in Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6461. [PMID: 34203684 PMCID: PMC8296278 DOI: 10.3390/ijerph18126461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 11/17/2022]
Abstract
This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of 100 adult individuals (60% females) with excessive weight (69% overweight; 31% obesity) was recruited. They completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centered on the individual, a cluster analysis was performed. Three distinct intraindividual psychosocial and diet-related profiles were identified: a group of healthy individuals with excess weight (46%); a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile (18%); and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles, but were troubled by their weight (36%). Furthermore, individuals in the affected cluster had higher obesity (mean BMI ± SD = 32.1 ± 3.7) than those in the clusters of healthy (28.0 ± 3.0) and dysfunctional individuals (28.1 ± 3.3) (p < 0.05). The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese and to individualize the interventions, with a focus from weight change to the individual's overall well-being.
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Affiliation(s)
- Débora Godoy-Izquierdo
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain;
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
| | - Raquel Lara
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
- Departamento de Psicología Social, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain
| | - Adelaida Ogallar
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain;
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
| | - Alejandra Rodríguez-Tadeo
- Departamento Ciencias de la Salud, Instituto de Ciencias Biomédicas, Anillo Envolvente del Pronaf y Estocolmo, Universidad Autónoma Ciudad Juárez, Ciudad Juárez 32300, Chihuahua, Mexico;
| | - María J. Ramírez
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
| | - Estefanía Navarrón
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (CTS-267), Centro de Investigación Mente, Cerebro y Comportamiento, Facultad de Psicología, Campus Universitario de Cartuja, Universidad de Granada, 18071 Granada, Spain; (R.L.); (M.J.R.); (E.N.)
| | - Félix Arbinaga
- Departamento de Psicología Clínica y Experimental, Facultad de Educación, Psicología y Ciencias del Deporte, Campus Universitario El Carmen, Universidad de Huelva, 21071 Huelva, Spain;
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13
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Associations Between Approach and Avoidance Coping, Psychological Distress, and Disordered Eating Among Candidates for Bariatric Surgery. Obes Surg 2020; 29:3596-3604. [PMID: 31278657 DOI: 10.1007/s11695-019-04038-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Individuals seeking bariatric surgery evidence risk for binge and disordered eating behaviors, which can lead to poorer post-surgical weight loss outcomes. Use of avoidant coping strategies to manage stress, along with symptoms of depression, are associated with disordered eating in the general population. However, the role of coping has not been examined among candidates for bariatric surgery, and coping and depression have rarely been considered in combination. Given the emerging standard that psychologists are involved in evaluations and treatment before and after surgery, consideration of these variables is clinically relevant. METHODS Participants were 399 patients undergoing pre-surgical bariatric psychological assessment. Hierarchical linear regression analyses tested whether gender, age, and BMI; approach and avoidance coping; and depression and anxiety were associated with disordered eating (binge eating, restraint, eating concerns, shape concerns, weight concerns) in a cross-sectional study design. RESULTS In initial steps of the model controlling demographic variables, approach coping predicted less and avoidance coping predicted more disordered eating across most outcomes examined. In models including depression and anxiety, avoidance (but not approach) coping remained a relevant predictor. The effects of depression were also quite robust, such that participants who were more depressed reported more disordered eating. More anxious participants reported more restrained eating. CONCLUSIONS Avoidance coping and depressive symptoms emerged as key variables in understanding recent disordered eating among patients considering bariatric surgery. Pre-surgical psychological evaluations and treatment approaches could be enhanced with consideration of patient coping strategies, particularly avoidant coping responses to stress, independent of psychological distress.
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14
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Lavender JM, King WC, Kalarchian MA, Devlin MJ, Hinerman A, Gunstad J, Marcus MD, Mitchell JE. Examining emotion-, personality-, and reward-related dispositional tendencies in relation to eating pathology and weight change over seven years in the Longitudinal Assessment of Bariatric Surgery (LABS) study. J Psychiatr Res 2020; 120:124-130. [PMID: 31670260 PMCID: PMC6901114 DOI: 10.1016/j.jpsychires.2019.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/01/2019] [Accepted: 10/17/2019] [Indexed: 12/28/2022]
Abstract
This study examined dispositional emotion-, personality/temperament-, and reward-related variables in relation to post-surgery eating pathology and weight-change among 107 adults who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB). As part of a prospective cohort study, annual post-surgical assessments were conducted to evaluate eating pathology, using the Eating Disorder Examination-Bariatric Surgery Version, and percent weight change from pre-surgery. Dispositional measures were administered at the 6- or 7-year assessment and included the Affect Intensity Measure, Difficulties in Emotion Regulation Scale, UPPS-P Impulsive Behavior Scale, Adult Temperament Questionnaire-Effortful Control Scale, and Sensitivity to Punishment/Sensitivity to Reward Questionnaire. Results from a series of linear mixed models revealed significant associations of emotion dysregulation, affect intensity, positive and negative urgency, effortful control, and reward sensitivity with eating pathology severity across 7 years; additionally, all but two of the subscales comprising the total scores were also significantly associated. Fewer statistically significant results were found in relation to weight change; emotion dysregulation and affect intensity (along with several subscales) were significantly associated with lower percent weight change (i.e., less weight loss), but of the reward-related and personality/temperament variables, only total effortful control emerged as significant. However, the associations of the other variables with both outcomes were consistently in the expected direction. Associations also appeared consistent across surgical procedures. Taken together, findings suggest that certain dispositional tendencies may relate to less optimal long-term outcomes following bariatric surgery and thus may be useful to assess in pre-surgical or early post-surgical evaluations to inform targeted recommendations.
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Affiliation(s)
- Jason M Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Military Cardiovascular Outcomes Research Program (MiCOR), Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Metis Foundation, San Antonio, TX, USA.
| | - Wendy C King
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | | - Michael J Devlin
- Columbia University Vagelos College of Physicians and Surgeons / New York State Psychiatric Institute, New York, NY, USA
| | - Amanda Hinerman
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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15
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Cloutier-Bergeron A, Provencher V, Mongeau L, Paquette MC, Carbonneau É, Turcotte M, Bégin C. Does Health At Every Size® fit all? A group-based trajectory modeling of a non-diet intervention. Appetite 2019; 143:104403. [DOI: 10.1016/j.appet.2019.104403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 11/26/2022]
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16
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Monteleone AM, Cascino G, Solmi M, Pirozzi R, Tolone S, Terracciano G, Parisi S, Cimino M, Monteleone P, Maj M, Docimo L. A network analysis of psychological, personality and eating characteristics of people seeking bariatric surgery: Identification of key variables and their prognostic value. J Psychosom Res 2019; 120:81-89. [PMID: 30929713 DOI: 10.1016/j.jpsychores.2019.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The interplay among personality traits, anxiety and eating symptoms in candidates for bariatric surgery has never been investigated through the network analysis approach. Thus, we aimed to use this method to identify the key psychological traits that characterize these individuals and to assess their role as predictors of surgical outcomes. METHODS One-hundred-eighty-five candidates for bariatric surgery filled in the State Trait Anxiety Inventory (STAI), the Revised Restraint Scale, the Power of Food Scale and the Temperament and Character Inventory-Revised (TCI-R) questionnaires. All these variables were included in a network analysis. Then, the most central network nodes were entered as independent variables in a regression model that included 9-month follow-up weight outcomes as the dependent variable. RESULTS The network has showed a good stability. TCI-self directedness and harm avoidance scores and STAI state and trait anxiety scores were the nodes with the highest centrality in the network. Weight outcomes were assessed in 64 patients at follow-up. Among central nodes, low TCI-self directedness was found to be the only significant independent predictor of worse weight outcome. CONCLUSIONS Our findings show for the first time the interplay between personality traits and symptoms in candidates for bariatric surgery combining the network approach with a follow-up evaluation. Low self-directedness has been proved to be the node with highest centrality and the only predictor of short-term weight outcome. These data suggest the importance to take into consideration personality and psychological variables either in the pre-surgery assessment or as possible targets for pre or post-surgery psychotherapeutic interventions. ORCID 0000-0002-6786-4458.
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Affiliation(s)
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
| | - Marco Solmi
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Raffaele Pirozzi
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Tolone
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Gianmattia Terracciano
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Simona Parisi
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Monica Cimino
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy.
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ludovico Docimo
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy.
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17
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Claes L, Boekaerts E, Verschueren M, Boukaert W, Luyckx K. Identity statuses in prebariatric patients with obesity: Associations with eating disorder symptoms, psychological complaints, and coping behaviour? EUROPEAN EATING DISORDERS REVIEW 2019; 27:410-420. [PMID: 31020776 DOI: 10.1002/erv.2681] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/12/2019] [Accepted: 03/29/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In the present study, we focused on the associations between identity processes/statuses and eating and general psychopathology and coping in prebariatric patients suffering from morbid obesity. METHOD Our sample consisted of 369 prebariatric patients (68.8% female) who filled out self-report questionnaires to assess identity processes, eating and general psychopathology, and coping. RESULTS Concerning identity processes, ruminative exploration was positively related to eating-related and general psychopathology and maladaptive coping, whereas commitment processes were protective against psychopathology and maladaptive coping. Based on cluster analyses, we identified five identity statuses, being achievement, foreclosure, moratorium, diffusion, and an undifferentiated status, showing some heterogeneity within the prebariatric patient group. Patients in the diffused and moratorium statuses reported more eating and general psychopathology and more maladaptive coping compared with prebariatric patients of the other statuses. CONCLUSIONS Given the clinical vulnerability to psychopathology of patients in the moratorium and diffused statuses, it would be advisable to increase the psychological help in their prebariatric and postbariatric trajectories.
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Affiliation(s)
- Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University Antwerp, Wilrijk, Belgium
| | - Els Boekaerts
- Obesity Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | | | - Wim Boukaert
- Obesity Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,UNIBS, University of the Free State, Bloemfontein, South Africa
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18
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Schäfer L, Hübner C, Carus T, Herbig B, Seyfried F, Kaiser S, Dietrich A, Hilbert A. Pre- and Postbariatric Subtypes and Their Predictive Value for Health-Related Outcomes Measured 3 Years After Surgery. Obes Surg 2018; 29:230-238. [PMID: 30251096 DOI: 10.1007/s11695-018-3524-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although bariatric surgery is the most effective treatment for severe obesity, a subgroup of patients shows insufficient postbariatric outcomes. Differences may at least in part result from heterogeneous patient profiles regarding reactive and regulative temperament, emotion dysregulation, and disinhibited eating. This study aims to subtype patients based on these aspects before and 2 years after bariatric surgery and tests the predictive value of identified subtypes for health-related outcomes 3 years after surgery. METHODS Within a prospective multicenter patient registry, N = 229 bariatric patients were examined before bariatric surgery, 2 and 3 years postoperatively via clinical interviews and self-report questionnaires. Pre- and postbariatric subtypes were differentiated by temperament, emotion dysregulation, and disinhibited eating using latent profile analyses (LPA). The predictive value of pre- and postbariatric subtypes for surgery outcomes measured 3 years postoperatively was tested via linear regression analyses. RESULTS LPA resulted in five prebariatric and three postbariatric subtypes which were significantly associated with different levels of general and eating disorder psychopathology. Post- versus prebariatric subtypes explained more variance regarding eating disorder psychopathology, depression, and quality of life assessed 3 years postoperatively, whereas neither pre- nor postbariatric subtypes predicted postbariatric weight loss. Patients with prebariatric deficits in self- and emotional control had an increased risk for showing these deficits postoperatively. CONCLUSIONS A re-evaluation of patients' psychological status after bariatric surgery is recommended to detect patients with potential risk for adverse psychological surgery outcomes in the long term.
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Affiliation(s)
- Lisa Schäfer
- Integrated Research and Treatment Center Adiposity Diseases, Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.
| | - Claudia Hübner
- Integrated Research and Treatment Center Adiposity Diseases, Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| | - Thomas Carus
- Department of General Surgery, Asklepios Clinic, Hamburg, Germany
| | - Beate Herbig
- Schön Klinik Hamburg Eilbek Bariatric Clinic, Hamburg, Germany
| | - Florian Seyfried
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany
| | - Stefan Kaiser
- Department of Visceral, Pediatric and Vascular Surgery, Hospital Konstanz, Constance, Germany
| | - Arne Dietrich
- Department of Surgery, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
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19
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Minkwitz J, Scheipl F, Cartwright L, Campbell IC, Chittka T, Thormann J, Hegerl U, Sander C, Himmerich H. Why some obese people become depressed whilst others do not: exploring links between cognitive reactivity, depression and obesity. PSYCHOL HEALTH MED 2018; 24:362-373. [PMID: 30252503 DOI: 10.1080/13548506.2018.1524153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Obesity and depression are two major public health concerns, particularly when they co-occur. To date, mechanisms underlying this association have not been established and it is unclear why some obese people become depressed whilst others do not. However, considering the strong association between depression and cognitive reactivity (CR), the present study explores possible associations between obesity, depression and CR in light of the scarce and conflicting nature of past literature. 254 participants were included for measures of depression, CR and obesity. Multivariate analyses of covariance examined the effects of depression and obesity as well as interaction effects of depression x obesity controlling for age and gender. Directions of effects were analysed by means of regression analyses and group contrasts. Linear analyses revealed (1) a significant effect of obesity on the rumination (RUM) and control/perfectionism subscales of CR, (2) a significant effect of depression on CR and all of its subscales, and (3) a significant interaction effect between obesity x depression on RUM. Results may support the 'Jolly Fat Hypothesis' and the existence of a psychologically protected subgroup of obese patients characterised by a lower ruminative thinking style and fewer depressive symptoms. Thus, incorporating anti-rumination therapy into treatment for obese individuals may be beneficial to prevent the development of comorbid depression.
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Affiliation(s)
- Juliane Minkwitz
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany.,b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany
| | - Fabian Scheipl
- c Institute for Statistics , Ludwig-Maximilians-Universität München , München , Germany
| | - Lydia Cartwright
- d Department of Psychological Medicine , IoPPN, King´s College London , London , UK
| | - Iain C Campbell
- d Department of Psychological Medicine , IoPPN, King´s College London , London , UK
| | - Tobias Chittka
- b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany
| | - Julia Thormann
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany.,b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany
| | - Ulrich Hegerl
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany.,b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany
| | - Christian Sander
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany
| | - Hubertus Himmerich
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany.,b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany.,d Department of Psychological Medicine , IoPPN, King´s College London , London , UK
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Abstract
PURPOSE OF THE REVIEW To update the recent findings on the influence of personality features on postoperative weight loss in patients undergoing bariatric surgery. RECENT FINDINGS Several studies investigated the influence of pre-surgical psychological variables on the outcome of bariatric surgery, but the effective role of personality factors (i.e., both normal personality traits and personality disturbances) in shaping bariatric surgery outcome is still unclear. We analyzed nine recent papers that examined the impact of pre-operative personality traits on postoperative weight loss among individuals undergoing surgery for severe obesity. A personality pattern denoting the ability to self-regulate in spite of the urges or demands of the moment emerged as a robust predictor of good outcome across studies, independently from baseline psychiatric comorbidity and personality disorders.
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Affiliation(s)
- Irene Generali
- School of Psychiatry, Department of Medicine and Surgery, University of Parma, via Gramsci 14, 43126, Parma, Italy.
| | - Chiara De Panfilis
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
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21
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Van der Oord S, Braet C, Cortese S, Claes L. Testing the dual pathway model of ADHD in obesity: a pilot study. Eat Weight Disord 2018; 23:507-512. [PMID: 28271452 DOI: 10.1007/s40519-017-0375-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/21/2017] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION There may be shared neuropsychological dysfunctions in ADHD and obesity. This study tested a neuropsychological model of ADHD (reward/executive dysfunctioning) in individuals with obesity. Furthermore, the association between co-morbid binge eating and reward/executive dysfunction was explored. METHODS Reward/executive dysfunctioning was assessed using both neuropsychological measures and questionnaires in individuals (aged 17-68) with obesity (N = 39; mean BMI = 39.70) and normal weight (N = 25; mean BMI = 22.94). RESULTS No significant differences emerged between individuals with and without obesity on the outcome measures. However, individuals with obesity and binge eating showed significantly more self-reported delay discounting and inattention than those individuals with obesity but without binge eating. When controlling for inattention, this difference in delay discounting was no longer significant. DISCUSSION Not obesity alone but obesity with binge eating was specifically associated with a mechanism often reported in ADHD, namely delay discounting. However, this effect may be more driven by inattention.
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Affiliation(s)
- Saskia Van der Oord
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Louvain, Belgium. .,Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands. .,Clinical Psychology, Department of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102 bus 3720, room 03.78, 3000, Louvain, Belgium.
| | - Caroline Braet
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Samuele Cortese
- Academic Unit of Psychology, Developmental Brain-Behavior Laboratory, University of Southampton, Southampton, UK.,New York University Child Study Center, New York, USA.,Solent NHS Trust, Southampton, UK
| | - Laurence Claes
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Louvain, Belgium.,Faculty of Medical Sciences and Mental Health (CAPRI), UAntwerp, Antwerp, Belgium
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22
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Abusnana S, Fargaly M, Alfardan SH, Al Hammadi FH, Bashier A, Kaddaha G, McGowan B, Nawar R, Sadiya A. Clinical Practice Recommendations for the Management of Obesity in the United Arab Emirates. Obes Facts 2018; 11:413-428. [PMID: 30372696 PMCID: PMC6257093 DOI: 10.1159/000491796] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/03/2018] [Indexed: 12/17/2022] Open
Abstract
With rapid urbanisation and improved living conditions as a result of rising incomes in Gulf Cooperation Council (GCC) countries, obesity has become a major and growing health problem for the region. The United Arab Emirates (UAE) has a resident population of 9.3 million (in 2016), many of whom (85.5%) lived in urban areas and led sedentary lifestyles. Based on the World Health Organisation (WHO) estimates for 2010, 25% of Emirati men and 40% of the women were obese. Obesity rates in this country has doubled from 16 to 34% compared to the year 2000, and severe obesity (BMI > 40 kg/m2) has risen dramatically from 2 to 11%. While a number of international guidelines for the management of obesity are already available in public domain, local guidelines for the UAE and the region, which are structured and individualized for the management of obesity, are sorely needed to help the family physician to provide affordable treatment for the patient at the point-of-care and to reduce the burden on the local healthcare system. A multi-disciplinary panel of international and regional experts who treat patients with overweight and obesity was convened with the aim of developing consensus recommendations for the UAE. The objective is to have a simple and easy-to-refer set of recommendations for busy clinicians as there were already many comprehensive international guidelines available. The panel reviewed and streamlined these recommendations in its entirety for relevance, coherence and usability in the local context. These recommendations for overweight and obesity management were circulated and endorsed by the local practising family medicine community, namely, the Emirates Medical Association and Family Medicine Society. We believe these recommendations would also be of interest to clinicians in other GCC countries. A summary and algorithm of these recommendations are provided.
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Affiliation(s)
- Salahedeen Abusnana
- University of Sharjah, Sharjah, United Arab Emirates
- *Prof. Dr. Salahedeen Abusnana, HoD Diabetes and Endocrine, University of Sharjah, 72772 Sharjah, United Arab Emirates,
| | | | - Shaima Hasan Alfardan
- Behavior Sciences Pavilion, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | | | - Alaaeldin Bashier
- Department of Diabetes and Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
| | - Ghaida Kaddaha
- Dr Sulaiman Al-Habib Medical Center, Dubai, United Arab Emirates
| | - Barbara McGowan
- Department of Diabetes and Endocrinology, Guy's & St Thomas's Hospital, London, UK
| | - Rita Nawar
- The Weight Care Clinic, Dubai HealthCare City, Dubai, United Arab Emirates
| | - Amena Sadiya
- Lifestyle Clinic, Sheikh Khalifa Medical City, Ajman, United Arab Emirates
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Schäfer L, Hübner C, Carus T, Herbig B, Seyfried F, Kaiser S, Schütz T, Dietrich A, Hilbert A. Identifying prebariatric subtypes based on temperament traits, emotion dysregulation, and disinhibited eating: A latent profile analysis. Int J Eat Disord 2017; 50:1172-1182. [PMID: 28815744 DOI: 10.1002/eat.22760] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in prebariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of this study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor postbariatric weight loss outcome. METHOD Within a prospective multicenter registry, N = 370 prebariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors. RESULTS Five prebariatric subtypes were identified with specific profiles regarding self-control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models. CONCLUSION By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific prebariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for postbariatric weight loss and health-related outcomes.
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Affiliation(s)
- Lisa Schäfer
- Medical Psychology and Medical Sociology, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
| | - Claudia Hübner
- Medical Psychology and Medical Sociology, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
| | - Thomas Carus
- Department of General Surgery, Asklepios Clinic, Suurheid 20, Hamburg, 22559, Germany
| | - Beate Herbig
- Schön Klinik Hamburg Eilbek Bariatric Clinic, Dehnhaide 120, Hamburg, 22081, Germany
| | - Florian Seyfried
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Oberdürrbacher Strasse 6, Würzburg, 97080, Germany
| | - Stefan Kaiser
- Department of Visceral, Pediatric and Vascular Surgery, Hospital Konstanz, Luisenstrasse 7, Konstanz, 78464, Germany
| | - Tatjana Schütz
- Core Unit Nutrition and Clinical Phenotyping, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
| | - Arne Dietrich
- Medical Psychology and Medical Sociology, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
| | - Anja Hilbert
- Medical Psychology and Medical Sociology, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
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24
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Peterhänsel C, Linde K, Wagner B, Dietrich A, Kersting A. Subtypes of Personality and ‘Locus of Control’ in Bariatric Patients and their Effect on Weight Loss, Eating Disorder and Depressive Symptoms, and Quality of Life. EUROPEAN EATING DISORDERS REVIEW 2017; 25:397-405. [DOI: 10.1002/erv.2534] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/31/2017] [Accepted: 06/12/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Carolin Peterhänsel
- Department of Psychosomatic Medicine and Psychotherapy; University Hospital Leipzig; Leipzig Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases; Leipzig University Medical Center; Leipzig Germany
| | - Katja Linde
- Department of Psychosomatic Medicine and Psychotherapy; University Hospital Leipzig; Leipzig Germany
| | | | - Arne Dietrich
- Integrated Research and Treatment Center (IFB) Adiposity Diseases; Leipzig University Medical Center; Leipzig Germany
- Department of Surgery, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery; University Hospital Leipzig; Leipzig Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy; University Hospital Leipzig; Leipzig Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases; Leipzig University Medical Center; Leipzig Germany
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25
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Gruner-Labitzke K, Claes L, Bartsch M, Schulze M, Langenberg S, Köhler H, Marschollek M, de Zwaan M, Müller A. Physical Activity in Bariatric Surgery Patients: Does Temperament Matter? EUROPEAN EATING DISORDERS REVIEW 2017; 25:275-282. [DOI: 10.1002/erv.2520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 12/21/2016] [Accepted: 03/21/2017] [Indexed: 12/12/2022]
Affiliation(s)
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences; University of Leuven; Leuven Belgium
- Faculty of Medicine and Health Sciences; University Antwerp; Antwerp Belgium
| | - Merle Bartsch
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hanover Germany
| | - Mareike Schulze
- Peter L. Reichertz Institute for Medical Informatics; University of Braunschweig - Institute of Technology and Hannover Medical School; Hanover Germany
| | - Svenja Langenberg
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hanover Germany
| | - Hinrich Köhler
- Department of Surgery; Herzogin Elisabeth Hospital; Braunschweig Germany
| | - Michael Marschollek
- Peter L. Reichertz Institute for Medical Informatics; University of Braunschweig - Institute of Technology and Hannover Medical School; Hanover Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hanover Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hanover Germany
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26
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Innamorati M, Imperatori C, Harnic D, Erbuto D, Patitucci E, Janiri L, Lamis DA, Pompili M, Tamburello S, Fabbricatore M. Emotion Regulation and Mentalization in People at Risk for Food Addiction. Behav Med 2017; 43:21-30. [PMID: 25909436 DOI: 10.1080/08964289.2015.1036831] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Researchers investigated the association among food addiction, difficulties in emotion regulation, and mentalization deficits in a sample of 322 Italian adults from the general population. All participants were administered the Italian versions of the Yale Food Addiction Scale (I-YFAS), the Difficulties in Emotion Regulation Scale, the Mentalization Questionnaire, the Binge Eating Scale, and the Michigan Alcohol Screening Test. Of respondents, 7.1% reported high food-addiction symptoms (ie, 3 or more symptoms of food addiction on the I-YFAS). In bivariate analyses, high food-addiction symptoms were associated with more difficulties in emotion regulation and mentalization deficits. In the multivariate analysis, high food-addiction symptoms remained independently associated with mentalization deficits, but not with difficulties in emotion regulation. Our data suggest that mentalization may play an important role in food addiction by making it difficult for an individual to understand his or her own inner mental states as well as the mental states of others, especially when powerful emotions arise.
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Affiliation(s)
| | | | - Désirée Harnic
- b Psychiatric Day Hospital, Catholic University of Sacred Heart, Policlinico Gemelli
| | - Denise Erbuto
- c Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome
| | | | - Luigi Janiri
- b Psychiatric Day Hospital, Catholic University of Sacred Heart, Policlinico Gemelli
| | | | - Maurizio Pompili
- c Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome
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27
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Paans NPG, Bot M, Gibson-Smith D, Van der Does W, Spinhoven P, Brouwer I, Visser M, Penninx BWJH. The association between personality traits, cognitive reactivity and body mass index is dependent on depressive and/or anxiety status. J Psychosom Res 2016; 89:26-31. [PMID: 27663107 DOI: 10.1016/j.jpsychores.2016.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 07/15/2016] [Accepted: 07/21/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE A range of biological, social and psychological factors, including depression and anxiety disorders, is thought to be associated with higher body mass index (BMI). Depression and anxiety disorders are associated with specific psychological vulnerabilities, like personality traits and cognitive reactivity, that may also be associated with BMI. The relationship between those psychological vulnerabilities and BMI is possibly different in people with and without depression and anxiety disorders. Therefore, we examined the relationship between personality traits, cognitive reactivity and severity of affective symptoms with BMI in people with and without depression and anxiety disorders. METHODS Data from 1249 patients with current major depressive and/or anxiety disorder and 631 healthy controls were sourced from the Netherlands Study of Depression and Anxiety. Linear and logistic regression analyses were used to determine the associations between personality traits (neuroticism, extraversion, conscientiousness), cognitive reactivity (hopelessness, aggression, rumination, anxiety sensitivity), depression and anxiety symptoms with BMI classes (normal: 18.5-24.9, overweight: 25-29.9, and obese: ≥30kg/m(2)) and continuous BMI. Due to significant statistical interaction, analyses were stratified for healthy individuals and depressed/anxious patients. RESULTS Personality traits were not consistently related to BMI. In patients, higher hopelessness and aggression reactivity and higher depression and anxiety symptoms were associated with higher BMI. In contrast, in healthy individuals lower scores on hopelessness, rumination, aggression reactivity and anxiety sensitivity were associated with higher BMI. CONCLUSION These results suggest that, particularly in people with psychopathology, cognitive reactivity may contribute to obesity.
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Affiliation(s)
- Nadine P G Paans
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - Mariska Bot
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Deborah Gibson-Smith
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Willem Van der Does
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Ingeborg Brouwer
- Department of Health Sciences, Faculty of Earth and Life Sciences, and the EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands; Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Earth and Life Sciences, and the EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands; Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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28
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Annesi JJ, Mareno N, McEwen KL. Mediation of self-regulation and mood in the relationship of changes in high emotional eating and nutritional behaviors: Moderating effects of physical activity. Scand J Psychol 2016; 57:523-534. [DOI: 10.1111/sjop.12327] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 07/19/2016] [Indexed: 12/19/2022]
Affiliation(s)
- James J. Annesi
- YMCA of Metro Atlanta; Atlanta Georgia USA
- Kennesaw State University; Kennesaw Georgia USA
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29
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Zientek F, Winter K, Müller A, Rullmann M, Luthardt J, Becker GA, Bresch A, Patt M, Sabri O, Hilbert A, Hesse S. Effortful control as a dimension of temperament is negatively associated with prefrontal serotonin transporter availability in obese and non-obese individuals. Eur J Neurosci 2016; 44:2460-2466. [PMID: 27519298 DOI: 10.1111/ejn.13362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/26/2016] [Accepted: 08/02/2016] [Indexed: 11/25/2022]
Abstract
There is evidence that temperamental factors are associated with obesity; however, the biological mechanism of such association remains elusive. We aimed to investigate a possible association between serotonin transmission and regulative temperament in obese and non-obese individuals by using positron emission tomography (PET) imaging of serotonin transporters (SERT) and the Adult Temperament Questionnaire. Twenty-nine obese individuals with body mass index (BMI) ≥ 35 kg/m2 and 13 non-obese controls (BMI < 30 kg/m2 ) underwent PET with [11 C]-labeled DASB (highly selective for SERT) and self-completed the Effortful Control (EC) scale of the Adult Temperament Questionnaire-Short Form (ATQ). With the help of this questionnaire, we aimed to assess the capacity of self-regulation. Overall, for obese and non-obese individuals together, VOI-based (volume of interest) analysis showed significant negative correlations between SERT BPND and ATQ-EC AC (Activation Control) subscale in several brain regions (all r ≤ -0.47). Obese and non-obese individuals separated showed equally strong positive, but non-significant correlations. The analysis did not reveal any significant correlations of SERT availability and ATQ-EC IC (Inhibitory Control) or ATQ-EC AtC (Attentional Control) subscale within and between the two groups. The results indicate that regulative temperament - particularly the capacity to mitigate negatively toned impulses and to resist inappropriate avoidance behavior - might be associated with the prefrontal serotonergic system.
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Affiliation(s)
- Franziska Zientek
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany. .,Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany.
| | - Karsten Winter
- Translational Centre for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Michael Rullmann
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany
| | - Julia Luthardt
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Georg-Alexander Becker
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Anke Bresch
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Osama Sabri
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany.,Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Anja Hilbert
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
| | - Swen Hesse
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany.,Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
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30
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Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. Surg Obes Relat Dis 2016; 12:731-749. [DOI: 10.1016/j.soard.2016.02.008] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 12/20/2022]
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31
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Agüera Z, García-Ruiz-de-Gordejuela A, Vilarrasa N, Sanchez I, Baño M, Camacho L, Granero R, Jiménez-Murcia S, Virgili N, Lopez-Urdiales R, de Bernabe MMG, Garrido P, Monasterio C, Steward T, Pujol-Gebelli J, Fernández-Aranda F, Menchón JM. Psychological and Personality Predictors of Weight Loss and Comorbid Metabolic Changes After Bariatric Surgery. EUROPEAN EATING DISORDERS REVIEW 2015; 23:509-16. [PMID: 26377595 DOI: 10.1002/erv.2404] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 08/11/2015] [Accepted: 08/18/2015] [Indexed: 12/19/2022]
Abstract
Bariatric surgery (BS) has proven to be the most effective treatment for weight loss and for improving comorbidities in severe obesity. A comprehensive psychological assessment prior to surgery is proposed to prepare patients for a successful post-surgical outcome. Therefore, the main aim of the present study was to assess psychological and personality predictors of BS outcome. The sample comprised 139 severely obese patients who underwent BS. Assessment measures included the Eating Disorders Inventory-2, the Symptom Checklist-Revised and the Temperament and Character Inventory-Revised. Our results show that favourable BS outcome, after 2 years follow up, was associated with younger age, less depression, moderate anxiety symptoms and high cooperativeness levels. Likewise, metabolic improvements were found to be linked to younger age and certain psychopathological factors. In conclusion, our findings suggest that age, baseline body mass index, psychopathological indexes and personality traits predict successful BS outcome.
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Affiliation(s)
- Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Amador García-Ruiz-de-Gordejuela
- Bariatric and Metabolic Surgery Unit, Service of General and Gastrointestinal Surgery, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Nuria Vilarrasa
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Sanchez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Marta Baño
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Lucía Camacho
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Nuria Virgili
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Rafael Lopez-Urdiales
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | | | - Pilar Garrido
- Dietetics and Nutrition Unit, University Hospital of Bellvitge, Barcelona, Spain
| | - Carmen Monasterio
- Department of Pneumology, University Hospital of Bellvitge, Barcelona, Spain
| | - Trevor Steward
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Jordi Pujol-Gebelli
- Bariatric and Metabolic Surgery Unit, Service of General and Gastrointestinal Surgery, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Jose M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain.,CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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32
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Claes L, Müller A. Temperament and Personality in Bariatric Surgery-Resisting Temptations? EUROPEAN EATING DISORDERS REVIEW 2015; 23:435-41. [DOI: 10.1002/erv.2398] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/30/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Laurence Claes
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
- Faculty of Medicine and Health Sciences (CAPRI); University Antwerp; Antwerp Belgium
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
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33
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Opolski M, Chur-Hansen A, Wittert G. The eating-related behaviours, disorders and expectations of candidates for bariatric surgery. Clin Obes 2015; 5:165-97. [PMID: 26173752 DOI: 10.1111/cob.12104] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 05/13/2015] [Accepted: 05/21/2015] [Indexed: 12/17/2022]
Abstract
It is important that clinicians and researchers understand the possible eating-related difficulties experienced by pre-bariatric surgery candidates, as well as their expectations of how their eating and hunger will change after surgery. This review examines English-language publications related to the eating-related behaviours, disorders and expectations of bariatric candidates. Seventy-five articles related to binge eating disorder, grazing, night eating syndrome, emotional eating, food cravings and addiction, and pre-surgical expectations of post-surgical eating in this population were critically reviewed. A variety of often problematic eating behaviours appear more common in bariatric candidates than in non-obese populations. The literature suggests that 4-45% of candidates may have binge eating disorder, 20-60% may graze, 2-42% may have night eating syndrome, 38-59% may engage in emotional eating and 17-54% may fit criteria for food addiction. Binge eating may also be more prevalent in bariatric candidates than in similarly obese non-surgical individuals. Expectations of surgery are high, with pre-surgical candidates believing their bariatric procedure will virtually guarantee significantly improved eating behaviours. Study replications are needed, and further investigation into prevalence, impacts and candidate characteristics related to disordered eating behaviours, as well as candidates' expectations of eating after surgery, will be important. Further comparisons of bariatric candidates to similarly obese non-bariatric populations will be important to understand eating-related characteristics of candidates beyond those related to their weight. Future research may be improved by the use of validated measures, replicable methodologies, minimization of data collected in circumstances where respondents may been motivated to 'fake good', use of prospective data and consistent definitions of key terminology.
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Affiliation(s)
- M Opolski
- School of Psychology, University of Adelaide, Adelaide, Australia
- Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - A Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - G Wittert
- Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
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34
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Temperamental factors in severe weight cycling. A cross-sectional study. Appetite 2015; 91:336-42. [PMID: 25931432 DOI: 10.1016/j.appet.2015.04.064] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 04/10/2015] [Accepted: 04/22/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Weight cycling is a prevalent phenomenon in obese individuals. There is evidence that temperamental factors are associated with obesity and subgroups among the obese have been identified based on reactive and regulative aspects of temperament. METHODS We aimed at investigating the association between reactive and regulative aspects of temperament and severe weight cycling in overweight and obese individuals of a representative German population sample (n = 923). Participants completed questionnaires assessing weight parameters including BMI and weight cycling, sensitivity to punishment and to reward (BIS/BAS scales), self-regulatory abilities (effortful control scale), depressive symptoms, and binge eating. RESULTS Severe weight cycling was more common in women, and was associated with higher reward sensitivity, higher current and maximum-ever BMI, higher weight suppression, more depressive symptoms, and a higher prevalence of binge eating. In contrast, sensitivity to punishment and effortful control were not associated with severe weight cycling. Also, the interaction between sensitivity to reward and effortful control did not predict weight cycling. DISCUSSION Higher reward sensitivity might not only render individuals vulnerable for weight regain but might also be associated with a higher frequency of weight loss attempts due to the putative rewarding properties of the initial success in weight loss at the early stages of a diet. Temperamental factors should be considered in the treatment of obesity.
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Figura A, Ahnis A, Stengel A, Hofmann T, Elbelt U, Ordemann J, Rose M. Determinants of Weight Loss following Laparoscopic Sleeve Gastrectomy: The Role of Psychological Burden, Coping Style, and Motivation to Undergo Surgery. J Obes 2015; 2015:626010. [PMID: 26649192 PMCID: PMC4662976 DOI: 10.1155/2015/626010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 10/25/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The amount of excess weight loss (%EWL) among obese patients after bariatric surgery varies greatly. However, reliable predictors have not been established yet. The present study evaluated the preoperative psychological burden, coping style, and motivation to lose weight as factors determining postoperative treatment success. METHODS The sample included 64 morbidly obese patients with a preoperative BMI of 51 ± 8 kg/m(2) who had undergone laparoscopic sleeve gastrectomy (LSG). Well-established questionnaires were applied before surgery to assess the psychological burden in terms of "perceived stress" (PSQ-20), "depression" (PHQ-9), "anxiety" (GAD-7), and "mental impairment" (ISR) as well as coping style (Brief COPE) and motivation to lose weight. %EWL as an indicator for treatment success was assessed on average 20 months after surgery. RESULTS Based on the %EWL distribution, patients were classified into three %EWL groups: low (14-39%), moderate (40-59%), and high (60-115%). LSG patients with high %EWL reported significantly more "active coping" behavior prior to surgery than patients with moderate and low %EWL. Patients' preoperative psychological burden and motivation to lose weight were not associated with %EWL. CONCLUSION An "active coping" style might be of predictive value for better weight loss outcomes in patients following LSG intervention.
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Affiliation(s)
- Andrea Figura
- Charité Center for Internal Medicine and Dermatology, Division for General Internal and Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- *Andrea Figura:
| | - Anne Ahnis
- Charité Center for Internal Medicine and Dermatology, Division for General Internal and Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Andreas Stengel
- Charité Center for Internal Medicine and Dermatology, Division for General Internal and Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Tobias Hofmann
- Charité Center for Internal Medicine and Dermatology, Division for General Internal and Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulf Elbelt
- Charité Center for Internal Medicine and Dermatology, Division for General Internal and Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Charité Center for Internal Medicine with Gastroenterology and Nephrology, Division for Endocrinology, Diabetes and Nutrition, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jürgen Ordemann
- Charité Center for Obesity and Metabolic Surgery, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Matthias Rose
- Charité Center for Internal Medicine and Dermatology, Division for General Internal and Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Abstract
PURPOSE OF REVIEW Bariatric surgery has been consistently shown to be effective in long-term marked weight loss and in bringing significant improvement to medical comorbidities such as metabolic syndrome. Empirical data suggest a high prevalence of psychiatric disorders among bariatric surgery candidates. In this review, we focus on the studies published recently with a high impact on our understanding of the role of psychiatry in bariatric surgery. RECENT FINDINGS This article reviews the specific psychopathologies before surgery, changes in psychopathologies after surgery, suicide risk related to bariatric surgery, factors associated with weight loss, and recommendations for presurgical and postsurgical assessment and management. Research indicates a decrease in certain psychiatric symptoms after weight loss with bariatric surgery. However, the risk of suicide and unsuccessful weight loss in some bariatric surgery patients make monitoring following surgery as important as careful assessment and management before surgery. Specific considerations for youth and older populations and future potential research foci are discussed. SUMMARY Recent publications suggest new directions for psychiatric evaluation and interventions for bariatric surgery patients. Future research on outcomes of specific populations, effectiveness of psychopharmacotherapy, and underlying pathophysiology are warranted for the advancement of treating bariatric surgery patients.
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Müller A, Claes L, Wilderjans TF, de Zwaan M. Temperament Subtypes in Treatment Seeking Obese Individuals: A Latent Profile Analysis. EUROPEAN EATING DISORDERS REVIEW 2014; 22:260-6. [DOI: 10.1002/erv.2294] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 04/19/2014] [Accepted: 04/21/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
| | - Tom F. Wilderjans
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
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Gade H, Rosenvinge JH, Hjelmesæth J, Friborg O. Psychological correlates to dysfunctional eating patterns among morbidly obese patients accepted for bariatric surgery. Obes Facts 2014; 7:111-9. [PMID: 24685661 PMCID: PMC5644889 DOI: 10.1159/000362257] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/08/2013] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To examine the relationships between dysfunctional eating patterns, personality, anxiety and depression in morbidly obese patients accepted for bariatric surgery. DESIGN The study used cross-sectional data collected by running a randomized controlled trial (http://clinicaltrials.gov/ct2/show/NCT01403558). SUBJECTS A total of 102 patients (69 women, 33 men) with a mean (SD) age of 42.6 (9.8) years and a mean BMI of 43.5 (4.4) kg/m(2) participated. MEASUREMENTS Measurements included the NEO-PI-R (personality: neuroticism, extroversion, openness, conscientiousness and agreeableness), the TFEQ-R-21 (dysfunctional eating: emotional eating (EE), uncontrolled eating (UE) and cognitive restraint of eating (CR)) and the HADS (anxiety and depression). RESULTS The personality traits neuroticism and conscientiousness were more strongly correlated with dysfunctional eating than anxiety and depression. These differences were most pronounced for emotional and cognitive restraint of eating. Emotional eating occurred more often in female than in male patients, a finding that was partially mediated by neuroticism but not by anxiety and depression. CONCLUSION Personality traits may be important to address in the clinical management of morbidly obese patients seeking bariatric surgery as neuroticism is particularly salient in female patients displaying an emotional eating behaviour.
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Affiliation(s)
- Hege Gade
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Psychology, University of Tromsø, Tromsø, Norway
- *Hege Gade, Morbid Obesity Centre, Vestfold Hospital Trust, P.B. 2168, 3103 Tønsberg (Norway),
| | | | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Oddgeir Friborg
- Department of Psychology, University of Tromsø, Tromsø, Norway
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