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Salameh-Dakwar R, Elran-Barak R, Zahra-Zeitoun Y, Soroka G, Froylich D, Assalia A, Latzer Y. Interpersonal Characteristics and Binge Eating among Patients Pursuing Bariatric Surgery. Healthcare (Basel) 2023; 11:2836. [PMID: 37957980 PMCID: PMC10647538 DOI: 10.3390/healthcare11212836] [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: 09/20/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Preoperative binge eating behavior has been associated with difficulties in weight loss maintenance among patients pursuing bariatric surgery. However, limited data exists on the relationship between interpersonal difficulties and binge eating. OBJECTIVES To identify interpersonal factors linked with binge eating among bariatric surgery candidates. SETTING One hundred and seventeen adult bariatric surgery candidates (BMI = 42.2 ± 5.2) from three different hospitals completed questionnaires on the day of their bariatric committee meeting for operation approval. METHODS Binge eating was assessed using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) as a dichotomous variable. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES), and interpersonal characteristics were evaluated using the short version of the Inventory of Interpersonal Problems (IIP-32). Sociodemographic variables (age, gender, income, education) and BMI were considered as confounders. RESULTS Approximately 25% of bariatric surgery candidates reported experiencing binge eating episodes within the previous three months. Participants with binge eating exhibited significantly lower self-esteem and more interpersonal difficulties, particularly in the domains of aggressiveness and dependence, compared to those without binge eating. Logistic regression analysis revealed that aggressiveness was a significant predictor of binge eating in this sample. CONCLUSIONS This study is the first, to the best of our knowledge, to investigate the relationship between interpersonal difficulties and binge eating among bariatric surgery candidates. The findings highlight the significant contribution of aggressiveness to binge eating and emphasize the importance of clinicians assessing patients' interpersonal functioning, particularly with regard to aggressiveness, as a factor that may contribute to the maintenance and occurrence of binge eating behaviors.
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Affiliation(s)
| | - Roni Elran-Barak
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | | | | | | | | | - Yael Latzer
- School of Public Health, University of Haifa, Haifa 3498838, Israel
- Rambam Medical Center, Haifa 3109601, Israel
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Monteleone AM, Cascino G, Salerno L, Albano G, Barone E, Cardi V, Lo Coco G. The interplay between emotion regulation, interpersonal problems and eating symptoms in individuals with obesity: A network analysis study. J Affect Disord 2023; 324:61-67. [PMID: 36565965 DOI: 10.1016/j.jad.2022.12.056] [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: 06/09/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION A complex and bidirectional relationship between eating and psychological symptoms in individuals with obesity has been proposed. This study aims to identify the specific processes playing a role in this association, using a data-driven approach. METHODS Two hundred ninety-four adults with obesity, including 106 (36 %) with binge-eating disorder, were consecutively admitted to a specialized public center. They completed self-report questionnaires to assess emotion regulation, interpersonal problems, self-esteem, binge-eating symptoms, and expectancies regarding eating behaviors. To assess the interplay among eating and psychological variables, a network analysis was used. The bridge function analysis was also performed to identify the bridge nodes among three communities (eating symptoms, interpersonal and emotional problems). RESULTS The network was stable. Limited access to emotion regulation strategies, eating helps manage negative affect, and non-assertiveness were the nodes with the highest strength centrality. Lack of emotional clarity, non-assertiveness, socially inhibition, and binge-eating were the nodes with the highest bridge strength. LIMITATIONS The main limitation of the study is the cross-sectional nature of the findings which prevents to infer causality regarding the association between symptoms in the network. DISCUSSION An interplay between eating symptoms and affective and interpersonal factors characterizes individuals with obesity. Across the variety of psychological problems associated with obesity, the present study suggests specific psychological variables and their connections that could be addressed to improve treatment outcome.
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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
| | - Laura Salerno
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Gaia Albano
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Eugenia Barone
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of General Psychology, University of Padova, Padova, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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Monteleone AM, Globus I, Cascino G, Klomek AB, Latzer Y. Psychopathology predicts mental but not physical bariatric surgery outcome at 3-year follow-up: a network analysis study. Eat Weight Disord 2022; 27:3331-3340. [PMID: 36029369 PMCID: PMC9803758 DOI: 10.1007/s40519-022-01463-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/29/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE This study aimed to explore the psychopathological variables that may predict bariatric surgery outcomes after 3 years. METHODS One hundred ninety-six candidates for bariatric surgery completed self-report questionnaires to assess eating attitudes, eating disorder (ED)-related psychopathology, affective symptoms, interpersonal and psycho-social functioning. One-hundred patients repeated this assessment 3 years after bariatric surgery. A network analysis was run including the pre-surgical measurements in the network. A composite score derived from the combination of the most central network nodes, as well as clinical and socio-demographical variables, was included in a multivariate regression analysis with weight loss, ED psychopathology and psycho-social functioning as outcomes. RESULTS Depression, stress, and shape concerns were the most central network nodes. The composite network score predicted higher ED psychopathology and worse psycho-social functioning at 3-year follow-up, but not weight loss. Higher age, restricting type of bariatric surgery and higher pre-operative BMI were further predictors of reduced weight loss and greater ED psychopathology. CONCLUSIONS Affective symptoms and shape concern play a central role in the psychopathology of candidates to bariatric surgery and predict post-surgery ED psychopathology and psycho-social functioning. These variables may allow to identify patients with higher pre-operative risk and in need of further psycho-social interventions. LEVEL OF EVIDENCE III, evidence obtained from well-designed cohort study.
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Affiliation(s)
| | - Inbal Globus
- School of Public Health, University of Haifa, Haifa, Israel
- Maccabi Healthcare Services, Tel-Aviv, Israel
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
| | | | - Yael Latzer
- Eating Disorders Institution, Psychiatric Division, Rambam Medical Center, Haifa, Israel
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Hossain MJ, Ahmmed F, Khan MR, Rashid PT, Hossain S, Rafi MO, Islam MR, Mitra S, Emran TB, Islam F, Alam M, Sarker MMR, Naina Mohamed I. Impact of Prolonged COVID-19 Lockdown on Body Mass Index, Eating Habits, and Physical Activity of University Students in Bangladesh: A Web-Based Cross-Sectional Study. Front Nutr 2022; 9:873105. [PMID: 35669065 PMCID: PMC9165530 DOI: 10.3389/fnut.2022.873105] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/11/2022] [Indexed: 12/20/2022] Open
Abstract
Objectives This current study aims to assess the prevalence and factors associated with body mass index (BMI), dietary patterns, and the extent of physical activities among university students following the prolonged coronavirus disease 2019 (COVID-19) lockdown in Bangladesh. Methods A cross-sectional web-based survey was conducted between July 10 to August 10, 2021, through a pre-designed Google Form to collect the data from Bangladeshi university students (age: ≥18 years). Informed consent was electronically obtained from each participant, and a simple snowball technique was employed during the sampling. Frequency and percentage distribution, paired t-test, chi-square [χ2] test, and multinomial and binary logistic regression analyses were consecutively applied to analyze the collected data. Results Among the total participants (n = 1,602), 45.1% were female and 55.6% were 22–25 years' age group students. The BMI (mean ± standard deviation, SD) during the COVID-19 lockdown was 23.52 ± 7.68 kg/m2, which was 22.77 ± 4.11 kg/m2 during the pre-lockdown period (mean difference = 0.753; p < 0.001). The multinomial logistic regression analysis found a significant impact of gender [male vs. female: adjusted relative risk ratio (RRR) = 1.448; 95% confidence interval (CI) = 1.022, 2.053; p = 0.037], age (years) (<22 vs. >25: RRR =0.389, 95% CI = 0.213,0.710; p = 0.002, and 22–25 vs. >25: RRR = 0.473, 95% CI = 0.290, 0.772; p = 0.003), monthly family income (BDT) (<25,000 vs. >50,000: RRR = 0.525, 95% CI = 0.334,0.826; p = 0.005), university type (public vs. private: RRR = 0.540, 95% CI = 0.369, 0.791; p = 0.002), eating larger meals/snacks (increased vs. unchanged: RRR = 2.401, 95% CI = 1.597, 3.610; p < 0.001 and decreased vs. unchanged: RRR = 1.893, 95% CI = 1.218, 2.942; p = 0.005), and verbally or physically abuse (yes vs. no: RRR = 1.438, 95% CI = 0.977, 2.116; p = 0.066) on obesity during COVID-19 pandemic. Besides, the female students and those who have constant eating habits, were more likely to be underweight. Additionally, the binary logistic regression analysis found that the students from private universities [others vs. private: adjusted odds ratio (AOR) = 0.461, 95% CI = 0.313, 0.680; p < 0.001], urban areas (urban vs. rural: AOR = 1.451, 95% CI = 1.165, 1.806; p = 0.001), wealthier families (<25,000 BDT vs. >50,000 BDT: AOR = 0.727, 95% CI = 0.540, 0.979; p = 0.036), and who were taking larger meals/snacks (increased vs. unchanged: AOR = 2.806, 95% CI = 2.190, 3.596; p < 0.001) and had conflicts/arguments with others (no vs. yes: AOR = 0.524, 95% CI = 0.418, 0.657; p < 0.001), were significantly more physically inactive. Finally, the level of education and smoking habits significantly influenced the eating habits of university students during the extended strict lockdown in Bangladesh. Conclusion The current findings would be helpful tools and evidence for local and international public health experts and policymakers to reverse these worsening effects on students mediated by the prolonged lockdown. Several effective plans, programs, and combined attempts must be earnestly implemented to promote a smooth academic and daily life.
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Affiliation(s)
- Md. Jamal Hossain
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- *Correspondence: Md. Jamal Hossain ; ; orcid.org/0000-0001-9706-207X
| | - Foyez Ahmmed
- Department of Statistics, Comilla University, Cumilla, Bangladesh
| | - Md. Robin Khan
- Bangladesh Reference Institute for Chemical Measurements, Dhaka, Bangladesh
| | | | - Sorif Hossain
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
- Department of Statistics, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Md. Oliullah Rafi
- Department of Genetic Engineering and Biotechnology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md. Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
| | - Saikat Mitra
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
| | - Fahadul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Morshed Alam
- Institute of Education and Research, Jagannath University, Dhaka, Bangladesh
| | - Md. Moklesur Rahman Sarker
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- Md. Moklesur Rahman Sarker ; ; orcid.org/0000-0001-9795-0608
| | - Isa Naina Mohamed
- Pharmacology Department, Medical Faculty, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
- Isa Naina Mohamed ; orcid.org/0000-0001-8891-2423
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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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Buratta L, Pazzagli C, Delvecchio E, Cenci G, Germani A, Mazzeschi C. Personality Features in Obesity. Front Psychol 2021; 11:530425. [PMID: 33519568 PMCID: PMC7840523 DOI: 10.3389/fpsyg.2020.530425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 11/25/2020] [Indexed: 11/20/2022] Open
Abstract
Obesity is a widespread and broadly consequential health condition associated with numerous medical complications that could increase mortality rates. As personality concerned individual's patterns of feeling, behavior, and thinking, it may help in understanding how people with obesity differ from people with normal-weight status in their typical weight-relevant behavior. So far, studies about personality and BMI associations have mainly focused on broad personality traits. The main purpose of this study was to explore the personality and health associations among a clinical group composed of 46 outpatients with overweight/obesity (mean age = 55.83; SD = 12.84) in comparison to a healthy control group that included 46 subjects (mean age = 54.96; SD = 12.60). Both the clinical and control groups were composed of 14 males and 32 females. Several personality and psychopathological aspects were assessed with the Personality Assessment Inventory (PAI). The results of the analysis of variance of aligned rank transformed (ART) showed that patients with overweight/obesity reported higher scores for Somatic Complaints, Depression, and Borderline Features than the control group. Logistic regression highlighted specifically that the subscales of the Borderline Features assessing the Negative Relationship contributed to the increased risk of belonging to the clinical group. For the purpose of this study, the role of gender was considered. The present findings highlight the importance of focusing on assessing personality functioning in the health context and on specific characteristics of interpersonal relationships to promote more tailored treatments.
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Affiliation(s)
- Livia Buratta
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
- Healthy Lifestyle Institute, Centro Universitario Ricerca Interdipartimentale Attività Motoria (CURIAMO), University of Perugia, Perugia, Italy
| | - Chiara Pazzagli
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
- Healthy Lifestyle Institute, Centro Universitario Ricerca Interdipartimentale Attività Motoria (CURIAMO), University of Perugia, Perugia, Italy
| | - Elisa Delvecchio
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
| | - Giulia Cenci
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
| | - Alessandro Germani
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
- Healthy Lifestyle Institute, Centro Universitario Ricerca Interdipartimentale Attività Motoria (CURIAMO), University of Perugia, Perugia, Italy
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Salerno L, Lo coco G, Gullo S, Iacoponelli R, Caltabiano ML, Ricciardelli LA. Self‐esteem mediates the associations among negative affect, body disturbances, and interpersonal problems in treatment‐seeking obese individuals. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12036] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Laura Salerno
- Department of Psychology, Università degli Studi di Palermo, Palermo, Italy,
| | - Gianluca Lo coco
- Department of Psychology, Università degli Studi di Palermo, Palermo, Italy,
| | - Salvatore Gullo
- Department of Psychology, Università degli Studi di Palermo, Palermo, Italy,
| | | | - Marie Louise Caltabiano
- Department of Psychology, School of Arts and Social Sciences, James Cook University, Cairns, Queensland, Australia,
| | - Lina A. Ricciardelli
- School of Psychology, Deakin University, Melbourne Burwood Campus, Victoria, Australia,
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Metacognitive Interpersonal Mindfulness-Based Training for Worry About Interpersonal Events: A Pilot Feasibility and Acceptability Study. J Nerv Ment Dis 2019; 207:944-950. [PMID: 31503182 DOI: 10.1097/nmd.0000000000001054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Individuals with personality disorders experience worry and repetitive thoughts regarding interpersonal scenarios. Mainstream mindfulness-based approaches may be insufficient to soothe these individual's distress due to difficulties in letting thoughts go and refocusing attention to the present moment. For this reason, we devised an adapted form of mindfulness-based program called Metacognitive Interpersonal Mindfulness-Based Training (MIMBT) for personality disorders. In this pilot study, 28 individuals attended nine weekly sessions to evaluate the feasibility and acceptability, and to establish preliminary outcomes. All individuals completed the program. Attendance was very high (96%). Significant changes were observed on the primary outcome of reduction in repetitive thinking, measured using the Metacognition Questionnaire-30. We also observed a decrease in depression severity. Despite important limitations, this pilot study suggests that MIMBT has the potential to be a viable and well-accepted option for increasing positive outcomes in the treatment of personality disorders. Clinical considerations and directions for future research are discussed.
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Wendt LP, Wright AGC, Pilkonis PA, Nolte T, Fonagy P, Montague PR, Benecke C, Krieger T, Zimmermann J. The latent structure of interpersonal problems: Validity of dimensional, categorical, and hybrid models. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:823-839. [PMID: 31556632 PMCID: PMC6816327 DOI: 10.1037/abn0000460] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Interpersonal problems are key transdiagnostic constructs in psychopathology. In the past, investigators have neglected the importance of operationalizing interpersonal problems according to their latent structure by using divergent representations of the construct: (a) computing scores for severity, agency, and communion (“dimensional approach”), (b) classifying persons into subgroups with respect to their interpersonal profile (“categorical approach”). This hinders cumulative research on interpersonal problems, because findings cannot be integrated both from a conceptual and a statistical point of view. We provide a comprehensive evaluation of interpersonal problems by enlisting several large samples (Ns = 5,400, 491, 656, and 712) to estimate a set of latent variable candidate models, covering the spectrum of purely dimensional (i.e., confirmatory factor analysis using Gaussian and nonnormal latent t-distributions), hybrid (i.e., semiparametric factor analysis), and purely categorical approaches (latent class analysis). Statistical models were compared with regard to their structural validity, as evaluated by model fit (corrected Akaike’s information criterion and the Bayesian information criterion), and their concurrent validity, as defined by the models’ ability to predict relevant external variables. Across samples, the fully dimensional model performed best in terms of model fit, prediction, robustness, and parsimony. We found scant evidence that categorical and hybrid models provide incremental value for understanding interpersonal problems. Our results indicate that the latent structure of interpersonal problems is best represented by continuous dimensions, especially when one allows for nonnormal latent distributions. This study suggests that interpersonal problems are best characterized by continuous differences in severity and interpersonal style (i.e., agency and communion), and not by “types” of people.
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Affiliation(s)
| | | | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Tobias Nolte
- Anna Freud National Centre for Children and Families
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families
| | - P Read Montague
- Research Department of Clinical, Educational, and Health Psychology, University College London
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Mason TB, Lewis RJ. Clustered Patterns of Behavioral and Health-Related Variables Among Young Lesbian Women. Behav Ther 2019; 50:683-695. [PMID: 31208679 DOI: 10.1016/j.beth.2018.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 10/10/2018] [Accepted: 10/16/2018] [Indexed: 01/13/2023]
Abstract
Lesbian women are at increased risk for a variety of mental and physical health problems compared to heterosexual women. In order to inform treatment and prevention, the purpose of this study was to examine behavioral and health-related patterns among lesbian women and elucidate how these patterns are associated with general discrimination, sexual minority stress, affect, and social support. A sample of self-identified lesbian women (N = 436) completed an online survey from August 2014-March 2015. A latent profile analysis was conducted using measures of body mass index, hazardous alcohol use, binge eating, eating disorder risk, and exercise as indicators. A 5-class solution best fit the data and included two healthy groups: (a) low health risk, moderate exercise (54%), (b) low health risk + high exercise (22%); and three unhealthy risk groups: (c) obese + binge eating (14%); (d) disordered eating + hazardous alcohol use (5%); (e) disordered eating + high exercise (5%). The three unhealthy classes generally reported more general discrimination, sexual minority stress, social anxiety, negative affect, and lower social support compared to the healthy classes. These findings show that behavioral and health-related variables cluster together in several distinct patterns among lesbian women. In addition, general discrimination and sexual minority stress and associated psychosocial functioning may be related to these maladaptive behavioral and health-related patterns and may be important to consider in behavioral interventions.
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Affiliation(s)
| | - Robin J Lewis
- Old Dominion University; Virginia Consortium Program in Clinical Psychology
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11
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Brugnera A, Lo Coco G, Salerno L, Sutton R, Gullo S, Compare A, Tasca GA. Patients with Binge Eating Disorder and Obesity have qualitatively different interpersonal characteristics: Results from an Interpersonal Circumplex study. Compr Psychiatry 2018; 85:36-41. [PMID: 29960139 DOI: 10.1016/j.comppsych.2018.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/14/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Patients with Binge Eating Disorder (BED) and obesity experience distressing relationships, which could trigger negative affect and over-eating. To date no studies compared the interpersonal profiles and prototypicality of both groups using the Interpersonal Circumplex. METHOD A sample of 177 patients with BED (mean age: 41.0 ± 12.5 years; 11.3% males), 321 obese non-BED adults (mean age: 44.5 ± 13.4 years; 28% males), and 108 normal weight adults (mean age: 37.3 ± 9.6 years; 52.77% males) completed the Inventory of Interpersonal Problems (IIP-32), and scales of binge eating and psychological distress at one time-point. RESULTS Compared to normal weight and obese participants, those with BED reported higher levels of interpersonal problems on all circumplex dimensions, except for Vindictive, with small to medium effects. All groups had highly prototypical profiles. Both obese and normal weight adults had very similar interpersonal profiles characterized by predominant friendly-dominant themes. On the contrary, those with BED had predominant friendly-submissive themes. Patients with BED reported significantly higher levels of psychological distress and binge eating severity, compared to the other two groups. Greater Domineering, Cold, Socially Inhibited and Non-Assertive scale scores, and lower Vindictive scale scores significantly predicted higher binge eating and psychological distress, regardless of group membership. DISCUSSION Findings lend support to an interpersonal model of binge eating and to the presence of qualitative differences between patients with obesity and BED. Finally, results suggest some strategies for the clinical management of BED focused on non-assertion and problems with experiences and expression of anger.
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Affiliation(s)
- Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
| | - Gianluca Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Laura Salerno
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Rachel Sutton
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Salvatore Gullo
- Department of Psychology, University "N. Cusano", Rome, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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The problem of overcontrol: Perfectionism, emotional inhibition, and personality disorders. Compr Psychiatry 2018; 83:71-78. [PMID: 29621675 DOI: 10.1016/j.comppsych.2018.03.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 02/28/2018] [Accepted: 03/13/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND AIMS Some individuals with Personality Disorders (PD), particularly of a non-Borderline type, present with difficulties relating to over-control of cognitions, emotion and behavior, perfectionistic traits, and impaired social interactions. The current study sought to evaluate the strength of association, and interactions of both emotional inhibition and perfectionism in PD's, after controlling for symptoms and interpersonal problems. METHOD We recruited a sample of 578 treatment seeking outpatients. Diagnosis of PD was made with the SCID-II. Individual's completed measures of perfectionism (Frost-MPS), Emotional Inhibition (EIS), Depression (BDI-II), Anxiety (STAI-Y), Global symptoms (SCL-90-R), and interpersonal problems (IIP-32). RESULTS Perfectionism was related to interpersonal problems, to the majority of PD symptomatology and to PD severity via number of SCID-II criteria met. Emotional inhibition was linked to symptoms and interpersonal problems as well as with avoidant, dependent, depressive and paranoid PDs; and with overall PD Severity. Inhibition and perfectionism were correlated with each other. Both variables predicted PD above and beyond other variables assessed. Mediation modeling demonstrated that the effect of emotional inhibition on PD severity was fully mediated by perfectionism and interpersonal problems. CONCLUSIONS Psychological mechanisms of overcontrol are a maintaining factor in many PDs. Both perfectionism and emotional inhibition impact on a broad range of PDs and there is an urgent need for research into these processes, and to adapt psychological interventions to consider these factors.
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Lo Coco G, Mannino G, Salerno L, Oieni V, Di Fratello C, Profita G, Gullo S. The Italian Version of the Inventory of Interpersonal Problems (IIP-32): Psychometric Properties and Factor Structure in Clinical and Non-clinical Groups. Front Psychol 2018; 9:341. [PMID: 29615945 PMCID: PMC5868495 DOI: 10.3389/fpsyg.2018.00341] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 02/28/2018] [Indexed: 11/13/2022] Open
Abstract
All versions of the Inventory of Interpersonal Problems (IIP) are broadly used to measure people's interpersonal functioning. The aims of the current study are: (a) to examine the psychometric properties and factor structure of the Italian version of the Inventory of Interpersonal Problems—short version (IIP-32); and (b) to evaluate its associations with core symptoms of different eating disorders. One thousand two hundred and twenty three participants (n = 623 non-clinical and n = 600 clinical participants with eating disorders and obesity) filled out the Inventory of Interpersonal Problems—short version (IIP-32) along with measures of self-esteem (Rosenberg Self-Esteem Scale, RSES), psychological functioning (Outcome Questionnaire, OQ-45), and eating disorders (Eating Disorder Inventory, EDI-3). The present study examined the eight-factor structure of the IIP-32 with Confirmatory Factor Analysis (CFA) and Exploratory Structural Equation Modeling (ESEM). ESEM was also used to test the measurement invariance of the IIP-32 across clinical and non-clinical groups. It was found that CFA had unsatisfactory model fit, whereas the corresponding ESEM solution provided a better fit to the observed data. However, six target factor loadings tend to be modest, and ten items showed cross-loadings higher than 0.30. The configural and metric invariance as well as the scalar and partial strict invariance of the IIP-32 were supported across clinical and non-clinical groups. The internal consistency of the IIP-32 was acceptable and the construct validity was confirmed by significant correlations between IIP-32, RSES, and OQ-45. Furthermore, overall interpersonal difficulties were consistently associated with core eating disorder symptoms, whereas interpersonal styles that reflect the inability to form close relationships, social awkwardness, the inability to be assertive, and a tendency to self-sacrificing were positively associated with general psychological maladjustment. Although further validation of the Italian version of the IIP-32 is needed to support these findings, the results on its cross-cultural validity are promising.
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Affiliation(s)
- Gianluca Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | | | - Laura Salerno
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Veronica Oieni
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Carla Di Fratello
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Gabriele Profita
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Gullo
- Faculty of Psychology, University Niccolò Cusano, Rome, Italy
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Dimaggio G, Popolo R, Montano A, Velotti P, Perrini F, Buonocore L, Garofalo C, D'Aguanno M, Salvatore G. Emotion dysregulation, symptoms, and interpersonal problems as independent predictors of a broad range of personality disorders in an outpatient sample. Psychol Psychother 2017; 90:586-599. [PMID: 28585718 DOI: 10.1111/papt.12126] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 02/20/2017] [Indexed: 11/28/2022]
Abstract
UNLABELLED Emotion dysregulation (ED) is considered a hallmark of borderline personality disorder and is prominent in other personality disorders (PDs). Its presence and contribution to personality pathology need to be explored in the whole range of PDs. In this study, we investigated the association of ED with the whole range of PD traits, symptoms, and interpersonal problems and then investigated whether ED had a unique contribution in predicting the different PDs. A sample of 478 treatment-seeking outpatients was interviewed with the SCID-II. The patients were then tested for symptoms (SCL-90-R), interpersonal problems (IIP-32), and ED (DERS). RESULTS ED correlated with the large majority of PDs and with symptoms and interpersonal problems. Regression showed how ED explained a unique part of the variance for many PDs. ED appears to be a relevant feature of pathology in many PDs; with replication, it can be considered a treatment target in this population. PRACTITIONER POINTS Emotion dysregulation is present in many personality disorders. Emotion dysregulation is not just explained by heightened symptoms and interpersonal problems in personality disorders. Emotion dysregulation could be considered a treatment target in personality disorders other than borderline.
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Affiliation(s)
| | - Raffaele Popolo
- Center for Metacognitive Interpersonal Therapy, Rome, Italy.,Studi Cognitivi, Milan, Italy
| | | | | | | | | | - Carlo Garofalo
- Department of Developmental Psychology, Tilburg University, The Netherlands
| | - Mario D'Aguanno
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Italy
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Metacognitive Interpersonal Therapy for Personality Disorders: A Case Study Series. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2016. [DOI: 10.1007/s10879-016-9342-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hilbert A. Social facilitation maintenance treatment for adults with obesity: study protocol for a randomised-controlled feasibility study (SFM study). BMJ Open 2016; 6:e010845. [PMID: 27580827 PMCID: PMC5013413 DOI: 10.1136/bmjopen-2015-010845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/27/2016] [Accepted: 06/16/2016] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The long-term success of non-surgical weight loss treatment in adults with obesity is limited by substantial relapse, and only a few evidence-based weight loss maintenance treatments exist. This clinical trial investigates the feasibility and efficacy of a social facilitation maintenance programme for weight loss maintenance, tailored to meet the needs of obese adults who have undergone a lifestyle weight loss intervention. METHODS AND ANALYSIS In a single-centre, open feasibility trial, 72 adults currently or previously obese or overweight who have undergone a lifestyle weight loss intervention are centrally randomised to 4 months of social facilitation maintenance treatment or treatment as a usual control condition. In 16 outpatient group sessions, the social facilitation maintenance treatment, based on a socioecological model and on evidence supporting social facilitation as a key process in maintaining weight loss, focuses on promoting interpersonal relationships to build up a healthy lifestyle for long-term weight loss maintenance. Primary outcome is the amount of weight regain at 6-month follow-up, compared with pre-treatment weight, derived from measured body weight. Secondary outcomes address feasibility, including recruitment, attrition, assessment non-completion, compliance and patients' programme evaluation; and in comparison with pre-weight loss maintenance, social and interpersonal functioning, eating behaviour and physical activity, psychological and physical symptoms, body composition and risk of comorbidity, and quality of life at post-treatment and follow-up assessments. ETHICS AND DISSEMINATION The study was approved by the Ethical Committee at the University of Leipzig (165-13-15072013). The study results will be disseminated through peer-reviewed publications. TRIAL REGISTRATION NUMBER DRKS00005182.
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Affiliation(s)
- Anja Hilbert
- Department of Medical Psychology and Medical Sociology, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Leipzig, Germany
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Lo Coco G, Sutton R, Tasca GA, Salerno L, Oieni V, Compare A. Does the Interpersonal Model Generalize to Obesity Without Binge Eating? EUROPEAN EATING DISORDERS REVIEW 2016; 24:391-8. [DOI: 10.1002/erv.2459] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/18/2016] [Accepted: 05/19/2016] [Indexed: 11/11/2022]
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Pokrajac-Bulian A, Tončić M, Anić P. Assessing the factor structure of the Body Uneasiness Test (BUT) in an overweight and obese Croatian non-clinical sample. Eat Weight Disord 2015; 20:215-22. [PMID: 25403266 DOI: 10.1007/s40519-014-0166-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 11/03/2014] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The study objectives are to investigate the psychometric properties of the Body Uneasiness Test (BUT-A) in a general sample of overweight and obese persons in Croatia, to evaluate structure differences between men and women and to examine the relationship with other measures of body dissatisfaction as well as with objective body mass measure. METHODS This study included 320 adults (156 women and 164 men; aged between 20 and 71) with BMIs ranging from 24 to 48.83 kg/m(2). RESULTS The analysis confirmed a structural one-factor model for BUT-A. The one-factor model fits the data equally as well as the more complex five-factor model did and should be considered a more robust, parsimonious and adequate model. Female participants showed higher results (higher body uneasiness), but the importance of items is roughly comparable between genders. The BUT-A score significantly contributes to the prediction of general body dissatisfaction, even after gender and BMI are controlled. The multifaceted nature of the BUT-A might explain the relatively low measure of general body dissatisfaction in this sample. Congruent with previous studies, obese subjects expressed dissatisfaction with their body on the figure rating scale by selecting the ideal figure two units thinner than their current body figure. In overweight and obese men, body dissatisfaction is lower than in women. CONCLUSION The BUT-A can be a reliable one-dimensional tool for the assessment of body uneasiness in a wide range of samples, including obese individuals.
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Affiliation(s)
- Alessandra Pokrajac-Bulian
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia,
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McEvoy PM, Burgess MM, Page AC, Nathan P, Fursland A. Interpersonal problems across anxiety, depression, and eating disorders: A transdiagnostic examination. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2012; 52:129-47. [DOI: 10.1111/bjc.12005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 06/26/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Andrew C. Page
- School of Psychology; University of Western Australia; Perth; Australia
| | - Paula Nathan
- Centre for Clinical Interventions; Perth; Australia
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Laghi F, Liga F, Baumgartner E, Baiocco R. Time perspective and psychosocial positive functioning among Italian adolescents who binge eat and drink. J Adolesc 2012; 35:1277-84. [DOI: 10.1016/j.adolescence.2012.04.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 04/26/2012] [Accepted: 04/28/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Fiorenzo Laghi
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via dei Marsi 78, 00185 Roma, Italy.
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