Fattori psicologici di rischio e protettivi rispetto al benessere psicofisico in persone obese sottoposte a intervento bariatrico: un’indagine longitudinale a medio termine

L’obesità rappresenta un problema di salute pubblica di rilevanza globale. Il rapporto 2022 sull’obesità in Europa, pubblicato dall’Organizzazione Mondiale della Sanità, stima che ben il 59% degli adulti è in sovrappeso o affetto da obesità, mettendo in luce che tale problematica è di proporzioni epidemiche in questa parte del mondo. L’obesità espone le persone che ne soffrono a patologie come diabete e malattie cardiovascolari. L’intervento di chirurgia bariatrica per la riduzione del peso è considerato il trattamento più efficace dell’obesità severa. Tale intervento implica la modifica dell’apparato digerente del paziente ed ha un impatto estremamente rilevante sulla sua vita, poiché comporta dei cambiamenti sostanziali dello stile di vita ed il funzionamento psicologico. Il nostro contributo, nell’equipe multidisciplinare dell’ambulatorio di chirurgia bariatrica dell’Ospedale di Cattinara di Trieste, è stato sia di ricerca che clinico, avendo come obiettivo quello di migliorare la valutazione psicologica del paziente in fase pre e postoperatoria elaborando dati empirici su cui poggiare interventi volti ad incrementare il benessere psico-fisico dei pazienti

A prospective study on the reciprocal influence between personality and attitudes, behaviors, and psychological characteristics salient in eating disorders in a sample of non-clinical adolescents

Eating disorders are mostly likely to occur for the first time in adolescence. Delineating vulnerable personality profiles of unhealthy conditions helps prevent their onset and development. This study investigated a non-clinical sample of 142 adolescents and how some theoretically salient individual differences in personality contribute to predict changes in behaviors, attitudes and psychological characteristics that are clinically significant in eating disorders (ED). The results from cross-lagged pattern analyses supported the influence of depression, obsessiveness, and self-esteem in the trajectories favoring the development of psychological characteristics, such as ineffectiveness and interoceptive awareness, which are salient in the ED risk process. Results also confirmed that BMI (Body Mass Index), perfectionism, and body dissatisfaction predict increases in dysfunctional concerns with weight control and food consumption. Empirical support for an impact of ED-relevant variables on personality self-views emerged as well. Trajectories linking ED and personality in relation to sex differences and permeability to transitory psychological conditions in adolescence were also confirmed

Personality profiles of adolescents with risky attitudes towards food, dieting, and their body image

Disordered eating (ED) clinical and subclinical conditions have a considerable impact on the population. Anticipating vulnerable profiles is crucial thereby in order to prevent the development of such pathological conditions [1, 2, 3]. Previous research has consistently shown that individual differences in Self-esteem, Impulsiveness, Obsessiveness, Ineffectiveness, and Interoceptive Awareness represent significant correlates of eating disorders [4]. The present longitudinal study was aimed at exploring distinctive personality profiles of non-clinical adolescents with stable risky attitudes towards food, dieting, and their body image. EDI-2 and a selected subset of MMPI-A content scales were administered twice, with a 7-month interval, to a sample of 142 adolescents. For the present study, we focused on the subsample of participants with reliably stable scores on the critical EDI-2 scales of Drive for Thinness (DT), Bulimia (Bu), and Body Dissatisfaction (BD) across the two measurement occasions, t1 and t2. When average profiles of adolescents with higher (> 85° percentile) vs lower (≤ 85° percentile) scores on the three EDI-2 scales at t1 were compared along the EDI- 2 and MMPI-A scales via one-way ANOVA, results indicated that adolescents with higher stable levels of DT revealed higher dissatisfaction with their body, higher Obsessiveness and depression levels and lower self-esteem levels; adolescents very dissatisfied with their body referred high DT scores, but they did not report higher Obsessiveness levels; adolescents with higher scores on Bu revealed lower Interoceptive Awareness and higher impulsivity, but did not refer higher levels of BD or DT. These differences in profile shapes were observed at t1 as well as at t2. Consistent with literature [5-10] our findings suggest that distinctive profile shapes might help to early identify adolescents who are at risk of developing EDs

Personality and Eating Disorders: A Longitudinal Study on a Non-Clinical Sample of Adolescents

The present longitudinal study is aimed at analyzing how adolescents change their dysfunctional attitudes towards their body and eating behaviors in relation to personality characteristics across a six-month time span. Via multiple regression analyses we investigated whether MMPI-A Obsessiveness, Low Self-Esteem, Depression, Family Problems and Concern for health are temporal antecedents of EDI-2 eating disorders, and vice versa. Our main findings revealed a bidirectional relationship between eating attitudes and personality. In fact, Obsessiveness, Low self-esteem, Depression, and Family problems significantly predicted changes in different dysfunctional eating attitudes, but also EDI-Interpersonal distrust and Ineffectiveness predicted changes in different MMPI-A scale scores. All together, findings suggest that personality development in adolescence is sensitive to attitudes towards eating and body appearance, and vice versa

Personality and eating disordered behaviors in adolescent boys

There is increasing evidence showing that gender specific attitudes and behaviors predict the onset of eating behaviors. Excessive exercise to gain weight and muscularity typically reveal body dissatisfaction and predict eating disorders in males. The present study explored how personality characteristics predict body dissatisfaction and muscle dysmorphia, in a sample of adolescent boys (N = 178) who provided selfreports along personality and body image concerns questionnaires. Results from regression analyses showed that Dynamism and low Constraint concurrently accounted for a significant variance proportion in Muscle Dysmorphia. Perfectionism, Obsessiveness, and Ineffectiveness predicted higher scores on Body Dissatisfaction. Results were controlled for age and BMI. A second data wave will be collected soon in order to explore personality antecedents of changes in body dissatisfaction and muscle dysmorphia. The results will help understand how personality self-views represent risk factors for dysfunctional body images and related eating disordered attitudes, in young males

Eating disorders and personality correlates in men: A validity study of the Eating Disorder Assessment for Men (EDAM) in the Italian language

Personality and eating disorders are associated in women, less is known however about how they are associated in men. The present study aimed at validating the Eating Disorder Assessment for Men (EDAM, Stanford & Lemberg, 2012) in the Italian language and exploring its correlates with personality variables. A non-clinical sample of Italian men (MAge = 39.0) provided self-ratings along EDAM and the HEXACO-PI and SD3 personality questionnaires. Principal component analysis of EDAM items suggested 5 contentcoherent dimensions: Vigorexia, Compensatory strategies, Body satisfaction, Overeating, and Drive for thinness. They did not fully replicate the expected structure. Regression analysis showed distinctive personality-EDAM domain associations, with Vigorexia positively correlating with SD3 Machiavellism, Compensatory strategies being positively associated with SD3 Narcisism, lower Control over eating with lower HEXACO-PI Conscientiousness, and higher Drive for thinness with lower Extraversion. Results are discussed in relation to gender differences in eatin

SCL-90 empirical factors predict post-surgery weight loss in bariatric patients over longer time periods

This longitudinal study examined how pre-intervention psychological health helps predict bariatric surgery (BS) success as percentage of expected body mass index loss (ëMIL) over shorter to longer periods

Vulnerability factors and developmental trajectories of Eating disorders-relevant attitudes and behaviours in non-clinical adolescents

Eating disorders (EDs) are regarded as a function of pubertal growth, personality, and body image (BI) development, as well as socio-cultural influences, during adolescence. Sex-specificities are getting more attention. However, empirical studies from this broad area of research do not systematically investigate EDs taking into account female and male specificities. The present PhD research project aims to explore vulnerability factors for increases in ED-related behaviours among boys and girls during adolescence, by conducting a 2-year longitudinal study. In literature, the onset and course of ED has been mostly connected with (1) body-related concerns and (dis)satisfaction, and (2) personality variables. However, vulnerability models have mainly been tested on females. Additionally, empirical findings reported mostly on inter-individual differences rather than intra-individual dynamics, with no study systematically investigating them. Body image (BI), and Body Dissatisfaction (BD), moreover, have been often used as interchangeable constructs and operationalized in many different ways, thus contributing to not fully coherent empirical findings. In the current project, we aimed to explore EDs development from an integrative perspective on the role of body-related constructs and personality among adolescent boys and girls, by using 1) a sex-sensitive approach in assessing EDs and 2) between-people and within-person approach simultaneously. In detail, the objectives of the present PhD project were as follows: 1) Defining trends of ED-related behaviours and attitudes, namely Muscle Dysmorphia (MD) and Binge Eating (BE) in males, and Drive for Thinness (DT) and Bulimia (Bu) in females, and their co-variations with BI-related constructs throughout adolescence, 2) Prospectively exploring the unique contribution of BI-related factors and BD in predicting ED outcome, further investigating their reciprocal influences; 3) Exploring multivariate models of ED by testing interaction models among BI-related and personality variables. The PhD thesis presents an introductory chapter providing a framework of prevalence and incidence of EDs in adolescents and vulnerability factors by evidencing the open issues related to sex-specificity. Chapter 2 presents an overview of the longitudinal study, and constructs and measures assessed in the study. Chapter 3 presents an empirical study on how body self-perceptions contribute to predict within-person changes in adolescent sex-specific ED behaviours and attitudes across 1-yr. With the aim of investigating more in deep the multi-facet and somehow ubiquitous construct of BI, Chapter 4 explored BI-factor structure by conducting a confirmatory factor analysis on all the body-related measures herein involved, across 5 waves, further testing for factorial invariance across gender and longitudinal invariance, across time. Chapter 5 represents an empirical contribution to prospectively inspect the unique impact of BI-related factors and BD on sex-specific ED outcomes. Chapter 6 aimed at further investigating the BI-ED association by including personality variables, as potential unique predictors as well as moderators. Results provided some original contributions, extending BI and ED research, as follows: 1) ED outcomes were moderately stable across 1 year with a general intra-individual attenuating trajectory across a 2-year time span, 2) Individual changes in BE and MD in boys co-varied with their actual body-related self-perceptions across one-year, and actual body shape and weight perception predicted DT in girls, along with their desired thin ideal body at intra- and inter-individual levels, 3) The support for the Cash\u2019s 2-factor model of BI among non-clinical adolescents, 4) Meaningful differences in the predictive validity of BI-related domains and BD for sex-specific ED symptoms, lastly 5) Individual differences in personality and emotion regulation aspects were unique predictors of EDs

Temporal Antecedents of Body Dissatisfaction and Muscle Dysmorphia in adolescent boys: Preliminary findings from a longitudinal study

Body dissatisfaction (BD) contributes to body image disturbances and represents a core aspect of eating disorders (ED) development. Research has focused attention on ED behaviors and BD in woman, mainly. However, there is increasing evidence that males are dissatisfied with their weight and body shape. In addition, they are at risk of excessively exercising in order to gain weight and muscularity. Thus, Muscle Dysmorphia (MD) represents a dysfunctional ED-related behavior in males. Given substantial sex differences in ED behaviors and attitudes, more research is needed on risk factors for ED development in males only [1]. The present study explores how base-line self-esteem, body uneasiness, and personality ED-related characteristics predict changes in BD and MD in adolescents boys 7 months later. Participants (N= 136) were boys, 16 \ub1 1.3 yrs, who self-reported on Eating Disorders Assessment for Man [2], EDI-2 Perfectionism, Interoceptive Awareness, and Ineffectiveness, Rosenberg Self-Esteem, also reflected, and Body Uneasiness Test. They completed the questionnaires twice, 7 months apart, further reporting on their weight and height. After controlling for base-line BMI, age, BD, and MD, results (p 64 0.05) showed that higher initial reflected self-esteem (\u3b2=-.12) predicted decreases in BD; in addition changes in BD positively correlated with changes in BUT Avoidance and Weight Phobia. EDI-2 Interoceptive Awareness (\u3b2=.16) and BUT Compulsive self-monitoring (\u3b2=.32) accounted for increases in MD. Consistently with previous research, the present study revealed some sex commonalities and differences in relation to ED vulnerabilities [1,2]. Specifically, our findings suggest that reflected self-esteem and compulsive self-monitoring, that is, reflected social image and attractiveness, may represent risk factors for EDs in young boys especially. Overall, the present results confirm that more attention is needed on male-specific indicators and vulnerability factors, in order to prevent the development of dysfunctional body weight and image in adolescence. 1. Ricciarderlli, L. A., & McCabe, M. P. (2004). A Biopsychosocial Model of Disordered Eating and the Pursuit of Muscularity in Adolescent Boys. Psychological Bulletin, 130, 179-205. 2. Stanford, S. C., & Lemberg, R. (2012). A Clinical Comparison of Men and Women on the Eating Disorder Inventory-3 (EDI-3) and the Eating Disorder Assessment for Men (EDAM). Eating Disorders,20,379-39

The Predictive Validity of Reflected Body Image and Self-Esteem for understanding Adolescent intra-individual changes in Eating Disordered Behaviors and Attitudes in adolescents

Body Image (BI) and Self-Esteem (SE) represent risk factors for the development of eating-related disorders (ED). Less is known, however, on how SE and BI, individually and in interaction, contribute to predict changes in EDs in adolescents, at the intra-individual level. The present three-wave study explored in an Italian community sample of adolescents how within-person variations in EDs symptoms, as specified by Muscle Dysmorphia and Binge Eating for boys (N=128), and Drive for thinness and Bulimia for girls (N=66), are predicted by actual and reflected BIs and SE across a one-year time span. Results showed that SE predict intra- individual changes in ED, both in girls and boys. Furthermore, this effect is moderated by reflected BI. The present findings provide further support for the relevance of SE and BI in ED conditions and suggest that beyond self-esteem, the way adolescents believe they are physically perceived by others deserves attention as well