Childhood Trauma, Posttraumatic Stress Disorder Symptoms, Early Maladaptive Schemas, and Schema Modes: a Comparison of Individuals with Obesity and Normal Weight Controls

Overview

Journal BMC Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2022 Jul 30

PMID 35907801

Authors

Dean Spirou

Jayanthi Raman

Ramy H Bishay

Golo Ahlenstiel

Evelyn Smith

Affiliations

Soon will be listed here.

Abstract

Background: Previous research on the psychological mechanisms of obesity has primarily focused on acute psychopathology. However, there is limited literature on the role of more complex and entrenched psychological processes in weight management. The current study aimed to expand previous research by examining more enduring psychological constructs, including early maladaptive schemas (EMS), schemas modes, and trauma.

Methods: Participants (N = 125) comprised adults with normal weight (n = 40) and obesity (n = 85) from community and clinical settings in Australia. Eligible participants completed a series of self-report questionnaires via Research Electronic Data Capture (REDCap). Two, separate, one-way multivariate analysis of variance (MANOVA) were conducted to examine group differences on the outcome variables.

Results: Findings indicated a significant effect of group on EMS and schema modes, V = .51, F(32, 92) = 2.97, p < .001, partial η = .51. Follow-up univariate tests revealed that individuals with obesity endorsed significantly more maladaptive schemas and schema modes and significantly less healthy schema modes than individuals with normal weight. In addition, results demonstrated a significant effect of group on childhood trauma and posttraumatic stress disorder (PTSD) symptoms, V = .19, F(6, 118) = 4.70, p < .001, partial η = .19. Subsequent univariate tests and chi-square analyses indicated that individuals with obesity reported significantly more childhood trauma as well as significantly more PTSD symptoms within the last month than normal weight individuals.

Conclusion: This was the first study to compare EMS and schema modes in treatment-seeking individuals with obesity and normal weight controls using the short form version 3 of the Young Schema Questionnaire and revised, 118-item, Schema Mode Inventory. Overall, findings revealed that individuals with obesity experience more complex and enduring psychological difficulties than normal weight individuals. Increased assessment and targeted treatment of these underlying mental health concerns may contribute to a more holistic conceptualisation of obesity and could improve the long-term success of weight management.

Citing Articles

A Qualitative Exploration of Postoperative Bariatric Patients' Psychosocial Support for Long-Term Weight Loss and Psychological Wellbeing.

Van Zyl N, Lusher J, Meyrick J Behav Sci (Basel). 2024; 14(2).

PMID: 38392475 PMC: 10886391. DOI: 10.3390/bs14020122.

References

Gustafson T, Sarwer D . Childhood sexual abuse and obesity. Obes Rev. 2004; 5(3):129-35. DOI: 10.1111/j.1467-789X.2004.00145.x. View

Lobbestael J, van Vreeswijk M, Spinhoven P, Schouten E, Arntz A . Reliability and validity of the short Schema Mode Inventory (SMI). Behav Cogn Psychother. 2010; 38(4):437-58. DOI: 10.1017/S1352465810000226. View

Freire C, Zanella M, Segal A, Arasaki C, Matos M, Carneiro G . Associations between binge eating, depressive symptoms and anxiety and weight regain after Roux-en-Y gastric bypass surgery. Eat Weight Disord. 2020; 26(1):191-199. DOI: 10.1007/s40519-019-00839-w. View

Luiz L, Brito C, Debon L, Brandalise L, Azevedo J, Monbach K . Variation of Binge Eating One Year after Roux-en-Y Gastric Bypass and Its Relationship with Excess Weight Loss. PLoS One. 2016; 11(12):e0167577. PMC: 5167256. DOI: 10.1371/journal.pone.0167577. View

Pugh M . A narrative review of schemas and schema therapy outcomes in the eating disorders. Clin Psychol Rev. 2015; 39:30-41. DOI: 10.1016/j.cpr.2015.04.003. View

Blevins C, Weathers F, Davis M, Witte T, Domino J . The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation. J Trauma Stress. 2015; 28(6):489-98. DOI: 10.1002/jts.22059. View

Phillips K, Brockman R, Bailey P, Kneebone I . Young Schema Questionnaire - Short Form Version 3 (YSQ-S3): Preliminary validation in older adults. Aging Ment Health. 2017; 23(1):140-147. DOI: 10.1080/13607863.2017.1396579. View

Bernstein D, Stein J, Newcomb M, Walker E, Pogge D, Ahluvalia T . Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003; 27(2):169-90. DOI: 10.1016/s0145-2134(02)00541-0. View

Basile B, Tenore K, Mancini F . Early maladaptive schemas in overweight and obesity: A schema mode model. Heliyon. 2019; 5(9):e02361. PMC: 6819863. DOI: 10.1016/j.heliyon.2019.e02361. View

10.

Trottier K, MacDonald D . Update on Psychological Trauma, Other Severe Adverse Experiences and Eating Disorders: State of the Research and Future Research Directions. Curr Psychiatry Rep. 2017; 19(8):45. DOI: 10.1007/s11920-017-0806-6. View

11.

Harris P, Taylor R, Minor B, Elliott V, Fernandez M, ONeal L . The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019; 95:103208. PMC: 7254481. DOI: 10.1016/j.jbi.2019.103208. View

12.

Paixao C, Dias C, Jorge R, Carraca E, Yannakoulia M, de Zwaan M . Successful weight loss maintenance: A systematic review of weight control registries. Obes Rev. 2020; 21(5):e13003. PMC: 9105823. DOI: 10.1111/obr.13003. View

13.

Midei A, Matthews K . Interpersonal violence in childhood as a risk factor for obesity: a systematic review of the literature and proposed pathways. Obes Rev. 2011; 12(5):e159-72. PMC: 3104728. DOI: 10.1111/j.1467-789X.2010.00823.x. View

14.

Isaacs A, Enticott J, Meadows G, Inder B . Lower Income Levels in Australia Are Strongly Associated With Elevated Psychological Distress: Implications for Healthcare and Other Policy Areas. Front Psychiatry. 2018; 9:536. PMC: 6213368. DOI: 10.3389/fpsyt.2018.00536. View

15.

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

16.

Danese A, Tan M . Childhood maltreatment and obesity: systematic review and meta-analysis. Mol Psychiatry. 2013; 19(5):544-54. DOI: 10.1038/mp.2013.54. View

17.

Raman J, Spirou D, Jahren L, Eik-Nes T . The Clinical Obesity Maintenance Model: A Theoretical Framework for Bariatric Psychology. Front Endocrinol (Lausanne). 2020; 11:563. PMC: 7438835. DOI: 10.3389/fendo.2020.00563. View

18.

Kofman M, Lent M, Swencionis C . Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an Internet survey. Obesity (Silver Spring). 2010; 18(10):1938-43. DOI: 10.1038/oby.2010.27. View

19.

Walsh E, Rosenstein L, Dalrymple K, Chelminski I, Zimmerman M . The Importance of Assessing for Childhood Abuse and Lifetime PTSD in Bariatric Surgery Candidates. J Clin Psychol Med Settings. 2017; 24(3-4):341-354. DOI: 10.1007/s10880-017-9518-7. View

20.

Mauro M, Papelbaum M, Brasil M, Carneiro J, Coutinho E, Coutinho W . Is weight regain after bariatric surgery associated with psychiatric comorbidity? A systematic review and meta-analysis. Obes Rev. 2019; 20(10):1413-1425. DOI: 10.1111/obr.12907. View