Childhood traumatic experiences in people with obesity with and without eating disorders who are seeking bariatric surgery: the role of attachment relationships and family functioning.
Emanuela Paone, Michela Di Trani, Enrico Visani, Cinzia Di Monte, Virginia Campedelli, Gianfranco Silecchia, Carlo Lai
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Abstract
Purpose: The present study examines the impact of traumatic childhood experiences in people with obesity seeking bariatric surgery. It considers the presence of eating disorders (ED) in the population with obesity and tests the role of attachment and family relationships as mediators of the relationship between traumatic events and ED.
Method: 110 participants with severe obesity and 98 participants of a healthy weight (control group) filled out The Childhood Trauma Questionnaire (CTQ-SF), the Attachment Style Questionnaire (ASQ) and the Family Adaptability and Cohesion Evaluation Scale (FACES IV).
Results: Comparing the two groups on psychological variables, higher scores in the CTQ Emotional neglect and ASQ insecure attachment scales emerged in the control group than the group with obesity. Considering the presence/absence of an ED only in the group with obesity, and comparing these subgroups, higher scores in traumatic experiences emerged in the individuals with obesity and with ED than the individuals with obesity without ED. Moreover, participants with ED scored higher in ASQ insecure attachment and had lower levels of flexibility in family functioning than the group without ED. Finally, Logistic Regression models showed that insecure anxious attachment and dysfunctional familial relationships affected the relationship between traumatic childhood experiences and the presence of ED in the group with obesity.
Conclusion: These findings suggest the importance focusing on psychosocial factors linked to obesity, specifically on attachment styles and familial relationships as emotion regulation strategies, since the impact of traumatic childhood events on psychopathology could be ameliorated by an individual's ability to rely on a significant attachment figure.
Level of evidence: Level II, evidence obtained from well-designed controlled trials without randomization.
目的：本研究探讨了童年创伤经历对寻求减肥手术的肥胖症患者的影响。研究考虑了肥胖症患者中是否存在进食障碍（ED），并测试了依恋和家庭关系在创伤事件与进食障碍之间的中介作用：110名重度肥胖者和98名体重健康者（对照组）填写了童年创伤问卷（CTQ-SF）、依恋风格问卷（ASQ）和家庭适应性与凝聚力评估量表（FACES IV）：比较两组的心理变量，对照组在 CTQ 情感忽视和 ASQ 不安全依恋量表中的得分高于肥胖症组。如果只考虑肥胖症组是否存在 ED，并对这些亚组进行比较，则肥胖症和 ED 患者的创伤经历得分高于无 ED 的肥胖症患者。此外，与无 ED 的人群相比，有 ED 的人群在 ASQ 不安全依恋方面得分更高，在家庭功能灵活性方面得分更低。最后，逻辑回归模型显示，不安全的焦虑依恋和不正常的家庭关系会影响童年创伤经历与肥胖症患者出现 ED 之间的关系：这些研究结果表明，关注与肥胖有关的社会心理因素，特别是作为情绪调节策略的依恋方式和家庭关系非常重要，因为个体依靠重要依恋人物的能力可以减轻童年创伤事件对精神病理学的影响：证据等级：II 级，证据来自设计良好的非随机对照试验。
期刊介绍：
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.
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