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.

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.

The role of family functioning, attachment style, and care setting on pre-loss grief symptoms and burden in caregivers of terminally cancer patients.

OBJECTIVES: The aim of the present cross-sectional study was to investigate the associations between caregivers' attachment styles, family functioning, the care setting and pre-loss grief symptoms, the burden, and the caregivers' belief of patients' awareness of the terminal cancer diagnosis. METHODS: A total of 101 caregivers of patients with terminal cancer in residential hospice care and home care were interviewed and completed self-report questionnaires. RESULTS: Insecure attachment style and home care setting were associated with worse psychological effects in caregivers of patients with terminal cancer. Moreover, family cohesion can promote low social burden and the patient's awareness of their terminal condition. SIGNIFICANCE OF RESULTS: This study highlighted the importance of evaluating the caregiver's attachment style, family functioning, and the setting of care during the terminal phase of the patient's life. These findings will be useful to planning interventions to prevent burden and the pre-loss grief symptoms in the caregivers.

Body Image and Body Mass Index Influence on Psychophysical Well-Being in Bariatric Patients: A Cross-Sectional Study.

BACKGROUND: Psychophysical factors may have an impact on the disease of obesity, and it is important to explore which aspects may play an important role on the well-being of obese patients undergoing bariatric surgery. The purpose of this study was to assess the associations of a high body mass index (BMI) and greater dissatisfaction with body image with higher levels of psychopathological aspects, feelings of hopelessness, and psychological and physical health in patients undergoing evaluation for bariatric surgery. METHODS: Fifty-nine patients undergoing bariatric surgery filled out the Symptom Checklist-90-Revised, the Body Uneasiness Test, the 12-item Short Form Survey, the Beck Inventory Scale II, and the Beck Hopelessness Scale. Correlations and hierarchical regressions between measures were performed. RESULTS: Dissatisfaction with the perception of one's own body image was strongly correlated with a worse psychophysiological health. On the contrary, BMI showed no significant correlation with the previous variables. Furthermore, the perception of one's own body image significantly predicted the state of psychological health. CONCLUSIONS: The findings showed a more relevant role of body image compared to the BMI in the association with psychological outcomes, suggesting the importance of considering body image in the assessment and treatment of obese patients requiring bariatric treatment.

Escaping the Reality of the Pandemic: The Role of Hopelessness and Dissociation in COVID-19 Denialism.

BACKGROUND: Denialism of coronavirus disease 2019 (COVID-19) severely affected governments' attempts to contain the spread of the virus. Indeed, groups of deniers showed scepticism and misinformation toward the causes of the virus, leading to less adherence to official guidelines and vaccination campaigns. The present study aimed to investigate the sociodemographic and psychological factors associated with COVID-19 denialism, expressed in the forms of scepticism, nonadherence to guidelines, and negative attitudes toward vaccination. METHODS: Four hundred and sixty-one volunteers completed an online survey composed of the Beck Hopelessness Scale, the Dissociative Experiences Scale-II, the Sense of Community Index, and a questionnaire about COVID-19 denialism. RESULTS: The multiple regression analyses showed that higher age and a lower level of education were positive predictors of COVID-19 denialism. Furthermore, the structural equation model showed that hopelessness positively predicted dissociation and negatively predicted the sense of community. In turn, only dissociation was found to positively predict COVID-19 denialism. CONCLUSIONS: The findings of the present study suggested that hopelessness could exacerbate a defensive dissociative response that could be associated with greater COVID-19 denialism. Moreover, older and less educated people showed a greater propensity to engage in COVID-19 denialism.