Childhood trauma, posttraumatic stress disorder symptoms, early maladaptive schemas, and schema modes: a comparison of individuals with obesity and normal weight controls

• Published in: BMC psychiatry Vol. 22; no. 1; pp. 1 - 517
• Main Authors: Spirou, Dean, Raman, Jayanthi, Bishay, Ramy H, Ahlenstiel, Golo, Smith, Evelyn
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 30.07.2022; BioMed Central; BMC
• Subjects: Adults; Adverse childhood experiences; Chi-square test; Childhood trauma; Children; Comparative analysis; Complications and side effects; Coping; Early maladaptive schemas; Eating disorders; Emotions; Gastrointestinal surgery; Health aspects; Mental disorders; Mental health; Multivariate analysis; Obesity; Overweight; Post traumatic stress disorder; Posttraumatic stress disorder; Psychiatry; Psychic trauma in children; Psychological aspects; Psychological research; Psychopathology; Questionnaires; Risk factors; Schema modes; Schema therapy; Self control; Social isolation; Trauma; Weight control; Australia
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-022-04169-7

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 2  = .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 2  = .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.