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

Title

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

Reference

Spirou, D., Raman, J., Bishay, R. H., Ahlenstiel, G., & Smith, E. (2022). Childhood trauma, posttraumatic stress disorder symptoms, early maladaptive schemas, and schema modes: a comparison of individuals with obesity and normal weight controls. BMC psychiatry, 22(1), 517.

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 η2 = .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 η2 = .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.

Keywords

obesity; early maladaptive schemas; schema modes; schema therapy; childhood trauma; posttraumatic stress disorder; Adaptation, Psychological; Adult; Adverse Childhood Experiences; Humans; Stress Disorders, Post-Traumatic; Surveys and Questionnaires; Schema

Country

Australia

Sample type

Clinical

Study focus

Schema modes

Study design

Comparison between clinical group/s and/or healthy adult controls