Abstract
Objective: To study the relationship between degree of obesity and personality measures of mental distress. Method: The Rorschach method (Comprehensive System) and the Beck Depression Inventory. General descriptors were also included. Participants were 120 obese patients with a mean body mass index (BMI) of 41 (±SD 6) kg/m2. Results: Depression, stress or psychopathology such as distortions in perception and cognitions were not related to the degree of obesity. Body concern and body-related anxiety (An+Xy) were more common in relatively lower degrees of obesity. According to general descriptors heavier patients had lower educational and socio-economic level, and more bodily pain problems. Discussion: Depression was not related to body weight, in spite of findings of more depression in obesity compared to normal weights. Other factors than severity of obesity would account for the mental distress in obese patients. The differences in body concern and anxiety in varying degrees of obesity could be related to the social and educational context, where attitudes toward obesity differ. Less Rorschach signs of body concern in the morbidly obese contrasted with more self-reported bodily pain problems.
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References
World Health Organization: Obesity: Preventing and managing the global epidemic. Geneva, Switzerland, 2000.
National task force on the prevention and treatment of obesity: Overweight, obesity, and health risk. Arch. Intern. Med., 10, 898–904, 2000.
Bouchard C., Pérusse L., Rice T., Rao D.C.: The genetics of human obesity. In: Bray G.A., Bouchard C., James W.P.T. (Eds.), Handbook of obesity. New York, Marcel Dekker Inc., 1998, pp. 157–190.
Arner P.: Genetic variance and lipolysis regulation: implications for obesity. Ann. Med., 33, 542–546, 2001.
Whitaker R.C., Wright J.A., Pepe M.S., Seidel K.D., Dietz W.H.: Predicting obesity in young adulthood from childhood and parental obesity. N. Engl. J. Med., 337, 869–837, 1997.
van Rossum C.T., Hoebee B., Seidell J.C., Bouchard C., van Baak M.A., de Groot C.P., Chagnon M., de Graaf C., Saris W.H.: Genetic factors as predictors of weight gain in adult Dutch men and women. Int. J. Obes. Relat. Metab. Disord., 26, 517–528, 2002.
Sobal J., Stunkard A.J.: Socioeconomic status and obesity: a review of the literature. Psychol. Bull., 105, 260–275, 1989.
Lahmann P.H., Lissner L., Gullberg B., Berglund G.: Sociodemographic factors associated with long-term weight gain, current body fatness and central adiposity in Swedish women. Int. J. Obes. Relat. Metab. Disord., 24, 685–694, 2000.
Mokdad A.H., Serdula M.K., Dietz W.H., Bowman B.A., Marks J.S., Koplan J.P.: The spread of the obesity epidemic in the United States, 1991–1998. JAMA, 282, 1519–1522, 1999.
Rössner S.: Obesity through the ages of man. Int. J. Obes. Relat. Metab. Disord., 25, S29–33, 2001.
Sobal J.: Social and cultural influences on obesity. In: Björntorp P. (Ed.), International textbook of obesity. Chichester, John Wiley & Sons, 2001, pp. 305–322.
Heitmann B.L., Garby L.: Patterns of long term weight changes in overweight developing Danish men and women between 30 and 60 years. Int. J. Obes. Relat. Metab. Disord., 23, 1074–1078, 1999.
Friedman M.A., Brownell K.D.: Psychological correlates of obesity: moving to the next research generation. Psychol. Bull., 117, 3–20, 1995.
Sullivan M., Karlsson J., Sjöström L., Backman L., Bengtsson C., Bouchard C., Dahlgren S., Jonsson E., Larsson B., Lindstedt S., Näslund I., Olbe L., Wedel H.: Swedish obese subjects (SOS) — an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int. J. Obes. Relat. Metab. Disord., 17, 503–512, 1993.
Sullivan M., Karlsson J., Sjöström L., Taft C.: Why quality of life measures should be used in treatment of patients with obesity. In: Björnortp P. (Ed.), International Textbook of Obesity. Chichester, John Wiley & Sons, 2001, pp. 485–510.
Larsson U., Karlsson J., Sullivan M.: Impact of overweight and obesity on health related quality of life. Int. J. Obes. Relat. Metab. Disord., 26, 417–424, 2002.
Ford E.S., Moriatry D.G., Zack M.M., Mokdad A., Chapman D.P.: Self reported body mass index and and health related quality of life: findings from the Behavioral Risk Factor Surveillance. Obes. Res., 9, 21–31, 2001.
Fontaine K.R., Barofsky I.: Obesity and health related quality of life. Obes. Rev., 2, 173–182, 2001.
Fine J.T., Colitz G.A., Coakley E.H.: A prospective study of weight change and health related quality of life in women. JAMA, 282, 2136–2142, 1999.
Heo M., Allison D.B., Faith M.S., Zhu S., Fontaine K.R.: Obesity and quality of life: mediating effects of pain and comorbidities. Obes. Res., 11, 209–216, 2003.
Faith M.S., Matz P.E., Jorge M.A.: Obesity-depression associations in the population. J. Psychosom. Res., 53, 935–942, 2002.
Faith M.S., Allison D.B.: Assessment of psychological status among obese persons. In: Thompson J.K. (Ed.), Body image, eating disorders and obesity. Washington, American Psychological Association, 1997, pp. 365–387.
Hällström T., Noppa H.: Obesity in women in relation to mental illness, social factors and personality traits. J. Psychosom. Res., 25, 75–82, 1981.
Horner T.N., Utermohlen V.: A multivariate analysis of psychological factors related to Body Mass Index and eating preoccupation in female college students. J. Am. Coll. Nutr., 12, 459–465, 1993.
Carpenter K.M., Hasin D.S., Allison D.B., Faith M.S.: Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: Results from a general population study. Am. J. Public Health, 90, 251–257, 2000.
Becker E.S., Margraf J., Türke V., Soedner U., Neumer S.: Obesity and mental illness in a representative sample of young women. Int. J. Obes. Relat. Metab. Disord., 25, S5–S9, 2001.
Roberts R.E., Delger S., Strawbridge W.J., Kaplan G.A.: Prospective association between obesity and depression: evidence from the Alameda county study. Int. J. Obes. Relat. Metab. Disord., 27, 514–521, 2003.
Noppa H., Hällström T.: Weight gain in adulthood in relation to socioeconomic factors, mental illness, and personality traits: a prospective study of middle aged women. J. Psychosom. Res., 25, 83–89, 1981.
Hill A.J., Williams J.: Psychological health in a nonclinical sample of obese women. Int. J. Obes. Relat. Metab. Disord., 22, 578–583, 1998.
Lauer J.B., Wampler R., Lantz J.B., Madura J.A.: MMPI profiles of female candidates for obesity surgery: A cluster analytical approach. Obes. Surg., 6, 28–37, 1996.
Charles S.C.: Psychiatric evaluation of morbidly obese patients. Gastroenterol. Clin. North Am., 16, 415–432, 1987.
Allison D.B., Heshka S.: Emotion and eating in obesity? A critical analysis. Int. J. Eat. Disord., 13, 389–295, 1993.
Exner J.E.: The Rorschach: A comprehensive system. Volume 2. Current research and advanced Interpretation. New York, John Wiley & Sons, 1991.
Exner J.E.:The Rorschach: A comprehensive system. Volume 1. Basic foundations (3rd ed.). New York, John Wiley & Sons, 1993.
Bornstein R.F.: Clinical utility of the Rorschach inkblot method: reframing the debate. J. Pers. Assess., 77, 39–47, 2001.
Meyer G.J., Finn S.E., Eyde L., Kay G.G., Moreland K.L., Dies R.R., Eisman E.J., Kubiszyn T.W., Reed G.M.: Psychological testing and psychological assessment: a review of evidence and issues. Am. Psychol., 56, 128–165, 2001.
Yoshida S., Murano S., Saito Y., Inader H., Tashiro J., Kobayashi J., Tadokoro N., Kanzaki T., Shinomiya M., Morisaki N., Ohono K., Ishikawa Y., Shirai K., Azuma Y., Kodama K.: Treatment of obesity by personality classification-oriented program. Obes. Res., 3, 205–209, 1995.
Clerici M., Albonetti S., Papa R., Penati G., Invernizzi G.: Alexithymia and obesity. Psychother. Psychosom., 57, 88–93, 1992.
Mardsen E., Michel A., Mormont C.: Study of the impact of a gastroplasty on the self-image through the Rorschach. Rorschachiana, 23, 43–57, 1999.
Masling J., Rabie L.: Obesity, level of aspiration, and Rorschach and TAT measures of oral dependence. J. Consult. Psychol., 31, 233–239, 1967.
Bornstein R.F., Greenberg R.P.: Dependency and eating disorders in female psychiatric inpatients. J. Nerv. Ment. Dis., 179, 148–152, 1991.
Mattlar C.-E., Salminen J.K., Alanen E. Rorschach findings for the extremely obese: Results from a twoyear reducing programme. Br. J. Project. Psychol., 34, 2–27, 1989.
Ihanus J.: Anatomical Rorschach responses of gravely psychosomatic patients. Percept. Mot. Skills, 59, 337–338, 1984.
Ihanus J.: Preliminary remarks on the psychodynamics underlying morbid obesity. Br. J. Project. Psychol., 31, 16–24, 1986.
Lee Silberg J., Armstrong J.G.: The Rorschach test for predicting suicide among depressed adolescent inpatients. J. Pers. Assess., 59, 290–303, 1992.
Exner J.E., Wylie J.R.: Some Rorschach data concerning suicide. J. Pers. Assess., 41, 474–485, 1977.
Exner J.E., Martin L.S., Mason B.: A review of the Suicide Constellation Index. Paper presented at the 11th International Rorschach Congress, Barcelona, 1984, July.
Buhler C., LeFever D.: A Rorschach study on the psychological characteristics of alcoholics. Quarterly Journal of Studies on Alcoholism, 8, 197–260, 1977.
Weiner I.B.: Principles of Rorschach interpretation. Mahwah, New Jersey, Lawrence Erlbaum Associates, 1998.
Renzi C., Pescatori M.: Psychologic aspects in proctalgia. Dis. Colon Rectum, 43, 535–539, 2000.
Bénoy H., Daloz L., Bungener C., Chahraoui K., Frenay C., Auvin J.: Emotional factors and subjective quality of life in subjects with spinal cord injuries. Am. J. Phys. Med. Rehab., 81, 437–445, 2002.
Exner J.E.: The Rorschach: A comprehensive system. Volume 1. Basic foundations. (3rd ed.). New York, John Wiley & Sons, 1993, pp. 489–538.
Carnes G.D.: Identifying clients predisposed to failure. J. Couns. Psychol., 20, 79–83, 1973.
Prokopec M., Bellisle F.: Adiposity in Czech children followed from 1 month of age to adulthood: analysis of individual BMI patterns. Ann. Hum. Biol., 206, 517–525, 1993.
Harris H.E.: Pregnancy. In: Björntorp P. (Ed.), International textbook on obesity. Chichester, John Wiley & Sons, 2001, pp. 383–404.
Rorschach H.: Psychodiagnostik (Hans Huber Verlag, Trans.). Bern, Bircher, 1921.
Cohen J.: The cost of dichotomization. Applied Psych. Measurement, 7, 249–253, 1998.
Beck A.T., Ward C.H., Mendelson M., Mock J., Erlbaugh J.: An inventory for measuring depression. Arch. Gen. Psychiatry, 4, 561–571, 1961.
Swedish socioeconomic classification. (Reports on statistical Co-ordination). Örebro, Statistics Sweden, 1995 (1982:4).
Janson H.: Rorschach Research Utilities (Version 0.9.3). Oslo (Norway): [Unpublished computer software]. University of Oslo, Institute of psychology, 2002.
Janson H., Meyer G.J., Exner J.E., Nakamura N., Tuset A.M.: Computing Rorschach agreement among many coders on various data levels: An illustration with three international data sets. Paper presented at the XVII International Congress of Rorschach and Projective Methods, Rome, Italy, 2002, September.
Janson H., Olsson U.: A measure of agreement for interval or nominal multivariate observations. Educational Psychol. Measurements, 61, 277–289, 2001.
Chiccetti D.V., Sparrow S.S.: Developing criteria for establishing interrater reliability of specific items: Applications of assessment of adaptive behavior. Am. J. Ment. Defic., 86, 127–137, 1981.
Shrout P., Fleiss J.: Intraclass correlations: Uses in assessing rater reliability. Psychol. Bull., 86, 420–428, 1979.
Curran P.J., West S.G., Finch J.F.: The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychol. Methods, 1, 16–29, 1996.
Elfhag K., Carlsson, A.M., Rössner S.: Subgrouping in obesity based on Rorschach personality characteristics. Scand. J. Psychol., 44, 399–407, 2003.
Friedman K.E., Reichman S.K., Costanzo P.R., Musante G.J.: Body image partly mediates the relationship between obesity and psychological distress. Obes. Res., 10, 33–41, 2002.
Stewart A.L., Brook R.H.: Effects of being overweight. Am. J. Publi Health, 73, 171–178, 1983.
Furnham A., Baguma P.: Cross-cultural differences in the evaluation of male and female body shapes. Int. J. Eat. Disord., 15, 81–89, 1994.
Jeffery R.W., French S.A., Forster J.L., Spry V.M.: Socioeconomic status differences in health behaviours related to obesity: the healthy worker project. Int. J. Obes., 15, 689–696, 1991.
Sobal J.: Obesity and socioeconomic status: A framework for examining relationships between physical and social variables. Med. Anthropol., 13, 231–247, 1991.
Wadden T.A., Foster G.D., Stunkard A.J., Linowitz J.R.: Dissatisfaction with weight and figure in obese girls: Discontent but not depression. Int. J. Obes., 13, 89–97, 1988.
Anderson L.A., Eyler A.A., Galuska D.A., Brown D.R., Brownson R.C.: Relationship of satisfaction with body size and trying to lose weight: a national survey of overweight and obese women aged 40 and older. Prev. Med., 35, 390–396, 2002.
Igoin L., Apfelbaum M.: Differences in tolerance to frustration between moderately obese and severely obese subjects. Int. J. Obes., 6, 227–232, 1981.
Taylor G.J., Bagby R.M., Oarker J.D.A.: Disorders of affect regualtion. New York, Cambridge University Press, 1997.
Baladaro B., Rossi N., Caterina R., Codispoti M., Balsamo A., Trombini G.: Deficit in the discrimination of nonverbal emotions in children with obesity and their mothers. Int. J. Obes., 27, 191–195, 2003.
Pinaquy S., Chabrol H., Simon C., Louvet J.P., Barbe P.: Emotional eating, alexithymia, and binge-eating disorder in obese women. Obes. Res., 11, 195–201, 2003.
Porcelli P., Meyer G.J.: Construct validity of Rorschach variables for alexhithymia. Psychosomatics, 43, 360–369, 2002.
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Elfhag, K., Rössner, S. & Carlsson, A.M. Degree of body weight in obesity and Rorschach personality aspects of mental distress. Eat Weight Disord 9, 35–43 (2004). https://doi.org/10.1007/BF03325043
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DOI: https://doi.org/10.1007/BF03325043