Date of Award

9-25-2024

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Graduate Department of Clinical Psychology

First Advisor

Greg Fischer, PhD

Second Advisor

Danny Rodriguez, PsyD

Third Advisor

Luann Foster, PsyD

Abstract

Since the National Institute of Health recommendation in 1991, most bariatric clinics and insurance companies across the United States now require psychological evaluations for patients before receiving bariatric surgery (Marek & Heinberg, 2016). Clinicians are now using various objective personality measures and other assessment tools during comprehensive evaluations to help make recommendations to surgeons and clinical staff about patient suitability for weight loss surgery. Previous studies suggest that specific demographics and clinical elevations on objective personality assessments may predict the reduction of body mass index (BMI) in patients after bariatric surgery (Oltmanns et al., 2020; Hoyt & Walter, 2022a). This study investigated the relationship and predictive quality of the clinical scales on the Personality Assessment Inventory (PAI) on BMI reduction in a population of rural adults who underwent weight loss surgery. We analyzed an archival data set to identify pre- and post-surgery BMI, demographic variables (i.e., age and education), and the clinical scales of the PAI, which we administered to a sample of 78 bariatric patients. We hypothesized that there would be several associations between the PAI clinical scales and total BMI reduction. Results showed significant positive correlations between presurgical BMI and the number of months after surgery, during which staff measured total BMI reduction. We also found significant positive correlations between BMI reduction and the following PAI clinical scales: cognitive anxiety, borderline identity concerns, anxiety-related disorders, and drug problems. This suggests that rumination and worry, a lack of a sense of self, anxiety-related disorders (i.e., obsessive-compulsive disorder, complex or post-traumatic stress disorder, and phobic disorders), and historical or current drug use may help patients in the short term after surgery to reduce BMI compared to those with lower scores on these PAI scales. Our hierarchical regression analysis, however, showed that once all extraneous and demographic variables were controlled for, the four PAI clinical scales accounted for 8% of the variance in BMI reduction, an insignificant statistical finding.

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