The stability of self-reported adverse experiences in childhood: a longitudinal study on obesity.

The literature on the effect of maltreatment has revealed several methodological problems of retrospective studies, such as the validity and stability of retrospective reports, which may be influenced by factors such as one's mental health at the time of the report. This study aims to assess the temporal stability of self-reported adverse childhood experiences at three different time points, separated by 6 months each, and to analyze the relationship between general psychopathology and the number of reported experiences. Thirty obese participants responded to the Portuguese version of the Childhood History Questionnaire, a self-report measure that assesses adverse childhood experiences, and the Brief Symptom Inventory. The results suggest that adverse childhood experiences are common in these participants (time 1: X = 1.87, SD = 1.3; time 2: X = 1.98, SD = 1.6; time 3: X = 1.98, SD = 1.6). The agreement levels, as measured by kappa values, were satisfactory for the dimensions of maltreatment focused on the individual, with kappas ranging between .34 and .44. Our participants did not exhibit psychopathology at any of the time points, and the psychopathological symptoms were not related to total adversity reported. The major contribution of this study is the comparison of self-reports at three time points, separated by significant time intervals, and the inclusion of 10 different dimensions of childhood adversity. The data show an adequate stability in the report of maltreatment toward the individual (abuse and physical neglect) and in specific aspects of adversity in the family.

Patients' experiences after bariatric surgery: a qualitative study at 12-month follow-up.

This study used a qualitative approach to understand patients' experiences in post-surgery adaptation related to bariatric surgery, 12 months after this procedure. The study population included 30 obese adults, with a mean age of 40.17 years, who were interviewed 12 months after bariatric surgery. Individual interviews, using open-ended questions, were audiotaped, transcribed and coded according to the grounded theory methodology. The data showed that the subjects described themselves as belonging to one of two opposite and separate groups: success or failure. In both groups, two core categories emerged from the data: outcomes and treatment. Previous expectations were reached by the patients who described themselves as successful, with some remaining concerns related to future weight maintenance and aesthetics issues. The failure group emphasized their unmet expectations and the expectancy that surgery would change their lives remained. Treatment in the successful cases integrated lifestyle changes and bariatric surgery, highlighting the personal commitment required to achieve the objectives. The failure group emphasized bariatric surgery without personal commitment, and healthy eating behaviour was understood as a sacrifice. The post-surgical adaptation experiences were diverse: the cases that were described as a success highlighted lifestyle changes, personal efforts and commitment with the global treatment process. External understanding and the desire for a miracle surgery characterized the cases described as a failure. According to these results, it is necessary to promote adequate information about the whole process and skills required to ensure commitment in all treatment dimensions.

Obesity and treatment meanings in bariatric surgery candidates: a qualitative study.

BACKGROUND: This study used a qualitative approach to comprehend how the morbid obese conceptualize and deal with obesity and obesity treatment, with the particular aim of exploring the expectations and beliefs about the exigencies and the impact of bariatric surgery. METHODS: The study population included 30 morbid obese patients (20 women and 10 men) with a mean age of 39.17 years (SD = 8.81) and a mean body mass index of 47.5 (SD = 8.2) (reviewer #2, comment #9) interviewed individually before surgery using open-ended questions. The interviews were audiotaped, transcribed, and then coded according to grounded analysis methodology. RESULTS: Three main thematic areas emerged from the data: obesity, eating behavior, and treatment. Obesity is described as a stable and hereditary trait. Although participants recognize that personal eating behavior exacerbates this condition, patients see their eating behavior as difficult to change and control. Food seems to be an ever-present dimension and a coping strategy, and to follow an adequate diet plan is described as a huge sacrifice. Bariatric surgery emerges as the only treatment for obesity, and participants highlight this moment as the beginning of a new life where health professionals have the main role. Bariatric surgery candidates see their eating behavior as out of their control, and to commit to its demands is seen as a big sacrifice. For these patients, surgery is understood as a miracle moment that will change their lives without requiring an active role or their participation. CONCLUSION: According to these results, it is necessary to validate them with qualitative and quantitative studies (reviewer #2, comment #3); it is necessary to promote a new awareness of the weight loss process and to empower patients before and after bariatric surgery.