Early Maladaptive Schemas and Cognitive Distortions in Adults with Morbid Obesity: Relationships with Mental Health Status

Abstract

Dysfunctional cognitions may be associated with unhealthy eating behaviors seen in individuals with obesity. However, dysfunctional cognitions commonly occur in individuals with poor mental health independently of weight. We examined whether individuals with morbid obesity differed with regard to dysfunctional cognitions when compared to individuals of normal weight, when mental health status was controlled for. 111 participants—53 with morbid obesity and 58 of normal weight—were assessed with the Mini-Mental State Examination, Young Schema Questionnaire, Cognitive Distortions Questionnaire, Depression, Anxiety and Stress Scale, and a Demographic and Clinical Questionnaire. Participants with morbid obesity showed higher scores in one (insufficient self-control/self-discipline) of 15 early maladaptive schemas and in one (labeling) of 15 cognitive distortions compared to participants of normal weight. The difference between groups for insufficient self-control/self-discipline was not significant when mental health status was controlled for. Participants with morbid obesity showed more severe anxiety than participants of normal weight. Our findings did not show clinically meaningful differences in dysfunctional cognitions between participants with morbid obesity or of normal weight. Dysfunctional cognitions presented by individuals with morbid obesity are likely related to their individual mental health and not to their weight.

The Association between Food Addiction and Early Maladaptive Schemas in Overweight and Obese Women: A Preliminary Investigation

“…Our results also showed that binge eating severity was positively associated with three maladaptive schemas (i.e., disconnection/rejection, impaired limits, and other-directedness domains). No significant association was observed between BMI and EMSs scores, suggesting that dysfunctional schemas in overweight and obese women are likely related to their individual mental health (i.e., dysfunctional eating patterns and/or psychopathology) and not to their weight, as has been previously hypothesized for patients with morbid obesity [ 30 ]. Finally, our regression analysis showed that the disconnection/rejection schema score was independently associated with FA symptoms, after controlling for the presence of other potential confounding variables (e.g., psychopathology and binge eating severity), suggesting that this domain may be a crucial factor for the development of FA.…”

“…Poursharifi et al [ 29 ] reported that some aspects of identity (e.g., social and relational identities) were positively associated with EMSs in obese patients. More recently, da Luz et al [ 30 ] observed that, compared to normal-weight individuals, patients with morbid obesity (BMI > 40 kg/m 2 ) had higher scores for the insufficient self-control/self-discipline schema, even though this difference was not significant when mental health status was controlled for. Finally, it has been reported that, compared to normal-weight adolescents, overweight [ 31 ] and obese [ 32 ] adolescents reported higher EMSs.…”

Early maladaptive schemas in overweight and obesity: A schema mode model

“…Previous studies [15, 26, 27, 28, 29, 30, 31] have shown an association between early maladaptive schemas (i.e., abandonment, insufficient self-control social isolation, failure to achieve, defectiveness/ shame, dependence/ incompetence, entitlement/ grandiosity) and overeating, and other eating-related dysfunctional attitudes, such as food addiction and bingeing. Similarly, in our study overweight/obese participants reported more intense abandonment, dependence, subjugation and insufficient-self control schemas, compared with normal weight subjects.…”

Personality Features in Obesity

“…Consistent with the present results on the quality of interpersonal relationships, studies showed that individuals with obesity reported elevated interpersonal distress (e.g., Lo Coco et al, 2012 ). Some studies reported the presence of maladaptive schemata related to social isolation, shame, and failure to achieve and an association between overeating and early maladaptive schemas ( Anderson et al, 2006 ; Da Luz et al, 2017 ; Imperatori et al, 2017 ). Specifically, a recent study showed that individuals with overweight and obesity reported more intense abandonment, dependence, subjugation, and insufficient self-control schemas, compared with normal-weight subjects ( Basile et al, 2019 ).…”