Dataset Information

Attachment style and post-bariatric surgery health behaviours: the mediating role of self-esteem and health self-efficacy.

ABSTRACT:

Background

Attachment avoidance and anxiety have been linked to overweight and poor health behaviours, yet the mechanisms that underpin the relationship between attachment and health behaviours are not fully understood. Self-esteem and self-efficacy have been found to differ between attachment styles, rendering these variables potential mediators of the relationship. This longitudinal study investigated the serial mediation between preoperative attachment and 2-year post-operative health behaviours through self-esteem and health self-efficacy.

Methods

Participants were 263 bariatric surgery patients (75.7% females, aged 47.7 ± 10.4 years, BMI 38.9 ± 3.6 kg/m²) assessed before the operation and again one and two years after the surgery. Patients completed the Experiences for Close Relationships Brief Scale, Rosenberg Self-esteem scale, Weight Efficacy Lifestyle Questionnaire, Bariatric Surgery Self-Management Questionnaire, Exercise Self-Efficacy Scale and the Exercise Behaviour Scale.

Results

Higher preoperative attachment anxiety and avoidance were associated with lower self-esteem one year after bariatric surgery and poorer health self-efficacy two years after the surgery. Self-esteem and health self-efficacy mediated the relationships between preoperative anxious and avoidant attachment and 2- year post-operative diet adherence and physical activity.

Conclusions

Helping patients to feel more worthy and reinforcing their beliefs about their own competences could lead to higher engagement with healthy lifestyle and adherence to treatment protocols, ultimately helping patients to achieve their goals for bariatric surgery.

Clinical trial registration

BARIA: Netherlands Trial Register: NL5837 (NTR5992) https://www.trialregister.nl/trial/5837 . Diabaria: ClinicalTrials.gov identifier (NCT number): NCT03330756.

SUBMITTER: Pyykko JE

PROVIDER: S-EPMC10464092 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Attachment style and post-bariatric surgery health behaviours: the mediating role of self-esteem and health self-efficacy.

Pyykkö Johanna Eveliina JE Hinnen Chris C Aydin Ömrüm Ö Nieuwdorp Max M De Brauw L Maurits LM Bruin Sjoerd C SC van Olst Nienke N Gerdes Victor E A VEA Sanderman Robbert R Hagedoorn Mariët M

BMC psychology 20230825 1

<h4>Background</h4>Attachment avoidance and anxiety have been linked to overweight and poor health behaviours, yet the mechanisms that underpin the relationship between attachment and health behaviours are not fully understood. Self-esteem and self-efficacy have been found to differ between attachment styles, rendering these variables potential mediators of the relationship. This longitudinal study investigated the serial mediation between preoperative attachment and 2-year post-operative health ...[more]

PMID: 37626349

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Project description:Copious studies have identified a link between disorganised attachment and engagement in controlling caregiving or controlling punitive behaviours. Studies have suggested that consistently engaging in these behaviours can cause difficulties within relationships and contribute to the development of a personality disorder. Most of the literature thus far has focused on engagement in controlling behaviours by children with a disorganised attachment style, despite there being theoretical grounds to suggest they may also be used by adults and across all types of insecure attachment. This study aimed to address these gaps by looking at adult attachment style and engagement in controlling behaviours in romantic relationships, across all insecure attachment styles; avoidant, anxious and disorganised. The current study recruited a non-clinical sample; specifically, 149 English-speaking adults, living in the UK, between the ages of 18 and 77 years old (M = 34.28, SD = 14.90). The participants answered an anonymous online questionnaire containing four self-report measures which assessed the participants' attachment security and organisation, caregiving style and engagement in punitive behaviours. The results indicated that participants who scored higher in disorganised attachment were more likely to use controlling punitive behaviours in their romantic relationships. Moreover, participants who reported a more insecure-anxious attachment style were more likely to use compulsive caregiving behaviours in their romantic relationships. In contrast, participants who reported a higher insecure avoidant attachment style were less likely to use compulsive caregiving behaviours in their romantic relationships. These results have implications for adult attachment theory and aid the understanding of some of the behaviours that can be harmful within romantic relationships. The findings could be used to help at-risk individuals develop healthy interpersonal relationship going forward.

Project description:ObjectivesParanoia is known to be associated with insecure attachment, with negative self-esteem as a mediator, but this pathway is insufficient to explain the paranoid individual's beliefs about malevolent others. Mistrust is a likely additional factor as it is a core feature of paranoid thinking also associated with insecure attachment styles. In this study, we tested whether mistrust - operationalized as judgements about the trustworthiness of unfamiliar faces - constitutes a second pathway from insecure attachment to paranoia.DesignThe design of the study was cross-sectional.MethodsA nationally representative British sample of 1,508 participants aged 18-86, 50.8% female, recruited through the survey company Qualtrics, completed measurements of attachment style, negative self-esteem, and paranoid beliefs. Usable data were obtained from 1,121 participants. Participants were asked to make trustworthiness judgements about computer-generated faces, and their outcomes were analysed by conducting signal detection analysis, which provided measures of bias (the tendency to assume untrustworthiness in conditions of uncertainty) and sensitivity (accuracy in distinguish between trustworthy and untrustworthy faces).ResultsResults using structural equation modelling revealed a good model fit (RMSEA = .071, 95% CI: 0.067-0.075, SRMR = .045, CFI = .93, TLI = .92). We observed indirect effects through bias towards mistrust both for the relationship between attachment anxiety and avoidance (β = .003, 95% CI: 0.001-0.005,p < .001) and attachment anxiety and paranoia (β = .003, 95% CI 0.002-0.006, p < .001). We observed an indirect effect through negative self-esteem only for the relationship between attachment anxiety and paranoia (β = .064, 95% CI: 0.053-0.077, p < .001). Trust judgements and negative self-esteem were not associated with each other.ConclusionsWe find that a bias towards mistrust is associated with greater paranoia. We also find indirect effects through bias towards mistrust between attachment styles and paranoia. Finally, we reaffirm the strong indirect effect through negative self-esteem between attachment anxiety and paranoia. Limitations of the study are discussed.Practitioner pointsWhen working with individuals suffering from paranoia, clinicians should consider not only explicit, deliberative cognitive processes of the kind addressed in cognitive behaviour therapy (e.g. cognitive restructuring) but also the way in which their patients make perceptual judgements (e.g., their immediate reactions on encountering new people) and consider interventions targeted at these judgements, for example, bias modification training. Assessment and clinical interventions for people should consider the role of trust judgements and the way in which they combine with low self-esteem to provoke paranoid beliefs. Psychological interventions targeting paranoid beliefs should focus on both attachment anxiety and attachment avoidance.

Dataset Information

Attachment style and post-bariatric surgery health behaviours: the mediating role of self-esteem and health self-efficacy.

Background

Methods

Results

Conclusions

Clinical trial registration

Publications

Attachment style and post-bariatric surgery health behaviours: the mediating role of self-esteem and health self-efficacy.

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