Temperament and Character among Patients Waiting for Obesity Surgery Danilo Garcia1, 2, 3*, Henrik Forssell1, 4, Kevin M. Cloninger1, 5 1Blekinge Center of Competence, Blekinge County Council, Karlskrona, Sweden 2Department of Psychology, University of Gothenburg, Gothenburg, Sweden 3Network for Empowerment and Well-Being, Sweden 4Department of Surgery, Blekinge County Hospital, Karlskrona, Sweden. 5Anthropedia Foundation, St. Louis, Missouri, USA
Table 1. Means and standard deviations (sd) for each personality dimension for both patients waiting for Aspire operation and individuals from the normal population. T-test statistics and effect size (Cohen’s d) are also presented in this table. PERSONALITY Domain CHARACTER TEMPERAMENT
Abstract The aim was to investigate differences in temperament and character between patients waiting for obesity surgery and the general population. Patients waiting for obesity surgery scored higher in harm-avoidance, reward dependence, persistence, and cooperativeness and also lower in self-directedness. Background Whereas successful long-term weight loss among people suffering from obesity can be achieved through a combination of psychological intervention, exercise, and dietary strategies, surgery is suggested as the most effective treatment available today (e.g., Norén & Forsell, 2016). For instance, patients treated with Aspire Therapy (an endoscopically placed gastrostomy tube allowing patients to aspirate gastric contents 20 min after meal consumption) had an excess weight loss of 54.4% and a significant increase in quality of life one year after the surgery (Norén & Forsell, 2016). Nevertheless, obesity is more likely to be understood as a spectrum syndrome. Maladaptive behavior or destructive coping strategies (physical inactivity, smoking, and drinking), for example, alter bodily functions, which in turn lead to obesity and to cardiovascular or other diseases. This type of maladaptive behavior is related to, besides genetic factors, the person’s inability to make healthy self-directed choices. Nevertheless, results are inconsistent regarding the relationship between obesity and personality traits. Some researchers even suggest that obese individuals do not differ in personality from the general population. But this inconsistency might depend on limitations in the measures used for most research, which are designed to evaluate abnormal personality, rather than variations in normal personality, or not being designed to assess a biopsychosocial view of personality. Cloninger’s biopsychosocial model, for instance, consists of a temperament domain, aspects of emotional responses that are stable through time, and a character domain, mental self-government, or what the individual makes of her/himself intentionally, and develops with time. Aims The aim of this study was to investigate differences in personality between patients waiting for obesity surgery (i.e., Aspire Therapy) and the general population. Subjects & Methods Seventy Swedish patients were compared to normative data (N = 1,230) from the Swedish population. All answered to the Temperament and Character Inventory–Revised, which measures Cloninger’s biopsychosocial model of personality.
Results Patients waiting for Aspire Therapy scored higher in three of the four temperament dimensions: harm-avoidance, reward dependence, and persistence (see Table 1). With regard to character, patients scored lower in self-directedness and higher in cooperativeness.
Dimensions
PATIENTS
NORMAL POPULATION
T-TEST STATISTICS AND EFFECT SIZE
Mean
sd
Mean
sd
t
df
p
Cohen's d
Novelty Seeking
59.21
7.15
58.51
8.73
0.82
69
.413
0.10
Harm Avoidance
57.11
11.49
52.09
10.91
3.66
69
.001
0.44
Reward Dependence
70.76
9.41
66.61
9.15
3.69
69
.001
0.44
Persistence
68.13
8.74
65.23
9.85
2.77
69
.007
0.33
Self-directedness
72.54
10.64
75.57
11.26
-2.38
69
.020
-0.28
Cooperativeness
79.4
7.53
76.70
9.14
3.00
69
.004
0.36
Self-transcendence
38.6
10.32
37.93
9.92
0.54
69
.589
0.06
Note: significant differences marked in bold type.
Acknowledgments The study was funded by the Blekinge Scientific Council at Landstinget Blekinge. We dedicate this poster to our colleague Henrik Forssell who passed away after a short time of illness. For additional information, please contact:
[email protected]
References Cloninger, C. R. (2004). Feeling good: the science of well-being. New York: Oxford University Press. Norén, E., & Forsell, H. (2016). Aspiration therapy for obesity; a safe and effective treatment. BMC Obesity, 3:56. DOI: 10.1186/s40608-016-0134-0.
