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Psychological flexibility and the gains of acceptance-based treatment for post-bariatric surgery: six-month follow-up and a test of the underlying model
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
2012 (English)In: Clinical Obesity, ISSN 1758-8103, E-ISSN 1758-8111, Vol. 2, no 1-2, 15-24 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Blackwell Publishing Ltd , 2012. Vol. 2, no 1-2, 15-24 p.
Keyword [en]
Acceptance and commitment therapy, bariatric surgery, body dissatisfaction, eating behaviour
National Category
Social Sciences
Research subject
Psychology
Identifiers
URN: urn:nbn:se:uu:diva-183022DOI: 10.1111/j.1758-8111.2012.00041.xOAI: oai:DiVA.org:uu-183022DiVA: diva2:561709
Available from: 2012-10-21 Created: 2012-10-21 Last updated: 2017-12-07Bibliographically approved
In thesis
1. A Contextual Behavioral Approach for Obesity Surgery Patients
Open this publication in new window or tab >>A Contextual Behavioral Approach for Obesity Surgery Patients
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis investigates a contextual behavioral approach for obesity surgery patients. In a contextual approach a behavior is interpreted as inseparable from its current and historical context. Candidates for bariatric surgery often have a history of self-stigma, body dissatisfaction and eating for emotional relief. Despite losing a large amount of weight post surgery, psychological problems may still be present for some patients. One possible common underlying process observed in body concerns and eating patterns is experiential avoidance. Experiential avoidance is defined as; any attempt to avoid, change, or control unwanted thoughts and feelings when so doing causes harm.

Though a multidisciplinary team is recommended for post-surgical care, there are few studies evaluating the psychological treatment of patients undergoing bariatric surgery. In this thesis a protocol based on Acceptance and Commitment Therapy (ACT), was developed and implemented, partly via the Internet, in a clinical setting. In an acceptance-based approach to obesity, psychological well-being is the main outcome. ACT was significantly more effective than ‘treatment as usual’ in terms of body dissatisfaction and quality of life after surgery. Both groups improved in eating disordered attitudes and behaviors. Predictions based on the underlying treatment model were also investigated. Positive treatment outcomes were found to be associated with increased psychological flexibility.  Despite some methodological limitations, the results are promising and future studies should further evaluate ACT in the context of bariatric surgery.

This thesis also acknowledges the need for clinical assessment tools appropriate for the bariatric surgery context. The Acceptance and Action Questionnaire for Weight (AAQ-W) is a measure of experiential avoidance, and was evaluated in the present thesis. The AAQ-W was found to be a reliable and valid measure for people undergoing bariatric surgery. Another measure, Disordered Eating in Bariatric Surgery (DEBS) was developed and evaluated. The DEBS was found to posses satisfactory psychometric properties in terms of reliability and validity.  The AAQ-W and the DEBS may facilitate both systematic clinical evaluation and future research within the area of bariatric surgery.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 103 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 84
Keyword
obesity, bariatric surgery, stigma, emotional eating, body dissatisfaction, Acceptance and Commitment therapy, Internet
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:uu:diva-183622 (URN)978-91-554-8524-5 (ISBN)
Public defence
2012-12-14, Universitetshuset sal IV, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-11-23 Created: 2012-10-30 Last updated: 2013-02-11Bibliographically approved

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Weineland, S.Dahl, J.

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