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Psychosocial Issues and Bariatric Surgery (LABS3)

Bariatric surgery is associated with long-term weight loss, as well as short-term improvements in obesity-related medical comorbidities. However, a significant proportion of patients fail to lose sufficient weight, or experience significant weight regain. Although no robust predictors of response have been identified, pilot data that will be presented and reviewed suggest that surgery has profound effects on eating behaviors and psychosocial functioning, and that these factors may affect postoperative weight control.

The present investigation capitalizes on the Longitudinal Assessment of Bariatric Surgery (LABS) consortium to conduct an in-depth examination of the psychosocial aspects of surgery among a geographically, ethnically, and racially diverse sample of men and women undergoing bariatric surgery. This project unites experts in the areas of psychopathology, eating behaviors and quality of life to conduct a naturalistic study using state-of-the-art assessment tools; to document the relationships among psychosocial factors; and to examine psychosocial predictors of surgical outcomes.

調査の概要

詳細な説明

Primary Objective. Despite the obvious impact of bariatric surgery procedures on intake, no study to date has included a careful assessment of psychological factors, feeding patterns, energy intake and eating problems in this group of patients longitudinally. The Investigators believe that a careful examination of the structure of eating behavior and eating problems (e.g. vomiting) would be very helpful in guiding bariatric surgeons and dieticians who work with this group of patients in terms of dietary advice and recommendations, and with the prediction of eating problems and poor nutrient intake in the subgroup that develops such problems. This study involves prospective assessment of psychosocial outcomes of surgery by adding a supplemental battery to the LABS-2 assessment schedule. Conducting assessments at three of the LABS clinical sites assures the geographic, ethnic, and racial diversity of the sample, and hence enhances the potential to identify a subgroup or subgroups of patients susceptible to poor outcomes after surgery and the generalizability of study results.

This study would also include an evaluation of psychopathological and behavioral variables that might impact on weight loss and weight regain, and psychosocial complications post-operatively, as well as quality of life.

The overall goal of this study is to obtain detailed information that will allow a careful assessment of psychopathology, quality of life and eating behavior pre-surgically and at regular intervals for up to 7 years after the surgical intervention.

The Investigators believe that the instruments and procedures selected will allow a detailed examination of psychopathology, eating pathology and quality of life in detail.

The Investigators believe that the measures and tasks added at year 7 will allow the examination of theories of affect regulation, cognitive control, and reward processing in understanding postsurgical outcomes regarding pathological eating behavior and alcohol/substance use and their shared similarities as well as underlying neurobiological systems.

研究の種類

観察的

入学 (実際)

202

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • North Dakota
      • Fargo、North Dakota、アメリカ、58103
        • Neuropsychiatric Research Institute

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

Patients will be approached for inclusion into LABS1 and LABS2 at the Sanford Surgery Department, Fargo ND, at the University of Pittsburgh Medical Center and at Cornell/Columbia Medical Center in New York. LABS3 Psychosocial participants will be selected from those individuals participating in LABS1 and LABS2.

説明

Inclusion Criteria:

  • Male and female patients who are at least 18 years of age and undergo bariatric surgery by a LABS certified surgeon.
  • Previous enrollment in LABS-1 and LABS-2.
  • BMI at baseline of greater than or equal to 35.

Exclusion Criteria:

  • Informed consent not obtained
  • Type 1 Diabetes Mellitus
  • Unlikely to comply with follow-up protocol (ie: geographically inaccessible for study visits)
  • Unable to communicate with local study staff

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change in Psychopathology as measured by the SCID
時間枠:annually up to 7 years post bariatric surgery
Structured Clinical Interview for DSM-IV, Patients Edition (SCID) will be administered to assess comorbid Axis I psychopathology.
annually up to 7 years post bariatric surgery

二次結果の測定

結果測定
メジャーの説明
時間枠
Change in Quality of life as measured by the IWQOL
時間枠:annually up to 7 years post bariatric surgery
Impact of Weight on Quality of Life Questionnaire: This is a 31-item, self-report, obesity-specific quality of life measure that will be utilized to assess quality of life.
annually up to 7 years post bariatric surgery
Change in Quality of life as measured by the SF-36
時間枠:annually up to 7 years post bariatric surgery
ShortForm-36: The SF-36 is a 36-item questionnaire that assesses functioning and quality of life as it relates to health status.
annually up to 7 years post bariatric surgery
Change in Depression as measured by the BDI
時間枠:annually up to 7 years post bariatric surgery
Beck Depression Inventory: The BDI is a 21-item instrument that is widely used to assess depressive symptoms.
annually up to 7 years post bariatric surgery
Change in Eating behaviors as measured by the EDE
時間枠:annually up to 7 years post bariatric surgery
Eating Disorder Examination: The diagnostic version of the EDE will be used as the primary measure of eating behavior and pathology.
annually up to 7 years post bariatric surgery
Change in Impulse Control as measured by the SCID-ICD module
時間枠:annually up to 7 years post bariatric surgery
The impulse control module of the SCID will be administered to assess impulsive/compulsive disorders for participants.
annually up to 7 years post bariatric surgery

その他の成果指標

結果測定
メジャーの説明
時間枠
Affect regulation as measured by the DERS
時間枠:7 year post bariatric surgery
Difficulties in Emotion Regulation Scale: The DERS is a 36-item self-report questionnaire that assesses six domains of emotion dysregulation and has been found to have acceptable internal consistency as well as adequate test-retest reliability and construct validity.
7 year post bariatric surgery
Affect regulation as measured by the AIM
時間枠:7 years post bariatric surgery
Affect Intensity Measure:The AIM is a 40-item self-report measure of positive and negative emotional intensity and reactivity.
7 years post bariatric surgery
Impulsivity
時間枠:7 years post bariatric surgery
UPPS-P Impulsive Behavior Scale: This is a 59-item self-report measure assessing five dimensions of impulsivity. Only the negative urgency and positive urgency subscales will be administered.
7 years post bariatric surgery
Behavioral inhibition as measured by the SPSRQ
時間枠:7 years post bariatric surgery
Sensitivity to Punishment and Sensitivity to Reward Questionnaire: This is a 44-item self-report measure that is based on Gray's behavioral inhibition and activation motivational systems conceptualization, and assesses sensitivity to punishment and reward.
7 years post bariatric surgery
Temperament as measured by the ATQ
時間枠:7 years post bariatric surgery
Effortful Control Scale of the Adult Temperament Questionnaire: This 19-item self-report measure assesses several components of dispositional effortful control, including attentional control (i.e., ability to voluntarily focus or shift attention), inhibitory control (i.e., ability to inhibit behavior), and activation control (i.e., ability to activate behavior as needed).
7 years post bariatric surgery
Cognitive Control as measured by the Go/No-Go Task
時間枠:7 years post bariatric surgery
Go/No-Go Task: This computerized task assesses the capacity for suppressing previously reinforced responses.
7 years post bariatric surgery
Cognitive Control as measured by the Delay Discounting Task
時間枠:7 years post bariatric surgery
Delay Discounting Task: Delay discounting tasks require participants to choose between receiving a larger amount of money after a delay versus receiving a smaller amount immediately.
7 years post bariatric surgery

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:James E. Mitchell, MD、Neuropsychiatric Research Institute

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2010年7月1日

一次修了 (実際)

2019年6月30日

研究の完了 (実際)

2019年6月30日

試験登録日

最初に提出

2015年7月6日

QC基準を満たした最初の提出物

2015年7月8日

最初の投稿 (見積もり)

2015年7月13日

学習記録の更新

投稿された最後の更新 (実際)

2019年8月20日

QC基準を満たした最後の更新が送信されました

2019年8月19日

最終確認日

2019年8月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 5R01DK084979-06 (米国 NIH グラント/契約)

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