Multidisciplinary Residential Program for the Treatment of Obesity: How Body Composition Assessed by DXA and Blood Chemistry Parameters Change During Hospitalization and Which Variations in Body Composition Occur from Discharge Up to One Year Follow-Up

Purpose Since obesity is a pathology characterized by a complex variable clinical presentation with comorbidities, multidisciplinary residential program (MRP) represents one of the best options for treating obesity. The purpose of this study was to evaluate the effectiveness of 8-weeks MRP on weight loss, body composition assessed by DXA and metabolic blood parameters between entry (T0) and discharge (T1). The secondary endpoint was the evaluation of the patients' adherence to diet during the check-up outpatient visits, at 2 (T2), 6 (T3) and 12 (T4) months after discharge. Methods One hundred and seventy-eight subjects were enrolled (61 males and 117 females, aged 58.5±13, BMI 41.3±6). The difference in values ​​(end of hospitalization compared to baseline) was calculated through the univariate GLM procedure, which provides regression analysis and analysis of variance for a variable dependent on one or more variables. Results There was a statistically significant (p<0.001) improvement of all parameters investigated: total mass (-5.68 kg), fat free mass (-1236.03 g), fat mass (-4416.85 g), fat mass index (-1724.56), visceral adipose tissue (-332.76 g), arm circumference (-1.63 cm) and calf circumference (-1.16 cm). The skeletal muscle index was not affected. Statistically significant improvement in glycaemic and lipid profile were reported. The BMI average reduction continued from discharge until T4. No statistically significant changes in fat free mass and visceral adipose tissue (VAT) were reported during a year of follow-up. Conclusion The present study demonstrated the clinical benefits of 8-weeks MRP, which includes hypocaloric diet, physical exercise, and psychological support.

Subjective Well-Being of Young People in Therapeutic Residential Care from a Gender Perspective

A growing body of research focus on subjective well-being (SWB) in adolescence; however there are few studies focus specifically on the residential care population and even fewer on differences by type of residential facility separately for males and females. This study aims to analyze SWB in therapeutic residential care (a residential program created to address youths with severe emotional and behavioral problems) in relation to young people in other kinds of residential child care (RCC). 567 adolescents aged 14-18 from Therapeutic Residential Care (TRC) (n=256) and RCC (n=311) participated in the study. Results showed few significant differences concerning the residential program factor. Satisfaction with their own family was greater for young people in TRC and satisfaction, both with the groups they belong to and with their own residential facility, rated higher among the RCC group. Regarding differences by sex, females reported less SWB in all the domains including overall life satisfaction. The effect of the interaction between sex and type of residential program showed that females in TRC reported SWB, particularly low. The main implications for research and intervention will be discussed.

Applying the PAI Treatment Process Index to PAI-As Completed by Adolescents in a Residential Program

The Personality Assessment Inventory (PAI) Treatment Process Index (TPI) is a measure of treatment amenability based on an index of factors related to poor treatment outcomes (e.g., hostility, lack of social support, and poor impulse control). In this study, the formula used to calculate the TPI for the adult PAI was applied to PAI-Adolescent (PAI-As) protoocols completed by 372 adolescents (mean age: 16.8 years; 80% male) during a 22-week residential program for at-risk youth. The number of disciplinary infractions received during the program was used as an indicator of the participants’ response to the program. Average PAI-A scale scores and TPI scores were higher than those previously reported for community samples, but lower than those found in clinical samples. TPI scores were positively associated with disciplinary infractions, particularly nonaggressive infractions, when controlling for demographic factors and other clinically relevant variables. Results suggest that the the TPI has relevance for adolescents completing the PAI-A.

Peer Perceptions of Communal Narcissism and Communalism in At-Risk Adolescents

The present study extended research on the relation of communal narcissism in adolescents with self- and peer-reported personality and behavior. Although communal narcissism may be associated with negative peer perceptions, a communal orientation that does not also convey superiority (i.e., communalism) may be viewed more favorably. Self- and peer-perceptions were investigated as a function of communal narcissism and a non-narcissistic communal orientation (i.e., by altering the Communal Narcissism Inventory to reflect more humble self-views). Participants were 246 adolescents, ages 16–19 years, who were attending a quasi-military residential program for youth who have dropped out, or were at-risk of dropping out, of school. Communal narcissism and communalism were significantly interrelated. Communal narcissism was negatively associated with unique variance in self-reported empathy, whereas communalism was positively associated with self-reported empathy and more strongly related to peer-reported prosociality. The role of superiority in communal domains in adolescent self-perception and peer relationships is discussed.