title: Socially desirable responding by bariatric surgery candidates during psychological assessment.
abstract: BACKGROUND
  Most bariatric surgery programs in the United States require preoperative psychological evaluations for candidates for surgery. Among those who perform these evaluations is concern that many patients engage in "impression management" or minimizing the symptoms of distress to receive a recommendation to proceed with surgery from the mental health professional. We sought to assess the prevalence of socially desirable responding and its associations with measures of psychological functioning among bariatric surgery candidates at 2 academic medical centers in the United States.
  
  
  METHODS
  The participants were male (n = 66) and female (n = 293) bariatric surgery candidates who presented for psychological evaluation. The participants completed 2 measures of socially desirable response styles (Marlowe-Crowne Social Desirability Scale and Personality Assessment Inventory Positive Impression Management scale) and standardized measures of anxiety, depression, and alcohol-related problems.
  
  
  RESULTS
  The participants exhibited elevated scores on the social desirability indicators, with 33.3-39.8% scoring above the recommended cut-score on the Personality Assessment Inventory Positive Impression Management scale and 62.3-67% scoring 1 standard deviation above the standardization mean on the Marlowe-Crowne Social Desirability Scale. Scores on the Marlowe-Crowne Social Desirability Scale and Personality Assessment Inventory Positive Impression Management scale correlated inversely with the clinical measures of anxiety and depression, and the high/low scorers on the social desirability indices exhibited significant differences in anxiety and depression. Thus, elevated scores on the social desirability indices were associated with underreporting of certain clinical symptoms.
  
  
  CONCLUSIONS
  A substantial proportion of bariatric surgery candidates appear to present themselves in an overly favorable light during the psychological evaluation. This response style is associated with less reporting of psychological problems and might interfere with the accurate assessment of patient functioning.
authors.affiliation: Department of Psychology, Dickinson College, Carlisle, Pennsylvania 17013, USA. ambwanis@dickinson.edu
authors.forename: Suman
authors.initials: S
authors.lastname: Ambwani
authors.forename: Abbe G
authors.initials: AG
authors.lastname: Boeka
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Brown
authors.forename: T Karl
authors.initials: TK
authors.lastname: Byrne
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Budak
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Fabricatore
authors.forename: Leslie C
authors.initials: LC
authors.lastname: Morey
authors.forename: Patrick M
authors.initials: PM
authors.lastname: O'Neil
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D018579:Patient Selection; D010552:Personality Assessment; D011300:Preoperative Care; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012928:Social Desirability