title: Distress Tolerance and Psychological Comorbidity in Patients Seeking Bariatric Surgery.
abstract: Distress intolerance is characterized by a low threshold for negative emotional experiences and lack of emotion regulation and has been shown to predict various health outcomes. As such, the primary aim of this study was to determine the association between distress tolerance and psychological variables (eating behaviors, mood, substance use, trauma history), completion of bariatric surgery, and post-bariatric surgery weight loss outcomes and follow up with a provider.
  
  
  
  Two hundred forty-eight patients (75 % female, 89 % Caucasian) underwent a multidisciplinary evaluation for bariatric surgery and were assessed for psychiatric disorders via semi-structured clinical interview and psychometric questionnaires.
  
  
  
  Low distress tolerance was associated with symptoms of depression (p ≤ 0.001), anxiety (p ≤ 0.001), disordered eating behaviors (p ≤ 0.001), substance abuse (p ≤ 0.001), a history of being the victim of childhood sexual abuse (p ≤ 0.001), and with high BMI (p < .05). Patients endorsing higher levels of distress tolerance were more likely to undergo bariatric surgery (p < .01). Distress tolerance was not related to 2-year post-surgical weight loss outcomes or follow up with a provider.
  
  
  
  The ability to tolerate negative affect may be a variable that differentiates which patients undergo bariatric surgery rather than early postoperative outcomes.
authors.affiliation: Department of Behavioral Health, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA.
authors.forename: Afton M
authors.initials: AM
authors.lastname: Koball
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Lahey Hospital and Medical Center, Burlington, MA, 01805, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Himes
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Sim
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Collazo-Clavell
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Manpreet
authors.initials: M
authors.lastname: Mundi
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Kellogg
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Graszer
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA. grothe.karen@mayo.edu.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Grothe
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology*; D015897:Comorbidity; D000066498:Emotional Adjustment; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000601:surgery*; D011184:Postoperative Period; D011795:Surveys and Questionnaires; D015431:Weight Loss
keywords: Bariatric Surgery; Distress Tolerance; Eating Disorders; Risk for Weight Regain; Substance Use