Exploring the Utility of the Rorschach Test in Predicting Weight Loss After Bariatric Surgery

Abstract

Bariatric surgery (BS) is an effective approach to treat severe obesity, which should include multidisciplinary care. Prior to surgery, candidates for BS usually undergo a psychological assessment based mostly on self-report of clinical symptoms. However, the results of this assessment are not always sufficient to predict outcomes. Therefore, this study examined the potential of a multimethod approach to assessing patients seeking BS using both self-report and performance-based measures of cognitive and affective functioning. A sample of 50 women who had applied for surgery at a public facility in Brazil were assessed with the Difficulties in Emotion Regulation Scale (DERS), the Rorschach Performance Assessment System (R-PAS), and the Trail Making Test (TMT). Patients who dropped out before treatment ( n = 27) had higher initial body mass index and poorer performance on cognitive flexibility at baseline. In the remaining 23 patients who underwent surgery, indicators of emotional and cognitive functioning from all measures were associated with weight loss (WL) at 6 and 12 months after surgery. However, only R-PAS variables regarding psychological resources were associated with WL 18 months after surgery. We discuss the usefulness of the Rorschach as a source of information for patients seeking BS and the implications for current assessment practices in the field.

Editorial

“…Two other articles represent the research “with” the Rorschach. The contributions by Stivaleti Colombarolli and colleagues (2024) and by Aoki and colleagues (2024) present the utility of the Rorschach assessment with candidates for bariatric surgery and with patients displaying recurrent nonsuicidal self-harm behaviors. These studies reminded me of the recent work by Hwang and colleagues (2023) on the differences between Rorschach protocols of first responders in Korea with and without posttraumatic stress disorder.…”