Smoking among bariatric patients: the role of adult attachment style, emotion regulation, and psychopathology
Bibliographic record
Abstract
Cigarette smoking after bariatric surgery is associated with complications and is advised against in clinical guidelines. However, it continues to be problematic and there is a paucity of research regarding the factors related to smoking in this population. This secondary data analysis study uses previously collected longitudinal data and moderated mediation analysis to determine if emotion regulation (Difficulties in Emotion Regulation Scale) mediates the relationship between adult attachment style (Experiences in Close Relationships scale) and the likelihood of smoking postsurgery. Psychopathology (diagnoses and symptom measures [Patient Health Questionnaire-9; Generalized Anxiety Disorder-7]) was considered as a moderator. A total of 423 adult patients at the Toronto Western Hospital Bariatric Surgery Program participated. Attachment insecurity predicted emotion dysregulation, which predicted likelihood of smoking. Anxiety scores moderated the mediating effect, such that protective effects were observed for low to average anxiety. Implications for targeting emotion dysregulation and anxiety to reduce smoking are discussed. Keywords: bariatric surgery, smoking, tobacco, adult attachment style, emotion regulation, psychopathology, depression, anxiety, moderated mediation
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".