Childhood Obesity in a Chinese Family Context

This qualitative study explored themes that described families with obese children in Chinese society. Eight obese children and their families participated in the study. Six of the children were male and two were female, ranging in age from 7 to 13. The themes found were: over-involvement between allied parent and obese child, coalition, diffused boundary between extended family and nuclear family, lack of conflict resolution, and disengaged couple boundary. In this study, the significant role that may be played by the extended family in contributing to a child’s obesity, as well as female power dominance in the domestic sphere are considered. Implications for therapy are discussed.     

Predicting Change in Parenting Stress Across Early Childhood: Child and Maternal Factors

This study examined maternal parenting stress in a sample of 430 boys and girls including those at risk for externalizing behavior problems. Children and their mothers were assessed when the children were ages 2, 4, and 5. Hierarchical linear modeling (HLM) was used to examine stability of parenting stress across early childhood and to examine child and maternal factors predicting parenting stress at age 2 and changes in parenting stress across time. Results indicated that single parenthood, maternal psychopathology, child anger proneness, and child emotion dysregulation predicted 2-year parenting stress. Child externalizing behaviors predicted initial status and changes across time in parenting stress. Stability of parenting stress was dependent upon child externalizing problems, as well as interactions between child externalizing problems and gender, and child externalizing problems and emotion regulation. Results are discussed in the context of mechanisms by which parenting stress may influence the development of child externalizing behaviors.     

Risk and Protective Factors Associated with Childhood Obesity in a Sample of Low-Income,Single Female,Parent/Guardian Households: Implications for Family Therapists

The United States is in the midst of a childhood obesity epidemic that disproportionately impacts underserved and diverse populations. In this study, in-depth qualitative interviews were conducted with 16 low-income, single, female, parent/guardians of an overweight or obese 3- to 8-year-old from socioeconomically disadvantaged backgrounds. Following the tenets of the thematic analysis approach, interviews focused on identifying risk and protective factors influencing parental and child health behaviors associated with child weight status. Results from the interviews are organized according to the Socioecological Framework to help identify risk and protective factors at various system levels. Findings from this investigation have relevance for family therapists as they can inform clinical and advocacy-focused interventions with disadvantaged families affected by childhood obesity.     

Treatment of Childhood Obesity: A Systematic Review

Childhood obesity trends have increased dramatically over the past three decade’s. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment effect size. Searches revealed 61 relevant articles published from January 2000 to 2009, including both randomized and non-randomized controlled trials of childhood and adolescent obesity treatment interventions. The review identified scant measurement and reporting of issues around treatment fidelity, an increase in the number of interventions outside of the US, (particularly across Europe) and an emergence of studies involving older children and adolescents in a range of settings. Interventions comprising a dietary, exercise, and behavioral component, supported by family involvement and delivered by trained interventionists in specialized or supervised settings, appeared to offer a potentially effective treatment for obesity. However, concern remains over study quality (particularly sample size), dropout rates and study design. Variations in outcome measures and intervention designs means generalizable conclusions cannot be easily be made. Of greater concern is the lack of consideration for treatment fidelity, which has implications for the transfer of knowledge and the reliability of interventions. Conclusions from the review include; the need for increased accuracy of reporting and objective measurement of treatment fidelity; the need for further investigation of potential cost-effective treatment options (including maintenance strategies to enhance sustainability of current interventions); and an increase in the number of longitudinal trials beyond 1?year in duration.     

Family Factors in the Development, Treatment, and Prevention of Childhood Anxiety Disorders

It is now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We focus on three anxiety disorders in youth, namely, generalized, separation, and social anxiety as they often co-occur both at the symptom and disorder level and respond to similar treatments. We begin by presenting an overview of a broad range of family factors associated with anxiety disorders. Findings from these studies have informed intervention and prevention strategies that are discussed next. Throughout the paper we shed light on the challenges that plague this research and look toward the future by proposing directions for much needed study and discussing factors that may improve clinical practice and outcomes for affected youth and their families.     

National Origin and Behavioural Problems of Toddlers: The Role of Family Risk Factors and Maternal Immigration Characteristics

In many societies the prevalence of behavioural problems in school-aged children varies by national origin. We examined the association between national origin and behavioural problems in 1½-year-old children. Data on maternal national origin and the Child Behavior Checklist for toddlers (n?=?4943) from a population-based cohort in the Netherlands were used. Children from various non-Dutch backgrounds all had a significantly higher mean behavioural problem score. After adjustment for family risk factors, like family income and maternal psychopathology, the differences attenuated, but remained statistically significant. Non-Dutch mothers with immigration risk factors, such as older age at immigration or no good Dutch language skills, reported significantly more behavioural problems in their offspring. In conclusion, the present study indicated more behavioural problems in immigrant toddlers from various backgrounds. Researchers and policymakers aiming to tackle disparities in behavioural problems should take into account that risks associated with national origin are intertwined with unfavourable family and immigration characteristics.     

Well-being and Substance Use in Emerging Adulthood: The Role of Individual and Family Factors in Childhood and Adolescence

The present study examined the long-term impact of individual and family factors during childhood and adolescence on outcomes associated with the transition to adulthood, specifically well-being and substance use. Data for this study were drawn from the Child Development Supplement (CDS) and Transition to Adulthood (TA) surveys (n?=?1362), both a part of The Panel Study of Income Dynamics (PSID). We first examined the influence of individual and family factors from childhood and adolescence on well-being and substance use during the transition to adulthood using Structural Equation Modeling (SEM). We then applied a mixture modeling approach to evaluate whether there were subgroups (latent classes) in these transitions to adulthood outcomes, and how these subgroups linked with the individual and family factors from younger years. We found that, in general, parental acceptance and psychological control in childhood and adolescence predicted all aspects of well-being during the transition to adulthood. Substance use during this transition was linked with being male, White, and heightened parental psychological control. Overall, observable differential associations between individual and family factors during childhood and adolescence and outcomes in later life highlighted a need to evaluate transitional aspects independently, rather than grouping young adults all together.     

Examining Latino Family Participation in Treatment for Childhood ADHD: The Role of Parental Cultural Factors and Perceptions

Attention-deficit/hyperactivity disorder (ADHD) is a common mental health disorder in childhood. Unfortunately, Latino youth and their families are at increased risk of demonstrating poor treatment outcomes. The current study examined the impact of parental cultural factors and perceptions on Latino family participation in a psychosocial intervention for childhood ADHD. Sixty-one Latino youth and at least one of their primary parents and teachers participated in the current study. Results indicated that parental acculturation, attitudes regarding treatment, and baseline severity of child symptomatology and functional impairment were related to treatment participation outcomes. Implications and future directions are discussed.     

Maternal Childhood Sexual Trauma and Early Parenting: Prenatal and Postnatal Associations

Existing research suggests that approximately 19% of females experience childhood sexual trauma (CST). Little is known, however, about the parenting behaviour of mothers who have experienced CST. Using propensity‐matched controls, the present study examines prenatal psychosocial distress, postnatal depressive symptomatology, and caregiving behaviours of women reporting CST at or before the age of 14. Data for these analyses were obtained from mother reports and from observational protocols from a longitudinal study of low‐income, rural families. Propensity score methodology was used to create a contrast group matched on family of origin variables in an effort to isolate and examine the long‐term associations of CST beyond the effects of other childhood adversities such as poverty. Study findings provide evidence that women with CST histories report greater prenatal psychosocial distress compared to women without trauma histories. Findings further provide evidence for a spillover process from prenatal distress to the broader caregiving system including less sensitive parenting through postnatal depressive symptoms for women with CST histories. These results highlight the importance of screening for CST and psychosocial distress and depression prenatally. Interventions for women with CST histories and directions for future study are proposed. Copyright © 2016 John Wiley & Sons, Ltd.     

Maternal Intrusiveness,Family Financial Means,and Anxiety Across Childhood in a Large Multiphase Sample of Community Youth

Intrusive parenting has been positively associated with child anxiety, although examinations of this relationship to date have been largely confined to middle to upper middle class families and have rarely used longitudinal designs. With several leading interventions for child anxiety emphasizing the reduction of parental intrusiveness, it is critical to determine whether the links between parental intrusiveness and child anxiety broadly apply to families of all financial means, and whether parental intrusiveness prospectively predicts the development of child anxiety. This study employed latent growth curve analysis to evaluate the interactive effects of maternal intrusiveness and financial means on the developmental trajectory of child anxiety from 1st grade to age 15 in 1,121 children (50.7 % male) and their parents from the NICHD SECCYD. The overall model was found to provide good fit, revealing that early maternal intrusiveness and financial means did not impact individual trajectories of change in child anxiety, which were stable from 1st to 5th grade, and then decrease from 5th grade to age 15. Cross-sectional analyses also examined whether family financial means moderated contemporaneous relationships between maternal intrusiveness and child anxiety in 3rd and 5th grades. The relationship between maternal intrusiveness and child anxiety was moderated by family financial means for 1st graders, with stronger links found among children of lower family financial means, but not for 3rd and 5th graders. Neither maternal intrusiveness nor financial means in 1st grade predicted subsequent changes in anxiety across childhood. Findings help elucidate for whom and when maternal intrusiveness has the greatest link with child anxiety and can inform targeted treatment efforts.     

Impact of a Kentucky Maternal, Infant, and Early Childhood Home-Visitation Program on Parental Risk Factors

As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families’ participation in a home-visitation program offered by a central Kentucky health department on parental risk factors. A family social worker or nurse interviewed parents pre-intervention, completing a Parent Survey which assessed multiple parental risk factors associated with negative health and well-being and to calculate a total risk score. Upon exiting the program, parents are re-interviewed to document improvements, review progress and accomplished goals, plan for transitional services, and calculate a new risk score. As of December 2010, 64 families had completed the home-visitation program and had pre- and post-risk scores available for analysis. Based on paired-sample t tests, there was a statistically significant difference in total mean risk scores among both mothers and fathers from pre to post. The McNemar–Bowker test also revealed statistically different scores for four of the six risk factors for mothers and fathers pre- and post-home-visitation: lifestyle behaviors and mental health, coping skills and support systems, stresses, and anger management skills. Findings suggest that families who were deemed at-risk for adverse pregnancy and child health outcomes benefit from participation in the home-visitation program. Programs designed to promote positive pregnancy outcomes and child development may benefit from providing social support, fostering parental knowledge, skill development and problem solving, insuring proper medical care, and connecting parents with community resources.     

Maternal Intergenerational Transmission of Childhood Multitype Maltreatment

Previous research suggests that child maltreatment is transmitted across familial generations. However, extant studies focused exclusively on single maltreatment subtypes, instead of the more common experience of multitype maltreatment. This limitation is addressed in the first known study to examine the maternal intergenerational transmission of childhood multitype maltreatment among 104 mothers and their children. Findings demonstrated that mothers' childhood multitype maltreatment directly predicted their children's multitype maltreatment, instead of having indirect effects through maternal romantic attachment dimension, intimate partner violence, and psychological distress. Mothers' childhood multitype maltreatment was also related to intimate partner violence and anxious romantic attachment but unrelated to psychological distress. Our findings highlight the need for clinical attention to the long-term generational effects of diverse childhood traumas.     

Family Adjustment to Childhood Cancer: A Systematic Review

This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer, were written in English, and were published between 1996 and 2009. Overall, qualitative findings show that families alter roles, responsibilities, and day-to-day functioning to accommodate the needs of children with cancer. Although some degree of family reorganization is normative, the extent and impact of these changes varies. Quantitative work shows that mean levels of family functioning (e.g., cohesion, flexibility) are similar between families facing cancer and normative or comparison samples. However, families follow different trajectories of improvement, decline, or stability in family closeness and marital quality. Parenting has received limited quantitative research attention, but qualitative work suggests that parents perceive deeper bonds with ill children and may spoil or overprotect them. Conclusions support future work examining the influence of family-level variables on the adjustment of individual family members.     

Early Childhood Anxious Solitude and Subsequent Peer Relationships: Maternal and Cognitive Moderators

It was hypothesized that the relation between early anxious solitude and subsequent peer relations would be moderated by early relational (maternal sensitivity) and individual factors (child school readiness). Participants were 1364 children from the National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development. Anxious solitude was assessed by child care providers from 2 to 4.5 years, maternal sensitivity was observed during mother–child interactions from 2 to 4.5 years, school readiness was tested at 3 years, children's interactions with a friend were observed at 4.5 years, and friendship quantity and peer rejection were assessed by first grade teachers. Results indicate that anxious solitary children who had experienced high versus low early maternal sensitivity contributed significantly more actively to positive interaction and less actively to negative interaction with a friend at 4.5 years (these results were contingent on school readiness), and had more friends and were less rejected by peers in first grade. Although high school readiness predicted interactive competency and positive peer relationships in children low in anxious solitude, these benefits were suppressed in anxious solitary children.     

Maternal Depression and Adolescent Emotions: The Role of Family Functioning

Maternal depression may affect children through various mechanisms, including the stressful contexts of the children’s lives and maternal maladaptive affection, behaviors, and cognition, which affect the psychopathological development of children and contribute to disorders. The aims of the present study were to explore how family functioning mediates the relationship between maternal depression and the positive and negative emotions of adolescents. A total of 430 paired questionnaires were collected from junior high school students and their mothers. The mothers completed the Center for Epidemiologic Studies Depression Scale (CESD), and the adolescents completed the CESD, Mood and Anxiety Symptom Questionnaire, and Family Function Scale. The results revealed significant correlations among maternal depression, family functioning, and positive and negative emotions in the adolescents. The family functioning subscales of conflict and emotional expression partially mediated the relationship between maternal depression and the positive and negative emotions of the adolescents. Furthermore, the family functioning subscales of cohesion, problem solving, and responsibility fully mediated the relationship between maternal depression and positive moods in the adolescents. Analysis of the results for maternal depression, family functioning, and the emotional adjustment of the adolescents indicated that family functioning is the mediator between maternal depression and the positive and negative emotions of the adolescents. The current results suggest that adequate family functioning can prevent depression being transmitted from mothers to their adolescent children.     

血压正常的超重和肥胖人群的肾功变化

为了探讨健康体检中血压正常的超重和肥胖人群的肾功有无变化。对3756例体检者测量身高、体重、血压,检测各项生化指标,计算肾小球滤过率（GFR）、体质指数（BMI）。结果显示：男性的eGFR较女性低。年龄与eGFR相关性强。消除了性别和年龄的影响后,分析表明随着体质指数的升高,eGFR逐渐降低,而肌酐却无差异。我们发现血压正常的超重和肥胖人群体检虽肌酐正常,但eGFR却明显下降,表明存在肾功损害,故我们需早期识别,定期复诊,防止肥胖相关性肾病发生。