Maternal Weight Control Behaviors for Preschoolers Related to Children’s Gender

The purpose of this study was to identify significant factors associated with Korean mothers’ behaviors in controlling their preschool children’s weight and to examine gender differences among the significant associated factors. This study involved a convenience sample of 223 pairs of mothers and their preschool children (114 boys and 109 girls) in South Korea. Maternal desire for their children to lose weight, concern about children being overweight or obese, and interaction between gender and concern about children being overweight or obese were significant factors associated with maternal behaviors to control children’s weight. Regarding the interaction between gender and concern about children being overweight or obese, mothers who were concerned about their daughter being overweight or obese were more likely to control their child’s weight than those who were concerned about their son being overweight or obese. Additionally, mothers with concerns about their daughter being overweight or obese were more likely to conduct weight control behaviors for their child than mothers of girls without such concern. However, among mothers of boys, there was no difference in maternal behaviors to control their child’s weight between those with concern and without concern. Therefore, health care providers should understand gender specific maternal concerns regarding their child’s weight and provide tailored weight control interventions for mother and child pairs considering the child’s gender.     

Overvaluation of shape and weight among overweight children and adolescents with loss of control eating

Little is known about the phenomenology of pediatric loss of control (LOC) eating. Overvaluation of shape and weight, however, appears to be diagnostically meaningful among binge eating adults. We explored the significance of shape and weight overvaluation among children and adolescents with LOC eating. Participants (n = 526) included 149 overweight youth with LOC eating and 377 overweight controls (CON). Participants were categorized as those reporting at least moderate overvaluation (LOC-Mod, n = 74; CON-Mod, n = 106) or less than moderate overvaluation (LOC-Low, n = 75; CON-Low, n = 271), and compared on measures of eating-related and general psychopathology. LOC-Mod evidenced lower self-esteem than CON-Low, and greater behavioral problems than CON-Mod and CON-Low, but did not differ from LOC-Low in these domains. With the exception of LOC-Low and CON-Mod, all groups differed on global eating-disorder severity, with LOC-Mod scoring the highest. Overvaluation of shape and weight appears to be of questionable importance in defining subtypes of youth with LOC eating. However, as overvaluation and LOC eating each independently predicts eating-disorder onset, their confluence may confer even further risk for eating-disorder development. Longitudinal studies should address this possibility. Developmentally appropriate discussion about body image disturbance may be indicated in interventions targeting pediatric LOC eating and/or obesity.     

Psychological adjustment of pediatric lung transplantation candidates and their parents

Investigated psychological functioning of 45 children and adolescents (ages 5 to 17 years) and their parents presenting at a major medical center for evaluation for lung transplantation. Patients completed self-reports, and parents completed measures on their children's behavior problems and emotional distress as well as on their own symptoms of distress. In general, children and their parents reported normal functioning on standard psychological measures. Few children fell in the clinically significant range, whereas 21% of mothers and 14% of fathers reported clinically significant levels of distress. Older children reported lower levels of depressive symptoms than younger children, and patients with cystic fibrosis manifested lower levels of internalizing symptoms than those with other pulmonary diseases. Findings demonstrate the resiliency of children and their parents facing a stressful point in the child's medical status and document the usefulness of psychological screening of patients and parents to identify those in need of clinical intervention.     

THE EFFECT OF A TOKEN ECONOMY ON DIETARY COMPLIANCE FOR CHILDREN ON HEMODIALYSIS

Adherence to dietary restrictions is a recurring problem for children on hemodialysis. The effect of behavior modification in maintaining dietary control is reported for four patients aged 11 to 18 years. Weight gain, potassium level, and blood urea nitrogen were utilized as criteria measures. A token reinforcement program implemented by the hemodialysis team resulted in significant changes in the dietary pattern of the children. The average weight gain between dialysis sessions for the four subjects during treatment was reduced by 45% and the degree of weight fluctuation was lessened. Potassium levels and BUN were controlled to their appropriate level for subjects who initially exceeded the criterion level. With the withdrawal of weight gain from the contingency system, increase of weight gain between dialysis sessions was noted for all subjects.     

Portrayal of body weight on children's television sitcoms: a content analysis

Television programs portray characters with idealized body types that for most viewers are unattainable. These body types have become a common source of comparison for many young viewers who evaluate their own self-worth and bodies based on the models they see on television. This study examines body weight, both in terms of frequency and portrayals, focusing on how preadolescent and adolescent characters’ bodies are presented on the sitcoms from three children's television networks. The results indicate that while children's situation comedies have relatively few overweight characters, this small percentage closely parallels national figures. Male and female characters do not differ in their distribution across weight categories. However, when character ethnicity is factored, significant shifts occur. Surprisingly, no differences were observed in the portrayal of physical and mental attributes among weight categories except in social popularity where overweight characters were not as embedded in social networks. Compared to other relevant studies, this research provides some evidence that the treatment and portrayal of overweight characters in children-targeted sitcoms is more positive, equitable, and less stereotypical than in other programming venues and that children are experiencing body type diversity in these fictional portrayals. Nonetheless, above average weight characters still suffer some social marginality and ethnic misrepresentation.     

Body image and body change strategies among adolescent males and females from Fiji, Tonga and Australia

The current study was designed to investigate the body image and body change strategies of adolescents from Fiji, Tonga and Australia. Participants were 628 Fijians, 463 Indo-Fijians, 598 Tongans and 535 European Australians. Adolescents completed measures of height, weight, body dissatisfaction, strategies to lose weight, increase weight and increase muscles. The results demonstrated that overweight adolescents were more dissatisfied with their bodies than those who were normal weight. Overweight Fijians and Tongans were more satisfied with their body than Indo-Fijian or Australian adolescents. Tongans, followed by Fijians and Indo-Fijians, were more likely to engage in strategies to lose weight, increase weight and increase muscles. These results are consistent with the focus in Fiji and Tonga on the value of the large body ideal, but may also reflect the recent focus on the attainment of a healthy body size.     

Subtyping children and adolescents who are overweight based on eating pathology and psychopathology

Children and adolescents who are overweight can differ on dimensions measuring dietary restraint and psychopathology. Classifying clinical obese children and adolescents based on these psychological characteristics is shown to be useful in making differential prognoses. The present study aimed to research the validity of subtyping children and adolescents with overweight (N?=?138) in a non-clinical sample. Using cluster analysis, results revealed three subtypes: a dietary restraint/internalizing group (DR?+?IN; n?=?41), a pure internalizing group (IN; n?=?20) and a non-symptomatic group (NS; n?=?77). The DR?+?IN group outscored both other groups on measures of eating pathology, whereas the IN group outscored both other groups on measures of negative offect. Interestingly, the three groups did not differ on degree of overweight. The results seem to suggest that different psychological mechanisms can be observed in subgroups of young overweight adolescents. Further research should explore how individual psychological characteristics can be helpful when stipulating weight loss treatment programmes.     

Peer-Enhanced Weight Management Treatment for Overweight Adolescents: Some Preliminary Findings

The purpose of this study was to evaluate the utility of adding a peer-based intervention (peer-based skills training [PBST]) to a traditional cognitive–behavioral weight management intervention for overweight adolescents. Sixteen adolescents between the ages of 13 and 16 years and between 30 and 80$percnt; overweight participated in a 16-week group-based weight management program with the addition of peer-based skills training. Adolescents and parents separately attended 60-min group sessions addressing diet, physical activity, and behavior modification techniques. In addition, adolescents attended a 90-min PBST session each week. Group activities included both mental and physical challenges that fostered development of trust, social skills, and self-confidence. Measures of height and weight, as well as questionnaires assessing self-concept, physical self-worth, and social functioning, were obtained prior to treatment, immediately following the 16-week intervention, and 6 months after completion of active treatment. Paired t tests revealed significant improvements over time in measures of physical self-worth, physical appearance and romantic appeal. Adolescents lost an average of 14.73 pounds from the start to end of treatment, and this was maintained at 6-month follow-up. These preliminary findings provide some support for the application of a novel peer-based program as an adjunctive treatment for adolescent weight management intervention.     

Sensitization and habituation of motivated behavior in overweight and non-overweight children

The rate of habituation to food is inversely related to energy intake, and overweight children may habituate slower to food and consume more energy. This study compared patterns of sensitization, as defined by an initial increase in operant or motivated responding for food, and habituation, defined by gradual reduction in responding, for macaroni and cheese and pizza in overweight and non-overweight 8- to 12-year-old children. Non-overweight children habituated faster to both foods than overweight children (p = .03). All children recovered motivated responding for a new food (chocolate). Overweight children consumed more energy than non-overweight children (p = .0004). Children who showed a sensitization in responding consumed more food (p = .001), and sensitization moderated the effect of overweight on habituation, with slower habituation for overweight children who sensitized (p < .001). This study replicates previous data on overweight/non-overweight differences in habituation of food and energy intake, and provides new information that individual differences in sensitization and habituation of motivated responding to obtain food may be associated with a sustained motivation to eat, resulting in greater energy intake.     

Weight and health status of inner city African American children: Perceptions of children and their parents

Poor socioeconomic status and African American (AA) ethnicity contribute to an increased risk of obesity for many inner city children. One hundred and forty six AA children and 108 AA parents attending an inner city health fair completed surveys regarding perceptions of their own (or their child's) weight and the impact of weight on health. The children were measured and their body mass indexes were calculated. Thirty-seven percent of the child respondents (n = 52) were at risk of overweight or overweight; of these, 67% perceived themselves as normal weight, and 77% thought their weight was healthy. Weighing more was felt to be healthy by 17% of children and 29% of parents. Of 39 parents whose children were at risk of overweight or overweight, 68% felt their child's weight was normal and 80% thought it was healthy. These results suggest that inner city AA children and their parents often do not recognize being overweight or the health implications of being overweight.     

Changes in 10‐year‐old children's body esteem: A time‐lag study between 2000 and 2010

This time‐lag study examined if there has been any changes in body esteem over a 10‐year period for 10‐year old children in Gothenburg, Sweden. Two cohorts of children, one in year 2000 and one in 2010, answered the same questionnaire about body esteem. A total of 960 children, 515 girls and 445 boys, participated in the first wave in 2000 and a total of 342 children, 171 girls and 171 boys participated in the second wave in 2010. The results showed a general stability in levels of body esteem for both girls and boys over the past 10 years. The gender differences, with boys being more satisfied with their appearance and weight compared to girls also seems to be stable over the years. In addition, the results also showed a somewhat positive development among the overweight girls with enhanced body esteem for the overweight girls compared to the non‐overweight girls during the ten years studied. Unfortunately, the same pattern was not found for overweight boys. For them the discrepancy in body esteem compared to non‐overweight boys, with the overweight boys being more dissatisfied, found in 2000 remained in 2010.     

Emotion recognition in children with Fetal Alcohol Spectrum Disorders

There is a limited amount of research that examines social-emotional functioning in children with Fetal Alcohol Spectrum Disorder (FASD), and the majority of it relies on parent and teacher reports of social impairments. Because these provide broad measures of social function, they fail to elucidate the underlying specific skills with which this group of children has difficulty. The current study examines emotion-recognition abilities in children with FASD, as it plays a central role in social interaction. Participants were 22 children with diagnosed FASD (ages 8–14), and age- and gender-matched typically developing controls. Tasks included measures of emotion recognition from three nonlinguistic modalities: facial expressions, emotional tone of voice, and body positioning and movement. Participant’s parents completed measures of adaptive and behavioral function that were related to children’s performance on aspects of emotion recognition. Overall, the results show that children with FASD have more difficulties with emotion recognition than typically developing age-matched peers, but these difficulties may not be clinically significant (e.g., smaller effect size) or may be specific to the age of the individual exhibiting the emotion (i.e., child vs. adult). These results are discussed in the context of previous studies.     

Body-esteem in Swedish 10-year-old children

This study examined body-esteem in 10-yr.-old children. The study group comprised 960 schoolchildren, 515 girls and 445 boys (M age= 10.4, SD=0.5). Analysis showed that girls who were overweight had more negative body-esteem on all dimensions (weight, appearance, and attribution). The overweight boys had more negative perceptions on only two dimensions (weight and appearance). Twice as many girls perceived themselves as too fat (20%) as too skinny (10%). Of the girls who perceived themselves as fat, only 31% were overweight; similarly only 33% of the boys who perceived themselves as fat were overweight. The children's perception of their weight seemed as important as their actual weight and was associated with their body-esteem in the same way. Although few children had dieted (7% of the girls and 5% of the boys), the ones who had dieted had more negative body-esteem than children who had not dieted.     

The relationship between children's overweight and quality of life: A comparison of Sizing Me Up,PedsQL and Kid-KINDL

Background/Objective: Overweight and obese children are likely to encounter negative impact on psychological well-being and quality of life (QoL). Hence, for overweight and obese children, measuring QoL could go beyond simply assessing objective medical parameters and cover their physical health, psychological well-being, and social interaction. Generic (Kid-KINDL and Pediatric Quality of Life Inventory [PedsQL]) and weight-related (Sizing Me Up) measures are two major types of QoL measurement instruments; however, little is known about the differences between them. Method: We recruited 569 3rd to 6th graders from eleven schools in Southern Taiwan. In addition to the three QoL questionnaires, the Child Depression Inventory and Rosenberg Self-Esteem Scale were applied. Results: Depression had significantly negative associations with all three QoL questionnaires. Self-esteem was only associated with Kid-KINDL. Body mass index had a significantly stronger relationship with Sizing Me Up than its relationships with PedsQL and Kid-KINDL. In other words, the items related to body size concerns in Size Me Up significantly contributed to impaired overweight/obese children’s QoL. Conclusions: The study further identified the characters and strength of these QoL measures for better suggestions on evaluating physical and psychological issues for overweight/obese children.     

Some generalization and follow-up measures on autistic children in behavior therapy

We have treated 20 autistic children with behavior therapy. At intake, most of the children were severely disturbed, having symptoms indicating an extremely poor prognosis. The children were treated in separate groups, and some were treated more than once, allowing for within- and between-subject replications of treatment effects. We have employed reliable measures of generalization across situations and behaviors as well as across time (follow-up). The findings can be summarized as follows: (1) Inappropriate behaviors (self-stimulation and echolalia) decreased during treatment, and appropriate behaviors (appropriate speech, appropriate play, and social non-verbal behaviors) increased. (2) Spontaneous social interactions and the spontaneous use of language occurred about eight months into treatment for some of the children. (3) IQs and social quotients reflected improvement during treatment. (4) There were no exceptions to the improvement, however, some of the children improved more than others. (5) Follow-up measures recorded 1 to 4 yr after treatment showed that large differences between groups of children depended upon the post-treatment environment (those groups whose parents were trained to carry out behavior therapy continued to improve, while children who were institutionalized regressed). (6) A brief reinstatement of behavior therapy could temporarily re-establish some of the original therapeutic gains made by the children who were subsequently institutionalized.     

Facial memory deficits in children with fetal alcohol spectrum disorders

Prenatal exposure to alcohol may lead to a range of neurobehavioral effects, including impaired learning and memory. Although children with fetal alcohol spectrum disorders (FASD) exhibit both verbal and nonverbal memory impairments, their memory for faces has not been as thoroughly investigated and the extent literature provides inconsistent results. The aim of the current study was to determine whether difficulties in face memory exist in children with FASD and whether the difficulties are mediated by task demands. To address this, we used two measures of immediate and delayed facial recognition memory, the Children's Memory Scale (CMS) and Test of Memory and Learning (TOMAL). Compared to typically developing controls, children with FASD showed memory deficits on all tests and were more likely to perform in a clinically significant range. As well, children performed more poorly on the CMS compared to TOMAL, a finding consistent with the greater difficulty of the CMS task. Our results are consistent with our hypothesis that children with FASD show impairment in facial memory, particularly on demanding memory tasks.     

Facial memory deficits in children with fetal alcohol spectrum disorders

Prenatal exposure to alcohol may lead to a range of neurobehavioral effects, including impaired learning and memory. Although children with fetal alcohol spectrum disorders (FASD) exhibit both verbal and nonverbal memory impairments, their memory for faces has not been as thoroughly investigated and the extent literature provides inconsistent results. The aim of the current study was to determine whether difficulties in face memory exist in children with FASD and whether the difficulties are mediated by task demands. To address this, we used two measures of immediate and delayed facial recognition memory, the Children's Memory Scale (CMS) and Test of Memory and Learning (TOMAL). Compared to typically developing controls, children with FASD showed memory deficits on all tests and were more likely to perform in a clinically significant range. As well, children performed more poorly on the CMS compared to TOMAL, a finding consistent with the greater difficulty of the CMS task. Our results are consistent with our hypothesis that children with FASD show impairment in facial memory, particularly on demanding memory tasks.     

Childhood Overweight and Obesity: Maternal and Family Factors

Treatment programs for childhood overweight and obesity have highlighted the importance of the family in treatment. Considering this, it is surprising that few studies have examined the role of family factors in the development of childhood overweight and obesity. The objective of this study was to examine which family and maternal factors predict increases in weight in boys and girls during middle to late childhood. This study used longitudinal data from the childhood growth and development (GAD) Study. The GAD Study involved 286 healthy weight, overweight and obese children, aged 6–13 years at baseline, who completed baseline, 1-year follow-up and 2-year follow-up assessments. Overweight/obese children were recruited from clinical and community settings. A broad range of maternal and family factors were assessed. Linear mixed models were used to identify which factors predicted child Body Mass Index (BMI) z-scores over time. For community-based children, maternal BMI and single-parent family structure were significant longitudinal predictors of child BMI z-scores. For the clinical participants, low family income was the only significant multivariate predictor of child BMI z-scores. The strong association between child BMI, maternal BMI and family structure confirms the need to target prevention and intervention efforts for childhood overweight and obesity towards families with overweight parents, particularly single-parent families.     

Pedometers and brief e-counseling: increasing physical activity for overweight adults

Physical inactivity has emerged as a public health epidemic and is associated with the rising obesity rate. A multiple-treatments reversal design was utilized to test whether pedometer-aided self-monitoring and brief e-counseling could help 3 overweight adults increase their physical activity. Dependent measures were taken for pedometer steps and weight. Two participants approximately doubled their daily step totals and lost a modest amount of weight by study end.     

Mother–Child Agreement on Reports of Internalizing Symptoms Among Children Referred for Evaluation of ADHD

The effects of maternal (bias), child (age, severity of behavior problems), and measurement characteristics (similarity of parent and child measures; types of internalizing symptoms) on mother–child agreement on reports of children's internalizing symptoms were examined for 65 children referred for evaluation of ADHD. Agreement was low and did not improve when parents and children completed parallel measures. Mothers and children were more likely to agree on severity of internalizing symptoms rated as behavioral than those rated as ideational. The majority of discordant reports were of the type that mothers, but not children, reported clinically elevated symptoms. This type of discordance appeared to be a function of maternal negative bias rather than underreporting of symptoms by children.