Lifestyle interventions in the treatment of childhood overweight: a meta-analytic review of randomized controlled trials.

CONTEXT: Evaluating the efficacy of pediatric weight loss treatments is critical. OBJECTIVE: This is the first meta-analysis of the efficacy of RCTs comparing pediatric lifestyle interventions to no-treatment or information/education-only controls. DATA SOURCES: Medline, PsycINFO, and Cochrane Controlled Trials Register. STUDY SELECTION: Fourteen RCTs targetting change in weight status were eligible, yielding 19 effect sizes. DATA EXTRACTION: Standardized coding was used to extract information on design, participant characteristics, interventions, and results. DATA SYNTHESIS: For trials with no-treatment controls, the mean effect size was 0.75 (k = 9, 95% confidence interval [CI] = 0.52-0.98) at end of treatment and 0.60 (k = 4, CI = 0.27-0.94) at follow-up. For trials with information/education-only controls, the mean ES was 0.48 (k = 4, CI = 0.13-0.82) at end of treatment and 0.91 (k = 2, CI = 0.32-1.50) at follow-up. No moderator effects were identified. CONCLUSIONS: Lifestyle interventions for pediatric overweight are efficacious in the short term with some evidence for extended persistence. Future research is required to identify moderators and mediators and to determine the optimal length and intensity of treatment required to produce enduring changes in weight status.     

Emotional References in Mother-Daughter and Mother-Son Dyads' Conversations About School

The conversations of 100 mother-child (mean age4.5 years) dyads about the children's school experienceswere examined for their emotional content. Dyads variedalong the dimensions of gender of child (53 girls; 57 boys), ethnicity (31African-American, 39 Anglo-American, and 40Mexican-American), and SES (55 lower and 55 higher).When compared to mother-son dyads, mother-daughter dyadsmade more emotional references, particularly when discussing topicsrelated to interpersonal relationships and whendiscussing emotions experienced by the daughters.Higher-SES dyads made more emotional references than did lower-SES dyads. While there was no main effectof ethnicity associated with the overall tendency todiscuss emotions, relative to other dyads,African-American dyads made more emotional referenceswhen discussing noninterpersonal, nonacademic topicsthan did other dyads, Anglo-American dyads made moreemotional references during the discussing of learningtopics, and Mexican-American dyads discussed emotion more in relation to interpersonal topics thandid African-American dyads.     

A note on Lawley's formulas for standard errors in maximum likelihood factor analysis

Evidence is given to indicate that Lawley's formulas for the standard errors of maximum likelihood loading estimates do not produce exact asymptotic results. A small modification is derived which appears to eliminate this difficulty.The authors are indebted to Walter Kristof and Thomas Stroud for their helpful reviews of an earlier version of this paper and particularly to D. N. Lawley for his review, comments, and encouragement.     

Behavioral techniques in the treatment of obesity: A comparative analysis

The relative efficacy of the major techniques typically used in behavioral treatment programs for weight reduction was investigated using obese adult volunteers. Study 1 compared the effects of self-monitoring, self-control procedures, monetary rewards, aversive imagery and relaxation training. These procedures resulted in significantly greater weight reduction than either a no treatment group or subjects who graphed and recorded daily weight. Self-monitoring of daily caloric intake was as effective as the other methods, both singly and combined, over a 4 week treatment period. Study 2 compared the long-term effects of self-monitoring vs the full complement of behavioral techniques used in Study 1. The full behavior management program was significantly more effective, both during the treatment period and at 3 and 12 week follow-ups, although self-monitoring again produced substantial weight loss.     

Self-concept in educable mentally retarded and emotionally handicapped children

A total of 48 educable mentally retarded (EMR) and emotionally handicapped (EH) children ( \(\overline {CA} \) =137.7 months) were pretested on Coopersmith's Self-Esteem Inventory (SEI), Nowicki-Strickland's Locus of Control Scale for Children (LCSC), and 3 behavioral measures: (1) risk-taking, (2) a chance/skill task, and (3) delay of gratification. One group of 12 children from each population was then exposed to either a self-confident or a control model. After exposure, Ss were given an opportunity to perform successfully on an ambiguous task and answer questions about their success, and were readministered the SEI, LCSC, and 3 behavioral choices. Correlational analyses of pretreatment data revealed significant relationships between defensiveness and LCSC, SEI, and delay of gratification and a near-significant relationship between LCSC and SEI. EMR and EH Ss were both lower on self-esteem than the general population, while EMR Ss were more defensive, more external, and less likely to delay gratification than EH Ss. Both treated groups matched more of the behavioral choices than the control groups, while only treated EH Ss were more likely to attribute their success to internal causes. It was concluded that EMR and EH children differ in self-concept development and that future attempts to modify self-concept should include greater modeling exposure as well as increased opportunity for performance with its resultant feedback.