Walking onset: a poor predictor for motor and cognitive skills in healthy preschool children.

BACKGROUND: The onset of walking is thought to be an indicator of early development. However, evidence is mixed and clear data on this relationship at preschool age is missing. The study aimed at investigating if walking onset and motor and cognitive development in preschool children are related. METHODS: A total of 555 children (mean age 3.86 years) of the Swiss Preschoolers' Health Study SPLASHY were tested twice at their childcare center (at baseline and one year later). Motor skills and cognitive skills were assessed by standardized testing procedures and parents were asked to provide information on walking onset of their child. RESULTS: Late onset of walking was related to poorer motor skills (fine motor skills, static and dynamic balance (all p < 0.003)) and poorer cognitive skills (selective attention and visual perception (p = 0.02; p = 0.001) in late preschool age. CONCLUSIONS: For children with late walking onset a close monitoring of their development in the regular pediatric child health visits may be reasonable. TRIAL REGISTRATION: ISRCTN41045021 .

BED-online: Acceptance and efficacy of an internet-based treatment for binge-eating disorder: A randomized clinical trial including waitlist conditions.

OBJECTIVE: Internet-based guided self-help (GSH) programs increase accessibility and utilization of evidence-based treatments in binge-eating disorder (BED). We evaluated acceptance and short as well as long-term efficacy of our 8-session internet-based GSH program in a randomized clinical trial with an immediate treatment group, and two waitlist control groups, which differed with respect to whether patients received positive expectation induction during waiting or not. METHOD: Sixty-three patients (87% female, mean age 37.2 years) followed the eight-session guided cognitive-behavioural internet-based program and three booster sessions in a randomized clinical trial design including an immediate treatment and two waitlist control conditions. Outcomes were treatment acceptance, number of weekly binge-eating episodes, eating disorder pathology, depressiveness, and level of psychosocial functioning. RESULTS: Treatment satisfaction was high, even though 27% of all patients dropped out during the active treatment and 9.5% during the follow-up period of 6 months. The treatment, in contrast to the waiting conditions, led to a significant reduction of weekly binge-eating episodes from 3.4 to 1.7 with no apparent rebound effect during follow-up. All other outcomes improved as well during active treatment. Email-based positive expectation induction during waiting period prior to the treatment did not have an additional beneficial effect on the temporal course and thus treatment success, of binge episodes in this study. CONCLUSION: This short internet-based program was clearly accepted and highly effective regarding core features of BED. Dropout rates were higher in the active and lower in the follow-up period. Positive expectations did not have an impact on treatment effects.

Body-related cognitive distortions (thought-shape fusion body) associated with thin-ideal exposure in female students-An ecological momentary assessment study.

Etiological models of eating disorders (EDs) describe body dissatisfaction (BD)as one of the major influences fostering dysfunctional body-related behaviour and disordered eating behaviour. BD is influenced by repeated exposure to thin ideals that evoke high self-ideal discrepancy and result in body-related cognitive distortions such as thought-shape fusion body (TSF-B). The aim of this study was to investigate the covariation of daily media exposure and the experience of TSF-B in a naturalistic setting. It was further analysed whether TSF-B is associated with self-ideal discrepancy, dysfunctional body-related behaviour, and disordered eating behaviour. Moreover, person-related predictors of TSF-B were explored. Altogether, 51healthy female students (mean age 21.06years, SD = 1.76) participated in an ecological momentary assessment study with four daily surveys during 10consecutive days. Exposure with thin ideals in contrast to exposure to unspecific media contents went along with the experience of TSF-B. TSF-B was associated with higher self-ideal discrepancy and dysfunctional body-related behaviour as well as more pronounced disordered eating behaviour, suggesting that TSF-B is a common phenomenon in young healthy females' everyday life. A main effect of trait measures (e.g., pre-existing BD) on TSF-B was observable but has no moderating effect. Thus, a specific vulnerability has not been detected.

Facial Emotion Recognition Abilities in Women Experiencing Eating Disorders.

OBJECTIVE: Impairments in facial emotion recognition are an underlying factor of deficits in emotion regulation and interpersonal difficulties in mental disorders and are evident in eating disorders (EDs). METHODS: We used a computerized psychophysical paradigm to manipulate parametrically the quantity of signal in facial expressions of emotion (QUEST threshold seeking algorithm). This was used to measure emotion recognition in 308 adult women (anorexia nervosa [n = 61], bulimia nervosa [n = 58], healthy controls [n = 130], and mixed mental disorders [mixed, n = 59]). The M (SD) age was 22.84 (3.90) years. The aims were to establish recognition thresholds defining how much information a person needs to recognize a facial emotion expression and to identify deficits in EDs compared with healthy and clinical controls. The stimuli included six basic emotion expressions (fear, anger, disgust, happiness, sadness, surprise), plus a neutral expression. RESULTS: Happiness was discriminated at the lowest, fear at the highest threshold by all groups. There were no differences regarding thresholds between groups, except for the mixed and the bulimia nervosa group with respect to the expression of disgust (F(3,302) = 5.97, p = .001, η = .056). Emotional clarity, ED pathology, and depressive symptoms did not predict performance (RChange ≤ .010, F(1,305) ≤ 5.74, p ≥ .079). The confusion matrix did not reveal specific biases in either group. CONCLUSIONS: Overall, within-subject effects were as expected, whereas between-subject effects were marginal and psychopathology did not influence emotion recognition. Facial emotion recognition abilities in women experiencing EDs compared with women experiencing mixed mental disorders and healthy controls were similar. Although basic facial emotion recognition processes seems to be intact, dysfunctional aspects such as misinterpretation might be important in emotion regulation problems. CLINICAL TRIAL REGISTRATION NUMBER: DRKS-ID: DRKS00005709.

Accelerometer-derived physical activity estimation in preschoolers - comparison of cut-point sets incorporating the vector magnitude vs the vertical axis.

BACKGROUND: ActiGraph accelerometers are a widely used tool to objectively measure physical activity (PA) behavior in young children and several validated cut-point sets exist to estimate time spent in different PA intensities (sedentary time, light PA, moderate-to-vigorous PA). Applying different cut-point sets leads to large and meaningful differences in results. So far, only cut-point sets validated for the vertical axis have been compared and only the influence on time spent in moderate-to-vigorous PA has been analyzed. METHODS: A range of validated cut-point sets with their respective epoch length was applied to analyze cross-sectional data of the Swiss Preschoolers' Health Study (SPLASHY): 1) Vertical axis in combination with an epoch length of 15 s (VA-15), 2) Vertical axis in combination with an epoch length of 60 s (VA-60) and 3) Vector magnitude in combination with an epoch length of 60 s (VM-60). PA was measured for eight consecutive days using ActiGraph accelerometers (wGT3X-BT). Three days were required to be included in the analysis (minimum two weekdays and one weekend-day with at least ten hours recording per day). RESULTS: Four hundred forty-five preschoolers (mean age 3.9 ± 0.5 years; 46% girls) had valid accelerometer measurements. A longer epoch (VA-60 vs VA-15) resulted in 2% less sedentary time (ST), 18% more light PA (LPA) and 51% less moderate-to-vigorous PA (MVPA); using the vector magnitude compared to the vertical axis (VM-60 vs VA-60) resulted in 34% less ST, 27% more LPA and 63% more MVPA (all p ≤ 0.001). Comparing all three sets of cut-points, ST ranged from 4.0 to 6.2 h, LPA from 5.1 to 7.6 h and MVPA from 0.8 to 1.6 h. CONCLUSIONS: Estimated time spent in different PA intensities was strongly influenced by the choice of cut-point sets. Both, axis selection and epoch length need to be considered when comparing different studies especially when they relate PA behavior to health. The differences in the prevalence of children fulfilling PA guidelines highlight the relevance of these findings. TRIAL REGISTRATION: Current Controlled Trials ISRCTN41045021 (date of registration: 21.03.2014).

Association of physical activity with adiposity in preschoolers using different clinical adiposity measures: a cross-sectional study.

BACKGROUND: More research is needed about the association between physical activity (PA), sedentary behaviour (SB), and adiposity in preschoolers, particularly using more direct clinical measures of adiposity. Therefore, the main objective of this study was to investigate the association between objectively measured PA and different clinical adiposity measures in a large sample of preschoolers. METHODS: Four hundred sixty-three predominantly normal-weight (77%) 2-6-year-old preschool children participated in the Swiss Preschoolers' Health Study (SPLASHY). Physical activity was measured using accelerometers and was analyzed using 15-s (uni-axial) epoch length using validated cut-offs. Adiposity measures included body mass index (BMI), the sum of four skinfolds, and waist circumference (WC). Multilevel linear regression modeling, adjusted for age, sex and wear time, was used to assess the association between PA and SB with BMI, WC, and skinfold thickness. RESULTS: Total PA and different PA intensities were positively and SB was inversely associated with BMI in the total sample and in the normal-weight children (p < 0.05). Total PA was inversely associated with skinfold thickness in overweight and obese children (p < 0.05), while there was only a weak association for vigorous PA (p > 0.05). Moderate and moderate-to-vigorous PA were positively, and SB was negatively associated with WC in the total sample and in the normal-weight children (p < 0.05). Additional adjustment for potential sociocultural and biological confounding variables attenuated some of the results. CONCLUSIONS: In this very young and predominantly normal-weight population, PA is positively related to BMI and WC, but this relationship is not observed in overweight and obese children. In this latter population, PA is inversely, and SB is positively related to skinfold thickness. Skinfold thickness could represent a useful and simple clinical measure of body fat in preschoolers. The role of vigorous PA in the prevention of early childhood obesity should be further investigated in future studies. TRIAL REGISTRATION: ISRCTN ISRCTN41045021 . Retrospectively registered 06 May 2014.

Prevalence and Predictors of Behavioral Problems in Healthy Swiss Preschool Children Over a One Year Period.

Behavioral problems impair children's health but prevalence rates are scarce and persistence rates vary due to divergence in age ranges, assessment methods and varying environmental factors. The aim of this study was to assess prevalence rates of behavioral problems, their persistence over a 1-year period, and the impact of child- and parent-related factors on behavioral problems. 555 2-6-year-old healthy preschool children were assessed at baseline and 382 of the initial sample at 1-year follow-up. Assessment included questionnaires concerning behavioral problems and their potential predictors (e.g. socio-economic status or parenting style). Altogether, nearly 7% of these children showed clinically relevant behavioral problems, and 3% showed persistent symptoms. Low SES, inconsistent parenting and corporal punishment were positively associated with behavioral problems. The prevalence rates of behavioral problems in Swiss preschoolers are similar to other European countries, but persistence is still rather low within preschool age. These findings need further confirmation in longitudinal studies.

Physical activity and sedentary behavior in preschoolers: a longitudinal assessment of trajectories and determinants.

BACKGROUND: Despite physical activity (PA) being recognized as a critically important factor for good physical and mental health already early in life and throughout the life course, prospective data on activity behavior during the preschool years remains scarce. This study examined trajectories and determinants of levels and change in total PA (TPA), moderate-to-vigorous PA (MVPA) and sedentary behavior (SB) in a representative sample of Swiss preschoolers. METHODS: Data were drawn from the Swiss Preschoolers' Health Study (SPLASHY), a multi-site prospective cohort study including 555 children (53% boys) aged 2-to-6 years at baseline. A follow-up was conducted after 12 months. Activity behavior was measured using accelerometers. Information on 35 potential determinants from different socio-ecological domains was either directly measured or parent-reported. Trajectories of TPA, MVPA and SB over time were described for boys and girls. Linear mixed models were used to investigate factors that predicted levels and change in TPA, MVPA and SB. RESULTS: All children were sufficiently physically active according to published recommendations for preschoolers. Trajectory profiles revealed a marked increase in TPA and MVPA in boys and girls whereas SB remained fairly stable over time. Mixed modeling demonstrated that variables most relevant to determining PA levels were sex, age and activity temperament (all positively associated). Together with gross motor skills, birth weight, family structure (only for TPA) and season (only for MVPA), these factors accounted for 26 and 32% of total variance explained in TPA and MVPA, respectively. Activity temperament emerged as the strongest determinant of SB (negative association) and explained with sex, season and family structure 20% of total variance in SB. The presence of older siblings was the only factor that predicted change in PA over time. CONCLUSIONS: In this healthy physically active cohort of preschoolers, non-modifiable individual-level factors had the greatest influence on PA. The limited success of this and previous studies to identify modifiable determinants and the finding that most preschoolers were sufficiently active suggest that future attempts should provide insights into how preschoolers' activity levels can be maintained and fostered to prevent subsequent harmful declines attributable, amongst others, to educational transitions. Thus, good-quality longitudinal studies are needed. TRIAL REGISTRATION: Current Controlled Trials ISRCTN41045021 (date of registration: 21.03.14).

Prevalence in primary school youth of pica and rumination behavior: The understudied feeding disorders.

OBJECTIVE: Little epidemiological evidence exists on rumination disorder behavior (RB) and pica behavior (PB). We examined prevalence of RB and PB and presence of comorbid feeding/eating disorder symptoms among school-aged children. METHOD: In elementary schools in Switzerland, 1,430 children (54.0% female) ages 7-13 completed the Eating Disorder Examination-Questionnaire for children (ChEDE-Q) and the Eating Disturbances in Youth Questionnaire (EDY-Q). RESULTS: EDY-Q behavior frequency showed 9.7% reported RB only, 10.0% reported PB only, and 3.1% reported RB + PB (≥1 on 0-6 Likert scale). At a clinical cut-off score of ≥ 4, 1.7% had RB only, 3.8% had PB only, and 1.1% had RB + PB. Avoidant/restrictive food intake disorder symptoms were most common in those with RB + PB, and more common in those with RB or PB than those without. The degree of eating disorder symptoms (by ChEDE-Q) over the past 28 days were similar among those with RB, PB, or RB + PB, but less common in those without RB or PB. DISCUSSION: RB and PB were commonly reported in our sample of school-aged children, even at a potential clinically significant cut-off. Our findings also suggest that the degree of eating disorder symptom comorbidity is similar between those with RB and PB.

Cue reactivity, habituation, and eating in the absence of hunger in children with loss of control eating and attention-deficit/hyperactivity disorder.

OBJECTIVE: Childhood loss of control (LOC) eating and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid conditions and present with disordered eating behaviors, such as overeating. This study sought to delineate shared and specific abnormalities in physiological, cognitive-motivational, and behavioral components of food-specific impulsivity in children with LOC eating and ADHD. Specifically, children's reactivity and habituation to food and eating in the absence of hunger were examined. METHODS: Within this community-based study, four groups of 8-13-year-old children with LOC eating (n = 24), ADHD (n = 32), comorbid LOC eating/ADHD (n = 9), and matched controls (n = 34) received a standard laboratory test meal to establish satiety and were then exposed to their favorite snack food in a cue exposure/reactivity trial, while salivation and desire to eat were repeatedly assessed. Subsequently, they were offered a variety of snack foods ad libitum. RESULTS: Children with LOC eating, ADHD, and LOC/ADHD did not differ from controls in salivary reactivity and habituation to food cues. Children with LOC eating and ADHD showed greater cue reactivity of the desire to eat than controls, but groups did not differ in its longer-term increments. At free access, only children with LOC/ADHD consumed significantly more energy than controls. Longer-term increments of desire to eat predicted greater energy intake beyond LOC/ADHD group status. DISCUSSION: Desire to eat among children with comorbid LOC eating and ADHD was associated with overeating in the absence of hunger, which may contribute to excess weight gain. Delineation of the specific features of childhood LOC eating versus ADHD warrants further study.

The validity of parental reports on motor skills performance level in preschool children: a comparison with a standardized motor test.

Motor skills are interrelated with essential domains of childhood such as cognitive and social development. Thus, the evaluation of motor skills and the identification of atypical or delayed motor development is crucial in pediatric practice (e.g., during well-child visits). Parental reports on motor skills may serve as possible indicators to decide whether further assessment of a child is necessary or not. We compared parental reports on fundamental motor skills performance level (e.g., hopping, throwing), based on questions frequently asked in pediatric practice, with a standardized motor test in 389 children (46.5% girls/53.5% boys, M age = 3.8 years, SD = 0.5, range 3.0-5.0 years) from the Swiss Preschoolers' Health Study (SPLASHY). Motor skills were examined using the Zurich Neuromotor Assessment 3-5 (ZNA3-5), and parents filled in an online questionnaire on fundamental motor skills performance level. The results showed that the answers from the parental report correlated only weakly with the objectively assessed motor skills (r = .225, p < .001). CONCLUSION: Although a parental screening instrument for motor skills would be desirable, the parent's report used in this study was not a valid indicator for children's fundamental motor skills. Thus, we may recommend to objectively examine motor skills in clinical practice and not to exclusively rely on parental report. What is Known: • Early assessment of motor skills in preschool children is important because motor skills are essential for the engagement in social activities and the development of cognitive abilities. Atypical or delayed motor development can be an indicator for different developmental needs or disorders. • Pediatricians frequently ask parents about the motor competences of their child during well-child visits. What is New: • The parental report on fundamental motor skills performance level used in this study was not a reliable indicator for describing motor development in the preschool age. • Standardized examinations of motor skills are required to validly assess motor development in preschoolers.

Emotional eating is related with temperament but not with stress biomarkers in preschool children.

Emotional eating (EE) corresponds to a change in eating behavior in response to distress and results in an increase of food intake (overeating (EOE)) or in food avoidance (undereating (EUE)). EE has been related to temperament (i.e. negative emotionality) and dysregulated stress biomarkers in school-aged children; parenting has been understood to influence this relationship in older children. The aim of the study was to investigate to which extent stress biomarkers and negative emotionality are related to EE and to understand the role of parenting in this relationship. The sample consisted of 271 children aged 2-6 years of the Swiss cohort study SPLASHY. We assessed the child's EE, negative emotionality and parenting by parent based reports. Salivary samples were collected over two days to analyze cortisol and salivary alpha-amylase levels. From the whole sample of children, 1.1% showed EOE and 32.9% EUE. Negative emotionality was related to EOE and EUE (0.13 (CI 0.06, 021), p < 0.001; 0.25 (CI 0.14, 0.35), p < 0.001). There was no relationship between stress biomarkers and EE and parenting had any moderating role (all p > 0.05). Similar to a Danish study, parents reported more often EUE than EOE of their child. Both are related to the temperament. Even though the course of EE has not yet been well documented, we conclude that a certain subgroup of children with difficult temperament could be at-risk for eat and weight regulation problems in later childhood.

Physiological stress measures in preschool children and their relationship with body composition and behavioral problems.

BACKGROUND: The relationship between physiological stress measures and body composition or behavioral problems in older children remains controversial, and data in young children are lacking. The aim of the study was to investigate this relationship in predominantly healthy preschool children. METHOD: Physiological stress measures were assessed using diurnal salivary alpha-amylase (sAA) and salivary cortisol, nail cortisol and parasympathetic activation (PNS) by overnight heart rate variability, and body composition (body mass index, skinfold thickness) and behavior problems (using the Strengths and Difficulties Questionnaire) in 324 children aged 2-6 years of the SPLASHY study. RESULTS: Parasympathetic nervous system was inversely related to body fat, to emotional, and to peer problems. Diurnal sAA was related to hyperactivity problems and moderated the relationship of cortisol and hyperactivity problems. Cortisol was not related to any other health problems. DISCUSSION: The relationship of PNS with body composition and behavioral problems might highlight the protective role of the parasympathetic system early in life.

Relevance of the Thought-Shape Fusion Trait Questionnaire for healthy women and women presenting symptoms of eating disorders and mixed mental disorders.

Thought-shape fusion (TSF) describes the experience of marked concerns about body weight/shape, feelings of fatness, the perception of weight gain, and the impression of moral wrongdoing after thinking about eating fattening/forbidden foods. This study sets out to evaluate the short version of the TSF trait questionnaire (TSF). The sample consists of 315 healthy control women, 244 women with clinical and subthreshold eating disorders, and 113 women with mixed mental disorders (mixed). The factor structure of the TSF questionnaire was examined using exploratory and subsequent confirmatory factor analyses. The questionnaire distinguishes between a Concept scale and a Clinical Impact scale. However, a lack of measurement invariances refers to significant differences between groups in terms of factor loadings, thresholds, and residuals, which questions cross-group validity. Results indicate that the concept is understood differently in the 3 groups and refers to the suitability of the questionnaire primarily for individuals presenting with symptoms of eating disorders.

Correlates of preschool children's objectively measured physical activity and sedentary behavior: a cross-sectional analysis of the SPLASHY study.

BACKGROUND: Identifying ways to promote physical activity and decrease sedentary time during childhood is a key public health issue. Research on the putative influences on preschool children's physical activity (PA) and sedentary behavior (SB) is limited and has yielded inconsistent results. Our aim was to identify correlates of PA and SB in preschool children. METHODS: Cross-sectional data were drawn from the Swiss Preschoolers' Health Study (SPLASHY), a Swiss population-based cohort study. Of 476 two to six year old children, 394 (54% boys) had valid PA data assessed by accelerometry. Information on exposure data was directly measured or extracted from parental questionnaires. Multilevel linear regression modeling was used to separately assess associations between 35 potential correlates and total PA (TPA), moderate-to-vigorous PA (MVPA) and SB. RESULTS: In total, 12 correlates from different domains were identified. TPA and MVPA were greater in boys than girls, increased with age and were positively associated with gross motor skills. Children from single parent families had a higher level of TPA and spent less time sedentary than those living with two parents. Time spent outdoors was positively associated with TPA and negatively with SB. The child's activity temperament was related all three outcomes, whereas parental sports club membership, living area per person and neighborhood safety were associated with SB only. Fixed and random factors in the final models accounted for 28%, 32% and 22% of the total variance in TPA, MVPA and SB, respectively. Variance decomposition revealed that age, sex and activity temperament were the most influential correlates of both, TPA and MVPA, whereas the child's activity temperament, time outdoors and neighborhood safety were identified as the most important correlates of SB. CONCLUSIONS: A multidimensional set of correlates of young children's activity behavior has been identified. Personal factors had the greatest influence on PA, whereas environmental-level factors had the greatest influence on SB. Moreover, we identified a number of previously unreported, potentially modifiable correlates of young children's PA and SB. These factors could serve to define target groups or become valuable targets for change in future interventions. TRIAL REGISTRATION: Current Controlled Trials ISRCTN41045021 (date of registration: 21.03.14).

Satiety regulation in children with loss of control eating and attention-deficit/hyperactivity disorder: A test meal study.

Children with loss of control (LOC) eating and attention-deficit/hyperactivity disorder (ADHD) are at risk for excessive weight gain. However, it is unclear whether or not these children show disturbances in hunger and satiety regulation. The goal was to examine the food intake and sense of LOC over eating as well as LOC eating-related characteristics during test meal in children with LOC eating and ADHD. Children aged 8-13 y with LOC eating (n = 33), ADHD (n = 32), and matched healthy controls (n = 33), consumed a test meal consisting of their chosen lunch food, with the instruction to eat until feeling full. Sense of LOC over eating, desire to eat, feelings of hunger, and liking of food were repeatedly assessed during test meal. Children with LOC eating and ADHD did not show a higher food intake at maximum satiety compared to control children. Sense of LOC over eating was significantly higher in children with LOC eating compared to children with ADHD and matched controls. Secondary analyses revealed that children with LOC eating ate marginally faster than control children. Both children with LOC eating and ADHD reported greater desire to eat, feelings of hunger, and liking of food during test meal than control children. Even though the results did not reveal statistical evidence to support the assumption of a disturbed food intake in children with LOC eating and ADHD, LOC eating related characteristics were significantly higher in these children compared to the control children. Sense of LOC over eating was confirmed as a specific characteristic of LOC eating. The examination of behavioral indicators of hunger and satiety dysregulation should be complemented with physiological indicators in future research.

Influence of Parental Expressed Emotions on Children's Emotional Eating via Children's Negative Urgency.

We investigated whether parental expressed emotion (criticism and emotional overinvolvement) is related to children's emotional eating and whether this relationship is mediated by children's negative urgency. One hundred children, aged 8 to 13 years, either healthy or have binge-eating disorder and/or attention-deficit/hyperactivity disorder, completed the questionnaires, along with their parents. Parental criticism and, to a lesser extent, parental emotional overinvolvement were both positively related to children's emotional eating, and this relationship was mediated by children's negative urgency. Further exploratory analyses revealed that the mediating role of children's negative urgency in the relationship between parental criticism and children's emotional eating was pronounced in the clinical group of children with binge-eating disorder and attention-deficit/hyperactivity disorder but almost absent in the healthy control group. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Variants of early-onset restrictive eating disturbances in middle childhood.

OBJECTIVE: This study sought to determine the factor structure of the newly developed self-report screening questionnaire Eating Disturbances in Youth-Questionnaire (EDY-Q) as well as to report the distribution of variants of early-onset restrictive eating disturbances characteristic of avoidant/restrictive food intake disorder (ARFID) in a middle childhood population sample. METHOD: Using the EDY-Q, a total of 1,444 children aged 8-13 years were screened in elementary schools in Switzerland via self-report. The factor analysis of the 12 items covering ARFID related symptoms was performed using a principal component analysis (PCA). RESULTS: The PCA showed a four factor solution, with clear allocation to the scales covering three variants of early-onset restrictive eating disturbances and weight problems. Inadequate overall food intake was reported by 19.3% of the children, a limited accepted amount of food by 26.1%, and food avoidance based on a specific underlying fear by 5.0%. DISCUSSION: The postulated factor structure of the EDY-Q was confirmed, further supporting the existence of distinct variants of early-onset restrictive eating disturbances. Avoidant/restrictive eating behavior seems to be a common experience in middle childhood, but results have to be confirmed using validated interviews.

Short-term effects of media exposure to the thin ideal in female inpatients with an eating disorder compared to female inpatients with a mood or anxiety disorder or women with no psychiatric disorder.

OBJECTIVE: Previous research demonstrated that the exposure to media portrayals of the thin body ideal negatively affects body satisfaction and mood of healthy women and thus represents a sociocultural risk factor for the development of eating disorders. However, at present, it is not known whether negative effects of the thin ideal are pronounced in eating-disordered patients. METHOD: Female inpatients with a current diagnosis of anorexia nervosa (N = 36), bulimia nervosa (N = 32), or mood or anxiety disorder (N = 31), and women with no current psychiatric diagnosis were randomly assigned to exposure to magazine pictures depicting the thin female body ideal or landscape scenes in two experimental phases (leafing through a magazine followed by instructed imagination of a picture from the magazine). The groups were compared on measures of body satisfaction and mood that were collected before and after the two phases. RESULTS: Leafing through a fashion magazine was not associated with negative effects on body satisfaction or mood in all groups. Imagining the thin ideal resulted in a decrease in body satisfaction and a decrease in positive mood. We found no diagnosis-specific effects indicating no stronger negative impact of the thin ideal on eating-disorder patients. DISCUSSION: Given the lacking differences between eating-disordered patients and controls, these findings underline the importance of future research to enhance our understanding of what happens when patients are exposed to external or internal stimuli of media images of the thin ideal. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:708-715).

The Swiss Preschoolers' health study (SPLASHY): objectives and design of a prospective multi-site cohort study assessing psychological and physiological health in young children.

BACKGROUND: Children's psychological and physiological health can be summarized as the child's thinking, feeling, behaving, eating, growing, and moving. Children's psychological and physiological health conditions are influenced by today's life challenges: Thus, stress exposure and lack of physical activity represent important health challenges in older children. However, corresponding evidence for young children is scarce. The aim of Swiss Preschoolers' Health Study (SPLASHY) is to examine the role of stress and physical activity on children's psychological and physiological health, particularly on cognitive functioning, psychological well-being, adiposity and motor skills in children at an early stage of childhood. We will also assess the role of child and environmental characteristics and aim to define sensitive time points. METHODS/DESIGN: In a total of 84 child care centers, children at preschool age (2-6 years) are recruited and are assessed immediately and one year later. Assessments include direct measurements of the children in the child care centers and at home as well as assessments of children's behavior and environmental factors through informants (parents and child care educators). DISCUSSION: SPLASHY is one of the first studies in early childhood aiming to investigate the influence of stress and physical activity on children's psychological and physiological health in a community-based longitudinal design. TRIAL REGISTRATION: Current Controlled Trials ISRCTN41045021 (date of registration: 21.03.14).