The reciprocal interplay of physical activity and health-related quality of life in children and adolescents: Evidence for both upward and downward spirals.

OBJECTIVE: This study examines the bidirectional effect between physical activity (PA) and health-related quality of life in children and adolescents, focusing on within-person effects. METHODS: PA and health-related quality of life were assessed in children and adolescents (N = 685, age: M = 10.29 years, SD = 1.35, range = 8-14), via self-report across four waves, each 6 months apart, and a random-intercept cross-lagged panel model with time-invariant cross-lagged effects was calculated. RESULTS: Positive cross-lagged effects between prior PA and health-related quality of life 6 months later ( γ y = 0.536, 95% CI [0.016, 1.055], p = .043, d = 0.11) and vice versa ( γ x = 0.015, 95% CI [0.001, 0.030], p = .039, d = 0.12) were found. Furthermore, the random intercept correlation was significant ( T xy = 3.622, 95% CI [2.204, 5.041], p < .001, d = 0.27). CONCLUSIONS: The findings confirm known correlations between PA and health-related quality of life and extends them by indicating both an upward and downward spiral of PA and health-related quality of life in children and adolescents.

[Examination of the Multidimensional Anxiety Inventory for Children and Adolescents (MAICA) in Clinical Samples]. / Überprüfung des Mehrdimensionalen Angstinventars für Kinder und Jugendliche (MAI-KJ) an klinischen Stichproben.

Questionnaires such as the Multidimensional Anxiety Inventory for Children and Adolescents (MAICA) provide a diagnostic approach to alert for anxiety- or depression-related problems. The aim is to examine the MAICA within two clinical samples.We first investigated whether children having anxiety- or depression-related problems (n = 94) scored higher on anxiety (i.e., emotionality and worry) and depression (i.e., dysthymia and low joy) than a non-clinical control group (n = 282). Then, we contrasted a clinical sample with other mental disorders unrelated to anxiety or depression (n = 45) with another non-clinical control group (n = 135). Across all scales of the MAICA, children with anxiety- or depression-related problems showed less favourable values than the non-clinical control group (d = 0.34 to 0.54 for anxiety, 0.55 to 0.68 for depression). Children with other mental problems showed no differences in either the anxiety or depression scales. For the use as a screening instrument, preliminary cutoff scores for identifying anxiety- or depression-related problems with the MAICA are given.

Increasing Heart Rate Variability through Progressive Muscle Relaxation and Breathing: A 77-Day Pilot Study with Daily Ambulatory Assessment.

The aim of this study was to examine whether it is possible to gradually increase heart rate variability (HRV) in healthy individuals (21 participants, M = 21.24 years, SD = 1.57, range 19 to 26) through regular exercises of average resonance frequency training (RFT; 6 breaths/min; 5 min each day) and progressive muscle relaxation (PMR; three times a week for 20 min). The effects were tested against an active control group using a linear mixed effect model with random slopes (day), random intercepts (participants) and an autoregressive error term. The special feature of this pilot study is that HRV was measured every day in an ambulatory assessment over 77 days, so that graduate long-term effects on HRV can be mapped. The results indicated that the PMR group significantly increased their HRV compared to the active control group. However, no effect was observed for the RFT group. Possible explanations for these results and important recommendations for subsequent studies are provided.

Stress-symptoms and well-being in children and adolescents: factor structure, measurement invariance, and validity of English, French, German, Russian, Spanish, and Ukrainian language versions of the SSKJ scales.

OBJECTIVE: The present cross-cultural study examined the factor structure, measurement invariance, and convergent validity of the Stress-Symptom and Well-Being Scales from the Stress and Coping Questionnaire for Children and Adolescents (SSKJ), originally in German, across gender and for five newly developed language versions: English, French, Russian, Spanish, and Ukrainian. DESIGN: Children and adolescents (N = 5,227) from Germany, France, Russia, the Dominican Republic, Ukraine, and several English-speaking countries participated in the survey study. MAIN OUTCOME MEASURES: The SSKJ Stress-Symptom and Well-Being Scales capture stress symptomatology and well-being with five subscales: Somatic Symptoms, Anger, Sadness, Anxiety, and Well-Being. The Strengths and Difficulties Questionnaire (SDQ) was used for validation. RESULTS: The factorial structure (five factors) was confirmed. In multi-group comparisons, confirmatory factor analyses showed partial metric invariance across the different languages. Regarding gender, results showed scalar invariance for all languages, except for Spanish. Gender differences were shown with girls scoring higher on somatic symptoms, sadness, anxiety (German-, French-, Russian-speaking samples), anger (French), and well-being (German, Ukrainian). Correlations with indicators of mental health and behavioral problems demonstrated convergent validity. CONCLUSION: The SSKJ Stress-Symptom and Well-Being Scales showed psychometric evidence for equivalence across the different languages and gender. Thus, this instrument is a useful tool for cross-cultural research in children and adolescents.

Predicting self-control capacity - Taking into account working memory capacity, motivation, and heart rate variability.

The present study analyzes possible indicators for state self-control capacity (measured by a Simon task) after demanding executive function tasks as well as for trait self-control (measured by a questionnaire) by focusing on the interplay between control capacity and motivation (measured by demand-related action-state orientation; 154 students; M = 23.55 years; SD = 3.15). As possible control capacity variables, we focused on working memory capacity, based on the integrative theory of self-control, as well as on the baseline cardiac vagal control as a possible physiological index (not a resource itself) indicating control capacity based on the vagal tank theory. The vagal tank theory also focuses on within-subject changes in cardiac vagal control as a possible index of self-control capacity. Therefore, we analyzed among the first 54 participants (M = 24.61 years; SD = 2.67) baseline to post-event changes in cardiac vagal control. Following the integrative theory of self-control, the results indicated that both state and trait self-control capacity are predicted by an interplay of working memory capacity and action-state orientation. Focusing on the vagal tank theory, the results suggest that state self-control capacity can best be detected by the within-subject changes in cardiac vagal control instead of analyzing between-subject differences in cardiac vagal control. However, when focusing on trait self-control, cardiac vagal control might be an indicator, if considered without action state orientation.

Dimensionality of mental health activities in a German sample.

For the promotion of mental health and the reduction of mental impairment, a person's behavior is of vital importance. Therefore, the assessment of mental health behavior is crucial in the development of suitable interventions. The present study investigates 14 self-help strategies compiled by Morgan and Jorm (Self-help strategies that are helpful for sub-threshold depression: a Delphi consensus study. J Affect Disord2009;115: 196-200) as items of a self-report scale to assess mental health promoting behavior. Dimensionality and psychometrics of mental health activities were examined in a sample of 852 German adults (76% female). After exploratory factor analyses (EFAs, n = 543), several factor structure possibilities were subsequently tested by confirmatory factor analyses (CFAs, n = 309). Based on these results, psychometric properties were calculated. Factor analyses result in a three-factor solution with the subscales positive orientation, physical engagement and emotion regulation. CFAs indicate a good model fit. The total scale showed acceptable reliability. Correlations with indicators of positive mental health were higher than with those of mental impairment. Moreover, correlations support the three-factor structure of the instrument. Women scored higher than men in the total scale, due to differences in the subscale emotion regulation. Although some modifications were performed, the results of our analyses suggest that the self-help strategies introduced by Morgan and Jorm (2009) are indeed useful items for a brief scale to assess mental health activity. The identification of the multidimensionality is an important step in supporting the work of mental health promotion.

Fear of Being Laughed at in Children and Adolescents: Exploring the Importance of Overweight, Underweight, and Teasing.

Weight bias toward obese youths is often accompanied by the experience of psychological stress in those affected. Therefore, the fear of being laughed at (i.e., gelotophobia) in overweight children and adolescents can be rather serious. In four explorative studies, the importance of relative weight, self-awareness of weight (incl. satisfaction with weight), experiences of teasing and ridicule, as well as the role of social-evaluative situations in school were analyzed with regard to gelotophobia. In two online interviews of adults with pronounced gelotophobia (Study I: 102 English-speaking participants, Study II: 22 German-speaking participants) relating to reasons they assumed for their development of gelotophobia, there was evidence of injurious appearance-related experiences during childhood and adolescence. In Study III (75 Swiss adolescents) associations between the experience of weight-related teasing and mockery with overweight, self-perceptions of weight, and gelotophobia were analyzed. Especially in girls, overweight was associated with the experience of weight-related teasing and ridicule, which in turn was accompanied by gelotophobia. Study IV included 178 German adolescents who were asked to report their body image ("Do you think you are… too thin, just the right weight, or too fat?"). In addition, gelotophobia, teasing, BMI based on self-reports, and joy at school were measured. In particular, girls who felt too fat and boys who felt too thin reported teasing. Teasing was related to diminished joy at school and to gelotophobia. Among boys, underweight mediated by weight-related teasing contributed to gelotophobia. The results suggest that more research should be devoted to gelotophobia and the experience of weight-related teasing and mocking to better understand factors contributing to the well-being of children and adolescents with weight problems.

Self-regulation of healthy nutrition: automatic and controlled processes.

BACKGROUND: Self-regulatory behaviour refers to both controlled and automatic processes. When people are distracted, automatic over controlled processes prevail. This was analysed with regard to nutritional behaviour (food choices, beverage intake) in situations of low or high distraction. METHODS: A self-concept Implicit Association Test (IAT) was adapted to assess the implicit associations of self (vs. other) with healthy (vs. unhealthy) food. Explicit preferences for healthy and unhealthy food and the diet's healthiness were measured by self-report. Both implicit and explicit measures were used as predictors of nutritional behaviour. Among 90 undergraduates, the choice of fruit versus snack in a food choice task (low distraction) and the amount of mineral water and soft drinks consumed in a taste comparison task to cover liquid intake (high distraction) were observed. RESULTS: In the low distraction situation, food choice was predicted solely by explicit measures. Fruits were chosen less, when unhealthy foods were explicitly liked. In the high distraction situation, mineral water intake was predicted solely by the IAT. Participants implicitly associating themselves with healthy foods drank more mineral water than those implicitly associating themselves with unhealthy foods. CONCLUSIONS: Nutritional behaviour is influenced by both automatic and controlled processes depending on the available capacity for self-regulation.

Perception makes the difference: the association of actual and perceived weight status with self-reported and parent-reported personal resources and well-being in adolescents.

The study analyzed associations between actual weight status and weight perceptions with personal resources, physical and psychological health, as well as physical performance among adolescents (N = 5,518; age: 11-17 years). Analyses are based on data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Self-report measures, parental reports, as well as objective test data were considered. Results indicate that weight perceptions, rather than actual weight status, were associated with personal resources, health, and perceived physical performance. Comparing groups, we found that adolescents who felt they had "just the right weight" achieved more favourable results than those who perceived themselves as "too fat", regardless of their actual weight status. However, actual physical performance was predicted better by actual weight status. Furthermore, weight perceptions were found to mediate the link between actual weight status and all the assessed outcomes (personal resources, health, and physical performance). With respect to self-reports, the mediational effect was consistently stronger for girls, whereas the reverse was true regarding physical performance. Parental reports were not moderated by sex. Findings provide further evidence that among overweight adolescents there are subgroups that differ significantly with regard to risks and resources. Implications for practice are discussed.

[Coping in children and adolescents with migrant origin]. / Stressprävention bei Kindern und Jugendlichen mit Migrationshintergrund.

Children and adolescents of migrant origin often have disadvantages regarding education opportunities and health. This paper reports on the extra-curricular "Special Instruction Project for Children and Adolescents of Migrant Origin'", launched by the Stiftung Mercator and administered in Schwäbisch Gmünd. The project aims to improve education opportunities for children and adolescents of migrant origin by providing language and subject support. During the years 2006 to 2008 full-time holiday courses were realized in addition to the weekly subject instructions in German, Mathematics and English. In these holiday schools creative, sportive and health promoting aspects were integrated in language support. In terms of resource promotion and empowerment a module on stress and coping was developed and realized in the holiday courses. This module on stress and coping in context of the language support project is presented and discussed.

Physician-diagnosed obesity in German 6- to 14-year-olds. Prevalence and comorbidity of internalising disorders, externalising disorders, and sleep disorders.

OBJECTIVE: This study analyses whether children with obesity have an increased risk of internalising disorders, externalising disorders, and sleep disorders compared to children without physician-diagnosed obesity. METHOD: The study included 156,948 children aged between 6 and 14 years. We analysed data of a German national health insurance company concerning the rates of the physician-diagnosed ICD-10 disorders of obesity and psychiatric disorders. RESULTS: Greater odds for externalising disorders (odds ratio (OR) = 1.64), internalising disorders (OR = 2.00), sleep disorders (OR = 1.87), and a stay in hospital (OR = 1.44) were found among children with physician-diagnosed obesity compared to children without physician-diagnosed obesity. The increased ORs were higher in girls with obesity compared to boys with obesity for externalising disorders (OR = 1.91 vs. 1.52) and internalising disorders (especially anxiety, OR = 2.15 vs. 1.43). According to age group, the increased OR was highest in young adolescents (12- to 14-year-olds) with obesity compared to younger children with obesity for internalising disorders (especially anxiety, OR = 2.32 vs. 1.59 and 1.43). CONCLUSION: For obesity prevention and obesity intervention, it is important to understand comorbid health problems as well as potential interindividual influence factors (such as gender or age), both of which should be a focus in respective programmes.

Attentional biases for threatening faces in children: vigilant and avoidant processes.

The authors examined the processing of threat-related information in childhood anxiety with the emotional Stroop task and the dot probe task. In study 1, a nonclinical sample of 112 pupils (mean age = 9 years) performed pictorial versions of both tasks. For each task, an index indicating a bias for threat processing was computed. Positive correlations were found between these indices and anxiety. When compared with the original emotional Stroop index, the absolute value of the emotional Stroop index was a better predictor of anxiety. It was possible to replicate this result in study 2 with 80 pupils (mean age = 8.6 years). Results are discussed with regard to vigilance and avoidance as basic mechanisms underlying performance on the tasks.

Facets of dynamic positive affect: differentiating joy, interest, and activation in the positive and negative affect schedule (PANAS).

This article proposes the differentiation of Joy, Interest, and Activation in the Positive Affect (PA) scale of the Positive and Negative Affect Schedule (PANAS; D. Watson, L. A. Clark, & A. Tellegen, 1988). Study 1 analyzed the dynamic course of PA before, during, and after an exam and established the differentiation of the three facets. Study 2 used a multistate-multitrait analysis to confirm this structure. Studies 3-5 used success-failure experiences, speaking tasks, and feedback of exam results to further examine PA facets in affect-arousing settings. All studies provide convincing evidence for the benefit of differentiating three facets of PA in the PANAS: Joy, Interest, and Activation do have distinct and sometimes even opposite courses that make their separation meaningful and rewarding.