Stress and eating responses in adolescent females predisposed to obesity: A pilot and feasibility study.

OBJECTIVE: To explore how chronic stress, reactivity to acute stress, and obesogenic eating are linked in adolescent females predisposed to obesity. METHODS: Participants included 21 adolescent females (mage = 14.57 years) and their biological mothers with obesity (body mass index [BMI] ≥ 30 kg/m2). The pilot and feasibility study involved adolescent self-report of chronic stress, an acute stress-induction paradigm (Trier Social Stress Task, TSST), salivary cortisol collection to assess stress reactivity, and both subjective (self-report) and objective (snack buffet) measures of obesogenic eating. RESULTS: Adolescent females reporting high chronic stress were significantly more likely to engage in self-reported emotional and external eating and to have higher food cravings (p's < .05) compared to adolescents with low chronic stress. Effect size estimates suggested a blunting effect of cortisol in the high chronic stress group. Blunted cortisol reactivity significantly predicted higher self-reported food cravings for the high chronic stress group (p = .04). Associations among chronic stress, cortisol, and self-reported and objective obesogenic eating reflected medium to large effect sizes. CONCLUSIONS: This study built on limited extant research on stress and eating to demonstrate that chronic stress was associated with self-reported obesogenic eating patterns in adolescent females predisposed to obesity. Different patterns of cortisol reactivity and eating emerged depending on chronic stress group (low versus high). Understanding these eating patterns in the context of chronic stress can inform interventions to reduce obesity risks in adolescence.

The scale matters: assessing body size with figure rating scales in a diverse sample of young adults.

PURPOSE: To explore intersectional differences in weight perception accuracy in a diverse sample of young adults using CDC-defined weight status labels and four separate figure rating scales (FRS). METHODS: This cross-sectional study of 322 18-25-year-olds with body mass index (BMI) ranging from 18.5 to 57.2 (MBMI = 26.01, SD = 6.46) enrolled participants as part of a larger university subject pool cohort in the U.S. MidSouth. Height and weight measurements were obtained. Participants (55% Black, 45% white; 74% female) selected images that best represented their current body size using four FRS and described their weight perception using five labels from "very underweight" to "very overweight/obese". Receiver operating characteristic (ROC) curve analyses were used to compare variability in classification of weight status by FRS and weight perception category across gender and race. RESULTS: Area under the curve (AUC) statistics indicated all scales were significantly better at classifying weight status than chance. Among Black females and Black males, the culturally adapted scale had the strongest discriminatory ability [(AUC = 0.93, SE = 0.02, p < 0.001, 95% CI = 0.89-0.97) and (AUC = 0.93, SE = 0.04, p < 0.001, 95% CI = 0.86-1.00), respectively]. Among white females, the silhouette scale had the strongest discriminatory ability (AUC = 0.93, SE = .03, p < 0.001, 95% CI = 0.88-0.99). Among white males, the photo-based scale had the strongest discriminatory ability (AUC = 0.84, SE = 0.06, p = 0.001, 95% CI = 0.71-0.96). Across all groups, weight perception labels were the weakest classifier of weight status. CONCLUSION: Weight perception labels are an ineffective method of assessing weight status and FRS accuracy varies by race and gender, suggesting the value of gender- and culturally tailored scales. LEVEL OF EVIDENCE: Level III. Evidence obtained from well-designed cohort or case-control analytic studies.

Parenting in matched pairs of women of color experiencing intimate partner violence and living with and without HIV.

This study explored the associations between depression and parenting among women of color with low income levels who were exposed to intimate partner violence (IPV) and HIV. Participants were 60 Black, multiracial, and Hispanic/Latina mothers (Mage = 36.66, SD = 6.99) in the midsouth region of the United States. Mothers were recruited from community organizations and reported their experiences with IPV, HIV, depression, potentially traumatic events (PTE), parenting practices, and child maladaptive functioning. Participants living with HIV and experiencing recent IPV (i.e., cases) were matched on age, race, ethnicity, and educational attainment with mothers experiencing recent IPV (i.e., controls), for a matched sample of 30 pairs. Analyses were conducted to examine how HIV status moderated the associations between depressive symptoms and both negative and positive parenting while accounting for PTE, child maladaptive functioning, and IPV severity. The moderation model for negative parenting was significant, f2 = 0.58, but the moderation model for positive parenting was not, p = .346. Specifically, moderation was supported, B = 0.43, 95% CI [0.03, 0.83], t(53) = 2.17, p = .035, indicating that the association between depressive symptoms and negative parenting was moderated by HIV status. The findings highlight the added burden of a physical health condition on parenting practices. Given the role of negative parenting (i.e., inconsistency, poor monitoring, corporal punishment) in exacerbating poor health outcomes among children exposed to adversity, clinicians and researchers must develop family-based strategies to decrease these practices.

Examining Risk Factors of Health-Related Quality of Life Impairments Among Adolescents with Inflammatory Bowel Disease.

Inflammatory Bowel Disease (IBD) is a chronic, costly, and burdensome disease that is typically diagnosed during adolescence. Despite the use of effective treatments, rates of relapse and intestinal inflammation remain high and put patients at risk for long term physical and psychosocial health complications. Given the costs associated with IBD, it is critical to examine potential risk factors of poor health-related quality of life (HRQoL) among patients for the enhancement and further development of interventions. As such, the aim of the current study was to examine how sociodemographic and disease characteristics, psychosocial problems, and adherence behaviors impact HRQoL among a sample of youth with IBD. 107 adolescents with IBD and their caregiver completed self- and parent-report measures as part of a psychosocial screening service. Medical records were reviewed to obtain information regarding diagnosis, insurance, medication use, illness severity, and disease activity. Results revealed lower HRQoL scores among adolescents with more psychosocial problems (Est. = -3.08; p < .001), greater disease severity (Est. = -.40; p = .001), and those who identified as Black (Est. = -.38; p < .05). Greater disease severity (Est. = .13 p = .004), use of nonpublic insurance (Est. = .32 p = .004), and fewer psychosocial problems (Est. = -.13 p = .04) were associated with greater adherence behaviors. These findings suggest that implementing individually tailored, evidence-based psychological interventions focused on coping with psychosocial problems and symptoms may be important in enhancing adherence behaviors and HRQoL among adolescents with IBD.

Associations between Substance Use and Depressive Symptoms among Women Experiencing Intimate Partner Violence.

Associations between substance use and depression among women experiencing intimate partner violence (IPV) have received limited empirical attention. This study examined how demographics, frequency of IPV and problematic substance use were related to depressive symptoms among women exposed to recent IPV. Participants included 112 women (Mage = 32.26; 67% Black) recruited from community organizations in the U.S. Midsouth, many of whom had used substances (80.2%) and were living below the poverty threshold (71.3%). Results from a hierarchical multiple regression analysis revealed that, after accounting for age and income, more frequent IPV and more problematic tobacco use were associated with higher depressive symptoms. Neither alcohol nor illicit substance use were significantly associated with depressive symptoms. These findings highlight a meaningful connection between problematic tobacco use and depressive symptoms, indicating the potential benefits of incorporating tobacco use psychoeducation and cessation strategies into treatment programs for women experiencing depression in the context of IPV.

Black and White Parents' Willingness to Seek Help for Children's Internalizing and Externalizing Symptoms.

OBJECTIVE: Understanding social and environmental factors that contribute to parental help-seeking intentions is an important step in addressing service underutilization for children in need of treatment. This study examined factors that contribute to parents' intentions to seek formal and informal help for child psychopathology (anxiety and attention-deficit/hyperactivity disorder [ADHD]). METHOD: A total of 251 parents (N = 128 mothers, N = 123 fathers; 49% Black, 51% White) read 3 vignettes describing children with anxiety, ADHD, and no diagnosis. Measures of problem recognition, perceived barriers, and formal (pediatricians, psychologists, teachers) and informal (religious leaders, family/friends, self-help) help seeking were completed. Four separate hierarchical logistic regression models were used to examine parental help-seeking likelihood from formal and informal sources for internalizing and externalizing symptoms. Predictors were socioeconomic status, parent race, age, and sex, parent problem recognition (via study vignettes), and perceived barriers to mental health service utilization. RESULT: Mothers were more likely than fathers to seek help from pediatricians, psychologists, teachers, and religious leaders for child anxiety and pediatricians, religious leaders, and self-help resources for child ADHD. Black parents were more likely to seek help from religious leaders and White parents were more likely to use self-help resources. Problem recognition was associated with greater intentions to seek help from almost all formal and informal sources (except from friends/family). CONCLUSION: Understanding factors that contribute to parental help seeking for child psychopathology is critical for increasing service utilization and reducing the negative effects of mental health problems. This study highlights the importance of decreasing help-seeking barriers and increasing problem recognition to improve health equity.

Parent-child conversations about literacy: a longitudinal, observational study.

Conversations about literacy-related matters with parents can help prepare children for formal literacy instruction. We studied these conversations using data gathered from fifty-six US families as they engaged in daily activities at home. Analyzing conversations when children were aged 1;10, 2;6, 3;6, and 4;2, we found that explicit talk about the elements and processes of reading and writing occurred even when children were less than two years old and became more common as children grew older. The majority of literacy-related conversations included talk about alphabet letters. Literacy-related conversations occurred in a variety of contexts, not only book-reading. There were few differences as a function of family socioeconomic status in the proportion of utterances during the sessions that occurred in literacy-related conversations. At older ages, however, children in families of lower socioeconomic status bore more of the conversational burden than children in families of higher status.

Young Children's Knowledge of the Symbolic Nature of Writing.

Two experiments with one hundred and fourteen 3- to 5-year-old children examined whether children understand that a printed word represents a specific spoken word and that it differs in this way from a drawing. When an experimenter read a word to children and then a puppet used a different but related label for it, such as "dog" for the word , children often stated the puppet's label was incorrect. In an analogous task with drawings, children were more likely to state that the puppet was correct in using an alternative label. The results suggest that even young children who cannot yet read have some understanding that a written word stands for a specific linguistic unit in a way that a drawing does not.

Parents' Talk About Letters With Their Young Children.

A literacy-related activity that occurs in children's homes-talk about letters in everyday conversations-was examined using data from 50 children who were visited every 4 months between 14 and 50 months. Parents talked about some letters, including those that are common in English words and the first letter of their children's names, especially often. Parents' focus on the child's initial was especially strong in families of higher socioeconomic status, and the extent to which parents talked about the child's initial during the later sessions of the study was related to the children's kindergarten reading skill. Conversations that included the child's initial were longer than those that did not, and parents presented a variety of information about this letter.

Variation and repetition in the spelling of young children.

A number of investigators have suggested that young children, even those who do not yet represent the phonological forms of words in their spellings, tend to use different strings of letters for different words. However, empirical evidence that children possess a concept of between-word variation has been weak. In a study by Pollo, Kessler, and Treiman (2009), in fact, prephonological spellers were more likely to write different words in the same way than would be expected on the basis of chance, not less likely. In the current study, preschool-age prephonological and phonological spellers showed a tendency to repeat spellings and parts of spellings that they had recently used. However, even prephonological spellers (mean age∼4 years 8 months) showed more repetition when spelling the same word twice in succession than when spelling different words. The results suggest that children who have not yet learned to use writing to represent the sounds of speech show some knowledge that writing represents words and, thus, should vary to show differences between them. The results further suggest that in spelling, as in other domains, children have a tendency to repeat recent behaviors.

Self-worth and developmental outcomes in young adults after pediatric bariatric surgery.

OBJECTIVES: Bariatric surgery has emerged as a safe/effective treatment for adolescents with severe obesity; therefore, understanding its impact over the life course is imperative. This study examined self-worth and developmental outcomes during the transition to adulthood (19-24 years old) for youth who underwent surgery as adolescents (13-18 years old) and a nonsurgical group with severe obesity. METHOD: As part of a prospective and multisite observational study series, adolescents (139 surgical, 83 nonsurgical) were followed for 6 years postsurgery/baseline when they completed height/weight measurements and measures of global self-worth, maturity, and occupational, educational, and social functioning as young adults. Growth curve analysis examined global self-worth change, while regressions were used to compare groups and examine adolescent-reported familial predictors and weight-related correlates for outcomes. RESULTS: Relative to the nonsurgical group, the surgical group experienced a significant quadratic improvement in self-worth and higher year 6 romantic self-perceptions. For the surgical group only, greater family dysfunction predicted lower young adult self-worth and perceptions of maturity, while higher family connectedness predicted higher self-worth and perceptions of maturity. Greater percent weight loss was associated with higher perceptions of maturity for the surgical group. CONCLUSIONS: Group difference findings suggest that the impact of surgery was on self-worth and romantic self-perceptions, outcomes linked in the developmental literature to body image. For both groups, functioning appeared similar to population-based findings, suggesting they are meeting "expected" age-salient developmental outcomes. The impact of earlier positive family functioning on self-worth and self-perceptions of maturity may place adolescents on pathways to success. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Current Considerations in the Diagnosis and Treatment of Circadian Rhythm Sleep-Wake Disorders in Children.

Circadian Rhythm Sleep-Wake Disorders (CRSWDs) are important sleep disorders whose unifying feature is a mismatch between the preferred or required times for sleep and wakefulness and the endogenous circadian drives for these. Their etiology, presentation, and treatment can be different in pediatric patients as compared to adults. Evaluation of these disorders must be performed while viewed through the lens of a patient's comorbid conditions. Newer methods of assessment promise to provide greater diagnostic clarity and critical insights into how circadian physiology affects overall health and disease states. Effective clinical management of CRSWDs is multimodal, requiring an integrated approach across disciplines. Therapeutic success depends upon appropriately timed nonpharmacologic and pharmacologic interventions. A better understanding of the genetic predispositions for and causes of CRSWDs has led to novel clinical opportunities for diagnosis and improved therapeutics.

Measuring weight- and shape-based social identity threat vulnerability in young adults.

This study assessed the factor structure of a novel self-report measure of weight- and shape-based social identity threat vulnerability, Social Identities and Attitudes Scale-Weight and Body Shape (SIAS-WBS). Weight and race diverse young adults (N = 542; Mage=21.69 +2.32; 69% ciswomen) were recruited from Amazon Mechanical Turk and a university participant pool. Exploratory and confirmatory factor analyses, measurement invariance, internal consistency, convergent validity, and test-retest reliability were conducted. The SIAS-WBS had acceptable factor structure with 15 subscales that were invariant across race, ethnicity, gender, weight perception, and CDC-defined weight groups. The measure demonstrated high internal consistency, convergent validity, and good test-retest reliability. Subscales were Weight & Shape Identification (Influence and Centrality), Weight & Shape Stigma Consciousness, six identification and six negative affect factors across the domains of: Social, Familial, Romantic, Intellectual, Physical Activity, and Physical Attractiveness. Participants in higher weight groups who perceived themselves as lower weight status, reported lower Weight & Shape Identification-Influence (p = 0.02) and lower Stigma Consciousness (p = 0.01), relative to those perceiving themselves as higher weight status. Participants perceiving themselves as higher weight status endorsed lower Physical Activity Identification (p < 0.001) and more negative affect across all domains (p's < 0.02). This suggests that weight misperceivers may be less susceptible to weight-based identity threat.

Psychosocial predictors of problematic eating in young adults who underwent adolescent bariatric surgery.

Introduction: This study examined problematic eating and eating-related psychopathology among young adults who underwent adolescent bariatric surgery including concurrent and prospective associations with psychosocial factors and weight change. Methods: VIEW point is a 6-year follow-up study within a prospective observational study series observing adolescents with severe obesity who had bariatric surgery (n = 139) or who presented to nonsurgical lifestyle modification programs (n = 83). Participants completed height/weight measurements, questionnaires, and diagnostic interviews. Regression analyses compared problematic eating across groups and examined Year 6 correlates (i.e., psychosocial factors and weight change) and baseline predictors (i.e., psychosocial factors) of eating-related psychopathology. Results: Compared to the nonsurgical group, the surgical group reported lower eating-related psychopathology, objective binge eating, and grazing at Year 6. While chewing/spitting out and vomiting for weight/shape-related reasons were very infrequent for the surgical group, self-induced vomiting for other reasons (e.g., avoid plugging) was more common. For the surgical group, lower self-worth, greater internalizing symptoms, and higher weight-related teasing in adolescence predicted increased eating-related psychopathology in young adulthood. Year 6 eating-related psychopathology was concurrently associated with lower percent weight loss for the surgical group and greater percent weight gain for the nonsurgical group. Conclusion: Undergoing adolescent bariatric surgery appears to afford benefit for problematic eating and eating-related psychopathology. Current findings suggest that the clinical intervention related to problematic eating and associated psychosocial concerns may be needed for young adults with obesity, regardless of surgical status.

Systemic Factors Associated With Prosocial Skills and Maladaptive Functioning in Youth Exposed to Intimate Partner Violence.

Children are frequently present in homes in which intimate partner violence (IPV) occurs. Following exposure to IPV, children may develop behavioral health difficulties, struggle with regulating emotions, or exhibit aggression. Despite the negative outcomes associated with witnessing IPV, many children also display resilience. Guided by Bronfenbrenner's bioecological model, this study examined person-level, process-level (microsystem), and context-level (mesosystem) factors associated with positive and negative functioning among youth exposed to IPV. Participants were 118 mothers who reported on their 6- to 14-year-old children. All mothers experienced severe physical, psychological, and/or sexual IPV in the past 6 months. Linear regression modeling was conducted separately for youth maladaptive functioning and prosocial skills. The linear regression model for maladaptive functioning was significant, F(6, 110) = 9.32, p < .001, adj R2 = 27%, with more severe IPV (ß = .18, p < .05) and more negative parenting practices (ß = .34, p < .001) associated with worse child outcomes. The model for prosocial skills was also significant, F(6, 110) = 3.34, p < .01, adj. R2 = 14%, with less negative parenting practices (ß = -.26, p < .001) and greater community connectedness (ß = .17, p < .05) linked to more prosocial skills. These findings provide critical knowledge on specific mutable factors associated with positive and negative functioning among children in the context of IPV exposure. Such factors could be incorporated into strength-based interventions following family violence.

Risk and protective factors associated with depressive symptoms in young adults with overweight and obesity.

Objective: Approximately one-third of college students are categorized as overweight/obese and elevated weight has been associated with increased risk of depressive symptoms. Less is known about protective factors in this context. This study examined associations between depressive symptoms and health behaviors, as well as body image variables among college students with overweight/obesity, while accounting for contributions of BMI and demographics. Participants: College students (N = 175; Mage = 19.87, SD = 1.93; 70% female; 58% Non-Hispanic Black) with overweight/obesity completed in-person surveys. Methods: Depressive symptoms, exercise and diet engagement, body positivity, and body dissatisfaction were assessed. Data were examined using a hierarchical linear regression. Results: Greater exercise engagement and greater body positivity were significantly associated with lower levels of depressive symptoms. Conclusions: Established links between elevated weight and depression are complex but imperative to understand, as mutable factors that contribute to this relationship may provide novel avenues for intervening.

The mediating role of internalized weight stigma on weight perception and depression among emerging adults: Exploring moderation by weight and race.

The current study examined internalized weight stigma as a mediator of the association between self-perceived weight and depressive symptoms. University students (N = 317) aged 18-25 years completed measures of self-perceived weight, internalized stigma, and depressive symptoms. Multigroup path analyses were used to examine the indirect effect of self-perceived weight on depression through self-stigma. Findings revealed that among persons of size, internalized stigma mediated the effect of higher self-perceived weight on higher depressive symptoms. Among lean persons, this indirect effect was only significant for Black participants. Among all groups, the direct effect of self-perceived weight on internalized stigma was significant. While the present results warrant future replication, the findings expand our understanding of the association between self-perceived weight and depression. These results also illuminate potential future opportunities for rich, culturally informed research and clinical advances that take into account the detrimental role of weight stigma.

Relating shape/weight based self-esteem, depression, and anxiety with weight and perceived physical health among young adults.

Simultaneous contributions of self-esteem, depression, and anxiety to weight and perceived physical health in young adults is understudied. A diverse sample of 424 young adults completed measures of shape/weight based self-esteem, depression, anxiety, and perceived physical health. Height and weight were measured to calculate body mass index (BMI). Latent profile analysis was conducted to derive patterns of depression, anxiety, and shape/weight based self-esteem. Then, we examined the association of the profiles with weight status and perceived physical health. Three profiles emerged: (1) High Shape/Weight Influence (HSWI); (2) Low Shape/Weight, Depression, & Anxiety Influence (LSWDAI); and (3) High Depression & Anxiety Influence (HDAI). The HSWI profile had significantly higher BMI than the LSWDAI and HDAI profiles, and significantly lower perceived physical health than the LSWDAI profile. Over emphasis on shape/weight, regardless of depression and anxiety, is associated with elevated weight and negative internalized health views.

Self-esteem and social support as moderators of depression, body image, and disordered eating for suicidal ideation in adolescents.

The current study investigated risk factors for suicidal ideation in a community sample of 392 adolescents (males 51.9 %; females 48.1 %), while also evaluating self-esteem, perceived parent support, and perceived peer support as protective factors and potential moderators between suicidal ideation and the 3 risk factors. Disordered eating, depression, parent support, and peer support were found to be significant predictors of current suicidal ideation, but body satisfaction was not. The relationship between depression and suicidal ideation was significantly moderated by both self-esteem and parent support, while the relationship between disordered eating and suicidal ideation was significantly moderated by peer support. Results underscore the importance of examining protective factors for suicide risk, as they have the potential to reduce suicidal ideation in adolescents.