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1.
Clin Psychol Psychother ; 27(1): 42-51, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31711275

RESUMO

Training self-control as the assumed underlying mechanism for weight loss is a promising pathway for improving long-term outcomes of childhood multidisciplinary obesity treatment (MOT). The present study is the first to analyse adherence to e-health self-control training in paediatric obesity. We hypothesized that low adherence would relate to child characteristics and to contextual treatment barriers. Participants were recruited as a part of a larger randomized controlled trial, evaluating an e-health self-control training during inpatient MOT (intensive phase) and its outpatient aftercare (booster phase). A number of 68 youngsters with severe obesity between 11 to 19 years old were included in the present study. Excellent adherence was observed in the intensive phase during inpatient MOT, but rates decreased in the booster phase. As predicted, the low adherence group had a significantly higher weight status throughout the entire study period. Differences in contextual treatment barriers did not appear. Further in-depth analysis showed that the low adherence group frequently experienced practical obstacles. The end of inpatient MOT and high weight status can be considered important risk factors for low adherence in an additional self-control training aimed at facilitating weight loss.


Assuntos
Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Obesidade Infantil/terapia , Autocontrole , Telemedicina/métodos , Adolescente , Adulto , Bélgica , Criança , Feminino , Humanos , Masculino , Obesidade Infantil/psicologia , Adulto Jovem
2.
Public Health Nutr ; 21(12): 2329-2344, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29607800

RESUMO

OBJECTIVE: Adolescents' snacking habits are driven by both explicit reflective and implicit hedonic processes. Hedonic pathways and differences in sensitivity to food rewards in addition to reflective determinants should be considered. The present study evaluated the feasibility and impact of a mobile phone-delivered intervention, incorporating explicit reflective and implicit rewarding strategies, on adolescents' snack intake. DESIGN: Adolescents (n 988; mean age 14·9 (sd 0·70) years, 59·4 % boys) completed a non-randomized clustered controlled trial. Adolescents (n 416) in the intervention schools (n 3) were provided with the intervention application for four weeks, while adolescents (n 572) in the control schools (n 3) followed the regular curriculum. Outcomes were differences in healthy snacking ratio and key determinants (awareness, intention, attitude, self-efficacy, habits and knowledge). Process evaluation data were collected via questionnaires and through log data of the app. RESULTS: No significant positive intervention effects on the healthy snack ratio (b=-3·52 (se 1·82), P>0·05) or targeted determinants were observed. Only 268 adolescents started using the app, of whom only fifty-five (20·5 %) still logged in after four weeks. Within the group of users, higher exposure to the app was not significantly associated with positive intervention effects. App satisfaction ratings were low in both high and low user groups. Moderation analyses revealed small positive intervention effects on the healthy snack ratio in high compared with low reward-sensitive boys (b=1·38 (se 0·59), P<0·05). CONCLUSIONS: The intervention was not able to improve adolescents' snack choices, due to low reach and exposure. Future interventions should consider multicomponent interventions, teacher engagement, exhaustive participatory app content development and tailoring.


Assuntos
Dieta/estatística & dados numéricos , Promoção da Saúde , Aplicativos Móveis , Recompensa , Lanches , Adolescente , Estudos de Viabilidade , Comportamento Alimentar , Feminino , Hábitos , Promoção da Saúde/métodos , Promoção da Saúde/estatística & dados numéricos , Humanos , Masculino , Inquéritos e Questionários
3.
BMC Public Health ; 18(1): 904, 2018 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-30031383

RESUMO

BACKGROUND: The transition from childhood into adolescence can be considered as a critical developmental period. Moreover, adolescence is associated with a decreased use of adaptive emotion regulation strategies and an increased use of maladaptive emotion regulation strategies increasing the risk of emotional problems. Targeting emotion regulation is therefore seen as an innovative prevention approach. The present study aims to evaluate the effectiveness of Boost camp, an innovative school-based prevention program targeting ER, on adolescents' emotion regulation skills and emotional wellbeing. Also secondary outcomes and possible moderators will be included. METHODS: The aim is to reach 300 adolescents (16 class groups, 6 schools) in their first year of high school. A clustered Randomized Controlled Trial (RCT) with two conditions, intervention (n = 150) and control (n = 150), will be set up. Adolescents in the intervention condition will receive 14 lessons over the course of 2 days, followed by Booster sessions, and will be compared with adolescents in a non-intervention control group. The outcomes will be measured by self-report questionnaires at baseline, immediately after Boost camp, and at three and 6 months follow-up. DISCUSSION: Data-collection is planned to be completed in May 2018. Data-analyses will be finished the end of 2018. The presented paper describes the Boost camp program and the clustered RCT design to evaluate its effectiveness. It is expected that Boost camp will have beneficial effects. If found effective, Boost camp will have the potential to increase adolescent's ER and well-being, and reduce the risk to become adults in need. The trials is registered on the 13th of June 2017 in ISRCTN registry [ISRCTN68235634].


Assuntos
Transtornos Mentais/prevenção & controle , Serviços de Saúde Mental , Serviços de Saúde Escolar , Autocontrole/psicologia , Estudantes/psicologia , Adolescente , Comportamento do Adolescente , Análise por Conglomerados , Emoções , Feminino , Humanos , Masculino , Saúde Mental , Pais , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes , Inquéritos e Questionários
4.
BMC Public Health ; 18(1): 1075, 2018 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-30157826

RESUMO

BACKGROUND: Obesity is a widespread problem that not only leads to medical and psychological diseases in adults, but also in children and adolescents at an early stage in life. Because of its global burden on both the individual and society, it is necessary to develop effective evidence-based treatments. Current "Multidisciplinary Obesity Treatments" (MOT) already provide significant weight loss, but still leave room for more long-lasting improvements. In this protocol paper, we outline the research goals of the WELCOME trial, based on a substantial proof of concept. METHODS: In this Randomized Controlled Trial (RCT) - conducted in both an inpatient and two outpatient treatment settings - existing MOT will be supplemented with an Executive Function (EF) training and compare effects on various parameters in an experimental versus an active control group of obese youngsters (8-18 years old). WELCOME aims to (a) train youngsters' executive functions to facilitate effects on weight loss, psychological and medical comorbidities, (b) to enhance the long-term effects by continuing the training in the daily home context with booster sessions, and (c) to investigate its effects until a 6-month follow-up. In comparison to the active control group, better progress is expected in the experimental group on following variables: weight, psychological comorbidities (unhealthy eating behavior, internalizing symptoms, impaired self-esteem) and medical comorbidities (metabolic syndromes, endothelia dysfunction, tonsillar hypertrophy and sleep obstruction). DISCUSSION: It is stated that this EF-training for enhancing self-control abilities is necessary for a long-lasting effect of childhood obesity treatment interventions. TRIAL REGISTRATION: The Study Procotol was registered on 10/05/2017 (n° ISRCTN14722584 ).


Assuntos
Função Executiva , Obesidade Infantil/prevenção & controle , Obesidade Infantil/psicologia , Adolescente , Criança , Protocolos Clínicos , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Obesidade Infantil/epidemiologia , Autocontrole/psicologia , Resultado do Tratamento , Redução de Peso
5.
Br J Nutr ; 117(4): 611-620, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28382893

RESUMO

Adolescents' snack choices could be altered by increasing the reinforcing value (RV) of healthy snacks compared with unhealthy snacks. This study assessed whether the RV of fruit increased by linking it to a reward and if this increased RV was comparable with the RV of unhealthy snacks alone. Moderation effects of sex, hunger, BMI z-scores and sensitivity to reward were also explored. The RV of snacks was assessed in a sample of 165 adolescents (15·1 (sd 1·5) years, 39·4 % boys and 17·4 % overweight) using a computerised food reinforcement task. Adolescents obtained points for snacks through mouse clicks (responses) following progressive ratio schedules of increasing response requirements. Participants were (computer) randomised to three experimental groups (1:1:1): fruit (n 53), fruit+reward (n 60) or unhealthy snacks (n 69). The RV was evaluated as total number of responses and breakpoint (schedule of terminating food reinforcement task). Multilevel regression analyses (total number of responses) and Cox's proportional hazard regression models (breakpoint) were used. The total number of responses made were not different between fruit+reward and fruit (b -473; 95 % CI -1152, 205, P=0·17) or unhealthy snacks (b410; 95 % CI -222, 1043, P=0·20). The breakpoint was slightly higher for fruit than fruit+reward (HR 1·34; 95 % CI 1·00, 1·79, P=0·050), whereas no difference between unhealthy snacks and fruit+reward (HR 0·86; 95 % CI 0·62, 1·18, P=0·34) was observed. No indication of moderation was found. Offering rewards slightly increases the RV of fruit and may be a promising strategy to increase healthy food choices. Future studies should however, explore if other rewards, could reach larger effect sizes.


Assuntos
Dieta , Preferências Alimentares/psicologia , Frutas , Comportamentos Relacionados com a Saúde , Recompensa , Lanches/psicologia , Adolescente , Feminino , Humanos , Masculino , Modelos de Riscos Proporcionais
6.
Appetite ; 112: 150-156, 2017 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-28108344

RESUMO

BACKGROUND: During the last three decades, the prevalence of childhood overweight and obesity has increased worldwide. It is well established that different child-related factors such as food approach behaviors (i.e. eating behaviors that imply movements towards food) contribute to the development of overweight. However, research is lacking on the underlying mechanisms leading to food approach behaviors, which in turn lead to overweight. SUBJECT/METHODS: Via parent-report questionnaires, we investigated the relation between the personality trait reward sensitivity and body weight in a convenience sample of 211 children aged 2.5-9 years. We further investigated the intervening role of food approach behaviors in the association between reward sensitivity and body weight. RESULTS: Unexpectedly, there was no direct association between reward sensitivity and body weight. Despite the absence of a direct effect, a significant indirect association was found between reward sensitivity and body weight through the intervening food approach variables (i.e. food responsive behavior and external eating). CONCLUSIONS: These results highlight the importance of the focus on eating behaviors as well as trait characteristics in prevention programs for overweight.


Assuntos
Peso Corporal , Comportamento Infantil , Sinais (Psicologia) , Comportamento Alimentar , Obesidade Infantil/etiologia , Personalidade , Recompensa , Índice de Massa Corporal , Criança , Pré-Escolar , Ingestão de Alimentos , Feminino , Alimentos , Humanos , Masculino , Sobrepeso/etiologia , Poder Familiar , Inquéritos e Questionários
7.
Int J Behav Nutr Phys Act ; 13: 17, 2016 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-26861539

RESUMO

BACKGROUND: Although previous research found a positive association between sensitivity to reward (SR) and adolescents' unhealthy snacking and drinking behavior, mechanisms explaining these associations remain to be explored. The present study will therefore examine whether the associations between SR and unhealthy snack and/or sugar-sweetened beverage (SSB) intake are mediated by external and/or emotional eating and if this mediation is moderated by availability at home or at school. METHODS: Cross-sectional data on snacking, availability of snacks at home and at school, SR (BAS drive scale) and external and emotional eating (Dutch eating behavior questionnaire) of Flemish adolescents (n = 1104, mean age = 14.7 ± 0.8 years; 51 % boys; 18.0% overweight) in 20 schools spread across Flanders were collected. Moderated mediation analyses were conducted using generalized structural equation modeling in three steps: (1) direct association between SR and unhealthy snack or SSB intake, (2) mediation of either external or emotional eating and (3) interaction of home or school availability and emotional or external eating. RESULTS: Partial mediation of external eating (a*b = 0.69, p < 0.05) and of emotional eating (a*b = 0.92, p < 0.01) in the relation between SR and intake of unhealthy snacks was found (step 2). The relation between SR and SSB intake was not mediated by external or emotional eating (step 2). No moderation effects of home or school availability were found (step 3). CONCLUSION: Our findings indicate that the association between SR and the consumption of unhealthy snacks is partially explained by external and emotional eating in a population-based sample of adolescents irrespective of the home or school availability of these foods.


Assuntos
Dieta , Emoções , Meio Ambiente , Comportamento Alimentar/psicologia , Preferências Alimentares/psicologia , Obesidade/etiologia , Recompensa , Adolescente , Comportamento do Adolescente/psicologia , Bélgica/epidemiologia , Bebidas , Estudos Transversais , Sinais (Psicologia) , Dieta/normas , Sacarose Alimentar/administração & dosagem , Comportamento de Ingestão de Líquido , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Países Baixos/epidemiologia , Obesidade/epidemiologia , Instituições Acadêmicas , Lanches/psicologia , Inquéritos e Questionários
8.
Eur J Nutr ; 55(4): 1623-32, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26163856

RESUMO

PURPOSE: High intake of palatable foods, such as energy-dense snacks and sugar-sweetened beverages (SSBs), is common among adolescents. An individual's sensitivity to reward (SR) may influence these intakes. The main objective of this study was to investigate the association between SR and both snack and SSB intake among adolescents. METHODS: A representative cross-sectional survey was conducted among 1104 14- to 16-year-olds (mean age = 14.7 ± 0.8 years; 50.9 % boys; 18.0 % overweight) in Flanders. Daily intakes were measured by a food frequency questionnaire. SR was assessed using the behavioral activation system (BAS) scales. Multilevel regression analyses (two level: adolescent school) were conducted using STATA version 13. RESULTS: BAS drive was positively associated with daily intakes of SSBs (13.79 %, p < 0.01), unhealthy snacks (5.42 %, p < 0.001), and energy and nutrients derived from SSBs (p < 0.001) and snacks (p < 0.01). BAS reward responsiveness (RR) was only positively associated with intake of unhealthy snacks (3.85 %, p < 0.05), healthy snacks (6.41 %, p < 0.05), and fat (4.05 %, p < 0.01) and Na (3.89 %, p < 0.05) from snacks. Interaction effects of gender and BAS RR (p < 0.05) were found. Significant positive associations between BAS RR and daily intakes of energy from snacks (6.48 %, p < 0.01) and fat from snacks (7.22 %, p < 0.001) were found only for girls. CONCLUSION: SR was associated with snack and SSB consumption in adolescents, especially in girls. These findings suggest that SR should be taken into account when designing interventions to improve the snack and SSB intake of adolescents.


Assuntos
Bebidas , Comportamento Alimentar/psicologia , Adoçantes Calóricos/administração & dosagem , Recompensa , Lanches , Adolescente , Estatura , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Gorduras na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Humanos , Modelos Lineares , Masculino , Análise Multinível , Avaliação Nutricional , Inquéritos e Questionários
9.
BMC Public Health ; 16(1): 1045, 2016 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-27716268

RESUMO

BACKGROUND: The aim of the current study is to identify strategies to promote healthy eating in young children that can be applied by caregivers, based on their own perceptions of effectiveness and feasibility. Whereas previous research mainly focused on parental influences on children's eating behavior, the growing role of other caregivers in the upbringing of children can no longer be denied. METHODS: Four focus groups were conducted with three types of caregivers of post-weaning children under 6 years old: parents (n = 14), family child care providers (n = 9), and daycare assistants (n = 10). The audiotaped focus group discussions were transcribed and imported into Nvivo 10.0 for thematic analysis. The behaviors put forward by the caregivers were categorized within three broad dimensions: global influences, general behaviors, and specific feeding practices. RESULTS: Perceived effective strategies to promote healthy eating behavior in children included rewards, verbal encouragement, a taste-rule, sensory sensations, involvement, variation, modeling, repeated exposure, and a peaceful atmosphere. Participants mainly disagreed on the perceived feasibility of each strategy, which largely depended on the characteristics of the caregiving setting (e.g. infrastructure, policy). CONCLUSIONS: Based on former research and the current results, an intervention to promote healthy eating behaviors in young children should be adapted to the caregiving setting or focus on specific feeding practices, since these involve simple behaviors that are not hindered by the limitations of the caregiving setting. Due to various misconceptions regarding health-promoting strategies, clear instructions about when and how to use these strategies are necessary.


Assuntos
Cuidadores/organização & administração , Cuidado da Criança/organização & administração , Saúde da Criança , Dieta Saudável/estatística & dados numéricos , Comportamento Alimentar , Relações Pais-Filho , Pais/educação , Adulto , Criança , Pré-Escolar , Feminino , Grupos Focais , Humanos , Masculino , Inquéritos e Questionários
10.
Appetite ; 103: 344-352, 2016 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-27103060

RESUMO

The present study investigates the effectiveness of different strategies to improve Willingness to Taste disliked vegetables and the moderating role of Reward Sensitivity. Preschool children (N = 204; age: M = 4.48, SD = 1.01) were randomly allocated to one of four different Willingness to Taste strategies. The findings indicate that first, Willingness to Taste is higher in the modelling and reward strategies compared to neutral instructions. Second, there is a differential effect of Willingness to Taste strategies dependent upon individual differences: children high in Reward Sensitivity were more likely to taste immediately when rewarded, while children low in Reward Sensitivity were more willing to taste when verbally encouraged, but with hesitation. This article thus highlights the roles of both individual differences and behavioral techniques for promoting a healthy diet in children.


Assuntos
Dieta Saudável/psicologia , Preferências Alimentares/psicologia , Promoção da Saúde/métodos , Paladar , Análise de Variância , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Demografia , Feminino , Humanos , Fome , Individualidade , Modelos Logísticos , Masculino , Distribuição Aleatória , Reforço Verbal , Recompensa , Inquéritos e Questionários , Verduras
11.
J Clin Child Adolesc Psychol ; 43(3): 486-500, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23795885

RESUMO

The purpose is to investigate whether a change in putative mediators (negative and positive thoughts, coping strategies, and perceived control over anxious situations) precedes a change in anxiety symptoms in anxiety-disordered children and adolescents receiving cognitive behavioral therapy (CBT). Participants were 145 Dutch children (8-18 years old, M = 12.5 years, 57% girls) with a primary anxiety disorder. Assessments were completed pretreatment, in-treatment, posttreatment, and at 3-month follow-up. Sequential temporal dependencies between putative mediators and parent- and child-reported anxiety symptoms were investigated in AMOS using longitudinal Latent Difference Score Modeling. During treatment an increase of positive thoughts preceded a decrease in child-reported anxiety symptoms. An increase in three coping strategies (direct problem solving, positive cognitive restructuring, and seeking distraction) preceded a decrease in parent-reported anxiety symptoms. A reciprocal effect was found for perceived control: A decrease in parent-reported anxiety symptoms both preceded and followed an increase in perceived control. Using a longitudinal design, a temporal relationship between several putative mediators and CBT-outcome for anxious children was explored. The results suggest that a change in positive thoughts, but not negative thoughts, and several coping strategies precedes a change in symptom reduction and, therefore, at least partly support theoretical models of anxiety upon which the anxiety intervention is based.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/terapia , Ansiedade/terapia , Cognição , Terapia Cognitivo-Comportamental/métodos , Pensamento , Adolescente , Adulto , Ansiedade/diagnóstico , Ansiedade/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Criança , Feminino , Humanos , Entrevista Psicológica , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Países Baixos , Pais/psicologia , Percepção , Resolução de Problemas , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Clin Psychol Psychother ; 21(6): 525-35, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24000105

RESUMO

The Anxiety Severity Interview for Children and Adolescents (ASICA) was developed for the repeated assessment of the impact of anxiety and control over anxiety symptoms. The ASICA incorporates three main components of anxiety: physical response, avoidant behaviour and anxious thoughts. The objective of this study was to evaluate the psychometric properties of the ASICA in children with anxiety disorder (n = 139, age 8-18 years) and a non-anxious control group (n = 40, age 8-18 years). A confirmatory factor analysis confirmed the intended factor structure. Internal reliability was moderate to good; inter-rater reliability was excellent. Four-week test-retest reliability was good. The ASICA discriminated between anxious and non-anxious children and appeared sensitive to treatment change. A cut-off score of 13 was determined. Convergent validity with anxiety symptoms was moderate; discriminant validity with depressive symptoms was less strong. The results suggest that the ASICA is a reliable instrument that could be used in clinical practice to repeatedly monitor anxiety severity.


Assuntos
Transtornos de Ansiedade/diagnóstico , Entrevista Psicológica/normas , Adolescente , Transtornos de Ansiedade/psicologia , Criança , Análise Fatorial , Feminino , Humanos , Entrevista Psicológica/métodos , Masculino , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Inquéritos e Questionários
13.
Behav Res Ther ; 167: 104335, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37327533

RESUMO

Research points to self-control as a possible mechanism for facilitating health behaviour and weight loss. The dual pathway model underpins the role of strong bottom-up reactivity towards food and weak top-down executive functions in obesity. Despite flourishing lab studies on attention bias modification or inhibition trainings, relatively few focused on training both processes to improve self-control in children and adolescents in inpatient multidisciplinary obesity treatment (MOT). Being part of the WELCOME project, this study investigated the effectiveness of Brain Fitness training (using the Dot Probe and Go/No-Go) as an adjunct to inpatient MOT in 131 Belgian children and adolescents. Changes in self-control (performance-based inhibitory control and attention bias as well as self-reported eating behaviour) in the experimental group were compared to sham training. Multiple Imputation was used to handle missing data. Inhibitory control and external eating improved over time (pre/post/follow-up), but we found no evidence for a significant interaction between time and condition. Future research should pay more attention to the role of individual variability in baseline self-control, sham training, and ecological validity of self-control training to improve real-life health behaviour and treatment perspectives for children and adolescents with weight problems.


Assuntos
Pacientes Internados , Autocontrole , Humanos , Criança , Adolescente , Obesidade , Função Executiva , Redução de Peso
15.
Front Endocrinol (Lausanne) ; 13: 822962, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35769076

RESUMO

Background: Inpatient pediatric obesity treatments are highly effective, although dropouts and weight regain threaten long-term results. Preliminary data indicate that leptin, adiponectin, and cardiometabolic comorbidities might predict treatment outcomes. Previous studies have mainly focused on the individual role of adipokines and comorbidities, which is counterintuitive, as these risk factors tend to cluster. This study aimed to predict the dropouts and treatment outcomes by pre-treatment patient characteristics extended with cardiometabolic comorbidities (individually and in total), leptin, and adiponectin. Methods: Children aged 8-18 years were assessed before, immediately after and 6 months after a 12-month inpatient obesity treatment. Anthropometric data were collected at each visit. Pre-treatment lipid profiles; glucose, insulin, leptin, and adiponectin levels; and blood pressure were measured. The treatment outcome was evaluated by the change in body mass index (BMI) standard deviation score (SDS) corrected for age and sex. Results: We recruited 144 children with a mean age of 14.3 ± 2.2 years and a mean BMI of 36.7 ± 6.2 kg/m2 corresponding to 2.7 ± 0.4 BMI SDS. The 57 patients who dropped out during treatment and the 44 patients who dropped out during aftercare had a higher pre-treatment BMI compared to the patients who completed the treatment (mean BMI, 38.3 ± 6.8 kg/m2 vs 35.7 ± 5.5 kg/m2) and those who completed aftercare (mean BMI, 34.6 ± 5.3 kg/m2 vs 37.7 ± 6.3 kg/m2) (all p<0.05). Additionally, aftercare attenders were younger than non-attenders (mean age, 13.4 ± 2.3 years vs 14.9 ± 2.0, p<0.05).Patients lost on average 1.0 ± 0.4 SDS during treatment and regained 0.4 ± 0.3 SDS post-treatment corresponding to regain of 43 ± 27% (calculated as the increase in BMI SDS post-treatment over the BMI SDS lost during treatment). A higher BMI and more comorbidities inversely predicted BMI SDS reduction in linear regression (all p<0.05).The absolute BMI SDS increase after returning home was predicted by pre-treatment leptin and systolic blood pressure, whereas the post-treatment BMI SDS regain was predicted by pre-treatment age, leptin, and adiponectin levels (all p<0.05) in multivariate linear regressions. Conclusion: Patients who need treatment the most are at increased risk for dropouts and weight regain, emphasizing the urgent need for interventions to reduce dropout and support inpatients after discharge. Furthermore, this study is the first to report that pre-treatment leptin and adiponectin levels predict post-treatment BMI SDS regain, requiring further research.


Assuntos
Doenças Cardiovasculares , Obesidade Infantil , Adipocinas , Adiponectina , Adolescente , Criança , Humanos , Leptina , Obesidade Infantil/terapia , Centros de Reabilitação , Fatores de Risco , Resultado do Tratamento , Aumento de Peso , Redução de Peso
16.
J Clin Child Adolesc Psychol ; 40(1): 144-55, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21229451

RESUMO

The present study first examined the links between reactive temperament (negative affectivity), regulative temperament (effortful control [EC]) and internalizing problems in adolescents (12-18 years) with anxiety disorders (ANX; N = 39) and without anxiety disorders (nANX; N = 35). Links differed between ANX and nANX participants. Negative affectivity predicted internalizing problems, with almost no role of EC in nANX, but a protective role of EC was found in ANX youth. Second, we investigated the role of attentional bias as a mediator between temperament and internalizing problems. Strategic threat-related bias was predicted by initial attention and EC, but these relations differed in both groups. In nANX participants, higher initial bias scores were predictive for lower strategic bias scores and higher levels of EC were associated with higher bias scores. In ANX participants, there was almost no effect of initial bias or EC on strategic attention. Internalizing problems were predicted by strategic attention, but again differently in ANX and nANX participants. High strategic bias scores were associated with an increase in anxiety in ANX and a decrease in anxiety in nANX participants.


Assuntos
Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Atenção , Temperamento , Adolescente , Afeto , Transtornos de Ansiedade/diagnóstico , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Controle Interno-Externo , Masculino , Determinação da Personalidade , Inquéritos e Questionários
17.
Front Psychol ; 12: 644512, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33746859

RESUMO

Several versions of the dot probe detection task are frequently used to assess maladaptive attentional processes associated with a broad range of psychopathology and health behavior, including eating behavior and weight. However, there are serious concerns about the reliability of the indices derived from the paradigm as measurement of attentional bias toward or away from salient stimuli. The present paper gives an overview of different attentional bias indices used in psychopathology research and scrutinizes three types of indices (the traditional attentional bias score, the dynamic trial-level base scores, and the probability index) calculated from a pictorial version of the dot probe task to assess food-related attentional biases in children and youngsters with and without obesity. Correlational analyses reveal that dynamic scores (but not the traditional and probability indices) are dependent on general response speed. Reliability estimates are low for the traditional and probability indices. The higher reliability for the dynamic indices is at least partially explained by general response speed. No significant group differences between youth with and without obesity are found, and correlations with weight are also non-significant. Taken together, results cast doubt on the applicability of this specific task for both experimental and individual differences research on food-related attentional biases in youth. However, researchers are encouraged to make and test adaptations to the procedure or computational algorithm in an effort to increase psychometric quality of the task and to report psychometric characteristics of their version of the task for their specific sample.

18.
Front Pediatr ; 9: 794256, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35004547

RESUMO

Background: Currently available treatment programs for children with obesity only have modest long-term results, which is (at least partially) due to the poorer self-control observed within this population. The present trial aimed to determine whether an online self-control training, training inhibition, and redirecting attentional bias, can improve the short- and long-term treatment outcome of (in- or outpatient) child obesity treatment programs. Methods: In this double-blind multi-center randomized controlled trial (RCT), participants aged 8-18 years with obesity were allocated in a 1:1 ratio to receive an online self-control or sham training added to their in- or outpatient multidisciplinary obesity treatment (MOT) program. The primary endpoint was BMI SDS. Data were analyzed by linear mixed models and the main interactions of interest were randomization by time and randomization by number of sessions, as the latter was cumulatively expressed and therefore represents the effect of increasing dose over time. Results: One hundred forty-four inpatient (mean age 14.3 ± 2.2 years, BMI 2.7 ± 0.4 SDS, 42% male) and 115 outpatient children (mean age 11.9 ± 2.1 years, BMI 2.4 ± 0.4 SDS, 45% male) were included. Children's BMI lowered significantly during treatment in both the in- and outpatient treatment centers, p < 0.001. In a mixed model with BMI as dependent variable, randomization by time was non-significant, but the number of self-control trainings (randomization * number of sessions) interacted significantly with setting and with age (p = 0.002 and p = 0.047), indicating a potential effect in younger inpatient residents. Indeed, a subgroup analysis on 22 inpatient children of 8-12 years found a benefit of the number of self-control trainings on BMI (p = 0.026). Conclusions: The present trial found no benefit of the self-control training in the entire study population, however a subgroup of young, inpatient participants potentially benefited.

19.
J Clin Child Adolesc Psychol ; 39(4): 481-91, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20589560

RESUMO

Automatic evaluations of clinically anxious and nonanxious children (n = 40, aged 8-16, 18 girls) were compared using a pictorial performance-based measure of automatic affective associations. Results showed a threat-related evaluation bias in clinically anxious but not in nonanxious children. In anxious participants, automatic evaluations of anxiety-relevant stimuli were more negative than those of negative stimuli. In nonanxious participants, evaluations of negative and anxiety-relevant stimuli did not differ. Furthermore, anxious youth had stronger negative evaluations of anxiety-relevant stimuli than nonanxious children. Automatic evaluations of positive, neutral, and negative stimuli did not differ between groups. Threat-related evaluations were predictive of parent-reported, but not child-reported, anxiety.


Assuntos
Afeto , Transtornos de Ansiedade/psicologia , Atenção , Adolescente , Análise de Variância , Criança , Feminino , Humanos , Masculino , Seleção de Pacientes , Estimulação Luminosa , Tempo de Reação , Inquéritos e Questionários
20.
Nutrients ; 12(1)2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31936404

RESUMO

BACKGROUND: Reward sensitivity has been associated with adolescents' intake of unhealthy snacks and sugar-sweetened beverages. However, so far, there are no studies published describing the impact of parenting practices on this relationship. The present study will, therefore, investigate whether food parenting practices can moderate the association between reward sensitivity and diet intakes. METHOD: A cross-sectional research study was conducted among 14- to 16-year old Flemish adolescents (n = 867, age 14.7 ± 0.8 y, 48.1% boys) and a subset of their parents (n = 131), collecting data on daily intakes, reward sensitivity, and food parenting practices. Linear regression was used to assess the moderation effect of parenting practices (both adolescent- and parent-reported) on the relationship between reward sensitivity, and diet using SPSS 25.0. RESULTS: In the main analysis (adolescent-reported), no significant moderation effects were found for parenting practices on the relationship between reward sensitivity and diet. However, the sensitivity analysis (parent-reported) showed a moderation effect for health-reducing parenting practices on the association between reward sensitivity and unhealthy snack intake (ß = 0.297, 95% CI = 0.062, 0.531, p = 0.01). CONCLUSION: Given the difference in the effect of parenting practices between the adolescent- and parent-reported data, our inconclusive findings warrant more research in larger adolescent-parent dyad samples.


Assuntos
Comportamento Alimentar/psicologia , Poder Familiar , Lanches , Bebidas Adoçadas com Açúcar , Adolescente , Adulto , Feminino , Promoção da Saúde , Humanos , Masculino
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