A Systematic Review of Sleep Disturbances in Pediatric Inflammatory Bowel Disease.

OBJECTIVE: The current systematic review (PROSPERO ID: CRD42020220142) aims to characterize sleep health in pediatric inflammatory bowel disease (IBD) and evaluate disease-related and psychosocial prognostic factors associated with sleep disturbances in pediatric IBD. METHODS: A search of PubMed, PsycINFO, CINAHL, Web of Science, and Cochrane databases was performed. Included studies were written in English, presented original peer-reviewed research, included participants with a mean age of 8-18 years, and reported on at least one quantitative sleep outcome for children with IBD or factors impacting sleep for these children. Studies that did not report on a sleep outcome or factors influencing sleep, or only examined fatigue were excluded. Study quality was evaluated using validated quality assessment tools. The data from the included studies were extracted and synthesized across sleep health domains. RESULTS: Database searches yielded 122 records (total participants = 3,905). After full-text and reference/citation searches, 28 articles were included in the review. Methods used to evaluate sleep widely varied across studies and a majority of the studies were cross-sectional. Results suggest that children with IBD may not experience more frequent sleep disturbance than healthy children. Greater sleep disturbance in pediatric IBD was found to be associated with poorer psychosocial functioning and greater active disease/severe symptoms. CONCLUSIONS: The findings from this review highlight the complex associations between sleep disturbances, inflammation, disease severity, and psychosocial functioning in children with IBD. Additional research with greater methodological rigor (e.g., use of validated sleep measures, longitudinal design, reporting of effect sizes) is warranted to further elucidate these relationships. SUMMARY: The current systematic review examines the existing evidence and methods of measurement of sleep disturbances in pediatric inflammatory bowel disease. We describe and evaluate factors associated with sleep disturbance in this population. The quality of evidence, strengths and weaknesses of the literature, and future directions are described.

Latent profiles of the feeding practices of caregivers of rural children with overweight and obesity and associations with child eating behaviors.

Previous research has shown that food parenting practices, which vary within the context of sociocultural factors, are associated with child weight, eating behaviors, and body dissatisfaction. While parents typically engage in multiple food parenting practices, few studies have examined what subgroups or combinations of food parenting practices are associated with child health outcomes and sociocultural factors. The current study examined profiles of food parenting practices among school-age children with overweight/obesity (OW/OB) from rural communities and examined how they may be associated with sociocultural factors, child-eating habits, and health outcomes. The study included 270 children with OW/OB aged 8-12 (Mage = 10.36 years) and their caregivers. Caregivers completed a measure assessing perceptions of their feeding practices and sociocultural questionnaires. Children completed measures assessing disordered eating habits, weight control behaviors, and body dissatisfaction. Weight status was measured for caregivers and children with height and weight measurements. Latent variable mixture modeling (LVMM) was conducted. Three profiles emerged: (a) Lower Parental Involvement, (b) Higher Parental Involvement, and (c) Mixed Parental Involvement. Lower family income and non-White child race were related to membership in the "Higher Parental Involvement" profile. After controlling for income and child race, children in the "Mixed Parental Involvement" profile reported significantly higher body dissatisfaction than children in the "Lower Parental Involvement" profile. There are subgroups of caregivers of rural children with OW/OB that demonstrate various patterns of parent feeding practices, and these subgroups differ by income, race, and child body dissatisfaction. Future research should consider how caregiver-specific feeding practices may impact child eating behaviors and their body image development, as well as the impact cultural factors may have on parent feeding practices.

Latent Profiles of Health Behaviors in Rural Children with Overweight and Obesity.

OBJECTIVE: The objectives were to identify profiles of school-age children with overweight and obesity (OW/OB) from rural counties based on patterns of diet, activity, and sleep, to examine demographic predictors, and to examine whether profiles were differentially associated with psychosocial functioning. METHODS: Participants included 163 children (Mage = 9.8) and parents. Children wore accelerometers to assess physical activity and sleep duration. Consumption of fruits and vegetables (F/V) and sugar-sweetened beverages (SSB) was assessed with a food frequency questionnaire. Self-report of emotional, social, and academic health-related quality of life (HRQOL), peer victimization, social skills, and social problem behaviors was collected, as well as parent-report of HRQOL. Latent variable mixture modeling (LVMM) was conducted. RESULTS: Sleep did not significantly contribute to profile differentiation and was removed. Four profiles emerged: (a) Low F/V + Low SSB + Low activity, (b) Low F/V + Low SSB + Moderate activity, (c) High F/V + High SSB + Low activity, and (d) Moderate F/V + Moderate SSB + High activity. Older children were more likely to be in profile 1. After controlling for child age, parents of children in profile 1 reported significantly lower child social HRQOL than parents of children in profiles 2 and 4. Children in profile 4 reported experiencing significantly lower victimization than those in profile 3. CONCLUSIONS: There are subgroups of rural children with OW/OB that engage in various combinations of healthy and unhealthy behaviors. LVMM has the potential to inform future interventions and identify needs of groups of children with OW/OB.

The use of internet sources for nutritional information is linked to weight perception and disordered eating in young adolescents.

The internet serves as an accessible and confidential resource for young adolescents seeking nutritional information. However, the quality of information retrieved online is mixed and could have serious implications for users. Young adolescents who perceive themselves as overweight may be disproportionately affected as they are at greater risk for disordered eating. The current study aimed to (1) assess whether the frequency of use of different internet sources to obtain nutritional information differs between healthy weight young adolescents and those with overweight/obesity based on both objective and perceived weight status and (2) evaluate the relationships between different internet sources utilized for nutritional information and disordered eating. Young adolescents (n = 167; 10-15 years) completed the Children's Eating Attitudes Test (ChEAT; total disordered eating), indicated their perceived weight status, and reported how often they obtained nutritional information from the following internet sources: professional websites, personal websites, social media, commercial weight loss websites, and forums. Objective height and weight measurements were obtained. Young adolescents that perceived themselves to be a little overweight or overweight reported greater use of personal websites (p = .012), commercial weight loss websites (p = .011), and social media (p = .019) for nutritional information than those that did not perceive themselves to be a little overweight or overweight. The frequency of use of internet sources for nutritional information did not differ based on objective weight status. Greater use of each of the internet sources for nutritional information was related to greater disordered eating (p's < 0.05). While longitudinal research is needed to further examine these relationships, healthcare providers and teachers should provide young adolescents with guidance for interpreting and using online nutritional information to encourage valid and reliable health recommendations.

Elevated fecal calprotectin is linked to psychosocial complexity in pediatric functional abdominal pain disorders.

OBJECTIVE: Children with functional abdominal pain disorders (FAPD) and clinical elevations in three risk areas (anxiety, functional disability, and pain) have been found to be at increased risk for persistent disability. We evaluated if the presence of these three risk factors corresponded with greater gastrointestinal inflammation (measured via fecal calprotectin; FC) compared to those with no risk factors. FC concentration differences between children with three risk factors and those with one and two risk factors were explored. RESULTS: Fifty-six children with FAPD (Mage = 12.23) completed measures of anxiety (Screen for Child Anxiety Related Disorders), disability (Functional Disability Inventory), and pain intensity (Numeric Rating Scale). Participants were stratified into risk groups (range: 0-3). Fisher's exact tests were conducted to determine if children with three versus fewer risk factors were more likely to have elevated FC (≥ 50 µg/g) versus normal levels. Children with three risk factors (MFC = 86.04) were more likely to have elevated FC compared to children with zero (MFC = 25.78), one (MFC = 38.59), and two risk factors (MFC = 45.06; p's < 0.05). Those with three risk factors had borderline elevated FC concentrations whereas those with fewer had normal FC concentrations. Findings suggest the importance of a biopsychosocial approach to help elucidate a FAPD phenotype.

Pediatric Obesity Treatment via Telehealth: Current Evidence and Future Directions.

PURPOSE OF REVIEW: Telehealth delivery of pediatric weight management interventions may address time, travel, and cost barriers to in-person interventions, thus improving accessibility. This narrative review highlights findings from the past 5 years of pediatric lifestyle interventions for weight management that utilize telehealth for treatment delivery. We describe impressions and future directions. RECENT FINDINGS: We identified and included 20 studies that described unique interventions from the past 5 years. The majority of reviewed studies indicated statistically significant reductions in BMI z-scores, high retention and attendance, and high satisfaction. However, mean decreases in BMI z-scores were marginal (approximately 0.10) in all but two studies. Studies did not often report effect sizes. Pediatric telehealth weight management interventions demonstrate good feasibility and acceptability. Improvement in reporting results and more rigorous research, including use of randomized designs, recruitment of larger samples, and incorporation of extended follow-up is needed to determine clinical impact and magnitude of effects.

Meta-analysis of lifestyle modification interventions addressing overweight and obesity in preschool-age children.

OBJECTIVE: Increased rates of pediatric obesity extend into early childhood. There have been increasing calls for intervention programs specifically designed to address obesity in preschool-age youth. A review of the literature is critical to guide intervention and future research. The objective of this study was to conduct a meta-analysis of randomized, controlled trials examining the efficacy of lifestyle modification interventions to address overweight and obesity in preschool-age children. METHOD: Six electronic databases were searched for articles through December 8, 2020. After screening articles for inclusion criteria, 14 articles with 12 randomized, controlled trials (41 effect sizes, 2,525 participants) were included in this meta-analysis. Weighted-standardized mean differences for body mass index-related variables were calculated using random-effects models to estimate effect sizes. Risk of bias assessment was conducted. RESULTS: There was a statistically significant impact of the interventions on child weight outcomes. Cohen's d was .32 (95% CI [.09, .55]). The quality of evidence was assigned a "low" GRADE rating. CONCLUSIONS: Lifestyle modification interventions for overweight and obesity in preschool-age children produce small but significant changes in child weight status. However, few new trials have been published in the last 5 years and the quality of evidence in this area is low, limiting confidence in the estimates and the power to examine potential moderator effects. Additional quality, randomized, control trials that report study information consistent with consort guidelines, use intent-to-treatment procedures, assess and report health behaviors and treatment adherence to explore mechanisms of change, and examine sustained effects of interventions are needed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Representing schizotypal thinking with dimensional traits: A case for the Five Factor Schizotypal Inventory.

Building on support for the five-factor model (FFM) of personality disorder, the Five Factor Schizotypal Inventory (FFSI) was developed to assess maladaptive traits relevant to schizotypal personality disorder. While the development of the FFSI supports a continuity between schizotypal thinking and perception (STAP) and the FFM domain of Openness to Experience, other studies show inconsistent findings concerning the strength of this relationship. The current study evaluates these relationships by investigating specific components of a short-form of the FFSI (e.g., the FFSI-SF) and 2 other measures of maladaptive traits with the lower order components within commonly employed measures of Openness to Experience. Nomological network similarities were evaluated for the relation of these scales with a series of conceptually relevant variables including intelligence, creativity, and positive schizotypy in a sample of 403 undergraduates, including 102 that were prescreened for elevated symptoms of schizotypal personality disorder (PD). These analyses revealed strong relations across the 3 measures of traits relevant to STAP, supporting the validity of the FFSI-SF. Most notably, 2 specific scales-Multidimensional Personality Questionnaire (MPQ) Absorption and Openness to Fantasy appeared to best capture the core variance across these measures. Furthermore, a nuanced pattern of relations suggested that specific components of STAP (e.g., oddity and fantasy proneness) matched closely with components of Openness to Experience. The results provide additional support for view that schizotypal thinking can be well-captured by personality dimensions that run continuously across normal and pathological levels. (PsycINFO Database Record