The Social and Emotional Lives of Overweight, Obese, and Severely Obese Children.

This study examines inter- and intrapersonal problems associated with being overweight among one thousand one hundred sixty-four 6- to 7-year-olds (49% boys) in 29 rural schools. Socioemotional data include child self-reports, peer sociometrics, and teacher reports. Results support the hypothesis that children with weight problems struggle socially and emotionally, and extend current understanding of child obesity by demonstrating that problems appear early, are evident in a community sample, can be identified using standard sociometric methods, and are worse among children with severe obesity. Sociometric status difference between levels of obesity were also found. Although obese children were neglected by peers, severely obese children were rejected.

The relationship of maternal and child illness uncertainty to child depressive symptomotology: a mediational model.

OBJECTIVE: To examine the relationship of parent and child ratings of illness uncertainty to depressive symptomotology in children with a chronic illness using a mediational model framework. METHOD: Mother-child dyads (N = 103 pairs) each completed measures of perceived illness uncertainty, while youth also completed a measure of depressive symptomotology. RESULTS: Maternal uncertainty was directly related to child depressive symptoms; however, this relationship was mediated by child uncertainty. CONCLUSION: It would appear that a key mechanism by which parent-related uncertainty influences child depressive symptoms is through child uncertainty, underscoring the importance of examining cognitive appraisal variables and means of transmission in parent-child interactions.

Parenting styles, parental response to child emotion, and family emotional responsiveness are related to child emotional eating.

The aim of the present study was to examine the relations of parenting style, parent response to negative child emotion, and family emotional expressiveness and support to child emotional eating. Mothers (N=450) completed questionnaires and their 6-8-year-old children (N=450) were interviewed. Results showed that emotional eating was negatively predicted by authoritative parenting style and family open expression of affection and emotion, and positively predicted by parent minimizing response to child negative emotion. Results suggest the need for early prevention/intervention efforts directed to these parenting and family variables.

The Families and Schools for Health Project: A Longitudinal Cluster Randomized Controlled Trial Targeting Children with Overweight and Obesity.

This cluster randomized controlled trial aimed at overweight and obese children compared three treatments. Two psychoeducation interventions for parents and children were conducted: Family Lifestyle (FL) focused on food and physical activity; Family Dynamics (FD) added parenting and healthy emotion management. A third Peer Group (PG) intervention taught social acceptance to children. Crossing interventions yielded four conditions: FL, FL + PG, FL + FD, and FL + FD + PG-compared with the control. Longitudinal BMI data were collected to determine if family- and peer-based psychosocial components enhanced the Family Lifestyle approach. Participants were 1st graders with BMI%ile >75 (n = 538: 278 boys, 260 girls). Schools were randomly assigned to condition after stratifying for community size and percent American Indian. Anthropometric data were collected pre- and post-intervention in 1st grade and annually through 4th grade. Using a two-level random intercept growth model, intervention status predicted differences in growth in BMI or BMI-M% over three years. Children with obesity who received the FL + FD + PG intervention had lower BMI gains compared to controls for both raw BMI (B = -0.05) and BMI-M% (B = -2.36). Interventions to simultaneously improve parent, child, and peer-group behaviors related to physical and socioemotional health offer promise for long-term positive impact on child obesity.

Maternal depression and socio-economic status moderate the parenting style/child obesity association.

OBJECTIVE: The purpose of the study was to test the moderating influence of two risk factors, maternal depression and socio-economic status (SES), on the association between authoritarian and permissive parenting styles and child obesity. DESIGN: Correlational, cross-sectional study. Parenting style was measured with the Parenting Styles and Dimensions Questionnaire (PSDQ). Maternal depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D). BMI-for-age percentile was used to categorize children by weight status (children with BMI-for-age > or = 95th percentile were classified as obese). SES was computed from parent education and occupational status using the four-factor Hollingshead index. SETTING: Rural public schools in a mid-western state in the USA. SUBJECTS: One hundred and seventy-six mothers of first-grade children (ninety-one boys, eighty-five girls) enrolled in rural public schools. RESULTS: Both maternal depression and SES were found to moderate the permissive parenting style/child obesity association, but not the authoritarian/child obesity association. For depressed mothers, but not for non-depressed mothers, more permissive parenting was predictive of child obesity. Similarly more permissive parenting was predictive of child obesity among higher SES mothers, but not for lower SES mothers. CONCLUSIONS: Maternal depression and SES interact with permissive parenting style to predict child obesity. Future research should examine the relationship among these variables using a longitudinal design.

The relationship of parental overprotection, perceived vulnerability, and parenting stress to behavioral, emotional, and social adjustment in children with cancer.

BACKGROUND: To examine the relationship of self-reported parental overprotection, perceived child vulnerability, and parenting stress to parent-reported behavioral, emotional, and social adjustment of children currently on treatment for cancer. PROCEDURE: Parents of 62 children (34 boys, 28 girls) currently on treatment for cancer were recruited from an outpatient pediatric cancer clinic. Children ranged in age from 2 to 12 years; age at diagnosis ranged from 1.33 to 11.83 years. RESULTS: Higher levels of parenting stress, but not parental overprotection or perceived child vulnerability, were associated with poorer behavioral and social adjustment. Higher levels of perceived child vulnerability and parenting stress, but not parental overprotection, were independently associated with poorer emotional adjustment. CONCLUSIONS: Specific parenting variables appear to be related to specific adjustment outcomes in children with cancer. Longitudinal follow-up of these children is necessary to determine the developmental trajectory of parent variables and long-term child outcomes.

Parental feeding practices predict authoritative, authoritarian, and permissive parenting styles.

BACKGROUND: Our goal was to identify how parental feeding practices from the nutrition literature link to general parenting styles from the child development literature to understand how to target parenting practices to increase effectiveness of interventions. Stand-alone parental feeding practices could be targeted independently. However, parental feeding practices linked to parenting styles require interventions treating underlying family dynamics as a whole. OBJECTIVE: To predict parenting styles from feeding practices and to test three hypotheses: restriction and pressure to eat are positively related whereas responsibility, monitoring, modeling, and encouraging are negatively related to an authoritarian parenting style; responsibility, monitoring, modeling, and encouraging are positively related whereas restriction and pressure to eat are negatively related to an authoritative parenting style; a permissive parenting style is negatively linked with all six feeding practices. DESIGN: Baseline data of a randomized-controlled intervention study. SUBJECTS/SETTING: Two hundred thirty-nine parents (93.5% mothers) of first-grade children (134 boys, 105 girls) enrolled in rural public schools. MEASURES: Parental responses to encouraging and modeling questionnaires and the Child Feeding Questionnaire, as well as parenting styles measured by the Parenting Styles and Dimensions Questionnaire. STATISTICAL ANALYSES: Correlation and regression analyses. RESULTS: Feeding practices explained 21%, 15%, and 8% of the variance in authoritative, authoritarian, and permissive parenting, respectively. Restriction, pressure to eat, and monitoring (negative) significantly predicted an authoritarian style (Hypothesis 1); responsibility, restriction (negative), monitoring, and modeling predicted an authoritative style (Hypothesis 2); and modeling (negative) and restriction significantly predicted a permissive style (Hypothesis 3). CONCLUSIONS: Parental feeding practices with young children predict general parenting styles. Interventions that fail to address underlying parenting styles are not likely to be successful.

Parenting quality: Confirmation of a higher-order latent construct with mothers of Head Start children.

We proposed a higher order latent construct of parenting young children, parenting quality. This higher-order latent construct comprises five component constructs: demographic protection, psychological distress, psychosocial maturity, moral and cognitive reflectivity, and parenting attitudes and beliefs. We evaluated this model with data provided by 199 mothers of 4-year-old children enrolled in Head Start. The model was confirmed with only one adjustment suggested by modification indices. Final RMSEA was .05, CFI .96, and NNFI .94, indicating good model fit. Results were interpreted as emphasizing the interdependence of psychological and environmental demands on parenting. Implications of the model for teachers, early interventionists, and public policy are discussed.

The impact of motivational interviewing on substance abuse treatment retention: a randomized control trial of women involved with child welfare.

Previous studies have supported the efficacy of Motivational Interviewing (MI) in increasing treatment engagement and retention among people with substance abuse disorders. However, few studies have assessed the impact of MI with coerced populations, particularly women referred to drug abuse treatment by child welfare due to prenatal drug use. Seventy-one such women who used drugs during pregnancy were randomly assigned to either receive three MI sessions or to watch two educational videos and participate in a home visit. Treatment retention group attendance and random urine analysis results were evaluated in these women during the first 8 weeks of treatment. No differences were found between the two conditions on these variables. Possible reasons for these negative findings are discussed, as are ideas for future research with coerced populations.

Emotion regulation is related to children's emotional and external eating.

OBJECTIVE: The objective of this study was to examine the associations between 2 types of emotion regulation (reactivity and inhibition) and 2 types of non-hunger-based eating (emotional eating and external eating). Although emotion regulation and eating regulation problems have both been linked to obesity in previous studies, there is little research examining the link between the two, particularly among children. METHODS: A total of 782 rural second graders (49% girls, 20% American Indian) were followed longitudinally through third grade. During both data collection points, children participated in face-to-face interviews at school using the Children's Emotion Management Scales and the revised Dutch Eating Behavior Questionnaire. RESULTS: Correlational analyses revealed that children's emotion regulation was significantly related to both external and emotional eating within and across grades, with reactivity appearing to be more consistently related to eating regulation than was inhibition. Regression analyses showed that second to third grade increases in external and emotional eating were predicted by increases in reactivity to anger and reactivity to worry. CONCLUSIONS: Given the established link in previous research between poor behavioral regulation and obesity in children, findings from this study linking child emotional reactivity and emotional and external eating (both forms of behavior dysregulation) are important in informing prevention and treatment programs. Based on these findings, targeting child emotion regulation in addition to behavior regulation skills as part of prevention and intervention programs may improve program effectiveness.

The influence of parental distress on child depressive symptoms in juvenile rheumatic diseases: the moderating effect of illness intrusiveness.

OBJECTIVE: To examine the role of children's illness-related cognitive appraisals in the parent-child adjustment relationship in a sample of children and adolescents with juvenile rheumatic disease (JRD). Specifically, we tested the moderating effect of children's perceived illness-induced barriers (i.e., illness intrusiveness) in the parent distress-child depressive symptom relationship. METHODS: Participants were 45 children and adolescents (ages 9-17) diagnosed with JRD. Children completed measures of depressive symptoms (Children's Depression Inventory), functional disability (Juvenile Arthritis and Functional Assessment Report), and illness intrusiveness (Illness Intrusiveness Scale-adapted for children); parents completed a brief measure of global distress (Brief Symptom Inventory). The pediatric rheumatologist provided functional disability ratings following a routine physical exam. RESULTS: Both increased parental distress and child illness intrusiveness were associated with greater child depressive symptoms. Direct effects were qualified by a significant Parent Distress x Illness Intrusiveness interaction. The influence of general parental distress on child depressive symptoms was enhanced under conditions of increased child-reported illness intrusiveness. CONCLUSIONS: Results support transactional conceptualizations of child adjustment to chronic illness. Findings also emphasize the need to examine the interaction of parent and child variables, particularly cognitive appraisals, in child adjustment. Results and treatment implications for children with JRD are discussed in terms of reinforcement theories of depression.