A biobehavioral examination of emotional eating in adolescents: Evaluating the role of acute cortisol stress reactivity in the context of a multi-method assessment of eating in response to stress.

Stress is linked to emotional eating among adolescents, which in turn increases risk for overweight/obesity (OW/OB) development and continuation. There is a lack of research disentangling chronic and acute stress as predictors of adolescent emotional eating. Further, there is a corresponding need to understand the effects of acute physiological stress reactivity within the context of adolescent emotional eating. The primary aim of this study was to examine the impact of cortisol stress reactivity on emotional eating in adolescents, above and beyond the effects of perceived chronic stress. The impact of subjective stress reactivity was also explored. Adolescents' (N = 49) intake of highly palatable snack foods was measured on separate control and stress-induction (following the Trier Social Stress Test for Children) days. A multi-method approach was used to assess objective (caloric intake) and subjective (self-report) emotional eating. Results indicated that greater cortisol reactivity, but not subjective stress reactivity, predicted subjective emotional eating, beyond the impact of chronic stress. Neither chronic stress nor subjective or objective stress reactivity predicted objective emotional eating following stress-induction. Findings point to the role of chronic stress and cortisol reactivity as risks for greater perceived emotional eating among adolescents, while elucidating differences between perceived and objective emotional eating. Future research should explore how chronic versus acute stress differentially contribute to adolescent weight management.

Parent-perceived barriers to child weight management: Measure validation in a clinical sample.

INTRODUCTION: Although families face many barriers to obtaining and maintaining a healthy weight status for children, there remains a lack of psychometrically sound tools to assess perceived barriers. The Barriers to Child Weight Management (BCWM) scale quantitatively assesses parents' perceptions of barriers to engaging in positive weight-related behaviors but has not been validated within a clinical sample. The present study sought to validate the BCWM scale among parents of children presenting to a tertiary pediatric weight management clinic. METHOD: Participants included 258 parents of children aged 6-18 years presenting to a tertiary care behavioral weight management program. Parents completed the BCWM prior to the initial clinic visit. Confirmatory factor analysis was conducted to test the previously identified 4-factor structure within a clinical sample. RESULTS: Overall model fit was good with the addition of 2 theoretically appropriate model respecifications, χ2(144) = 278.60, p < .001, comparative fit index = .90, root mean square error of approximation = .05, standardized root mean square residual = .06. DISCUSSION: The BCWM is a promising tool to assess parental perceptions of barriers to healthy weight-related behaviors among youth presenting for clinical weight management intervention. Incorporation of this measure into pediatric weight-management appointments may aid in quickly identifying points of intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Food Cravings and Eating: The Role of Experiential Avoidance.

Food cravings have been associated with problematic eating behaviors, such as emotional eating. Late adolescence is an important developmental period to examine this association, as late adolescents have greater independence in food choices as well as potentially higher demands during a transitional period of their lives. Mechanisms underlying the association between food cravings and problematic eating remain unclear. This study examined whether experiential avoidance (EA) may be one possible mechanism mediating the association between higher levels of food cravings and problematic eating behaviors. Late adolescents (n = 174) completed measures assessing EA, food cravings, and three problematic eating behaviors: emotional eating, cognitive restraint, and uncontrolled eating. Height and weight were measured objectively to calculate body mass index (BMI). Food cravings were positively associated with emotional eating and mediated by EA. EA also significantly mediated the association between greater cognitive restraint and greater food cravings. No significant mediation was detected for food cravings and uncontrolled eating. Future research may consider EA as a treatment target in intervention strategies for late adolescents seeking to decrease emotional or restrained eating behaviors.

Perceived stress and obesity-promoting eating behaviors in adolescence: The role of parent-adolescent conflict.

INTRODUCTION: Stress has been consistently related to obesity-promoting eating patterns (i.e., emotional, external, and restrained eating) throughout the life span, including during adolescence. One particularly salient source of stress within adolescence is parent-adolescent conflict. The current study sought to examine whether parent-adolescent conflict is a significant predictor of adolescent obesity-promoting eating patterns, beyond general adolescent stress. METHODS: A sample of adolescents (N = 51; 39.2% overweight or obese) completed a study examining stress and eating behaviors. As part of the larger study, adolescents completed measures related to parent-adolescent conflict, general adolescent stress, and obesity-promoting eating patterns. Adolescent height and weight were measured objectively and used to calculate adolescent body mass index (BMI) percentile for age and gender. RESULTS: General adolescent stress predicted all three obesity-promoting eating patterns, emotional, external, and restrained eating, controlling for adolescent BMI percentile. Higher levels of parent-adolescent conflict significantly predicted greater restrained eating, controlling for adolescent BMI percentile and general adolescent stress. Conflict did not predict emotional or external eating patterns. DISCUSSION: Adolescents' perceptions of parent-adolescent conflict appear to present a unique source of stress, above and beyond general perceived stress, that is, particularly relevant to the experience of restrained eating patterns. These findings provide support for the potential integration of assessment and intervention for parent-adolescent conflict within previously established behavioral weight control interventions to decrease restrained eating behaviors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Maternal Depressive Symptoms Mediate the Association between Socio-economic Status and Adolescent Weight Outcomes: A Longitudinal Analysis.

Introduction The prevalence of pediatric obesity is an issue in the United States, in which approximately one-third of children and adolescents are overweight or obese. Youth living in low socioeconomic (SES) households are at an increased risk for developing obesity; yet, research is needed to understand the mechanisms that might better explain the relationship between SES and obesity risk. Maternal depression presents a potential mechanism by which SES might predict a later risk for obesity in pediatric populations. Methods The present study used a national dataset from the National Institute of Child Health and Human Development-Study of Early Child Care and Youth Development (NICHD-SECCYD) to examine whether maternal depressive symptoms (at an age of 9 years) mediated the association between early SES (the income-to-needs ratio measured at an age of 1 month) and adolescent weight outcomes [Body Mass Index z-scores (zBMI) for age and sex, at an age of 15 years]. Results The results suggested that greater maternal depressive symptoms helped to explain a significant amount of the variance of lower SES predicting poorer weight outcomes in adolescents. Discussion These findings illustrate the role of maternal depressive symptoms in explaining how SES predicts adolescent weight outcomes. Implications are discussed, and future research is needed to identify women from lower SES households who are experiencing depressive symptoms to provide support and initiate points of early intervention to address relevant health outcomes in youths.

Familial influences on the use of controlling feeding practices with adolescents.

Little is known about what factors influence a caregiver to use controlling feeding practices with adolescents. The present study examines potential predictors (e.g., parent and child eating, parent and child weight, and the home environment) of the use of controlling feeding practices among adolescents, an age group that has not received much attention. Parents (N = 54, M age = 43.63 years, SD = 6.42; 94.4% female) of adolescents ages 12-17 (N = 54, M age = 13.94 years, SD = 1.75; 43.6% female) completed measures assessing their child feeding practices, eating patterns and the home environment. Adolescents completed measures of their eating patterns. Regression analyses were used to determine the most salient predictors of controlling child feeding practices, specifically restriction of food intake and pressure to eat. After controlling for adolescent age, parental dietary restraint was significantly associated with restriction and accounted for 15.2% of the variance in the use of restriction, F (1, 51) = 10.4, p<.01. Adolescent emotional eating and income-to-needs ratio were significantly associated with use of pressure above and beyond adolescent age and accounted for 29.1% of the variance in the use of pressure, F (2, 48) = 10.2, p<.001. This study suggests that future research should include factors from different levels of influence, such as child, parent and home environment. As understanding of these influences grows, efforts can be made to target specific contributors within intervention settings to address potential adverse outcomes associated with controlling feeding practices.

Does Social Support Buffer the Association Between Stress Eating and Weight Gain During the Transition to College? Differences by Gender.

This study sought to examine whether social support moderates the relationship between stress eating and body mass index (BMI) change over the freshman year in males and females. This longitudinal study included 70 college students (72.9% female; M age = 18.23) who completed self-reported measures of stress eating and perceived social support, with objective height and weight measurements collected. Among males, social support moderated the relationship between stress eating and BMI change. Among males, social support may serve as a buffer against the impact of stress eating on weight gain during the freshman year of college.

Physical and mental health outcomes associated with prior food insecurity among young adults.

Following a biopsychosocial model of food insecurity, this study examined differences in physical health and mental health outcomes among young adults ( N = 98) with and without a history of food insecurity. Young adults with a history of food insecurity had higher average levels of body mass index, waist-to-height ratio, depressive symptoms, stress, and disordered eating scores than individuals with no history of food insecurity. No differences were found with symptoms of anxiety. Future research should examine interventions targeted at decreasing negative mental health outcomes and risk for overweight among young adults who have experienced food insecurity.

From Bench to Bedside: Understanding Stress-Obesity Research Within the Context of Translation to Improve Pediatric Behavioral Weight Management.

A growing body of literature suggests that stress, including chronic stress and acute physiologic stress reactivity, is one contributor to the development and maintenance of obesity in youth. Little has been done to apply the literature on stress and obesity risk to inform the development of pediatric behavioral weight control (BWC) interventions. The aims of this review are to (1) discuss research linking stress and pediatric obesity, (2) provide examples of the implications of the stress-obesity research for pediatric BWC development, and (3) propose that a mindfulness-based approach may be useful in targeting stress reduction within pediatric BWC.

Parent psychopathology as a mediator of the relationship between anxiety and sleep problems in children.

INTRODUCTION: Sleep problems exert a negative impact on youths and their families. Parent and child mental health represent 2 posited, yet understudied, risk factors for sleep problems in youths. As such, this study sought to examine the role that parental psychopathology may play in mediating the relationship between child anxiety and sleep problems utilizing Internet sampling procedures. METHOD: Parents (n = 83; 90.4% female) answered questions about their own mental health, and about their child's (n = 83; 77.1% female) anxiety and sleep. RESULTS: Analyses found that parent anxiety and stress mediated the relationship between child anxiety and sleep problems. DISCUSSION: This is the first study to examine the joint roles of parent psychopathology and child anxiety in explaining sleep problems in youths. Limitations notwithstanding, these results suggest that both parent- and child-level variables are important for developing a more comprehensive understanding of child sleep problems. Future areas of research are discussed.

Predictors of emotional eating during adolescents' transition to college: does body mass index moderate the association between stress and emotional eating?

OBJECTIVE: This study sought to (1) examine perceived stress and resources to cope with stress as predictors of emotional eating during the transition to college and (2) determine whether body mass index (BMI) moderated the emotional eating-stress relationship. PARTICIPANTS: Participants were 97 college freshmen (73% female; BMI: M = 25.3 kg/m(2), SD = 5.7 kg/m(2)). Research was conducted in September 2012. METHODS: Participants completed the Perceived Stress Scale, Emotional Eating Scale, and Eating and Appraisal Due to Emotions and Stress Questionnaire during the first month of college. Height and weight were measured objectively. RESULTS: BMI moderated the relationship between perceived stress and emotional eating. Higher stress predicted greater emotional eating for the lower BMI groups, but not the highest group. Greater resources to cope with stress predicted lower emotional eating. CONCLUSIONS: Greater perceived stress and poorer resources to cope with stress may contribute to emotional eating during the transition to college. The relationship between perceived stress and emotional eating may vary by BMI.