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J Nutr Educ Behav ; 52(1): 55-63, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31706793


OBJECTIVE: To determine the feasibility of a pediatric weight management program for low-income Latino families. METHODS: A pretest-posttest pilot study was conducted among 60 Latino children, aged 4-9, who were overweight/obese (body mass index-for-age ≥85th percentile). The 10-week group-based community program addressed diet, exercise, and behavior modification. Demand was assessed through recruitment and attendance, acceptability using postintervention surveys with participants, and limited efficacy testing of participant anthropometrics and cardiometabolic markers. RESULTS: Overall 65% of families were retained for follow-up. All families reported feeling more confident in making healthier food choices and would participate in the program again. Pre/post intervention testing found statistically significant decreases (P < .05) in body mass index for age z score, waist circumference, and % body fat. CONCLUSIONS AND IMPLICATIONS: This culturally adapted group intervention for Latino families was acceptable and shows promise for improved health status, although it needs to be replicated with a larger group and longer follow-up.

Hispano-Americanos , Obesidade Pediátrica/terapia , Programas de Redução de Peso/métodos , Índice de Massa Corporal , Criança , Dietoterapia , Terapia por Exercício , Família , Estudos de Viabilidade , Feminino , Humanos , Masculino , Projetos Piloto , Circunferência da Cintura
Soc Dev ; 28(3): 637-656, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31602097


Parenting is a critical factor in adolescent social-emotional development, with maladaptive parenting leading to risk for the development of psychopathology. However, the emotion-related brain mechanisms underlying the influence of parenting on psychopathology symptoms are unknown. The present study utilized functional magnetic resonance imaging and laboratory measures to examine sex-differentiated associations among parenting, adolescent emotion-related brain function, and substance use and psychopathology symptoms in 66 12-14 year olds. Maternal parenting behaviors (warmth, negative parenting) were observed in a laboratory task. Adolescent brain responses to negative emotional stimuli were assessed in emotion processing regions of interest (left [L] and right [R] amygdala, anterior insula, anterior cingulate cortex [ACC]). Adolescents reported on substance use and depressive, anxiety, and externalizing symptoms. Maternal negative parenting predicted adolescent brain activation differently by sex. For girls, negative parenting predicted heightened R ACC activation to negative emotional stimuli. For boys, negative parenting predicted blunted L and R anterior insula and L ACC activation. Furthermore, for girls, but not boys, heightened L anterior insula and heightened L and R ACC activation were associated with substance use and depressive symptoms, respectively. Findings suggest neural response to negative emotion as a possible sex-specific pathway from negative parenting to psychopathology.

Dev Neuropsychol ; 44(5): 417-428, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31288587


The current study examines associations between neural activation to the receipt of monetary reward in a rewarding game task and bias toward immediate reward measured in a behavioral delay discounting task among early adolescents (N = 58, 12-14 years). As expected, heightened brain activation in reward-related regions were correlated with higher bias toward immediate reward. This suggests that bias toward immediate reward in delay discounting tasks may be linked to heightened activation to reward in reward processing regions. This interplay between neural reward processing and bias toward immediate reward might explain the sharp increases in bias toward immediate reward that occur in early adolescence.

Encéfalo/fisiologia , Tomada de Decisões/fisiologia , Desvalorização pelo Atraso/fisiologia , Recompensa , Adolescente , Antecipação Psicológica/fisiologia , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes Neuropsicológicos
Pediatrics ; 143(5)2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30988024


BACKGROUND AND OBJECTIVES: Youth with cognitive impairment or developmental disability (CI/DD) face higher rates of obesity and secondary medical issues. Bariatric surgery may be a helpful tool for health improvement because it has been shown efficacious for adolescents. We aim to contribute to literature regarding bariatric surgery for adolescents with CI/DD and explore the association between cognitive functioning and weight loss outcomes. METHODS: Adolescents (N = 64) received a preoperative psychological evaluation, including cognitive assessment, and bariatric surgery at 1 weight loss program between 2010 and 2017. For these adolescents with measured cognitive performance, CI/DD was defined by an IQ <80 or previous diagnosis. In analyses, we compared adolescents with and without CI/DD. Structural equation modeling was used to assess the impact of cognitive functioning on weight loss 3 to 24 months postsurgery. RESULTS: There were no significant differences between adolescents with or without CI/DD in terms of preoperative BMI, age, and sex. Having CI/DD did not significantly impact weight loss or weight loss trajectory in the 2 years after surgery, although modeling revealed a trend toward individuals with CI/DD losing more weight over time. Similarly, intelligence scores did not predict weight loss after surgery. CONCLUSIONS: Bariatric surgery may be a helpful tool for adolescents with severe obesity and CI/DD. They could benefit from the surgery as much as those with typical development, and having CI/DD should not be used as a criterion to deny surgery. Continuing research with this population can be used to determine long-term outcomes in addition to defining best practices.

Cirurgia Bariátrica/métodos , Disfunção Cognitiva/cirurgia , Deficiências do Desenvolvimento/cirurgia , Gastrectomia/métodos , Obesidade Mórbida/cirurgia , Adolescente , Índice de Massa Corporal , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologia , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/psicologia , Feminino , Seguimentos , Humanos , Masculino , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/psicologia , Cuidados Pré-Operatórios , Adulto Jovem
Cognit Ther Res ; 40(3): 368-380, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27330232


How are emotional processes associated with the increased rates of substance use and psychological disorders commonly observed during adolescence? An index of emotion-related physiological arousal-cortisol reactivity-and subjective emotion regulation have both been independently linked to substance use and psychological difficulties among youth. The current study (N = 134 adolescents) sought to elucidate the interactive effects of cortisol reactivity following a stressful parent-child interaction task and self-reported emotion regulation ability on adolescents' substance use and externalizing and internalizing behavior problems. Results revealed that adolescents with low levels of cortisol reactivity and high emotion regulation difficulties were more likely to use substances, and also had the highest parent-reported symptoms of oppositional defiant disorder. With respect to internalizing symptoms, high emotion-related physiological reactivity coupled with high emotion regulation difficulties were associated with higher self-reported major depression symptoms among youth. Findings reveal that different profiles of HPA axis arousal and emotion regulation are associated with substance use and symptoms of psychopathology among adolescents.

J Adolesc Health ; 55(6): 730-5, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24957574


PURPOSE: Although talking to youth about drugs is often recommended to parents, we know little about how parents actually discuss drugs with their children in the moment and how parental advice is linked to youth arousal and substance use. This study examined observed parental drug use advice and parenting behaviors during parent-adolescent drug use discussions and associations with adolescent physiological responses and substance use. METHODS: Fifty-eight 12-17 year olds and their primary caregivers participated in a laboratory session in which parents and youth discussed the topic of alcohol and/or drug use for 10 minutes. This discussion was videotaped and coded for drug use advice (rules against drug use, information on drug use consequences, scenarios or learning advice [discussing drug use scenarios and what the child has learned about drugs]) and general parenting behaviors (parental warmth and/or support, negative and/or critical parenting). Before, during, and after the discussions, adolescents' heart rate, blood pressure (BP), and salivary cortisol levels were assessed. RESULTS: Parental discussion of scenarios and/or learning was associated with lower adolescent BP responses to the discussions and lower likelihood of substance use. Parental discussion of rules against drug use was associated with higher heart rate and BP responses and greater likelihood of substance use. Criticism and/or negative parenting was associated with higher cortisol responses and greater likelihood of substance use at a trend level. CONCLUSIONS: Parenting characterized by greater discussion of drug use scenarios and less stating of rules against drug use and criticism may make youth feel more comfortable and be linked to lower substance use.

Comportamento do Adolescente/psicologia , Comunicação , Relações Pais-Filho , Fenômenos Fisiológicos/fisiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Comportamento do Adolescente/fisiologia , Conflito Psicológico , Humanos , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle