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1.
Nutrients ; 13(6)2021 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-34204927

RESUMO

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child's weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ± 1.74; MBMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit and vegetables (F&Vs), energy intake, sweetened beverage, total fat, and saturated fat) were assessed using random 24-h dietary recalls. Validated surveys were used to assess adolescent-reported EE and parental feeding practices. Results demonstrated a significant interaction between EE and parental monitoring (adjusted analyses; B = 0.524, SE = 0.176, p = 0.004), restriction (B = -0.331, SE = 0.162, p = 0.043), and concern (B = -0.602, SE = 0.171, p = 0.001) on F&V intake; under high monitoring, low restriction, and low concern, EE was positively associated with F&V intake. There were no significant effects for the other dietary outcomes. These findings indicate that parental feeding practices and EE may be important factors to consider for dietary interventions, specifically for F&V intake, among overweight African American adolescents.


Assuntos
Afro-Americanos/estatística & dados numéricos , Ingestão de Alimentos , Comportamento Alimentar , Pais/psicologia , Obesidade Pediátrica/etiologia , Adolescente , Afro-Americanos/psicologia , Bebidas Gaseificadas , Criança , Ingestão de Alimentos/etnologia , Ingestão de Alimentos/psicologia , Emoções , Ingestão de Energia , Comportamento Alimentar/etnologia , Comportamento Alimentar/psicologia , Feminino , Frutas , Humanos , Masculino , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/psicologia , Inquéritos e Questionários , Verduras
2.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34210069

RESUMO

The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.


Assuntos
Adaptação Psicológica , Comportamento do Adolescente/psicologia , Afro-Americanos/psicologia , Obesidade Pediátrica/psicologia , Estresse Psicológico/psicologia , Adolescente , Terapia Comportamental , Criança , Dieta/psicologia , Família/psicologia , Relações Familiares/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Humanos , Masculino , Obesidade Pediátrica/terapia , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Programas de Redução de Peso
3.
Nutrients ; 13(5)2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34065195

RESUMO

The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents (n = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors. Nuanced findings related to social- and self-esteem-related motivators for weight loss indicated a need for further understanding of these weight-loss motivators in the context of SDT. The current study findings highlight the importance of addressing motivational factors and family influences in research and practice related to promoting healthy dietary habits and weight management strategies among adolescents with obesity.


Assuntos
Família/psicologia , Comportamento Alimentar/psicologia , Motivação , Manejo da Obesidade , Obesidade Pediátrica/psicologia , Adolescente , Índice de Massa Corporal , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos , Poder Familiar/psicologia , Obesidade Pediátrica/terapia , Perda de Peso
4.
Nutrients ; 13(6)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34063799

RESUMO

Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial (n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child's weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness (p = 0.018) and demandingness (p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent's weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents.


Assuntos
Terapia Familiar/métodos , Refeições/psicologia , Poder Familiar/psicologia , Obesidade Pediátrica/terapia , Programas de Redução de Peso/métodos , Adolescente , Adulto , Afro-Americanos/psicologia , Dieta Saudável/etnologia , Dieta Saudável/psicologia , Comportamento Alimentar/etnologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Refeições/etnologia , Pessoa de Meia-Idade , Motivação , Análise Multinível , Relações Pais-Filho/etnologia , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/psicologia , Avaliação de Programas e Projetos de Saúde
5.
J Behav Med ; 44(4): 541-550, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33751355

RESUMO

This study evaluated the associations between parenting factors and adolescent weight related outcomes in African American adolescents with overweight and obesity. Baseline heights and weights were collected from 241 African American adolescents (11-16 years) with overweight and obesity. Self-reported adolescent perceptions of caregiver's parenting style (responsiveness, demandingness), parental feeding practices (monitoring, responsibility, weight related concerns, pressure-to-eat, and restriction), and their own dietary self-efficacy for healthy eating were assessed. Results demonstrated that greater parental responsiveness was significantly associated with lower adolescent body mass index (BMI) and higher adolescent dietary self-efficacy. In contrast, parental concern about adolescent weight was significantly associated with greater adolescent BMI, while greater parental responsibility for foods was associated with lower adolescent BMI. Although parental pressure-to-eat was significantly associated with higher dietary self-efficacy, greater parental restriction was associated with lower dietary self-efficacy. The results of this study highlight the importance of parental responsiveness and responsibility in understanding obesity related outcomes in African American adolescents with overweight and obesity.


Assuntos
Afro-Americanos , Poder Familiar , Adolescente , Índice de Massa Corporal , Comportamento Alimentar , Humanos , Obesidade , Sobrepeso , Relações Pais-Filho , Inquéritos e Questionários
6.
Am J Psychother ; 73(2): 43-49, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32050783

RESUMO

OBJECTIVE: Adolescent military dependents may be at higher risk for psychosocial stressors and disordered eating compared with civilian youths, but the mechanisms underlying these risks are unclear. Interpersonal theory proposes that difficult relationships lead to negative affect, thereby promoting emotional eating, which has been linked to and predictive of disordered eating. The interpersonal model may have particular relevance for understanding disordered eating among adolescent military dependents, given the unique stressors related to their parents' careers. This study aimed to examine the premise of the interpersonal model (that negative emotions mediate the association between multiple aspects of social functioning and emotional eating) among a cohort of adolescent military dependents. METHODS: Military dependents (N=136; 56% female, mean±SD age=14±2 years, body mass index adjusted for age and sex [BMIz]=2.0±0.4) at risk for adult obesity and binge eating disorder, as indicated by reported loss-of-control eating and/or anxiety symptoms, were assessed prior to participation in a study of excess weight-gain prevention. Bootstrapped mediation analyses were conducted to examine depressive symptoms as a potential mediator of the relationship between social functioning and emotional eating. Analyses were adjusted for age, sex, race-ethnicity, BMIz, and presence of reported loss-of-control eating and anxiety. RESULTS: Depressive symptoms were a significant mediator of the relationship between multiple domains of social functioning, including loneliness, social adjustment related to family and friends, attachment to father and peers, and emotional eating (p<0.05). CONCLUSIONS: The interpersonal model may contribute to our understanding of excess weight gain and binge eating disorder among adolescent military dependents. Prospective data are needed to determine the utility of interpersonal theory in predicting treatment response and outcomes among this population.


Assuntos
Transtorno da Compulsão Alimentar , Relações Interpessoais , Militares , Modelos Psicológicos , Obesidade , Adolescente , Adulto , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Estudos Prospectivos , Ganho de Peso
7.
Int J Eat Disord ; 53(2): 201-209, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31593352

RESUMO

OBJECTIVE: Parental military deployment can lead to stress in the family system due to concerns about the deployed service-member's safety and increased responsibilities for those not deployed. Parent-related stress can impact adolescent disordered eating. Given the important role that stress plays in disordered eating and obesity, it is crucial to understand the impacts of unique stressors to which vulnerable populations are exposed. METHOD: We studied 126 adolescent (14.3 ± 1.6 years; 59.5% girls; 44.4% non-Hispanic White; BMI-z, 1.91 ± .39) military dependents prior to entering an obesity and binge-eating disorder prevention trial. The Eating Disorder Examination was used to assess adolescent disordered eating. Parents self-reported their own distress and family deployment history that occurred during the adolescent's lifetime. RESULTS: Parental distress interacted with frequency of parental deployments such that for those with high parental distress, more frequent deployment was associated with greater adolescent shape and weight concerns (ß = .21, p = .012) and global eating pathology (ß = .18, p = .024). DISCUSSION: In this hypothesis-generating study, the combination of number of deployments and parental distress may be associated with disordered eating among adolescent military dependents seeking prevention of binge-eating disorder and adult obesity. If these preliminary findings are supported longitudinally, interventions to reduce parental stress related to deployment may be warranted to reduce disordered eating in adolescent dependents.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Militares/psicologia , Pais/psicologia , Angústia Psicológica , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino
8.
Eat Behav ; 33: 73-77, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31005683

RESUMO

Stressors unique to military families may place dependents of military service members of both sexes at high-risk for disordered-eating. Yet, there are no data examining sex-related differences in eating pathology and distress among this population. Therefore, we examined disordered-eating attitudes and associated psychosocial characteristics in adolescent military dependents at high-risk for both eating disorders and adult obesity (i.e., BMI ≥ 85th percentile and elevated anxiety symptoms and/or loss-of-control eating). One-hundred-twenty-five (55.2% female) adolescent (12-17 y) military dependents were studied prior to entry in an eating disorder and obesity prevention trial. Youth were administered the Eating Disorder Examination interview to determine disordered-eating attitudes, and completed questionnaires to assess self-esteem, social functioning, and depression. Girls and boys did not differ in BMIz (p = .66) or race/ethnicity (p = .997/p = .55). Adjusting for relevant covariates, girls and boys did not differ significantly with regard to disordered-eating global scores (p = .38), self-esteem (p = .23), or social functioning (p = .19). By contrast, girls reported significantly more symptoms of depression (p = .001). Adolescent male and female dependents at high-risk for eating disorders and adult obesity reported comparable levels of eating-related and psychosocial stress. Data are needed to elucidate how adolescent military dependents respond to intervention and whether sex moderates outcome.


Assuntos
Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Família Militar/psicologia , Obesidade/epidemiologia , Caracteres Sexuais , Adolescente , Adulto , Ansiedade/psicologia , Atitude , Depressão/psicologia , Feminino , Humanos , Masculino , Militares , Obesidade/psicologia , Psicopatologia , Autoimagem , Inquéritos e Questionários
9.
Eur Eat Disord Rev ; 25(5): 317-328, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28467032

RESUMO

Psychological and pharmacological interventions for binge-eating disorder have previously demonstrated efficacy (compared with placebo or waitlist control); thus, we aimed to expand that literature with a review of comparative effectiveness. We searched MEDLINE,® EMBASE,® Cochrane Library, Academic OneFile, CINAHL® for binge-eating disorder treatment articles and selected studies using predetermined inclusion and exclusion criteria. Data were sufficient for network meta-analysis comparing two pharmacological interventions; psychological interventions were analysed qualitatively. In all, 28 treatment comparisons were included in this review: one pharmacological comparison (second-generation antidepressants versus lisdexamfetamine) and 26 psychological comparisons. Only three statistically significant differences emerged: lisdexamfetamine was better at increasing binge abstinence than second-generation antidepressants; therapist-led cognitive behavioural therapy was better at reducing binge-eating frequency than behavioural weight loss, but behavioural weight loss was better at reducing weight. The majority of other treatment comparisons revealed few significant differences between groups. Thus, patients and clinicians can choose from several effective treatment options. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.


Assuntos
Transtorno da Compulsão Alimentar/terapia , Antidepressivos de Segunda Geração/uso terapêutico , Transtorno da Compulsão Alimentar/tratamento farmacológico , Terapia Cognitivo-Comportamental , Humanos , Dimesilato de Lisdexanfetamina/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
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