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Maurici M, Arigliani M, Dugo V, Leo C, Pettinicchio V, Arigliani R, Franco E. Empathy in vaccination counselling: a survey on the impact of a three-day residential course. Hum Vaccin Immunother 2018; 15:631-636. [PMID: 30325260 PMCID: PMC6605730 DOI: 10.1080/21645515.2018.1536587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND In an era of hesitance to use vaccines, the importance of effective communication for increasing vaccine acceptance is well known. This study aimed to assess the impact of a three-day residential course concerning empathy and counselling abilities on patients' ratings of the level of empathy of physicians and nurses working in vaccination centers. METHODS The empathy of healthcare providers was evaluated using the Adapted Consultation and Relational Empathy (CARE) Measure. The survey involved 20 healthcare workers, doctors, and nurses in three immunization services of a Local Health Unit in South Italy. Before and after attending the course, all of them administered the questionnaire to 50 consecutive parents of vaccinated children. Statistical tests were used to assess the homogeneity of pre- and post -course samples, to measure the level of empathy perceived by parents in doctors and nurses in pre- and post-course evaluations, and to compare the average CARE Measure scores among groups. RESULTS Analysis of the questionnaires showed an increase of "excellent" scores and statistically significant differences between the pre- and post -course median values. Statistically significant differences between doctors and nurses were shown in almost all questions pre-course and in only four questions post-course. CONCLUSIONS This study demonstrated that a residential course is effective at improving patient-rated empathy of doctors and nurses working in vaccination centers and could result in an increase of parents' adherence to vaccination programs.
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Affiliation(s)
- Massimo Maurici
- a Department of Biomedicine and Prevention , University of Rome Tor Vergata , Italy
| | - Michele Arigliani
- b Department of Clinical and Experimental Medical Sciences , University Hospital of Udine , Italy
| | - Valentina Dugo
- c Department of Biomedicine and Prevention, Specialization School for Hygiene and Preventive Medicine , University of Rome Tor Vergata , Rome , Italy
| | - Carlo Leo
- d Department of Clinical and Experimental Medical Sciences , University Hospital of Udine, Italy TO Department of Medicine , Udine , Italy
| | - Valentina Pettinicchio
- c Department of Biomedicine and Prevention, Specialization School for Hygiene and Preventive Medicine , University of Rome Tor Vergata , Rome , Italy
| | - Raffaele Arigliani
- e Department of Biomedicine and Prevention , Specialization School for Hygiene and Preventive Medicine, University of Rome Tor Vergata , Rome , Italy
| | - Elisabetta Franco
- a Department of Biomedicine and Prevention , University of Rome Tor Vergata , Italy
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Lee KS, Vaillancourt T. Body mass index, peer victimization, and body dissatisfaction across 7 years of childhood and adolescence: Evidence of moderated and mediated pathways. Dev Sci 2018; 22:e12734. [PMID: 30192039 DOI: 10.1111/desc.12734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/27/2018] [Indexed: 12/26/2022]
Abstract
Numerous studies have reported that children and adolescents who are overweight are more likely to get bullied, yet the literature is replete with methodological limitations. We examined the transactional associations between peer victimization and body mass index (BMI), considering potential mediating (body dissatisfaction) and moderating (biological sex) factors. Participants (n = 631) came from the McMaster Teen Study, where students were assessed annually between Grades 5-11, approximately half were girls (53.9%), and the majority were white (76.4%). Peer victimization (from Grade 5) and body dissatisfaction (from Grade 6) were self-reported by students, while parents reported their child's height and weight (from Grade 5). Cascade models were built up sequentially using path analysis across 2-year increments (Grades 5, 7, 9, and 11). The final model had excellent fit to the data (χ2 = 73.961, df = 66, p = 0.234). Grade 5 peer victimization had a direct effect on BMI across a 2-year period in girls (b = 0.59, SE = 0.21, p = 0.005) and boys (b = 0.82, SE = 0.30, p = 0.006), and an indirect effect on BMI via body dissatisfaction across a 4-year period (b = 0.074, 95% CI = 0.012-0.152, p = 0.036). At no point did BMI directly increase risk for peer victimization, yet there were indirect effects via body dissatisfaction among girls but not boys. Peer victimization and body dissatisfaction were proximally and longitudinally related at every time point and there was a transactional association in late-adolescence among girls but not boys. Targeting modifiable factors in the social (peer victimization) and psychological (body dissatisfaction) domains may limit accelerated weight gain and the health risks associated with excess adiposity.
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Affiliation(s)
- Kirsty S Lee
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada.,School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
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53
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Intersections of gender and sexual minority status: Co-occurring bullying victimization among adolescents. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.11.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Affiliation(s)
- Sally S Cohen
- New York University Rory Meyers College of Nursing, New York, NY, USA.
| | - Andrew Dwyer
- Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
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Lee K, Dale J, Guy A, Wolke D. Bullying and negative appearance feedback among adolescents: Is it objective or misperceived weight that matters? J Adolesc 2017; 63:118-128. [PMID: 29289824 DOI: 10.1016/j.adolescence.2017.12.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 01/08/2023]
Abstract
This study investigated (1) whether involvement in bullying as a bully, victim or bully-victim was associated with objectively measured overweight or underweight, or whether it was related to weight misperception (i.e., inaccurate perceptions), and (2) whether appearance-specific feedback mediated the relationship between bullying and weight misperception. In Stage 1, 2782 adolescents aged 11-16 years from British secondary schools were screened for peer bullying and victimisation. In Stage 2, 411 adolescents with weight and height data (objective n = 319, self-report n = 92) also self-reported on their weight perception and appearance-specific feedback. Neither bullying nor victimisation were related to objective underweight or overweight. Victims were at increased odds of overweight misperception, while bully-victims were at increased odds of underweight misperception. Additionally, there was an indirect effect of appearance feedback on overweight misperception in bully-victims. Both victims and bully-victims are at increased risk of weight misperception, posing further detrimental effects to their health and wellbeing.
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Affiliation(s)
- Kirsty Lee
- Department of Psychology, University of Warwick, Coventry, CV4 7AL, United Kingdom.
| | - Jeremy Dale
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom.
| | - Alexa Guy
- Department of Psychology, University of Warwick, Coventry, CV4 7AL, United Kingdom.
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, CV4 7AL, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom.
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Schroeder K, Smaldone A. What Barriers and Facilitators Do School Nurses Experience When Implementing an Obesity Intervention? J Sch Nurs 2017; 33:456-466. [PMID: 29108499 PMCID: PMC6080249 DOI: 10.1177/1059840517694967] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A recent evaluation of a school nurse-led obesity intervention demonstrated a 5% implementation rate. The purpose of this study was to explore school nurses' perceived barriers to and facilitators of the intervention in order to understand reasons for the low implementation rate. Methods included semi-structured individual interviews with school nurses. Data were analyzed using content analysis and heat mapping. Nineteen nurses participated and eight themes were identified. Parental and administrative gatekeeping, heavy nurse workload, obesogenic environments, and concerns about obesity stigma were barriers to implementation. Teamwork with parents and school staff was a key facilitator of implementation. Nurses also noted the importance of cultural considerations and highlighted the need to tailor the intervention to the unique needs of their school environment and student population. These findings suggest that for school nurses to play a key role in school-based obesity interventions, barriers must be identified and addressed prior to program implementation.
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Affiliation(s)
- Krista Schroeder
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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57
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Pont SJ, Puhl R, Cook SR, Slusser W. Stigma Experienced by Children and Adolescents With Obesity. Pediatrics 2017; 140:peds.2017-3034. [PMID: 29158228 DOI: 10.1542/peds.2017-3034] [Citation(s) in RCA: 319] [Impact Index Per Article: 45.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting.
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Affiliation(s)
- Stephen J Pont
- Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center of Central Texas, Ascension, Austin, Texas; .,Department of Pediatrics, Dell Medical School; Center for Health Communication, Moody College of Communication; Department of Nutritional Sciences; University of Texas at Austin, Austin Texas
| | - Rebecca Puhl
- Rudd Center for Food Policy and Obesity and Department of Human Development and Family Studies, University of Connecticut, Storrs, Connecticut
| | - Stephen R Cook
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, New York; and
| | - Wendelin Slusser
- Jane and Terry Semel Healthy Campus Initiative, David Geffen School of Medicine and Jonathan and Karin Fielding School of Public Health, University of Los Angeles, Los Angeles, California
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An R, Yan H, Shi X, Yang Y. Childhood obesity and school absenteeism: a systematic review and meta-analysis. Obes Rev 2017; 18:1412-1424. [PMID: 28925105 DOI: 10.1111/obr.12599] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/11/2017] [Accepted: 07/13/2017] [Indexed: 12/01/2022]
Abstract
Regular school attendance is a key determinant of student's academic achievement and psychosocial development. Obesity may affect children's school attendance through its detrimental impact on their physical and mental health. A literature search was conducted in the PubMed, Web of Science and Cochrane Library for articles published until April 2017 that examined the relationship between unhealthy body weight and school absenteeism among children and adolescents. Thirteen studies total (10 cross-sectional and three longitudinal) conducted in seven countries were identified. The mean and median sample sizes were 24,861 and 3,113, respectively. Ten studies objectively measured children's height and weight, and three were based on parents' self-report. Four studies measured absenteeism using school administrative data, and nine administered questionnaires on children's parents. Among them, 11 reported a statistically significant positive association between childhood overweight/obesity and school absence, whereas two reported null effect. The meta-analysis found that the odds of being absent from school was 27% and 54% higher among children with overweight and obesity than among their normal weight counterparts, respectively. Future studies should adopt an experimental study design and accurate measures on school attendance and delineate the underlining pathways linking childhood obesity to school absenteeism through obesity-related illnesses and psychosocial problems.
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Affiliation(s)
- R An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - H Yan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - X Shi
- Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Y Yang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Pinquart M. Systematic Review: Bullying Involvement of Children With and Without Chronic Physical Illness and/or Physical/Sensory Disability-a Meta-Analytic Comparison With Healthy/Nondisabled Peers. J Pediatr Psychol 2017; 42:245-259. [PMID: 27784727 DOI: 10.1093/jpepsy/jsw081] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/28/2016] [Indexed: 02/07/2023] Open
Abstract
Objective To compare levels of victimization and perpetration associated with bullying among children and adolescents with and without chronic physical illnesses and/or physical or sensory disabilities. Methods In total, 107 studies were identified using a systematic search in electronic databases and cross-referencing. A random-effects meta-analysis was computed. Results Children and adolescents with chronic physical illness or disability were more likely to be victims of bullying in general (odds ratio [OR] = 1.65), particularly physical bullying (OR = 1.47), relational bullying (OR = 1.47), verbal bullying (OR = 1.67), cyberbullying (OR = 1.39), and illness-specific teasing (OR = 5.29). They were also more likely to be bullies in general (OR = 1.28), as well physical (OR = 1.38) and relational bullies (OR = 1.13). The effect sizes varied across different illnesses and disabilities and, in part, by visibility of the disease, school type, and year of assessment. Conclusions Although most between-group differences tend to be small, some form of intervention is needed to reduce bullying among children and adolescents with chronic physical illnesses and/or physical or sensory disabilities, and illness-specific weight- and appearance-related teasing in particular.
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Affiliation(s)
- Martin Pinquart
- Department of Psychology, Philipps University, Marburg , Germany
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60
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Adolescent Desire for Cosmetic Surgery: Associations with Bullying and Psychological Functioning. Plast Reconstr Surg 2017; 139:1109-1118. [PMID: 28445361 DOI: 10.1097/prs.0000000000003252] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adolescent bullying may be a key driver of interest in cosmetic surgery. This study examined the extent of such interest and whether any effect was sex-specific, and examined psychological functioning as a potential mechanism through which bullying involvement may lead to a wish for cosmetic surgery. METHODS A two-stage design was used. In the first stage, 2782 adolescents (aged 11 to 16 years) were screened for bullying involvement using self-reports and peer nominations. In the second stage, 752 adolescents who were bullies, victims, bully-victims, or uninvolved in bullying reported their desire for cosmetic surgery. Psychological functioning was constructed as a composite of self-esteem and emotional problems (assessed at stage 1) and body-esteem scores (assessed at stage 2). RESULTS Adolescents involved in bullying in any role were significantly more interested in cosmetic surgery than uninvolved adolescents. Desire for cosmetic surgery was greatest in adolescents who were bullied (victims and bully-victims) and girls. Desire for cosmetic surgery was highest in girls, but sex did not interact with bullying role. Being victimized by peers resulted in poor psychological functioning, which increased desire for cosmetic surgery. In contrast, desire for cosmetic surgery in bullies was not related to psychological functioning, which was in the normal range. CONCLUSIONS Bullying victimization is related to poor psychological functioning, and both are related to a greater desire for cosmetic surgery in adolescents. Cosmetic surgeons should screen candidates for psychological vulnerability and may want to include a short screening questionnaire for a history of peer victimization.
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Kerr DCR, Gini G. Prospective associations between peer teasing in childhood and young men's obesity. Obes Res Clin Pract 2017; 11:640-646. [PMID: 28811177 DOI: 10.1016/j.orcp.2017.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 07/19/2017] [Accepted: 07/22/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Being teased and otherwise victimised by peers during childhood increases risk for obesity. However, few prospective studies have considered whether risk extends to adulthood. We tested whether being teased in childhood predicted higher body mass index (BMI) and increased odds of obesity in early adulthood in a community sample of American males. METHOD Boys (n=206) were classified as victims of peer teasing or non-victims (n=55 and 151, respectively) based on mother, father, and teacher reports at ages 10-12 years. BMI was assessed at ages 24 or 32 years for 203 of the participants. Family income, parent and child depressive symptoms, child antisocial behaviour, and childhood BMI were assessed at ages 10-13 years and served as control variables. RESULTS In unadjusted comparisons, childhood victims did not differ significantly from non-victims on BMI (mean [SD]=27.49 [4.53] and 26.97 [4.60], respectively) or rates of obesity (42% and 31%, respectively) in early adulthood. In adjusted models, no group differences emerged for BMI (β [95% confidence interval (CI)]=.02 [-.09 to .13], p=.77) or obesity (odds ratio [95% CI]=1.58 [.67-3.71], p=.30). CONCLUSIONS Peer victimization has been associated with immediate and long-term maladjustment outcomes that are in some cases life threatening. However, our null results do not support that peer victimization significantly increases long-term risk for obesity, and findings are consistent with two other long-term prospective studies of this issue.
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Affiliation(s)
- David C R Kerr
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States.
| | - Gianluca Gini
- Department of Developmental and Social Psychology, University of Padua, Italy
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Abstract
Cyberbullying has been portrayed as a rising 'epidemic' amongst children and adolescents. But does it create many new victims beyond those already bullied with traditional means (physical, relational)? Our aim was to determine whether cyberbullying creates uniquely new victims, and whether it has similar impact upon psychological and behavioral outcomes for adolescents, beyond those experienced by traditional victims. This study assessed 2745 pupils, aged 11-16, from UK secondary schools. Pupils completed an electronic survey that measured bullying involvement, self-esteem and behavioral problems. Twenty-nine percent reported being bullied but only 1% of adolescents were pure cyber-victims (i.e., not also bullied traditionally). Compared to direct or relational victims, cyber-victimization had similar negative effects on behavior (z = -0.41) and self-esteem (z = -0.22) compared to those not involved in bullying. However, those bullied by multiple means (poly-victims) had the most difficulties with behavior (z = -0.94) and lowest self-esteem (z = -0.78). Cyberbullying creates few new victims, but is mainly a new tool to harm victims already bullied by traditional means. Cyberbullying extends the reach of bullying beyond the school gate. Intervention strategies against cyberbullying may need to include approaches against traditional bullying and its root causes to be successful.
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Affiliation(s)
- Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, CV4 7AL UK
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
| | - Kirsty Lee
- Department of Psychology, University of Warwick, Coventry, CV4 7AL UK
| | - Alexa Guy
- Department of Psychology, University of Warwick, Coventry, CV4 7AL UK
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Subjective evaluation of psychosocial well-being in children and youths with overweight or obesity: the impact of multidisciplinary obesity treatment. Qual Life Res 2017; 26:3279-3288. [PMID: 28762099 DOI: 10.1007/s11136-017-1667-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate the effects of a multidisciplinary childhood obesity treatment programme on subjective evaluations of psychosocial well-being and quality of life. METHODS This longitudinal observational study included 1291 children, adolescents and young adults, 6-22 years of age, with overweight or obesity. At entry and after 2-82 months of obesity treatment, the patients evaluated the following domains of psychosocial well-being on a visual analogue scale: quality of life, mood, appetite, bullying, motivation for weight loss and body image satisfaction. The degree of overweight was calculated using a body mass index (BMI) standard deviation score (SDS) at each visit. RESULTS At entry, the mean BMI SDS was 2.81 (range: 1.35-6.65, 95% confidence interval (95% CI): 2.44-3.18). After a median of 14 months of treatment, the median reduction in BMI SDS was 0.29 (95% CI: 0.26-0.31, p < 0.0001). Improvements were observed in the domains of quality of life, mood, appetite, bullying and body image satisfaction (p < 0.0001). Larger reductions in BMI SDS were associated with greater improvements in the domains of quality of life (p = 0.001), mood (p = 0.04) and body image satisfaction (p < 0.0001), independent of BMI SDS at entry. However, improvements in psychosocial well-being were also observed in those increasing their BMI SDS (n = 315). CONCLUSIONS In a large group of children and youths, psychosocial well-being improved during a multidisciplinary childhood obesity treatment programme, irrespective of the degree of obesity at treatment entry. Greater reductions in BMI SDS were associated with greater improvements in psychosocial well-being, but even in the group increasing their BMI SDS improvements were observed.
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64
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Body mass index and depressive symptoms in adolescents in Taiwan: testing mediation effects of peer victimization and sleep problems. Int J Obes (Lond) 2017. [DOI: 10.1038/ijo.2017.111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Di Pasquale R, Celsi L. Stigmatization of Overweight and Obese Peers among Children. Front Psychol 2017; 8:524. [PMID: 28473781 PMCID: PMC5397522 DOI: 10.3389/fpsyg.2017.00524] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/22/2017] [Indexed: 11/13/2022] Open
Abstract
Children get involved in social categorization. Thus, they are able to stigmatize peers as well as to show in-group favoritism theorized by Tajfel and Turner (1986). Moreover, according to Aboud's Cognitive-Developmental Theory (1988, 2003) the intensity of children's stereotypes and negative attitudes toward socially devalued group members changes with age, in line with their cognitive development. In our Western society, which addresses especially females with the message that thinness is beauty, self-efficacy, power, and success, being overweight or obese is one of the most socially devalued and stigmatized conditions among children. Thus, overweight and obese children are more likely to be personally and socially devalued compared to their average size peers. Starting with these theoretical reflections, the objectives of this mini-review are to examine if: (1) obese children show in-group favoritism and thus show less anti-fat attitudes than their thin and normal weight peers; (2) fat stigma is more prevalent toward overweight and obese girls than toward boys; (3) the intensity of weight-related stigma changes with the cognitive development of children.
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Affiliation(s)
- Roberta Di Pasquale
- Department of Human Sciences, Università degli Studi di BergamoBergamo, Italy
| | - Laura Celsi
- Department of Human Sciences, Università degli Studi di BergamoBergamo, Italy
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66
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Lee K, Guy A, Dale J, Wolke D. Does psychological functioning mediate the relationship between bullying involvement and weight loss preoccupation in adolescents? A two-stage cross-sectional study. Int J Behav Nutr Phys Act 2017; 14:38. [PMID: 28340581 PMCID: PMC5364676 DOI: 10.1186/s12966-017-0491-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/08/2017] [Indexed: 11/10/2022] Open
Abstract
Background Adolescent bullying is associated with a range of adversities for those who are bullied i.e., victims and bully-victims (e.g., those who bully others and get victimised), including reduced psychological functioning and eating disorder symptoms. Bullies are generally well-adjusted psychologically, but previous research suggests that bullies may also engage in problematic diet behaviours. This study investigates a) whether adolescents involved in bullying (bullies, victims, bully-victims) are at increased risk of weight loss preoccupation, b) whether psychological functioning mediates this relationship and c) whether sex is a key moderator. Method A two-stage design was used. In stage 1, adolescents (n = 2782) from five UK secondary schools were screened for bullying involvement using self and peer reports. In stage 2, a sample of bullies, victims, bully-victims and uninvolved adolescents (n = 767) completed a battery of assessments. The measures included the eating behaviours component of the Child and Adolescent Psychiatric Assessment, which was reduced to one factor (weight loss preoccupation) and used as the outcome variable. Measures of self-esteem, body-esteem and emotional problems were reduced to a latent (mediator) variable of psychological functioning. Multi-group analysis examined the effects of sex and all models were adjusted for covariates (BMI, pubertal stage, age, parental education and ethnicity). Results Bullies, victims and bully-victims were at increased risk of weight loss preoccupation compared to adolescents uninvolved in bullying. The mechanism by which bullying involvement related to increased weight loss preoccupation varied by bullying role: in bullies the effect was direct, in victims the effect was indirect (via reduced psychological functioning) and in bully-victims the effect was both direct and indirect. Sex significantly moderated the relationship in bullies: weight loss preoccupation was only statistically significant in bullies who were boys. Conclusion Bullying involvement during adolescence is associated with weight loss preoccupation. Bullies are likely driven by a desire to increase attractiveness and social status; whereas weight loss preoccupation in bullied adolescents may have maladaptive influences on diet and exercise behaviours due to its association with reduced psychological functioning. Future research should consider peer victimisation as a potential modifiable risk factor for reduced psychological functioning and weight loss preoccupation, which if targeted, may help to prevent maladaptive diet and exercise behaviours. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0491-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kirsty Lee
- Department of Psychology, University of Warwick, Coventry, CV4 7AL, UK
| | - Alexa Guy
- Department of Psychology, University of Warwick, Coventry, CV4 7AL, UK
| | - Jeremy Dale
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, CV4 7AL, UK. .,Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
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Moreira H, Canavarro MC. Is body shame a significant mediator of the relationship between mindfulness skills and the quality of life of treatment-seeking children and adolescents with overweight and obesity? Body Image 2017; 20:49-57. [PMID: 27936409 DOI: 10.1016/j.bodyim.2016.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022]
Abstract
This study aimed to examine (a) whether mindfulness skills were associated with higher quality of life through lower body shame for treatment-seeking children/adolescents with overweight and obesity and (b) whether this indirect effect was moderated by children/adolescents' age and gender. The sample included 153 children/adolescents with overweight/obesity followed in individual nutrition consultations. Participants completed self-report measures of mindfulness, body shame, and quality of life. Moderated mediation analyses showed that higher levels of mindfulness were associated with better perceived quality of life through lower body shame, but only among girls. For boys, higher levels of body shame did not translate into a poorer perception of quality of life, and the indirect effect of mindfulness on quality of life via lower body shame was not significant. These results suggest that body shame is an important mechanism to explain why mindfulness may help girls with overweight/obesity perceive a better quality of life.
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Affiliation(s)
- Helena Moreira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
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Kenney EL, Redman MT, Criss S, Sonneville KR, Austin SB. Are K-12 school environments harming students with obesity? A qualitative study of classroom teachers. Eat Weight Disord 2017; 22:141-152. [PMID: 26980318 DOI: 10.1007/s40519-016-0268-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/26/2016] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Weight bias can negatively impact health, and schools may be risky environments for students with obesity. We aimed to explore teachers' perceptions of the school experiences and academic challenges of students with obesity. METHODS We conducted interviews with 22 teachers in the Northeast, mid-Atlantic, and Midwest in July-August 2014. All interviews were transcribed verbatim, coded, and analyzed for important themes by two researchers using the immersion/crystallization approach. RESULTS Most teachers felt that students with obesity were more likely to have academic difficulties. Two main perceptions of the reasons for these difficulties emerged: (1) obesity led to lower self-esteem that caused students to participate less, and (2) poorer nutrition, increased screen time, and reduced physical activity were simultaneously causing obesity and poorer academic performance. A few teachers described colleagues who felt students with obesity were not as motivated to work hard in school as their peers. Many teachers described school health promotion efforts focused on weight reduction that could exacerbate weight stigma and risk of disordered eating. CONCLUSIONS Students with obesity, particularly girls, may be at risk for negative social and academic experiences in K-12 schools and may be perceived as struggling academically by their teachers.
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Affiliation(s)
- Erica L Kenney
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Morgan T Redman
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Shaniece Criss
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Kendrin R Sonneville
- Departments of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA, 02131, USA
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69
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Tso MK, Rowland B, Toumbourou JW, Guadagno BL. Overweight or obesity associations with physical aggression in children and adolescents. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2017. [DOI: 10.1177/0165025417690265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Being overweight or obese (overweight/obesity) or physically aggressive in childhood and adolescence can have lifelong consequences, hence are important public health problems. Identifying a relationship between these problems would assist in understanding their developmental origins. The present paper sought to review previous studies and use meta-analysis to evaluate whether there is evidence of a relationship between overweight/obesity and physical aggression in children and adolescents. A systematic search of studies that reported the effect of overweight/obesity (in the form of body mass index) on physical aggression was conducted. A total of 23 studies were identified, representing data from 255,377 participants. The results indicate that children and adolescents who are overweight or obese are more physically aggressive than their normal-weight or underweight peers. The average weighted standardized mean difference (the effect size) for aggression in overweight and obese children and adolescents compared to others was found to be 0.27 (95% confidence interval [CI95]: .17–.37), and was significant ( p<.001). Gender sub-analysis indicated that higher physical aggression amongst overweight or obese compared to normal-weight or underweight peers is a slightly larger effect for boys (standardized mean difference of .35, CI95: .18–.52, p<.001) than girls (standardized mean difference of .24, CI95: .07–.42, p<.01). High levels of heterogeneity (94.41%) were found between study-level effect sizes. The developmental processes that may explain the association between overweight/obesity and physical aggression in children and adolescents are discussed.
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Affiliation(s)
| | - Bosco Rowland
- School of Psychology, Deakin University, Melbourne, Australia
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70
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Kumar S, Kelly AS. Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clin Proc 2017; 92:251-265. [PMID: 28065514 DOI: 10.1016/j.mayocp.2016.09.017] [Citation(s) in RCA: 802] [Impact Index Per Article: 114.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 09/12/2016] [Accepted: 09/21/2016] [Indexed: 12/11/2022]
Abstract
Childhood obesity has emerged as an important public health problem in the United States and other countries in the world. Currently 1 in 3 children in the United States is afflicted with overweight or obesity. The increasing prevalence of childhood obesity is associated with emergence of comorbidities previously considered to be "adult" diseases including type 2 diabetes mellitus, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, and dyslipidemia. The most common cause of obesity in children is a positive energy balance due to caloric intake in excess of caloric expenditure combined with a genetic predisposition for weight gain. Most obese children do not have an underlying endocrine or single genetic cause for their weight gain. Evaluation of children with obesity is aimed at determining the cause of weight gain and assessing for comorbidities resulting from excess weight. Family-based lifestyle interventions, including dietary modifications and increased physical activity, are the cornerstone of weight management in children. A staged approach to pediatric weight management is recommended with consideration of the age of the child, severity of obesity, and presence of obesity-related comorbidities in determining the initial stage of treatment. Lifestyle interventions have shown only modest effect on weight loss, particularly in children with severe obesity. There is limited information on the efficacy and safety of medications for weight loss in children. Bariatric surgery has been found to be effective in decreasing excess weight and improving comorbidities in adolescents with severe obesity. However, there are limited data on the long-term efficacy and safety of bariatric surgery in adolescents. For this comprehensive review, the literature was scanned from 1994 to 2016 using PubMed using the following search terms: childhood obesity, pediatric obesity, childhood overweight, bariatric surgery, and adolescents.
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Affiliation(s)
- Seema Kumar
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN.
| | - Aaron S Kelly
- Department of Pediatrics and Department of Medicine, University of Minnesota, Minneapolis
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71
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Rodriguez Barrera JC, Bastidas M, Genta G, Olaya-Contreras P. Calidad de vida percibida por los escolares con sobrepeso y obesidad, de sectores populares de Medellín, Colombia. UNIVERSITAS PSYCHOLOGICA 2016. [DOI: 10.11144/javeriana.upsy15-2.cves] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Obesity in children affects physical-and mental health and can develop anxiety, depression, as well as other disorders. The objective was to evaluate the Health-Related Quality of Live (HRQOL) in schoolchildren, according to the nutritional status, and to compare our results with those of the European Union. A cross-sectional study was conducted with 679 schoolchildren, 10-14 years, in a public school of Medellin. The KIDSCREEN -27 questionnaire was used to asses HRQOL. Women, especially with obesity, had a less favorable perception of their physical activity, health, mood and family life, while men perceived less social support from friends; they were mocked by their peers and also felt harassed. Our results are consistent with those found in the European study. The Health-Related Quality of Live in schoolchildren is not homogenous, is affected by age, sex and by the cultural constraints about the construction of the body image.
Key words: Bullying, obesity, schoolchildren, overweight, quality of life, social acceptance
Health Psychology, Quality of Life
La obesidad afecta la salud física y mental de niños/niñas. Se evaluó la calidad de vida relacionada con la salud (CVRS) en escolares, de acuerdo al estado nutricional y se compararon los resultados con los de la Unión Europea. Se realizó un estudio transversal con 679 escolares, 10 a 14 años, de una escuela pública de Medellín, Colombia. Se empleó el KIDSCREEN-27 para medir CVRS. Las mujeres, especialmente con obesidad, tuvieron una percepción menos favorable de la actividad física, salud, estado de ánimo y vida familiar, mientras que los hombres perciben más desfavorablemente el apoyo de amigos y la aceptación social, sintiéndose objeto de burla e intimidación. Los resultados son consistentes con los encontrados en el estudio europeo. La percepción de CVRS de los escolares no es homogénea, está afectada por la edad, el sexo y los condicionantes culturales alrededor de la construcción de la imagen corporal.
Palabras claves autores
Aceptación social, acoso escolar, calidad de vida, obesidad escolar, sobrepeso,
Palabras claves descriptores
Calidad de Vida, Psicología de la Salud,
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72
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Kagawa RMC, Fernald LCH, Behrman JR. Weight Status and Behavioral Problems among Very Young Children in Chile. PLoS One 2016; 11:e0161380. [PMID: 27583678 PMCID: PMC5008787 DOI: 10.1371/journal.pone.0161380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 08/04/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/OBJECTIVES Our objective was to explore the association between weight status and behavioral problems in children before school age. We examined whether the association between weight status and behavioral problems varied by age and sex. SUBJECTS/METHODS This study used cross-sectional data from a nationally-representative sample of children and their families in Chile (N = 11,207). These children were selected using a cluster-stratified random sampling strategy. Data collection for this study took place in 2012 when the children were 1.5-6 years of age. We used multivariable analyses to examine the association between weight status and behavioral problems (assessed using the Child Behavior Checklist), while controlling for child's sex, indigenous status, birth weight, and months breastfed; primary caregiver's BMI and education level; and household wealth. RESULTS Approximately 24% of our sample was overweight or obese. Overweight or obese girls showed more behavioral problems than normal weight girls at age 6 (β = 0.270 SD, 95% CI = 0.047, 0.493, P = 0.018). Among boys age 1 to 5 years, overweight/obesity was associated with a small reduction in internalizing behaviors (β = -0.09 SD, 95% CI = -0.163, -0.006, P = 0.034). CONCLUSIONS Our data suggest that the associations between weight status and behavioral problems vary across age and sex.
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Affiliation(s)
- Rose M. C. Kagawa
- School of Public Health, University of California, Berkeley, CA, United States of America
| | - Lia C. H. Fernald
- School of Public Health, University of California, Berkeley, CA, United States of America
| | - Jere R. Behrman
- Department of Economics, University of Pennsylvania, Philadelphia, PA, United States of America
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73
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Häkkänen P, Ketola E, Laatikainen T. Development of overweight and obesity among primary school children-a longitudinal cohort study. Fam Pract 2016; 33:368-73. [PMID: 27230744 DOI: 10.1093/fampra/cmw042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND School health care is crucial for obesity prevention. Data on constancy of childhood obesity are still scarce, but highly necessary for risk evaluation. OBJECTIVES We examined from electronic health records (EHRs) the continuity of obesity during primary school and searched for social and behavioural characteristics associated with childhood obesity. METHODS From randomly selected 2000 Finnish sixth graders (aged 12-14), we identified 402 'ever overweight' and 172 'ever obese' children who were overweight or obese at least once since their first grade. These cohort data of growth measurements and the content of all pre-seventh grade health checks were retrospectively analysed from EHRs. RESULTS Of the ever obese and ever overweight children, 69.3% (95% CI: 65.2-73.4%) continued to be overweight or obese in sixth grade. Of the ever obese children, nearly 40% were obese in first grade and 56% were obese or overweight in all six grades. Furthermore, 80% were obese or overweight already before school age. Obese children had experienced more bullying than overweight children (43.6% versus 30.8%, P = 0.003), had more frequently special needs for studying (25.6% versus 14.7%, P = 0.002) or had undergone a serious family crisis (20.3% versus 11.4%, P = 0.005). CONCLUSIONS Electronic data on children's growth and psychosocial characteristics are potentially useful when aiming for early action to counter obesity. Such routinely collected data appear to be underutilized and should be further exploited both in individual and population level to develop screening and treatment processes.
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Affiliation(s)
- Paula Häkkänen
- Department of Social Services and Health Care, School and Student Welfare, City of Helsinki, Finland, Network of Academic Health Center, University of Helsinki, Helsinki, Finland,
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74
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Odar Stough C, Merianos A, Nabors L, Peugh J. Prevalence and Predictors of Bullying Behavior among Overweight and Obese Youth in a Nationally Representative Sample. Child Obes 2016; 12:263-71. [PMID: 27058236 DOI: 10.1089/chi.2015.0172] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Child and adolescent overweight and obesity are independent risk factors for poor social outcomes. Whether children who are overweight display greater bullying behaviors than normal weight peers, controlling for demographic and other social-ecological factors, was examined. The influence of child (e.g., mental health), family (e.g., income, parent mental health, and exposure to domestic violence), and community (e.g., exposure to neighborhood violence, unfair treatment based on race or ethnic group) factors on bullying risk in the subset of children who are overweight and obese was explored. METHODS We conducted a secondary data analysis of the 2011-2012 National Survey of Children's Health, a cross-sectional study providing a nationally representative sample of participants, using a series of multinomial logistic regressions in Mplus software (Muthén & Muthén, Los Angeles, CA). Participants were 41,361 youth ages 10-17 years. RESULTS Despite statistically significant differences in unadjusted analyses, no differences were found in bullying behavior by weight status once controlling for other factors. Child, family, and neighborhood factors predicted bullying behavior in both the overall sample and the subset of overweight and obese youth. However, some risk factors were unique to children who were overweight or obese. CONCLUSIONS Children who are overweight or obese are not at greater risk for engaging in bullying behavior than normal weight peers. Health professionals targeting bullying behavior should be aware of the impact child, family, and neighborhood factors have on bullying by overweight and obese children and adolescents.
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Affiliation(s)
- Cathleen Odar Stough
- 1 Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH
| | - Ashley Merianos
- 2 School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati , Cincinnati, OH
| | - Laura Nabors
- 2 School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati , Cincinnati, OH
| | - James Peugh
- 1 Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH
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75
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Harrist AW, Swindle TM, Hubbs-Tait L, Topham GL, Shriver LH, Page MC. The Social and Emotional Lives of Overweight, Obese, and Severely Obese Children. Child Dev 2016; 87:1564-80. [PMID: 27223340 DOI: 10.1111/cdev.12548] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
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.
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76
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Wei HS, Hwa HL, Shen ACT, Feng JY, Hsieh YP, Huang SCY. Physical Conditions and Special Needs as Risk Factors of Peer Victimization Among School Children in Taiwan. J Sch Nurs 2016; 33:223-231. [PMID: 27216248 DOI: 10.1177/1059840516649237] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Students with physical symptoms and diseases may be at an increased risk of peer victimization. This study examined the associations of several medical conditions (obesity, asthma, allergy, epilepsy, and diabetes) with experience of physical, verbal, and relational victimization among children. A sample of 6,233 fourth-grade students from 314 elementary schools in Taiwan was recruited for the analysis. The mean age of the sample was 10.5, with an even distribution of gender (50.3% male and 49.7% female). Children with asthma, allergy, and epilepsy reported higher frequencies of peer victimization. Those who took daily medications or received treatment were also at a higher risk of being victimized. Diabetes and obesity were not found to be associated with peer victimization. The findings highlighted that children with physical conditions suffer maltreatment from peers. Sensitivity training should be provided to school health professionals, so they can evaluate the risk of victimization among students with special needs during assessment.
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Affiliation(s)
- Hsi-Sheng Wei
- 1 Department of Social Work, College of Social Sciences, National Taipei University, New Taipei City, Taiwan
| | - Hsiao-Lin Hwa
- 2 Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,3 National Taiwan University Children and Family Research Center, National Taiwan University, Taipei, Taiwan
| | | | - Jui-Ying Feng
- 5 Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ping Hsieh
- 6 Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
| | - Soar Ching-Yu Huang
- 7 California School of Professional Psychology, Alliant International University, San Diego, CA, USA
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Abstract
Prevalence rates of childhood obesity have risen steeply over the last 3 decades. Given the increased national focus, the frequency of this clinical problem, and the multiple mental health factors that coexist with it, make obesity a public health concern. The complex relationships between mental health and obesity serve to potentiate the severity and interdependency of each. The purpose of this review is to create a contextual connection for the 2 conditions as outlined by the research literature and consider treatment options that affect both health problems.
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Affiliation(s)
- Leigh Small
- Family and Community Health Nursing Department, Virginia Commonwealth University School of Nursing, 1100 East Leigh Street, PO Box 980567, Richmond, VA 23298, USA.
| | - Alexis Aplasca
- Pediatrics and Psychiatry, Children's Hospital of Richmond/Virginia Treatment Center for Children, Virginia Commonwealth University School of Medicine, 515 North 10th Street, Richmond, VA 23298, USA
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78
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Abrams D, Palmer SB, Van de Vyver J, Hayes D, Delaney K, Guarella S, Purewal K. Adolescents' Judgments of Doubly Deviant Peers: Implications of Intergroup and Intragroup Dynamics for Disloyal and Overweight Group Members. SOCIAL DEVELOPMENT 2016. [DOI: 10.1111/sode.12187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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79
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Jendrzyca A, Warschburger P. Weight stigma and eating behaviours in elementary school children: A prospective population-based study. Appetite 2016; 102:51-9. [PMID: 26851574 DOI: 10.1016/j.appet.2016.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 01/29/2016] [Accepted: 02/02/2016] [Indexed: 11/19/2022]
Abstract
The relevance of weight stigma as an important factor in disordered eating has been supported by research. However, because most of the studies were cross-sectional and focussed on older children, the causal relationships could not be fully determined in childhood. The current study explores the role of weight stigma in body dissatisfaction and eating behaviours. The sample consisted of 773 girls and 713 boys, aged 6-11 years, who completed surveys assessing weight stigma experiences, body dissatisfaction and eating behaviours at two points of measurement, approximately one year apart. The children's external and disordered eating was rated via parental questionnaires. As expected, the pattern of the associations between weight status, weight stigma, body dissatisfaction and eating behaviours differed by gender. Experience of weight stigma in girls led to external and restrained eating one year later, whereas in boys no such association was observed. Body dissatisfaction mediated the association between weight stigma and restrained eating behaviours in girls, whereas in boys, body dissatisfaction directly influenced restrained eating behaviours. However, in both girls and boys weight status predicted body dissatisfaction and disordered eating, while weight stigma did not have a direct effect on disordered eating. Results suggest that interventions involving weight stigma should be a part of eating disorder prevention programmes, and gender-specific pathways should be considered.
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Affiliation(s)
- Anna Jendrzyca
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany.
| | - Petra Warschburger
- Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476, Potsdam, Germany.
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80
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Liu X, Chen G, Yan J, Luo J. Weight status and bullying behaviors among Chinese school-aged children. CHILD ABUSE & NEGLECT 2016; 52:11-19. [PMID: 26773898 DOI: 10.1016/j.chiabu.2015.12.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 06/05/2023]
Abstract
This study was to examine the relationship between measured weight status and three experiences as victims, bullies and bully-victims. The participants were 10,587 Chinese school-aged students (girls: 5,527, boys: 5,060) who ranged in age from 7 to 18 years old. Height and weight were measured. Bullying behavior was obtained by one-to-one interview in 7-10 years older students and group-administered surveys in 11-18 years older students. The results showed that, obese girls were more likely to be victimized (OR=1.73, CI: 1.16-2.59) compared to normal students. For boys, obesity was not associated with victimization, but obese boys (OR=1.45, CI: 1.04-2.03), especially 7-13 years old boys (OR=1.98, CI: 1.35-2.90) were more likely to bully others; obese boys also were more likely to be victim/bullies (OR=1.67, CI: 1.05-2.64). Weight victimization in Chinese school-aged children is not as common as in the west countries, but obese girls clearly realize more victimization, and obese younger boys show obvious aggression. Related departments should provide specific intervention for school bullying according students' weight status, age and gender.
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Affiliation(s)
- Xiaoqun Liu
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China; Department of Women & Children Health, School of Public Health, Central South University, Changsha, Hunan, China
| | - Gui Chen
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Junxia Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, China
| | - Jiayou Luo
- Department of Women & Children Health, School of Public Health, Central South University, Changsha, Hunan, China
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81
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Bacchini D, Licenziati MR, Garrasi A, Corciulo N, Driul D, Tanas R, Fiumani PM, Di Pietro E, Pesce S, Crinò A, Maltoni G, Iughetti L, Sartorio A, Deiana M, Lombardi F, Valerio G. Bullying and Victimization in Overweight and Obese Outpatient Children and Adolescents: An Italian Multicentric Study. PLoS One 2015; 10:e0142715. [PMID: 26606393 PMCID: PMC4659571 DOI: 10.1371/journal.pone.0142715] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 10/26/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Being overweight or obese is one of the most common reasons that children and adolescents are teased at school. We carried out a study in order to investigate: i) the relation between weight status and school bullying and ii) the relation between weight status categories and types of victimization and bullying in an outpatient sample of Italian children and adolescents with different degrees of overweight from minimal overweight up to severe obesity. PARTICIPANTS/METHODS Nine-hundred-forty-seven outpatient children and adolescents (age range 6.0-14.0 years) were recruited in 14 hospitals distributed over the country of Italy. The participants were classified as normal-weight (N = 129), overweight (N = 126), moderately obese (N = 568), and severely obese (N = 124). The nature and extent of verbal, physical and relational bullying and victimization were assessed with an adapted version of the revised Olweus bully-victim questionnaire. Each participant was coded as bully, victim, bully-victim, or not involved. RESULTS Normal-weight and overweight participants were less involved in bullying than obese participants; severely obese males were more involved in the double role of bully and victim. Severely obese children and adolescents suffered not only from verbal victimization but also from physical victimization and exclusion from group activities. Weight status categories were not directly related to bullying behaviour; however severely obese males perpetrated more bullying behaviour compared to severely obese females. CONCLUSIONS Obesity and bullying among children and adolescents are of ongoing concern worldwide and may be closely related. Common strategies of intervention are needed to cope with these two social health challenges.
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Affiliation(s)
- Dario Bacchini
- Dipartimento di Psicologia, Seconda Università di Napoli, Caserta, Italy
| | - Maria Rosaria Licenziati
- Dipartimento di Pediatria Specialistica e Sistematica, AORN Santobono Pausilipon Annunziata, Napoli, Italy
| | - Alessandra Garrasi
- Servizio di Dietologia Clinica, Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italy
| | - Nicola Corciulo
- Centro di Prevenzione Diagnosi e Cura dell’Obesità in Età Evolutiva U.O. Pediatria, Presidio Ospedaliero di Gallipoli, Lecce, Italy
| | - Daniela Driul
- SOC Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Udine, Italy
| | - Rita Tanas
- U.O. di Pediatria, Azienda Ospedaliero-Universitaria S. Anna, Ferrara, Italy
| | - Perla Maria Fiumani
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università di Napoli, Napoli, Italy
| | | | - Sabino Pesce
- UOC di Malattie Metaboliche ed Endocrinologia Pediatrica A.O.U. Policlinico di Bari, Bari, Italy
| | - Antonino Crinò
- U.O.S. di Patologia Endocrina Autoimmune, Ospedale Pediatrico Bambino Gesù IRCCS, Palidoro, Roma, Italy
| | - Giulio Maltoni
- Dipartimento di Scienze Mediche e Chirurgiche, Unità Operativa di Pediatria, Programma di Endocrinologia Pediatrica, Policlinico Universitario S. Orsola Malpighi, Bologna, Italy
| | - Lorenzo Iughetti
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Università di Modena e Reggio Emilia, Modena, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Divisione di Auxologia e Malattie Metaboliche, Verbania, Italy
| | - Manuela Deiana
- Clinica Pediatrica, Ospedale F. Del Ponte, Varese, Italy
| | | | - Giuliana Valerio
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Napoli, Italy
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82
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Cook BG, Li D, Heinrich KM. Obesity, Physical Activity, and Sedentary Behavior of Youth With Learning Disabilities and ADHD. JOURNAL OF LEARNING DISABILITIES 2015; 48:563-576. [PMID: 24449262 DOI: 10.1177/0022219413518582] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Obesity, physical activity, and sedentary behavior in childhood are important indicators of present and future health and are associated with school-related outcomes such as academic achievement, behavior, peer relationships, and self-esteem. Using logistic regression models that controlled for gender, age, ethnicity/race, and socioeconomic status, we investigated the likelihood that youth with learning disabilities (LD) and attention-deficit/hyperactivity disorder (ADHD) are obese, physically active, and sedentary using a nationally representative sample of 45,897 youth in the United States from 10 to 17 years of age. Results indicated that youth with comorbid LD/ADHD were significantly more likely than peers without LD or ADHD to be obese; that youth with LD only, ADHD only, and comorbid LD/ADHD were significantly less likely to meet recommended levels of physical activity; and that youth with LD only were significantly more likely to exceed recommended levels of sedentary behavior. Medication status mediated outcomes for youth with ADHD. We offer school-based recommendations for improving health-related outcomes for students with LD and ADHD.
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83
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Andersen LP, Labriola M, Andersen JH, Lund T, Hansen CD. Bullied at school, bullied at work: a prospective study. BMC Psychol 2015; 3:35. [PMID: 26458372 PMCID: PMC4603733 DOI: 10.1186/s40359-015-0092-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 09/30/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The consequences of childhood bullying victimisation are serious. Much previous research on risk factors for being bullied has used a cross-sectional design, impeding the possibility to draw conclusions on causality, and has not considered simultaneous effects of multiple risk factors. Paying closer attention to multiple risk factors for being bullying can provide a basis for designing intervention programmes to prevent or reduce bullying among children and adolescents. METHODS Risk factors for bullying were examined by using questionnaire data collected in 2004 and 2007. In 2004, the participants were aged 14-15 years and 17-18 years in 2007. The baseline questionnaire was answered by 3054 individuals in 2004, and 2181 individuals participated in both rounds. We analysed risk factors for being bullied at the individual and societal level. Information on the social background of the participants was derived from a national register at Statistics Denmark. RESULTS Several risk factors were identified. Being obese, low self-assessed position in school class, overprotective parents, low self-esteem, low sense of coherence and low socioeconomic status were risk factors for being bullied at school. Being overweight, smoking, low self-assessed position in class, low sense of coherence and low socioeconomic status were risk factors for being bullied at work. However, most associations between risk factors in 2004 and being bullied in 2007 disappeared after adjustment for being bullied in 2004. CONCLUSIONS The strongest risk factor for being bullied was being previously bullied. Our results stress the importance of early prevention of bullying at schools. In addition, attention should be drawn to the role of overprotective parents.
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Affiliation(s)
- Lars Peter Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Merete Labriola
- Aarhus University, Department of Public Health, Universitets Parken, Aarhus, 8000, Denmark.
- CFK Public Health and Quality Improvement Central Denmark Region, P. P. Orumsgade 11, Aarhus, 8000, Denmark.
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Thomas Lund
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
- CFK Public Health and Quality Improvement Central Denmark Region, P. P. Orumsgade 11, Aarhus, 8000, Denmark.
| | - Claus D Hansen
- Department of Sociology & Social Work, Kroghstrædet 5, Aalborg University, Aalborg, 9220, Denmark.
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84
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Reece LJ, Bissell P, Copeland RJ. 'I just don't want to get bullied anymore, then I can lead a normal life'; Insights into life as an obese adolescent and their views on obesity treatment. Health Expect 2015; 19:897-907. [PMID: 27403849 PMCID: PMC4989446 DOI: 10.1111/hex.12385] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Adolescent obesity is a complex condition involving social, emotional, behavioural and cultural issues. DESIGN One-to-one interviews and small focus groups with overweight and obese young people were conducted. Qualitative research is an appropriate method to explore the complexity of this issue. SETTING AND PARTICIPANTS Overweight and obese adolescent's attending a community weight management intervention in South Yorkshire. MAIN VARIABLES STUDIED Interviews aimed to explore the experiences of obese adolescents and their perspectives towards obesity treatment. RESULTS Adolescent's provided detailed accounts of their perspectives on weight gain, alluding to disordered patterns of eating and overeating, reported as being triggered by social and emotional factors, and in particular, bullying. Avoidance of bullying and a desire to integrate socially with peers were key drivers to seek treatment. Young people reported what they should do to lose weight, yet responsibility for successful weight loss and lifestyle change was repeatedly attributed to the treatment received, as opposed to viewing this as a combination of self-motivation coupled with support provided by friends and family. CONCLUSION Weight loss programmes need to consider the complex experience of obese young people in their design, focusing on how to implement long-term lifestyle changes.
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Affiliation(s)
- Lindsey J Reece
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK
| | - Paul Bissell
- Professor School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert J Copeland
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK.,National Centre for Sport and Exercise Medicine NCSEM, Sheffield, UK
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85
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Abstract
OBJECTIVE To examine associations between 3 weight indices (weight status, perceived weight, and weight status perception accuracy) and heath-related quality of life (HRQOL). METHODS Data are for girls in the 2009 Health Behaviors in School-Age Children survey, a nationally representative sample of students in Grades 5 to 10 during the 2009/2010 school year (n = 5018). Controlling for sociodemographics, multivariate linear regressions examined associations between self-reported weight status (underweight/normal/overweight/obese), perceived weight (how children categorize their weight), weight status perception accuracy (underestimate/accurate perception/overestimate), and dimensions of HRQOL, including physical, emotional, social, and school functioning. RESULTS Although obesity was only associated with poor physical and emotional HRQOL, perceptions of being overweight were associated with worse physical, emotional, school, and social HRQOL. Furthermore, girls who overestimated their weight reported poorer HRQOL than those with accurate weight perceptions. Associations of perceptions of being overweight and weight status overestimation with poor HRQOL despite, in most instances, the absence of associations between weight status and HRQOL suggest that weight status perceptions may not merely be a mediator of a weight status-HRQOL association but a significant independent correlate of poor HRQOL. CONCLUSION These findings raise the issue of whether there is a need to prioritize intervention efforts to promote better HRQOL by redefining the population of girls most at risk. Parents, teachers, and clinicians should be aware that, rather than overweight status, perceptions of being overweight (accurately or not) are associated with a poor HRQOL among girls. Future research should examine the potential negative effect of using specific body image terminologies on adolescents' psychological health.
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86
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Puhl R, Luedicke J, King KM. Combating weight-based bullying in schools: is there public support for the use of litigation? THE JOURNAL OF SCHOOL HEALTH 2015; 85:372-381. [PMID: 25877434 DOI: 10.1111/josh.12264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 10/23/2014] [Accepted: 01/08/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Bullying litigation is an emerging area of law that has increased in response to serious cases of bullying at school. Weight-based bullying is prevalent at school, but no research has examined the use of litigation to address this problem. We assessed public support for litigation approaches to address weight-based bullying at school, and whether support for litigation varies according to the reason why a student is bullied. METHODS A national sample of 994 adults (49% parents) completed an online questionnaire assessing their support for litigation approaches in response to hypothetical incidents of youth bullying. RESULTS As many as two thirds of participants supported litigation against schools for failing to intervene and protect students from weight-based bullying. Litigation remedies received slightly higher support in response to bullying due to race or sexual orientation compared to body weight. Participants favored litigation approaches that target schools for inadequate intervention or a bully's parents on behalf of their child's actions. CONCLUSIONS Our study offers novel findings about public and parental views of litigation as a potential approach to address weight-based (and other forms of) bullying, and introduces considerations about the potential role of litigation as part of broader remedies to address youth bullying.
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Affiliation(s)
- Rebecca Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT 06103.
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87
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Kenney EL, Gortmaker SL, Davison KK, Bryn Austin S. The academic penalty for gaining weight: a longitudinal, change-in-change analysis of BMI and perceived academic ability in middle school students. Int J Obes (Lond) 2015; 39:1408-13. [PMID: 25982793 DOI: 10.1038/ijo.2015.88] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 04/13/2015] [Accepted: 05/06/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Worse educational outcomes for obese children regardless of academic ability may begin early in the life course. This study tested whether an increase in children's relative weight predicted lower teacher- and child-perceived academic ability even after adjusting for standardized test scores. SUBJECTS/METHODS Three thousand three hundred and sixty-two children participating in the Early Childhood Longitudinal Study-Kindergarten Cohort were studied longitudinally from fifth to eighth grade. Heights, weights, standardized test scores in maths and reading, and teacher and self-ratings of ability in maths and reading were measured at each wave. Longitudinal, within-child linear regression models estimated the impact of a change in body mass index (BMI) z-score on change in normalized teacher and student ratings of ability in reading and maths, adjusting for test score. RESULTS A change in BMI z-score from fifth to eighth grade was not independently associated with a change in standardized test scores. However, adjusting for standardized test scores, an increasing BMI z-score was associated with significant reductions in teacher's perceptions of girls' ability in reading (-0.12, 95% confidence interval (CI): -0.23, -0.03, P=0.03) and boys' ability in math (-0.30, 95% CI: -0.43, -0.17, P<0.001). Among children who were overweight at fifth grade and increased in BMI z-score, there were even larger reductions in teacher ratings for boys' reading ability (-0.37, 95% CI: -0.71, -0.03, P=0.03) and in girls' self-ratings of maths ability (-0.47, 95% CI: -0.83, -0.11, P=0.01). CONCLUSIONS From fifth to eighth grade, increase in BMI z-score was significantly associated with worsening teacher perceptions of academic ability for both boys and girls, regardless of objectively measured ability (standardized test scores). Future research should examine potential interventions to reduce bias and promote positive school climate.
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Affiliation(s)
- E L Kenney
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S L Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - K K Davison
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
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88
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Totura CMW, Figueroa HL, Wharton C, Marsiglia FF. Assessing implementation of evidence-based childhood obesity prevention strategies in schools. Prev Med Rep 2015; 2:347-54. [PMID: 26844091 PMCID: PMC4721446 DOI: 10.1016/j.pmedr.2015.04.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective Research suggests that schools can play a key role in obesity prevention by implementing evidence-based strategies promoting student health. This study explores school climate factors underlying implementation of evidence-based health and wellness policies and practices in Kindergarten–8th grade programs in the Southwestern United States. Method Utilizing a participatory research survey approach conducted in December 2011 with school health professionals (N = 62) and a multiple regression design, a moderated predictive model of implementation climate (i.e., attitudes and beliefs about prevention, school commitment to prevention, barriers, and stakeholder collaboration) was tested. Results Barriers to obesity prevention efforts, such as lack of resources, support, or strategy clarity, hinder implementation of healthy food policies despite strong school commitment to prevention. Along with the commitment to prevention, stakeholder collaboration predicts physical education strategies, specifically reducing restricted access to physical education as a punishment for student misconduct. Conclusion Obesity prevention strategy implementation relies on the supportiveness and structure of school climates. Barriers to prevention can impede efforts despite school commitment toward prevention, while stakeholder collaboration can enhance the likelihood that practices are in place. This study explored school implementation climate for obesity prevention. Barriers are associated with lower implementation of healthy food policies. Commitment and collaboration predict less restricted access to physical education. School prevention beliefs predict lower student access to physical education. Obesity prevention implementation depends on the supportiveness of school climates.
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Affiliation(s)
- Christine M W Totura
- Department of Psychology, Auburn University, 226 Thach Hall, Auburn, AL 36849, USA
| | - Holly Lewis Figueroa
- Southwest Interdisciplinary Research Center, Arizona State University, 411 North Central Avenue, Suite 720, Phoenix, AZ 85004, USA
| | - Christopher Wharton
- School of Nutrition and Health Promotion, Arizona State University, 500 N. Third Street, Phoenix, AZ 85004, USA
| | - Flavio F Marsiglia
- Southwest Interdisciplinary Research Center, Arizona State University, 411 North Central Avenue, Suite 720, Phoenix, AZ 85004, USA
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89
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Yanovski JA. Pediatric obesity. An introduction. Appetite 2015; 93:3-12. [PMID: 25836737 DOI: 10.1016/j.appet.2015.03.028] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/23/2015] [Accepted: 03/25/2015] [Indexed: 01/04/2023]
Abstract
The prevalence of child and adolescent obesity in the United States increased dramatically between 1970 and 2000, and there are few indications that the rates of childhood obesity are decreasing. Obesity is associated with myriad medical, psychological, and neurocognitive abnormalities that impact children's health and quality of life. Genotypic variation is important in determining the susceptibility of individual children to undue gains in adiposity; however, the rapid increase in pediatric obesity prevalence suggests that changes to children's environments and/or to their learned behaviors may dramatically affect body weight regulation. This paper presents an overview of the epidemiology, consequences, and etiopathogenesis of pediatric obesity, serving as a general introduction to the subsequent papers in this Special Issue that address aspects of childhood obesity and cognition in detail.
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Affiliation(s)
- Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD 20892, USA.
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90
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Qualter P, Murphy SM, Abbott J, Gardner KJ, Japel C, Vitaro F, Boivin M, Tremblay RE. Developmental associations between victimization and body mass index from 3 to 10 years in a population sample. Aggress Behav 2015; 41:109-22. [PMID: 27539933 DOI: 10.1002/ab.21580] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 11/28/2014] [Indexed: 11/06/2022]
Abstract
In the current prospective study, we investigated (1) whether high and low BMI in early childhood puts a child at risk of victimization by their peers, and (2) whether being victimized increases BMI over the short- and long-term, independent of the effect of BMI on victimization. We also examined whether gender moderated these prospective associations. Participants were 1,344 children who were assessed yearly from ages 3 to 10 years as part of the Québec Longitudinal Study of Child Development (QLSCD). BMI predicted annual increases in victimization for girls aged 6 years and over; for boys aged 7 and 8 years of age, higher BMI reduced victimization over the school year. Further, victimization predicted annual increases in BMI for girls after age 6 years. When these short-term effects were held constant, victimization was also shown to have a three and 5-year influence on annual BMI changes for girls from age 3 years. These short- and long-term cross-lagged effects were evident when the effects of family adversity were controlled. The findings support those from previous prospective research showing a link between higher BMI and victimization, but only for girls. Further, being victimized increased the likelihood that girls would put on weight over time, which then increased future victimization. The implications of these prospective findings for interventions are considered. Aggr. Behav. 42:109-122, 2015. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Pamela Qualter
- School of Psychology; University of Central Lancashire; Preston Lancashire UK
- Research Unit on Children's Psychosocial Maladjustment (GRIP); which is a multi-university (; Université de Montréal; Université Laval, and McGill University) research centre
| | - Suzanne M. Murphy
- Institute of Health Research; University of Bedfordshire; Hitchin Road Luton UK
| | - Janice Abbott
- School of Psychology; University of Central Lancashire; Preston Lancashire UK
| | - Kathryn J. Gardner
- School of Psychology; University of Central Lancashire; Preston Lancashire UK
| | - Christa Japel
- Université du Québec à Montréal (UQAM); Canada
- Research Unit on Children's Psychosocial Maladjustment (GRIP); which is a multi-university (; Université de Montréal; Université Laval, and McGill University) research centre
| | - Frank Vitaro
- School of Psycho-education; Université de Montréal; Montréal Québec Canada
- Research Unit on Children's Psychosocial Maladjustment (GRIP); which is a multi-university (; Université de Montréal; Université Laval, and McGill University) research centre
| | - Michel Boivin
- School of Psychology; Université Laval; Québec City Québec Canada
- Research Unit on Children's Psychosocial Maladjustment (GRIP); which is a multi-university (; Université de Montréal; Université Laval, and McGill University) research centre
| | - Richard E. Tremblay
- Departments of Pediatrics, Psychiatry, and Psychology; Université de Montréal; Montréal Québec Canada
- Research Unit on Children's Psychosocial Maladjustment (GRIP); which is a multi-university (; Université de Montréal; Université Laval, and McGill University) research centre
- School of Public Health, Physiotherapy and Population Sciences; University College Dublin; Ireland
- International Laboratory for Child and Adolescent Mental Health Development; INSERM, U669; Paris France
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91
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Abstract
Since the 1990s, concerns about a global obesity epidemic have flourished. These concerns regarding obesity are expressed in popular culture and scientific literature and emphasize both weight and weight loss when defining health and well-being. As a result scholars are now calling attention to a "shadow epidemic" of weight stigma that is shown to have harmful physiological and psychological impacts in youth. In tandem with "globesity" concerns, there has been a similar concern expressed over the epidemic of type 2 diabetes, which some have termed "diabesity." Although there is less known about diabetes stigma, the topic has much overlap with obesity stigma. In this narrative review we discuss the related problems of obesity and type 2 diabetes stigma, with an emphasis on issues specific to youth, as relevant. Drawing from literature on weight bias, critical weight studies, and Health at Every Size (HAES), we highlight pedagogical approaches to address obesity stigma and their implications to redress the problem of type 2 diabetes-related stigma in health care.
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Affiliation(s)
- Erin Cameron
- a Memorial University, Physical Education Building, St. John's, NL A1C 5S7, Canada
| | - Caitlin O'Reilly
- b School of Kinesiology, University of British Columbia, 210-6081 University Boulevard, Vancouver, BC V6T 1Z1, Canada
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92
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Ruggieri DG, Bass SB. A comprehensive review of school-based body mass index screening programs and their implications for school health: do the controversies accurately reflect the research? THE JOURNAL OF SCHOOL HEALTH 2015; 85:61-72. [PMID: 25440454 DOI: 10.1111/josh.12222] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 04/23/2014] [Accepted: 07/08/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Whereas legislation for body mass index (BMI) surveillance and screening programs has passed in 25 states, the programs are often subject to ethical debates about confidentiality and privacy, school-to-parent communication, and safety and self-esteem issues for students. Despite this debate, no comprehensive analysis has been completed that compares and contrasts how these issues differentially affect schools, parents, and students. METHODS A keyword search from electronic databases and a review of state legislation related to BMI surveillance and screening were used to identify relevant literature and data focused on surveillance and screening policies, BMI report cards, and parental perceptions of BMI screenings and their child's weight status [corrected]. RESULTS This article addresses the gap of previous literature by outlining the ethical considerations and implications that BMI screening programs and report cards have for schools, parents, and students, and links these with outcome studies to address whether these controversies are supported by research. CONCLUSIONS Despite the controversies surrounding these programs, this review shows that they can be valuable for all parties and demonstrates BMI screening programs to be vital to the development of robust school-based obesity prevention programs and promotion of healthy lifestyles in schools.
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Affiliation(s)
- Dominique G Ruggieri
- Department of Health Services, Saint Joseph's University, 5600 City Avenue, 116 Post Hall, Philadelphia, PA 19131
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93
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Gitau TM, Micklesfield LK, Pettifor JM, Norris SA. Eating attitudes, body image satisfaction and self-esteem of South African Black and White male adolescents and their perception of female body silhouettes. J Child Adolesc Ment Health 2014; 26:193-205. [DOI: 10.2989/17280583.2014.901224] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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94
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Bodde AE, Beebe TJ, Chen LP, Jenkins S, Perez-Vergara K, Finney Rutten LJ, Ziegenfuss JY. Misperceptions of weight status among adolescents: sociodemographic and behavioral correlates. PATIENT-RELATED OUTCOME MEASURES 2014; 5:163-71. [PMID: 25525400 PMCID: PMC4266328 DOI: 10.2147/prom.s72621] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective Accurate perceptions of weight status are important motivational triggers for weight loss among overweight or obese individuals, yet weight misperception is prevalent. To identify and characterize individuals holding misperceptions around their weight status, it may be informative for clinicians to assess self-reported body mass index (BMI) classification (ie, underweight, normal, overweight, obese) in addition to clinical weight measurement. Methods Self-reported weight classification data from the 2007 Current Visit Information – Child and Adolescent Survey collected at Mayo Clinic in Rochester, MN, were compared with measured clinical height and weight for 2,993 adolescents. Results While, overall, 74.2% of adolescents accurately reported their weight status, females, younger adolescents, and proxy (vs self) reporters were more accurate. Controlling for demographic and behavioral characteristics, the higher an individual’s BMI percentile, the less likely there was agreement between self-report and measured BMI percentile. Those with high BMI who misperceive their weight status were less likely than accurate perceivers to attempt weight loss. Conclusion Adolescents’ and proxies’ misperception of weight status increases with BMI percentile. Obtaining an adolescent’s self-perceived weight status in addition to measured height and weight offers clinicians valuable baseline information to discuss motivation for weight loss.
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Affiliation(s)
- Amy E Bodde
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
| | - Timothy J Beebe
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
| | | | - Sarah Jenkins
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
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95
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Jansen PW, Verlinden M, Dommisse-van Berkel A, Mieloo CL, Raat H, Hofman A, Jaddoe VWV, Verhulst FC, Jansen W, Tiemeier H. Teacher and peer reports of overweight and bullying among young primary school children. Pediatrics 2014; 134:473-80. [PMID: 25157018 DOI: 10.1542/peds.2013-3274] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Overweight is a potential risk factor for peer victimization in late childhood and adolescence. The current study investigated the association between BMI in early primary school and different bullying involvement roles (uninvolved, bully, victim, and bully-victim) as reported by teachers and children themselves. METHODS In a population-based study in the Netherlands, measured BMI and teacher-reported bullying behavior were available for 4364 children (mean age = 6.2 years). In a subsample of 1327 children, a peer nomination method was used to obtain child reports of bullying. RESULTS In both teacher- and child-reported data, a higher BMI was associated with more victimization and more bullying perpetration. For instance, a 1-point increase in BMI was associated with a 0.05 increase on the standardized teacher-reported victimization score (95% confidence interval, 0.03 to 0.07; P < .001). Combining the victimization and bullying scores into different types of bullying involvement showed that children with obesity, but not children with overweight, had a significantly higher risk to be a bully-victim (odds ratio = 2.25; 95% confidence interval, 1.62 to 3.14) than normal-weight peers. CONCLUSIONS At school entry, a high BMI is a risk factor associated with victimization and bullying perpetration, with obese children particularly likely to be victims and aggressors. Results were consistent for teacher and child reports of bullying, supporting the validity of our findings. Possibly, obesity triggers peer problems, but the association may also reflect a common underlying cause that makes obese children vulnerable to bullying involvement.
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Affiliation(s)
- Pauline W Jansen
- Departments of Child and Adolescent Psychiatry and Psychology, and Institute of Psychology, Erasmus University Rotterdam, Rotterdam, Netherlands;
| | - Marina Verlinden
- Departments of Child and Adolescent Psychiatry and Psychology, and The Generation R Study Group, and
| | | | - Cathelijne L Mieloo
- Municipal Public Health Service Rotterdam Rijnmond, Rotterdam, Netherlands Departments of Public Health
| | | | | | - Vincent W V Jaddoe
- The Generation R Study Group, and Epidemiology, and Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Frank C Verhulst
- Departments of Child and Adolescent Psychiatry and Psychology, and
| | - Wilma Jansen
- Municipal Public Health Service Rotterdam Rijnmond, Rotterdam, Netherlands Departments of Public Health
| | - Henning Tiemeier
- Departments of Child and Adolescent Psychiatry and Psychology, and Epidemiology, and Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands; and
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96
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Are overweight and obese youths more often bullied by their peers? A meta-analysis on the relation between weight status and bullying. Int J Obes (Lond) 2014; 38:1263-7. [PMID: 25002148 DOI: 10.1038/ijo.2014.117] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 06/10/2014] [Accepted: 06/28/2014] [Indexed: 11/08/2022]
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97
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Quelly SB. Childhood obesity prevention: a review of school nurse perceptions and practices. J SPEC PEDIATR NURS 2014; 19:198-209. [PMID: 24612520 DOI: 10.1111/jspn.12071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/24/2014] [Accepted: 01/28/2014] [Indexed: 12/01/2022]
Abstract
PURPOSE The purpose of this review is to examine key school nurse perceptions that may promote or deter school nurse involvement in childhood obesity prevention (COP) practices. CONCLUSIONS Ten research articles were identified through a systematic review of the literature. School nurse participation in COP is inconsistent, and this variation is not well understood. Some variations in COP practices may be explained by differences in self-efficacy, perceived benefits, and perceived barriers. PRACTICE IMPLICATIONS Efforts are needed to develop and implement interventions and policies to modify those perceptions that may promote school nurse active engagement in COP practices.
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Affiliation(s)
- Susan B Quelly
- College of Nursing, University of Central Florida, Orlando, Florida, USA
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98
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M. Bucchianeri M, Neumark-Sztainer D. Body dissatisfaction: an overlooked public health concern. JOURNAL OF PUBLIC MENTAL HEALTH 2014. [DOI: 10.1108/jpmh-11-2013-0071] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– In contrast to the attention it has received in related fields of research, body image has remained understudied within the field of public health. This is highly problematic, given a growing body of evidence implicating body dissatisfaction in a range of other public health concerns. The paper aims to discuss these issues.
Design/methodology/approach
– This commentary is based on a review of the public health, body image, eating disorder, and mental health literatures.
Findings
– Body dissatisfaction is implicated in a range of public health concerns, including impaired psychological health (e.g. depression) and eating- and weight-related problems (e.g. eating disorders, obesity).
Originality/value
– Given these associations, as well as the high levels of body dissatisfaction in the population, the authors argue for a critical need to address the prevalence of body image concerns as a public health issue worthy of greater consideration within programs and policies; dedicated funding for research on antecedents, consequences, and intervention strategies; and allocated resources for training.
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99
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Kostev K, Rex J, Waehlert L, Hog D, Heilmaier C. Risk of psychiatric and neurological diseases in patients with workplace mobbing experience in Germany: a retrospective database analysis. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2014; 12:Doc10. [PMID: 24872810 PMCID: PMC4036095 DOI: 10.3205/000195] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/29/2014] [Indexed: 11/30/2022]
Abstract
Introduction: The number of mobbing experiences recorded has increased during recent years and it has now been established as global phenomenon among the working population. The goal of our study was to analyze the incidence of certain neurologic and psychiatric diseases as a consequence of mobbing as compared with a control group and to examine the possible influence of previous diseases that occurred within one year before the first mobbing documentation on the incidence of mobbing. Material & methods: We used a large database (IMS® Disease Analyzer, Germany) to collect data from general practitioners in Germany from 01/2003 until 12/2012. Based on age, gender, and health insurance, patients with experience of mobbing were matched with a control group of patients who had not reported workplace mobbing and who were being treated by the same physicians. At first, diseases that occurred within one year before the bullying experience took place (“index date”) were noted and compared to a control group of similar composition in terms of gender, age, and health insurance. Subsequently, the prevalence of depression, anxiety, somatoform disorders, and sleep disorders following experiences of mobbing were determined. After adjustment to take into account the odds of bullying, the ratios of these diseases were assessed using a logistic regression model. Results: The study population consisted of n=2,625 patients and n=2,625 controls, of which 33% were men. The number of cases of bullying documented rose continuously from 2003 to 2011 and remained high in 2012. Those who would later become victims of mobbing demonstrated a considerably higher prevalence of diseases in general – these diseases were not confined to the neurologic-psychiatric spectrum. Following experiences of bullying, depression, anxiety, somatoform disorders, and sleep disorders were significantly more prevalent than in the control group (for all, p<0.05). Similarly, odds ratios (OR) representing the risk of suffering from diseases were higher in affected patients, with the highest value (4.28) for depression and the lowest value for sleep disorders (OR=2.4). Conclusion: Those who will later become the victims of bullying are more prone to suffer from diseases in general, even before this experience of mobbing has occurred, which underlines the importance of supporting (chronically) ill patients to protect them against bullying. Sequelae of mobbing include, in particular, diseases from the neurologic-psychiatric spectrum.
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Affiliation(s)
| | | | - Lilia Waehlert
- Fresenius University of Applied Sciences, Idstein, Germany
| | - Daniela Hog
- Fresenius University of Applied Sciences, Idstein, Germany
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100
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Yen CF, Liu TL, Ko CH, Wu YY, Cheng CP. Mediating effects of bullying involvement on the relationship of body mass index with social phobia, depression, suicidality, and self-esteem and sex differences in adolescents in Taiwan. CHILD ABUSE & NEGLECT 2014; 38:517-526. [PMID: 24011767 DOI: 10.1016/j.chiabu.2013.07.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 07/22/2013] [Accepted: 07/26/2013] [Indexed: 06/02/2023]
Abstract
The aims of this study were to examine the mediating effect of bullying involvement on the relationships between body mass index (BMI) and mental health problems, including social phobia, depression, suicidality, and low self-esteem among adolescents in Taiwan. The moderation effect of sex on the mediating role of bullying involvement was also examined. Five thousand two hundred and fifty-two students of high schools completed the questionnaires. Victimization and perpetration of passive and active bullying were assessed using the Chinese version of the School Bullying Experience Questionnaire. BMI was calculated from self-reported weight and height measurements. The Social Phobia Inventory, the Mandarin Chinese version of the Center for Epidemiological Studies-Depression Scale, the suicidality-related questionnaire from the epidemiological version of the Kiddie-Schedule for Affective Disorders and Schizophrenia, and the Rosenberg Self-Esteem Scale were applied to assess social phobia, depression, suicidality, and low self-esteem, respectively. The mediating effect of bullying involvement on the associations between increased BMI and mental health problems was examined by the Sobel test. The moderation effect of sex on the mediating role of bullying involvement was tested by the multiple-group structural equation model. Victimization of passive and active bullying and perpetration of passive bullying, but not perpetration of active bullying, had a mediating effect on the relationships between increased BMI and all four mental health problems. Sex did not have a significant moderation effect on the mediating role of bullying involvement. Bullying involvement should be a target of prevention and intervention in developing a strategy to improve mental health among adolescents with increased BMI.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Taiwan
| | - Yu-Yu Wu
- YuNing Psychiatry Clinic, Taiwan
| | - Chung-Ping Cheng
- Department of Psychology, National Cheng Kung University, Taiwan
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