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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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2
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Konrad C, Inhoffen J, Friederich HC, Hartmann M, Wild B. Prevalence of adverse childhood experiences and effect on outcomes in bariatric surgery patients: a systematic review and meta-analysis. Surg Obes Relat Dis 2023; 19:118-129. [PMID: 36270937 DOI: 10.1016/j.soard.2022.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/11/2022] [Accepted: 09/05/2022] [Indexed: 01/31/2023]
Abstract
Adverse childhood experiences (ACEs) are defined as childhood maltreatment (sexual, physical, and emotional abuse and neglect) and other childhood traumatic experiences. Published prevalence estimates for ACEs in bariatric samples vary greatly and evidence on the association between ACEs and bariatric surgery weight loss and psychosocial outcomes is inconclusive. A systematic literature search on PubMed/Medline, PsycInfo, Web of Science, CINAHL (Cumulative Index of Nursing and Allied Health Literature), and Open Grey for studies published until August 30, 2021, yielded 21 publications for qualitative synthesis: 20 reporting on prevalence of ACEs in bariatric surgery candidates and patients, and 10 on the association of ACEs with outcomes. In meta-analysis, overall moderate to high heterogeneity was observed for prevalence estimates and moderate heterogeneity was observed for associations. Prevalence estimate for at least 1 form of ACEs (6 studies, n = 1368 patients) was 51% (95% confidence interval [CI]: 32%-70%). Effect size (Hedge's g) for the difference between the groups of patients reporting any or a high number of ACEs versus no or a low number of ACEs was calculated from means, standard deviations and group size, or P values. Based on 7 studies (n = 946 patients), the association between ACEs and weight loss was not significant (Hedge's g = -.15 [95% CI: -.38 to .09]; I2 = 53%), regardless of short- or long-term follow-up (P = .413) and the proportion of patients in each study receiving Roux-en-Y gastric bypass (RYGB) (β = .0005, P = .868). Preliminary findings based on 3 short- and long-term studies (n = 414 patients) showed that ACEs were significantly (P = .001) associated with higher postoperative depressive symptoms (Hedge's g = .50 [95% CI: .22-.78]; I2 = 36%). Associations between ACEs and other psychosocial outcomes such as eating pathology were reported narratively. There is a need for additional long-term studies using validated assessment tools for ACEs to evaluate the effect of ACEs on weight and psychosocial outcomes after bariatric surgery.
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Affiliation(s)
- Cinara Konrad
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany.
| | - Johannes Inhoffen
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Mechthild Hartmann
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Beate Wild
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
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3
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Sysko R, Michaelides A, Costello K, Herron DM, Hildebrandt T. An Initial Test of the Efficacy of a Digital Health Intervention for Bariatric Surgery Candidates. Obes Surg 2022; 32:3641-3649. [PMID: 36074201 PMCID: PMC10312669 DOI: 10.1007/s11695-022-06258-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Rigorous research on smartphone apps for individuals pursuing bariatric surgery is limited. A digital health intervention was recently developed using standard behavioral weight loss programs with specific modifications for bariatric surgery. The current study evaluated this intervention for improving diet, exercise, and psychosocial health over 8 weeks prior to surgery in an academic medical center. METHODS Fifty patients were randomized to receive either the digital intervention or treatment as usual prior to a surgical procedure. Measures of anxiety, depression, stress, quality of life, physical activity, and diet were administered at baseline and at 8-week follow-up. Statistical power of 80% estimated for N = 50 to detect ES = 0.68 with alpha = 0.05. RESULTS Results of intent-to-treat (N = 50 baseline, N = 36 follow-up) analyses indicated significant moderate differences in stress and anxiety (ES = - 0.58 to - 0.62) favoring the digital intervention. Effects of the program on total daily calories consumed, body mass index, quality of life, and eating disorder symptoms were small (ES = - 0.24 to 0.33) and not significant. Given small effects for these domains, the sample size of the study likely affected the ability to detect significant differences. CONCLUSIONS The digital health intervention appears to significantly impact several measures of physical activity and emotional functioning in candidates for bariatric surgery, which could augment surgical outcomes.
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Affiliation(s)
- Robyn Sysko
- Center of Excellence for Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY, 10029, USA.
| | | | - Kayla Costello
- Center of Excellence for Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY, 10029, USA
| | - Daniel M Herron
- Garlock Division of General Surgery, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 3rd Fl, New York, NY, 10029, USA
| | - Tom Hildebrandt
- Center of Excellence for Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY, 10029, USA
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4
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Braun TD, Puhl RM, Quinn DM, Gorin A, Tishler D, Papasavas P. Weight stigma and posttraumatic stress disorder symptoms in individuals seeking bariatric surgery. Surg Obes Relat Dis 2022; 18:1066-1073. [PMID: 35811291 PMCID: PMC9797255 DOI: 10.1016/j.soard.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/13/2022] [Accepted: 05/10/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND After bariatric surgery, some patients experience adverse psychiatric outcomes, including substance use, suicidality, and self-harm. These factors are commonly associated with posttraumatic stress disorder (PTSD) and related symptoms (PTSD-S) that develop following adverse childhood experiences (ACEs) and traumatic events. However, emerging evidence suggests that chronic discrimination also may contribute to PTSD-S. Weight-based discrimination is salient for people with obesity but has received little attention in relation to PTSD-S. OBJECTIVE Our study examined factors that may contribute to the link between experienced weight stigma (WS), which is common in individuals seeking bariatric surgery, and PTSD-S. SETTING Teaching hospital and surgical weight loss center in the United States. METHODS A total of 217 participants completed self-report surveys of experienced and internalized WS, ACEs, and PTSD-S. Demographics and trauma history were obtained from patient medical records. A stepwise multiple regression examined associations between experienced WS and internalized WS with PTSD-S, co-varying demographics, ACEs, and trauma, followed by examination of whether findings held co-varying anxiety/depressive symptoms in a participant subset (n = 189). RESULTS After accounting for covariates in step 1 and ACEs and trauma in step 2 (ΔR2 = .14), experienced WS and internalized WS accounted for substantial PTSD-S variance in steps 2 and 3 (ΔR2 = .12 and .13, respectively; overall model R2 =.44; P < .001). Findings held after co-varying anxiety/depressive symptoms. CONCLUSIONS Over and above ACEs and trauma, experienced WS and internalized WS may contribute to PTSD-S. Longitudinal research is needed to better elucidate the pathways underlying these associations.
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Affiliation(s)
- Tosca D. Braun
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island,Centers of Preventive Medicine, The Miriam Hospital, Providence, Rhode Island,Butler Hospital, Providence, Rhode Island,Correspondence: Tosca D. Braun, Ph.D., Alpert Brown Medical School, Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906. (T.D. Braun)
| | - Rebecca M. Puhl
- Department of Human Development & Family Sciences, Rudd Center for Food Policy & Obesity, University of Connecticut, Storrs, Connecticut
| | - Diane M. Quinn
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, & Policy, University of Connecticut, Storrs, Connecticut
| | - Amy Gorin
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, & Policy, University of Connecticut, Storrs, Connecticut
| | - Darren Tishler
- Surgical Weight Loss Center, Hartford Healthcare, Hartford, Connecticut
| | - Pavlos Papasavas
- Surgical Weight Loss Center, Hartford Healthcare, Hartford, Connecticut
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Mohan S, Samaan JS, Premkumar A, Samakar K. History of abuse and bariatric surgery outcomes: a systematic review. Surg Endosc 2022; 36:4650-4673. [PMID: 35277764 DOI: 10.1007/s00464-022-09147-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/15/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although there is evidence to support the relationship between abuse history and obesity, the association between abuse history and outcomes after bariatric surgery is not well-established. We aimed to summarize the current literature examining this relationship, as well as provide clinical recommendations to optimize postoperative outcomes. METHODS PubMed and SCOPUS databases were queried to identify relevant published studies. RESULTS Overall, 20 studies were included. Rates of the various types of abuse reported in the bariatric surgery population varied widely across studies, as did the methodology used to assess it. The majority of studies found no significant associations between abuse history and postoperative weight loss outcomes. The literature examining the relationship between abuse history and postoperative psychiatric outcomes was less conclusive. CONCLUSIONS Most current evidence demonstrates that abuse history is not associated with weight loss outcomes after bariatric surgery. Literature on postoperative psychiatric outcomes is mixed, and more robust studies are needed to further investigate the relationship between abuse history and postoperative psychiatric outcomes. Importantly, abuse history should not preclude patients from undergoing bariatric surgery. Of note, patients may benefit from careful monitoring for emotional distress and worsening of psychiatric comorbidities after surgery and psychiatric counseling and treatment when indicated.
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Affiliation(s)
- Sukriti Mohan
- Division of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of USC, 1510 San Pablo St., Suite 514, Los Angeles, CA, 90033, USA
| | - Jamil S Samaan
- Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Agnes Premkumar
- Division of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of USC, 1510 San Pablo St., Suite 514, Los Angeles, CA, 90033, USA
| | - Kamran Samakar
- Division of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of USC, 1510 San Pablo St., Suite 514, Los Angeles, CA, 90033, USA.
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6
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Interpersonal childhood adversity and stress generation in adolescence: Moderation by HPA axis multilocus genetic variation. Dev Psychopathol 2019; 32:865-878. [DOI: 10.1017/s0954579419001123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractResearch suggests that childhood adversity (CA) is associated with a wide range of repercussions, including an increased likelihood of interpersonal stress generation. This may be particularly true following interpersonal childhood adversity (ICA) and for youth with high hypothalamic-pituitary-adrenal (HPA) axis-related genetic risk. In the current study, we applied a multilocus genetic profile score (MGPS) approach to measuring HPA axis-related genetic variation and examined its interaction with ICA to predict interpersonal stress generation in a sample of adolescents aged 14–17 (N = 241, Caucasian subsample n = 192). MGPSs were computed using 10 single nucleotide polymorphisms from HPA axis-related genes (CRHR1, NRC31, NRC32, and FKBP5). ICA significantly predicted greater adolescent interpersonal dependent stress. Additionally, MGPS predicted a stronger association between ICA and interpersonal dependent (but not independent or noninterpersonal dependent) stress. No gene–environment interaction (G×E) effects were found for noninterpersonal CA and MGPS in predicting adolescent interpersonal dependent stress. Effects remained after controlling for current depressive symptoms and following stratification by race. Findings extend existing G×E research on stress generation to HPA axis-related genetic variation and demonstrate effects specific to the interpersonal domain.
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Comment on: The impact of childhood trauma on change in depressive symptoms, eating pathology, and weight after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2019; 15:1088-1090. [PMID: 31109858 DOI: 10.1016/j.soard.2019.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/23/2022]
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King WC, Hinerman A, Kalarchian MA, Devlin MJ, Marcus MD, Mitchell JE. The impact of childhood trauma on change in depressive symptoms, eating pathology, and weight after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2019; 15:1080-1088. [PMID: 31153892 DOI: 10.1016/j.soard.2019.04.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/25/2019] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND History of childhood trauma is associated with increased risk of mental disorders, eating pathology, and obesity. OBJECTIVE To examine associations between childhood trauma and changes in depressive symptoms, eating pathology, and weight after Roux-en-Y Gastric Bypass (RYGB). SETTING Three U.S. academic medical centers. METHOD Adults undergoing bariatric surgery (2007-2011) were enrolled in a cohort study. Participants (96 of 114; 86%) completed the Beck Depression Inventory-1 (BDI-1) to assess depressive symptomology, the interviewer-administered Eating Disorder Examination (EDE) to assess subthreshold eating pathology, weight assessment before and 6 months and annually after RYGB for ≥7 years, and the Childhood Trauma Questionnaire (CTQ) once post-RYGB. RESULTS Presurgery, median age was 46 years, and median body mass index was 47 kg/m2; 79% were female. Data completeness across 7-year follow-up was 78% to 90%, 66% to 91%, and 93% to 100% for the BDI-1, EDE, and weight, respectively. Using mixed models, presence/severity of childhood emotional abuse, emotional neglect, and physical neglect, but not sexual abuse or physical abuse, were significantly associated (P < .05) with change (i.e., less improvement/worsening) in the BDI-1 and EDE global scores, as were higher total CTQ score and more types of moderate-intensity trauma. All CTQ measures were associated (P < .05) with less improvement or worsening in the EDE eating concern and shape concern scores. CTQ measures were not significantly related to weight loss or regain. CONCLUSIONS Although childhood trauma did not affect weight outcomes after RYGB, those who experienced childhood trauma had less improvement in depressive symptomology and eating pathology and therefore might benefit from clinical intervention.
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Affiliation(s)
- Wendy C King
- Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
| | - Amanda Hinerman
- Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | - Michael J Devlin
- Columbia University Vagelos College of Physicians and Surgeons/New York State Psychiatric Institute, New York, New York
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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9
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Sarwer DB, Schroeder K. Discussion of: the relationship between childhood maltreatment and psychopathology in adults undergoing bariatric surgery. Surg Obes Relat Dis 2019; 15:303-304. [PMID: 30665852 DOI: 10.1016/j.soard.2018.12.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 12/25/2018] [Indexed: 11/25/2022]
Affiliation(s)
- David B Sarwer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Krista Schroeder
- College of Public Health, Temple University, Philadelphia, Pennsylvania
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10
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Orcutt M, King WC, Kalarchian MA, Devlin MJ, Marcus MD, Garcia L, Steffen KJ, Mitchell JE. The relationship between childhood maltreatment and psychopathology in adults undergoing bariatric surgery. Surg Obes Relat Dis 2018; 15:295-303. [PMID: 31010652 DOI: 10.1016/j.soard.2018.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/15/2018] [Accepted: 11/09/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND A history of childhood maltreatment and psychopathology are common in adults with obesity. OBJECTIVES To report childhood maltreatment and to evaluate associations between severity and type of childhood maltreatment and lifetime history of psychopathology among adults with severe obesity awaiting bariatric surgery. SETTING Four clinical centers of the Longitudinal Assessment of Bariatric Surgery Research Consortium. METHODS The Childhood Trauma Questionnaire, which assesses presence/severity (i.e., none, mild, moderate, severe) of physical abuse, mental abuse, physical neglect, mental neglect, and sexual abuse, was completed by 302 female and 66 male bariatric surgery patients. Presurgery lifetime history of psychopathology and suicidal ideation/behavior were assessed with the Structured Clinical Interview for DSM-IV and the Suicidal Behavioral Questionnaire-Revised, respectively. Presurgery lifetime history of antidepressant use was self-reported. RESULTS Two thirds (66.6%) of females and 47.0% of males reported at least 1 form of childhood trauma; 42.4% and 24.2%, respectively, at greater than or equal to moderate severity. Among women, presence/greater severity of childhood mental or physical abuse or neglect was associated with a higher risk of history of psychopathology (i.e., major depressive disorder, posttraumatic stress disorder, other anxiety disorder, alcohol use disorder, binge eating disorder), suicidal ideation/behavior and antidepressant use (P for all ≤ .02). These associations were independent of age, race, education, body mass index, and childhood sexual abuse. Childhood sexual abuse was independently associated with a history of suicidal ideation/behavior and antidepressant use only (P for both ≤ .05). Statistical power was limited to evaluate these associations among men. CONCLUSION Among women with obesity, presence/severity of childhood trauma was positively associated with relatively common psychiatric disorders.
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Affiliation(s)
- Molly Orcutt
- Neuropsychiatric Research Institute, Sanford Neuroscience Clinic, Fargo, North Dakota; University of North Dakota, Grand Forks, North Dakota; Fargo VA Healthcare System, Fargo, North Dakota
| | - Wendy C King
- University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | - Michael J Devlin
- Vagelos College of Physicians and Surgeons, Columbia University, New York City, New York; New York State Psychiatric Institute, New York City, New York
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Luis Garcia
- Neuropsychiatric Research Institute, Sanford Neuroscience Clinic, Fargo, North Dakota; University of North Dakota, Grand Forks, North Dakota
| | - Kristine J Steffen
- Neuropsychiatric Research Institute, Sanford Neuroscience Clinic, Fargo, North Dakota; North Dakota State University, Fargo, North Dakota
| | - James E Mitchell
- Neuropsychiatric Research Institute, Sanford Neuroscience Clinic, Fargo, North Dakota; University of North Dakota, Grand Forks, North Dakota.
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Hoppen TH, Chalder T. Childhood adversity as a transdiagnostic risk factor for affective disorders in adulthood: A systematic review focusing on biopsychosocial moderating and mediating variables. Clin Psychol Rev 2018; 65:81-151. [PMID: 30189342 DOI: 10.1016/j.cpr.2018.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/25/2018] [Accepted: 08/14/2018] [Indexed: 02/09/2023]
Affiliation(s)
| | - Trudie Chalder
- Academic Department of Psychological Medicine, King's College London, UK
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12
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Palmisano GL, Innamorati M, Sarracino D, Bosco A, Pergola F, Scaltrito D, Giorgio B, Vanderlinden J. Trauma and dissociation in obese patients with and without binge eating disorder: A case – control study. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1470483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Affiliation(s)
- Giovanni Luca Palmisano
- Department of Psychology of the University of Bari “Aldo Moro”, Piazza Umberto I, 70121 Bari, BA, Italy
| | - Marco Innamorati
- Department of History, Cultural Heritage, Education and Society of the University of Rome “Tor Vergata”, Via Columbia 1, 00133 Roma, Italy
| | - Diego Sarracino
- Department of Psychology, University of Milan “Bicocca”, Piazza dell’Ateneo Nuovo 1, CP 20126 Milan, MI, Italy
| | - Andrea Bosco
- Department of Psychology of the University of Bari “Aldo Moro”, Piazza Umberto I, 70121 Bari, BA, Italy
| | - Filippo Pergola
- Department of History, Cultural Heritage, Education and Society of the University of Rome “Tor Vergata”, Via Columbia 1, 00133 Roma, Italy
| | - Daniela Scaltrito
- Department of Psychiatry of "Santa Maria Del Piede" Hospital, Eating Disorder Center “Salvatore Cotugno”, Gravina in Puglia, Via S Maria Del Piede 5, Bari, CP 70024, Italy
| | - Bartolomeo Giorgio
- Department of Psychiatry of "Santa Maria Del Piede" Hospital, Eating Disorder Center “Salvatore Cotugno”, Gravina in Puglia, Via S Maria Del Piede 5, Bari, CP 70024, Italy
| | - Johan Vanderlinden
- Eating Disorder Unit, University Psychiatric Center K.U. Leuven, Campus Kortenberg, Leuvense Steenweg 517, B-3070 Kortenberg, Belgium
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Hulme PA, Kupzyk KA, Anthone GJ, Capron KA, Nguyen T. Weight Loss and Timing of J Tube Removal in Biliopancreatic Diversion with Duodenal Switch Patients Who Report Physical or Sexual Abuse. Obes Surg 2018; 28:2361-2367. [PMID: 29512037 DOI: 10.1007/s11695-018-3166-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Bariatric surgery patients who report physical or sexual abuse form a sizeable cohort that stands out due to psychological comorbidity. Their possible vulnerability to suboptimal weight loss remains of interest. Their risk for malnutrition due to inadequate oral intake following surgery is underexplored. OBJECTIVES Study aims were to determine the effect of self-reported physical or sexual abuse in patients undergoing open biliopancreatic diversion with duodenal switch (BPD/DS) on (a) 3-year weight loss trajectories and (b) timing of feeding jejunostomy tube (J tube) removal. Delayed J tube removal served as an indicator for inadequate oral intake. METHODS In this retrospective cohort study, the sample (N = 189) consisted of all patients who underwent primary BPD/DS by the same surgeon during 2009 and 2010 at a Midwestern health system. All patients had a J tube placed during surgery. Longitudinal mixed models were used for testing differences in weight loss trajectories by abuse status. RESULTS There were no significant differences in weight loss trajectories by abuse status. The abused group had the J tube in place a mean of 61.9 days (SD = 39.5) compared to 44.8 days (SD = 32.8) for the not abused group, a significant difference. CONCLUSIONS Our use of the best available statistical methods lends validity to previous findings that suggest physical or sexual abuse does not affect weight loss after bariatric surgery. Increased likelihood of persistent inadequate oral intake in the abused group suggests the need for early multidisciplinary interventions that include mental health and nutrition experts.
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Affiliation(s)
- Polly A Hulme
- College of Nursing, South Dakota State University, Wagner Hall 204, Brookings, SD, 57007, USA.
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA
| | - Gary J Anthone
- Department of Surgery, Creighton University, 10506 Burt Circle, Omaha, NE, 68144, USA
| | | | - Thang Nguyen
- Nebraska Medicine, 987400 Nebraska Medical Center, Omaha, NE, 68198-7400, USA
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14
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Nagl M, Lehnig F, Stepan H, Wagner B, Kersting A. Associations of childhood maltreatment with pre-pregnancy obesity and maternal postpartum mental health: a cross-sectional study. BMC Pregnancy Childbirth 2017; 17:391. [PMID: 29166875 PMCID: PMC5700738 DOI: 10.1186/s12884-017-1565-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/06/2017] [Indexed: 12/31/2022] Open
Affiliation(s)
- Michaela Nagl
- Leipzig University Medical Center, IFB AdiposityDiseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweissstr. 10, 04103, Leipzig, Germany
| | - Franziska Lehnig
- Leipzig University Medical Center, IFB AdiposityDiseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweissstr. 10, 04103, Leipzig, Germany
| | - Holger Stepan
- Department of Obstetrics, University of Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Birgit Wagner
- Department of Clinical Psychology and Psychotherapy, MSB Medical School Berlin, Calandrellistraße 1-9, 12247, Berlin, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweissstr. 10, 04103, Leipzig, Germany.
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Hymowitz G, Salwen J, Salis KL. A mediational model of obesity related disordered eating: The roles of childhood emotional abuse and self-perception. Eat Behav 2017; 26:27-32. [PMID: 28131963 PMCID: PMC6075711 DOI: 10.1016/j.eatbeh.2016.12.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 12/23/2016] [Accepted: 12/30/2016] [Indexed: 10/20/2022]
Abstract
The extant literature indicates negative self-perceptions are a risk factor for disordered eating (DE) and DE is a risk factor for overweight and obesity. While childhood emotional abuse (EA) is often linked to DE and obesity, it is typically not included in comprehensive models of these health problems. Further investigation of interactions among EA, self-perception, and DE is needed to refine treatments for overweight, obesity, and DE. This study evaluated a model of DE and weight difficulties in which negative self-perception mediate the relationship between EA and DE, and DE predicts body mass index (BMI) in a population of emerging adults. Further, this study investigated the utility of history of EA for prediction of DE and classification of individuals with and without DE. Self-report questionnaires on childhood trauma, psychopathology, and eating behaviors were administered to 598 undergraduate students. Latent variable analysis confirmed the hypothesized model. Recursive partitioning determined that individuals reporting a high level of EA likely meet criteria for night eating syndrome (NES) or binge eating disorder (BED), and history of EA has a moderate to high level of specificity as a predictor of BED and NES. These findings confirm the necessity of evaluating EA and DE in emerging adults with weight difficulties, and the importance of assessing self-perception and DE in individuals with a history of EA. Future studies should investigate the utility of addressing EA and self-perception in interventions for DE and obesity and to determine whether these findings can be generalized to a clinical population.
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Affiliation(s)
- Genna Hymowitz
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2520, United States; Department of Surgery, Stony Brook Medicine, Stony Brook, NY 11794-8191, United States.
| | - Jessica Salwen
- Department of Psychology, Stony Brook University, Stony
Brook, NY 11794-2520, United States
| | - Katie Lee Salis
- Department of Psychology, Stony Brook University, Stony
Brook, NY 11794-2520, United States
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16
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Liu RT. Childhood Adversities and Depression in Adulthood: Current Findings and Future Directions. ACTA ACUST UNITED AC 2017; 24:140-153. [PMID: 28924333 DOI: 10.1111/cpsp.12190] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Considerable support exists supporting a relationship between childhood adversities and adult depression. Consistent evidence has emerged linking early life adversities with a more chronic course for depression, as well as to poorer treatment outcomes. What remain decidedly less clear, however, are the moderators and mediating mechanisms underlying this association. This article provides a review of the existing research relating early adversities to adult depression, as well as recent studies suggestive of potential mediators and moderators of this relation. Advances in these areas are important for their potential to lead to the identification of new targets for clinical intervention for adults with a history of childhood adversities, as well as to the development of individually tailored prevention and treatment strategies.
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Affiliation(s)
- Richard T Liu
- Department of Psychiatry and Human Behavior Alpert Medical School of Brown University
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17
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Lee MA, Song R. Childhood abuse, personality traits, and depressive symptoms in adulthood. CHILD ABUSE & NEGLECT 2017; 65:194-203. [PMID: 28189957 DOI: 10.1016/j.chiabu.2017.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 10/17/2016] [Accepted: 02/03/2017] [Indexed: 06/06/2023]
Abstract
This study examined associations among childhood abuse, personality traits, and depressive symptoms in adulthood, and whether and how the effects of childhood abuse on depressive symptoms are mediated by the Big Five personality traits (i.e., extraversion, conscientiousness, emotional stability, agreeableness, and openness). The data were drawn from the 2012 Korean General Social Survey, a nationally representative survey using a multistage area proportional probability sampling method. Random effects regression and the Sobel test were used. Random effects models showed that physical and emotional abuse in childhood significantly increased depressive symptoms in adulthood, even after controlling for personality traits and socio-demographic factors. The coefficients of childhood abuse slightly decreased when personality traits were controlled, suggesting that personality traits mediated the relationship between childhood abuse and depressive symptoms. Among the personality traits, extraversion and emotional stability were negatively associated with depressive symptoms whereas agreeableness was positively associated with depressive symptoms. The results of the Sobel test showed that only emotional stability significantly mediated the effects of childhood abuse on depressive symptoms. Those who were exposed to childhood abuse had lower levels of emotional stability, which, in turn, led to depressive symptoms in adulthood. The findings suggest that childhood abuse may have a long lasting effect on mental health over the life course by influencing the formation of personality traits through developmental periods.
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Affiliation(s)
- Min-Ah Lee
- Department of Sociology, Chung-Ang University, 84 Heukseok-ro, Dongjak-Gu, Seoul 06974, Republic of Korea.
| | - Rira Song
- Department of Sociology, Chung-Ang University, 84 Heukseok-ro, Dongjak-Gu, Seoul 06974, Republic of Korea.
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18
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Hernandez EM, Trout ZM, Liu RT. Vulnerability-specific stress generation: Childhood emotional abuse and the mediating role of depressogenic interpersonal processes. CHILD ABUSE & NEGLECT 2016; 62:132-141. [PMID: 27838584 DOI: 10.1016/j.chiabu.2016.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 10/22/2016] [Accepted: 10/25/2016] [Indexed: 06/06/2023]
Abstract
Stress generation in depression (i.e. the tendency for depression-prone individuals to experience more life stress that is in part influenced by the individual) has been well established. However, more research is necessary to clarify the role of specific types of life stress in this effect. The current study extends the stress generation hypothesis by examining whether the type of stress involved is contingent upon the nature of the individual's particular vulnerability. Childhood emotional abuse and interpersonal vulnerability factors were predicted to be associated with prospective interpersonal dependent but not non-interpersonal or independent stress. These interpersonal factors were examined as mediators of the association between childhood emotional abuse and interpersonal stress generation. Data were collected from 185 undergraduate participants at two time-points, four months apart. At baseline, participants completed assessments of depressive symptoms, childhood abuse history, interpersonal risk factors (rejection sensitivity, excessive reassurance-seeking, and negative feedback-seeking), and a diagnostic interview for depression. At the follow-up assessment, participants completed a life stress interview. Childhood emotional abuse prospectively predicted greater interpersonal dependent stress, but not non-interpersonal dependent or independent stress. Only rejection sensitivity mediated this relationship. Consistent with the stress generation hypothesis, neither childhood emotional abuse nor the three interpersonal risk factors predicted independent stress. These findings suggest that targeting interpersonal vulnerabilities in clinical settings, particularly rejection sensitivity, among individuals with a history of childhood emotional abuse, may help to reduce the occurrence of interpersonal dependent stress, thus possibly decreasing risk for depression.
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Affiliation(s)
- Evelyn M Hernandez
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States.
| | - Zoë M Trout
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States
| | - Richard T Liu
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States.
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19
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Palmisano GL, Innamorati M, Vanderlinden J. Life adverse experiences in relation with obesity and binge eating disorder: A systematic review. J Behav Addict 2016; 5:11-31. [PMID: 28092189 PMCID: PMC5322988 DOI: 10.1556/2006.5.2016.018] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 01/14/2016] [Accepted: 01/17/2016] [Indexed: 01/11/2023] Open
Abstract
Background and aims Several studies report a positive association between adverse life experiences and adult obesity. Despite the high comorbidity between binge eating disorder (BED) and obesity, few authors have studied the link between trauma and BED. In this review the association between exposure to adverse life experiences and a risk for the development of obesity and BED in adulthood is explored. Methods Based on a scientific literature review in Medline, PubMed and PsycInfo databases, the results of 70 studies (N = 306,583 participants) were evaluated including 53 studies on relationship between adverse life experiences and obesity, 7 studies on post-traumatic stress disorder (PTSD) symptoms in relation to obesity, and 10 studies on the association between adverse life experiences and BED. In addition, mediating factors between the association of adverse life experiences, obesity and BED were examined. Results The majority of studies (87%) report that adverse life experiences are a risk factor for developing obesity and BED. More precisely a positive association between traumatic experiences and obesity and PTSD and obesity were found, respectively, in 85% and 86% of studies. Finally, the great majority of studies (90%) between trauma and the development of BED in adulthood strongly support this association. Meanwhile, different factors mediating between the trauma and obesity link were identified. Discussion and conclusions Although research data show a strong association between life adverse experiences and the development of obesity and BED, more research is needed to explain this association.
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Affiliation(s)
| | - Marco Innamorati
- Department of Science and Technology of Education, University of Rome “Tor Vergata”, Rome, Italy
| | - Johan Vanderlinden
- Eating Disorder Unit, University Psychiatric Center K.U. Leuven, Leuven, Belgium
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20
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Armour C, Műllerová J, Fletcher S, Lagdon S, Burns CR, Robinson M, Robinson J. Assessing childhood maltreatment and mental health correlates of disordered eating profiles in a nationally representative sample of English females. Soc Psychiatry Psychiatr Epidemiol 2016; 51:383-93. [PMID: 26607728 PMCID: PMC4819599 DOI: 10.1007/s00127-015-1154-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 11/08/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Previous research suggests that childhood maltreatment is associated with the onset of eating disorders (ED). In turn, EDs are associated with alternative psychopathologies such as depression and posttraumatic stress disorder (PTSD), and with suicidality. Moreover, it has been reported that various ED profiles may exist. The aim of the current study was to examine the profiles of disordered eating and the associations of these with childhood maltreatment and with mental health psychopathology. METHODS The current study utilised a representative sample of English females (N = 4206) and assessed for the presence of disordered eating profiles using Latent Class Analysis. Multinomial logistic regression was implemented to examine the associations of childhood sexual and physical abuse with the disordered eating profiles and the associations of these with PTSD, depression and suicidality. RESULTS Results supported those of previous findings in that we found five latent classes of which three were regarded as disordered eating classes. Significant relationships were found between these and measures of childhood trauma and mental health outcomes. CONCLUSIONS Childhood sexual and physical abuse increased the likelihood of membership in disordered eating classes and these in turn increased the likelihood of adverse mental health and suicidal outcomes.
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Affiliation(s)
- Cherie Armour
- School of Psychology, University of Ulster, Coleraine, Northern Ireland, UK.
| | - Jana Műllerová
- School of Psychology, University of Ulster, Coleraine, Northern Ireland UK
| | - Shelley Fletcher
- School of Psychology, University of Ulster, Coleraine, Northern Ireland UK
| | - Susan Lagdon
- School of Psychology, University of Ulster, Coleraine, Northern Ireland UK
| | - Carol Rhonda Burns
- School of Psychology, University of Ulster, Coleraine, Northern Ireland UK
| | - Martin Robinson
- School of Psychology, University of Ulster, Coleraine, Northern Ireland UK
| | - Jake Robinson
- School of Psychology, University of Ulster, Coleraine, Northern Ireland UK
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21
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Salwen JK, Hymowitz GF. The Weight-Related Abuse Questionnaire (WRAQ): Reliability, validity, and clinical utility. Eat Behav 2015; 19:150-4. [PMID: 26402044 DOI: 10.1016/j.eatbeh.2015.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 06/05/2015] [Accepted: 09/16/2015] [Indexed: 11/26/2022]
Abstract
Weight-related teasing (WRT)/stigmatization may be distinct from teasing and general abuse and may differentially impact adult outcomes. As WRT increases in severity so do depression and disordered eating. Currently, there are no validated measures designed to assess abuse specific to weight. Thus, we developed the Weight-Related Abuse Questionnaire (WRAQ) and validated it in young adult and clinically obese populations. The WRAQ was administered to 3 samples of participants: 292 undergraduate students, 382 undergraduate students, and 59 individuals seeking bariatric surgery. Concurrent validity was assessed via measures of WRT and general childhood abuse. Convergent validity was assessed with measures of depression and disordered eating. Study 1 data were used to further develop the structure of the WRAQ. Study 2 indicated that the WRAQ had excellent psychometric properties (based on factor analyses and reliability/scale consistency analysis) and strong concurrent and convergent validity, supporting the validity of the questionnaire. 6-month test-retest reliability was also good. In Study 3 responses on the WRAQ converged well with interview responses, showed good psychometric properties, and showed moderate correlations with measures of childhood abuse and psychopathology. The WRAQ has strong psychometric properties and is strongly associated with measures of current psychopathology. Additionally, it fills a gap in the assessment literature and may be a beneficial tool for determining which individuals are at increased risk for psychopathology.
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Affiliation(s)
- Jessica K Salwen
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, United States.
| | - Genna F Hymowitz
- Departments of Psychology, Psychiatry, & Surgery, Stony Brook University, Stony Brook, NY 11794-2500, United States.
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22
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Mor A, Antonsen S, Kahlert J, Holsteen V, Jørgensen S, Holm-Pedersen J, Sørensen HT, Pedersen O, Ehrenstein V. Prenatal exposure to systemic antibacterials and overweight and obesity in Danish schoolchildren: a prevalence study. Int J Obes (Lond) 2015; 39:1450-5. [PMID: 26178293 DOI: 10.1038/ijo.2015.129] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 06/26/2015] [Accepted: 07/04/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND/OBJECTIVE Prenatal exposure to antibacterials may permanently dysregulate fetal metabolic patterns via epigenetic pathways or by altering maternal microbiota. We examined the association of prenatal exposure to systemic antibacterials with overweight and obesity in schoolchildren. SUBJECTS/METHODS We conducted a prevalence study among Danish schoolchildren aged 7-16 years using data from routine school anthropometric evaluations conducted during 2002-2013. Prenatal exposure to antibacterials was ascertained by using maternal prescription dispensations and infection-related hospital admissions during pregnancy. We defined overweight and obesity among the children using standard age- and sex-specific cutoffs. We computed sex-specific adjusted prevalence ratios (aPRs) of overweight and obesity associated with exposure to prenatal antibacterials, adjusting for maternal age at delivery, marital status, smoking in pregnancy and multiple gestation; we also stratified the analyses by birth weight. RESULTS Among 9886 schoolchildren, 3280 (33%) had prenatal exposure to antibacterials. aPRs associated with the exposure were 1.26 (95% confidence interval (CI): 1.10-1.45) for overweight and 1.29 (95% CI: 1.03-1.62) for obesity. Among girls, aPRs were 1.16 (95% CI: 0.95-1.42) for overweight and 1.27 (95% CI: 0.89 to 1.82) for obesity. Among boys, aPRs were 1.37 (95% CI: 1.13-1.66) for overweight and 1.29 (95% CI: 0.96-1.73) for obesity. The aPR for overweight was higher among schoolchildren with birth weight <3500 g (aPR: 1.30, 95% CI: 1.05-1.61) than in schoolchildren with birth weight ⩾3500 g (aPR: 1.18, 95% CI: 0.95-1.46). Inversely, the association for obesity was higher among schoolchildren with birth weight ⩾3500 g (aPR: 1.35, 95% CI: 1.00-1.81) than among those who were <3500 g at birth (aPR: 1.16, 95% CI: 0.82-1.65). CONCLUSIONS Prenatal exposure to systemic antibacterials is associated with an increased risk of overweight and obesity at school age, and this association varies by birth weight.
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Affiliation(s)
- A Mor
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - S Antonsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - J Kahlert
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - V Holsteen
- Child and Adolescent Health Section, Department of Family and Employment, Municipality of Aalborg, Aalborg, Denmark
| | - S Jørgensen
- Child and Adolescent Health Section, Department of Family and Employment, Municipality of Aalborg, Aalborg, Denmark
| | - J Holm-Pedersen
- Child and Adolescent Health Section, Department of Family and Employment, Municipality of Aalborg, Aalborg, Denmark
| | - H T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - O Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - V Ehrenstein
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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23
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Salwen JK, Hymowitz GF, Bannon SM, O'Leary KD. Weight-related abuse: Perceived emotional impact and the effect on disordered eating. CHILD ABUSE & NEGLECT 2015; 45:163-171. [PMID: 25636523 DOI: 10.1016/j.chiabu.2014.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/19/2014] [Accepted: 12/28/2014] [Indexed: 06/04/2023]
Abstract
The purpose of this article was to evaluate theories that (1) weight-related abuse (WRA) plays a unique role in the development of disordered eating, above and beyond general childhood verbal abuse and weight-related teasing, and (2) the perceived emotional impact of WRA mediates the relationship between WRA and current disordered eating. Self-report questionnaires on childhood trauma, weight-related teasing, WRA, and current eating behaviors were administered to a total of 383 undergraduate students. In initial regressions, WRA significantly predicted binge eating, emotional eating, night eating, and unhealthy weight control. WRA continued to significantly predict all 4 forms of disordered eating following the introduction of measures of weight-related teasing and childhood verbal abuse into the regression. Latent variable analysis confirmed that perceived emotional impact of WRA mediated the relationship between WRA and disordered eating, and tests for indirect effects yielded a significant indirect effect of WRA on disordered eating through perceived emotional impact. In sum, WRA is a unique construct and the content of childhood or adolescent maltreatment is important in determining eventual psychopathology outcomes. These findings support the necessity of incorporating information on developmental history and cognitive factors into assessment and treatment of individuals with disordered eating.
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Affiliation(s)
- Jessica K Salwen
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2520, USA
| | - Genna F Hymowitz
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2520, USA; Department of Surgery, Stony Brook Hospital, Stony Brook, NY 11794-2500, USA
| | - Sarah M Bannon
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2520, USA
| | - K Daniel O'Leary
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2520, USA
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