Family cohesion and psychopathological symptoms in pediatric obesity: Is there an indirect effect?

Change in parent and child psychopathology following obesity treatment and maintenance: A secondary data analysis

BACKGROUND

General and eating disorder (ED) psychopathology are common among children and adults with overweight/obesity; few studies have examined their course of change throughout family-based behavioural obesity treatment (FBT) and maintenance.

OBJECTIVES

Examine: (1) the changes in the parent and child general and ED psychopathology during FBT and maintenance interventions; (2) the associations between change in psychopathology and change in weight among children or parents; (3) the associations between change in psychopathology within parent-child dyads.

METHODS

172 parent-child dyads participated in 4-month FBT and were subsequently randomized to one of three 8-month maintenance interventions. General psychopathology (child anxiety/depressive symptoms, parent severity of global psychological distress), ED psychopathology (shape/weight concern), and percent overweight were assessed at baseline, post-FBT, and post-maintenance. Separate linear mixed-effects models evaluated change in general and ED psychopathology, including an interaction between maintenance condition and time. Partial correlations examined associations between change in psychopathology and percent overweight among children or parents, and associations between change in psychopathology within parent-child dyads.

RESULTS

Among children, significant reductions were observed from baseline to post-FBT in all forms of psychopathology and from post-FBT to post-maintenance in general psychopathology. Among parents, significant reductions were observed from baseline to post-FBT in all forms of psychopathology; reductions were maintained from post-FBT to post-maintenance. There was no significant interaction between maintenance condition and time. Correlations between change in most forms of parent or child psychopathology and percent overweight were observed.

CONCLUSIONS

Participation in FBT and maintenance was associated with improvements in general and ED psychopathology in both parents and children.

Developing a Measure of the Impact of COVID-19 Social Distancing on Household Conflict and Cohesion

This report introduces the COVID-19 Family Environment Scale (CHES), which aims to measure the impact of social distancing due to COVID-19 on household conflict and cohesion. Existing measures do not capture household experiences relevant to the pandemic, in which families are largely confined to their homes while sharing a life-threatening situation. Using best practice guidelines, we developed a pool of items and revised them with review by a panel of experts, and cognitive interviewing with community respondents. We administered the CHES by online survey to 3,965 adults. The CHES consists of 15 items for each of two subscales, household conflict (α = .847) and household cohesion (α = .887). Exploratory factor analysis yielded two factors, corresponding to the intended conflict and cohesion items, which accounted for 29% of variance. Confirmatory factor analysis partially supported the 2-factor model (RMSEA = .057; CFI = .729, TLI = .708, and SRMR = .098). The CHES also contains 25 optional items to describe respondent and household characteristics, and household-level COVID-19 exposure. The CHES, publicly available at https://elcentro.sonhs.miami.edu/research/measures-library/covid-19/index.html, provides a tool for measuring the impact of the COVID-19 pandemic on important determinants of resilience in the face of major stressful events. Further work is needed to address the factor structure and establish validity of the CHES.

Designing a mobile app to promote healthy behaviors and prevent obesity: analysis of adolescents' preferences

To ensure that adolescents adhere to programmes promoting healthy behaviors, these programmes must be appealing and interesting. This study aims to characterize and assess the devices, operating system and type of mobile apps frequently used by adolescents; understand the features that mHealth apps should have to be appealing; comprehend the facilitators and barriers for adolescents to use mHealth apps. The sample comprised 165 adolescents (12-18 years) from the main population, recruited in 2018. Most participants used smartphones and the Android system. Food and physical activity suggestions were considered the most important features for an mHealth app. 62.6% had never tried an mHealth app. For those who had tried one, 26.0% stated it was to improve health status/lifestyle. Their favorite feature was physical exercise tips/plans (41.8%). Adolescents pointed out that the reasons that made them keep using the app were utility and interest (35.7%). Regarding possible barriers, 48.4% reported a lack of a senseof need/practical utility, and 18.8% considered notifications as their least favorite feature. Lack of interest was pointed out for 38.2% as the main reason for stopping use. Results provide practical information for the planning, design, and implementation of future mHealth apps for the promotion of healthy behaviors - an important implication for future research in this area.

Are Psychosocial Consequences of Obesity and Hyperandrogenism Present in Adolescent Girls with Polycystic Ovary Syndrome?

STUDY OBJECTIVE

The objective of this study was to evaluate whether body weight status and clinical hyperandrogenism may influence social competencies and psychological gender features in adolescent girls.

DESIGN AND PARTICIPANTS

In 104 adolescent girls, psychological gender inventory (PGI) and social competencies questionnaire (SCQ) (assessing social abilities in three aspects: intimacy (I), social exposure (SE), and assertiveness (AS)) were performed. Subjects were divided into four subgroups: G1-24 nonobese girls without hyperandrogenism, G2-18 obese girls without hyperandrogenism, G3-30 nonobese hyperandrogenic girls, and G4-32 obese girls with hyperandrogenism.

RESULTS

There were no significant differences in all parts of SCQ and PGI between the study and control groups. The feminine woman type dominated in all groups; in G3 and G4, masculine woman type appeared more often than in G1 and G2 (13.3% and 12.5% versus 4.0% and 0.0%, resp.). In G4, positive relationship between BMI z-score and SCQ (r = 0.4, p = 0.03) was found. In G1, the relationship was opposite (r = -0.5, p = 0.03). Hirsutism correlated negatively with SCQ (r = -0.5, p = 0.02), I (r = -0.5, p = 0.02), and AS (r = -0.5, p = 0.02) only in G1; in other groups, this relationship was insignificant. In G4, higher testosterone level was associated with lower SCQ (r = -0.5, p = 0.008) and AS (r = -0.5, p = 0.003). In G2, testosterone concentration correlated positively with SCQ (r = 0.6, p = 0.01), SE (r = 0.5, p = 0.02), and AS (r = 0.6, p = 0.02).

CONCLUSION

In adolescent girls, neither body weight nor clinical features of hyperandrogenism seem to be the source of evaluated disorders in psychological functioning.