The Effects of Middle School Weight Climate on Youth With Higher Body Weight

The psychosocial functioning in adolescents with severe obesity evaluated throughout the strengths and difficulties questionnaire (SDQ): a preliminary report

Introduction

Childhood obesity is associated with poor psychological adjustment. Severely impacts the psychological adjustment of young patients. To assess the psychological functioning of children and adolescents, several questionnaires have been proposed so far. Although the Strengths and Difficulties Questionnaire (SDQ) is one of the most well-used tools, its application in obesity research is scarce. The study is aimed at assessing the psychological profile of a sample of Italian children and adolescents seeking an in-hospital multidisciplinary body weight reduction program for obesity, via SDQ.

Methods

One hundred and fourteen consecutive Italian children and adolescents with obesity (43 males/71 females, age range: 11-17 years, mean age ± SD: 15.1 ± 1.66, body mass index-BMI ± SD: 37.4 ± 6.13 kg/m2), were recruited at the Division of Auxology, Istituto Auxologico Italiano IRCCS, Piancavallo (VB).

Results

Obese Females reported worse conditions of emotional symptoms (t = 5.48; p < 0.001) and peer problems (t = 2.34; p = 0.021), as well as higher which were associated with greater scores of pro-social behaviors than obese males (t = 3.07; p = 0.003). The total difficulties score (t = 4.00; p < 0.001) and the total impact score (t = 4.53; p < 0.001) were significantly higher in females than males. No statistically significant differences in SDQ variables were found in relation to the degree of obesity (BMI SDS: 2-2.99; BMI SDS: > 3).

Discussion

These findings can contribute to understand the psychological condition of adolescents with obesity in a better way and also to develop effective interventions for the treatment of pediatric obesity which not only take into account the medical and physical aspects but also the emotional and social difficulties expressed by adolescents with obesity.

Exploring the Utility of Theory-Informed Methodological Approaches in Youth Harassment Research

In comparison to research on youth bullying, less research has been dedicated to youth harassment experiences in school. This study seeks to illustrate youth harassment experiences in school through three theoretically informed methodological approaches to modeling youth victimization: binary, cumulative risk, and attributional approaches. Data come from the 2015 Vermont School Climate Pilot Survey (N = 2,589 students). Students with complete harassment information (N = 2,481) were included. Using theoretically informed methodological approaches, regression models examined the associations between experiencing harassment (binary, attributions, and cumulative) and school connection, safety, and equity. About 16% of the sample experienced some form of harassment during the current school year (2014-2015). The most prominent attributions of harassment include weight (40%), sex (27%), and race (22%). After controlling for sociodemographics, ever experiencing harassment was associated with lower school safety, -0.73 (β), p < .001, lower connection with school, -0.52 (β), p < .001, and lower perceived equity, -0.77 (β), p < .001. Experiencing harassment is negatively related to school climate. The results from these analyses underscore the negative relationship among harassment victimization and several important indicators of school climate including student connection, perceived safety at and to/from school, and perceived equity of school. Theoretically informed methodological approaches in youth harassment research should be advanced to comprehensively assess the relationship between harassment victimization and harassment attributes on the social, academic, and behavioral development of youth.

Complexity and Stigma of Pediatric Obesity

Weight stigma is rooted in a fundamental misunderstanding of the origins of obesity, wherein the interplay of behavioral, environmental, genetic, and metabolic factors is deemphasized. Instead, the widespread societal and cultural presence of weight stigma fosters misconceptions of obesity being solely a result of unhealthy personal choices. Weight stigma is pervasive in childhood and adolescence and can affect individuals throughout their life. Although the prevalence of pediatric obesity remains high throughout the world, it becomes increasingly important to understand how weight stigma affects weight and health outcomes in children and adolescents with overweight or obesity, including in those with rare genetic diseases of obesity. We identified and reviewed recent literature (primarily published since 2000) on weight stigma in the pediatric setting. Articles were identified with search terms including pediatric obesity, weight bias, weight stigma, weight-based teasing and bullying, and weight bias in health care. In this narrative review, we discuss the stigma of pediatric obesity as it relates to the complex etiology of obesity as well as describe best practices for avoiding bias and perpetuating stigma in the health care setting.

Weight Stigma in Youth: Prevalence, Consequences, and Considerations for Clinical Practice

PURPOSE OF REVIEW

This review summarizes recent evidence on weight stigma experienced by youth with overweight or obesity. We examine the prevalence and sources of weight-based victimization targeting youth, consequences of these stigmatizing experiences for their psychological and physical health, and considerations for addressing weight stigma in clinical practice and pediatric care.

RECENT FINDINGS

Weight stigma is highly prevalent among youth with high body weight, who are targets of weight-based victimization from peers, parents, and teachers. These experiences place youth at risk for psychological distress (primarily depressive symptoms, low self-esteem, and suicidal ideation), worse social and academic outcomes, and adverse physical health consequences including maladaptive eating behaviors, lower physical activity, substance use, and weight gain. Healthcare professionals and clinicians have important roles to play in efforts to help reduce weight stigma and support youth with obesity. Fundamental to these efforts is the use of supportive, compassionate, and non-stigmatizing communication with youth and their families.

Engagement Norms Buffer Academic Risks Associated with Peer Rejection in Middle School

The current study examined school variations in academic engagement norms and whether such norms affect those most susceptible to peer influence. We presumed that behaviors associated with perceived popularity make norms salient and are most likely to affect socially marginalized (rejected) youth. Focusing on differences across 26 middle schools, the main aim was to test whether academic engagement norms moderate the association between peer rejection and subsequent academic difficulties. The U.S. public school sample included 5,991 youth (52% girls): 32% Latino/a, 20% White, 14% East/Southeast Asian, 12% African American, and 22% from other specific ethnic groups. Multilevel models were used to examine whether engagement norms moderated the association between sixth grade peer rejection and changes in grade point average (GPA) and academic engagement across middle school (i.e., from sixth to eighth grade). Consistent with our contextual moderator hypothesis, the association between peer rejection and academic engagement was attenuated-- and in the case of GPA eliminated-- in schools where higher engagement was a salient norm. The study findings suggest that the behaviors of popular peers affect those on social margins, and that academic difficulties are not inevitable for rejected youth.

Body weight and academic achievement: The role of weight diversity in urban middle schools

The current study was designed to examine one possible weight stigma-reduction mechanism: school-level weight diversity. It was hypothesized that greater weight diversity among same-sex peers at school would attenuate the negative association between weight and academic achievement. Across 26 urban public middle schools, 5,991 sixth-grade students (52% girls) were included: 12% African American/Black, 14% East/Southeast Asian, 30% Latino, 21% White, and 23% from other specific ethnic groups. Weight diversity was estimated as the likelihood that two randomly selected students would be from different weight categories, using Simpson's index. Standardized achievement test scores and grade point average (GPA) were used to assess academic achievement. Consistent with our contextual moderator hypothesis, high levels of weight diversity at school served a protective function. The negative association between body mass index (BMI) and achievement test scores, as well as GPA (girls only) was nonsignificant at schools with high levels of weight diversity. The study results offer a potential explanation for inconsistent findings regarding body weight and achievement, and a novel methodological approach to capture weight diversity in ways that provide new insights for school-based interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).