TY - JOUR A1 - Warschburger, Petra A1 - Gmeiner, Michaela Silvia A1 - Morawietz, Marisa A1 - Rinck, Mike T1 - Battle of plates BT - a pilot study of an approach-avoidance training for overweight children and adolescents JF - Public health nutrition : PHN / The Nutrition Society N2 - Objective: Approach-avoidance training (AAT) is a promising approach in obesity treatment. The present study examines whether an AAT is feasible and able to influence approach tendencies in children and adolescents, comparing implicit and explicit training approaches. Design/Setting/Subjects: Fifty-nine overweight children and adolescents (aged 8-16 years; twenty-six boys) participated in an AAT for food cues, learning to reject snack items and approach vegetable items. Reaction times in the AAT and an implicit association rest (IAT) were assessed pre- and post-intervention. Results: A significant increase in the AAT compatibility scores with a large effect (eta(2) = 0.18) was found. No differences between the implicit and explicit training approaches and no change in the IAT scores were observed. Conclusions: Automatic tendencies in children can be trained, too. The implementation of AAT in the treatment of obesity might support the modification of an unhealthy nutrition behaviour pattern. Further data from randomized controlled clinical trials are needed. KW - Approach-avoidance KW - Intervention KW - Child KW - Obesity KW - Feasibility study Y1 - 2017 U6 - https://doi.org/10.1017/S1368980017002701 SN - 1368-9800 SN - 1475-2727 VL - 21 IS - 2 SP - 426 EP - 434 PB - Cambridge Univ. Press CY - Cambridge ER - TY - JOUR A1 - Warschburger, Petra A1 - Gmeiner, Michaela Silvia A1 - Morawietz, Marisa A1 - Rinck, Mike T1 - Evaluation of an approach-avoidance training intervention for children and adolescents with obesity BT - a randomized placebo-controlled prospective trial JF - European eating disorders review : the professional journal of the Eating Disorders Associatio N2 - This study evaluated the efficacy of approach-avoidance training as an additional treatment for children and adolescents with obesity seeking inpatient treatment. Two hundred thirty-two participants (8-16years, 53.9% girls) were randomly assigned either to multisession approach-avoidance (IG) or to placebo training (CG). As outcomes, cognitive biases post intervention, body mass index, eating behaviour, food intake, self-regulation, and weight-related quality of life were assessed, also at 6- and 12-month follow-up. Modification of approach-avoidance bias was observed, but lacked in transfer over sessions and in generalization to attention and association bias. After 6months, the IG reported less problematic food consumption, higher self-regulation, and higher quality of life; effects did not persist until the 12-month follow-up; no significant interaction effects were observed regarding weight course. Despite there was no direct effect on weight course, approach-avoidance training seems to be associated with promising effects on important pillars for weight loss. Further research concerning clinical effectiveness is warranted. KW - approach-avoidance training KW - child KW - cognitive bias modification KW - intervention KW - obesity Y1 - 2018 U6 - https://doi.org/10.1002/erv.2607 SN - 1072-4133 SN - 1099-0968 VL - 26 IS - 5 SP - 472 EP - 482 PB - Wiley CY - Hoboken ER - TY - THES A1 - Gmeiner, Michaela Silvia T1 - Gewichtsstigmatisierung und Internalisierung des Gewichtsstigmas im Kindes- und Jugendalter: Einflussfaktoren und Folgen T1 - Weight stigma and internalization of weight stigma in childhood and adolescence: influencing factors and consequences N2 - Das Gewichtsstigma und insbesondere das internalisierte Gewichtsstigma sind bei Kindern und Jugendlichen mit negativen Folgen für die physische und psychische Gesundheit assoziiert. Da die Befundlage in diesem Altersbereich jedoch noch unzureichend ist, war es das Ziel der Dissertation, begünstigende Faktoren und Folgen von gewichtsbezogener Stigmatisierung und internalisiertem Gewichtsstigma bei Kindern und Jugendlichen zu untersuchen. Die Analysen basierten auf zwei großen Stichproben, die im Rahmen der prospektiven PIER-Studie an Schulen rekrutiert wurden. Die erste Publikation bezieht sich auf eine Stichprobe mit Kindern und Jugendlichen im Alter zwischen 9 und 19 Jahren (49.2 % weiblich) und untersuchte den prospektiven bidirektionalen Zusammenhang zwischen erlebter Gewichtsstigmatisierung und Gewichtsstatus anhand eines latenten Strukturgleichungsmodells über drei Messzeitpunkte hinweg. Die anderen beiden Publikationen beziehen sich auf eine Stichprobe mit Kindern und Jugendlichen im Alter zwischen 6 und 11 Jahren (51.1 % weiblich). Die zweite Publikation analysierte anhand einer hierarchischen Regression, welche intrapersonalen Risikofaktoren das internalisierte Gewichtsstigma prospektiv prädizieren. Die dritte Publikation untersuchte anhand von ROC-Kurven, ab welchem Ausmaß das internalisierte Gewichtsstigma mit einem erhöhten Risiko für psychosoziale Auffälligkeit und gestörtes Essverhalten einhergeht. Im Rahmen der ersten Publikation zeigte sich, dass ein höherer Gewichtsstatus mit einer höheren späteren Gewichtsstigmatisierung einhergeht und umgekehrt die Gewichtsstigmatisierung auch den späteren Gewichtsstatus prädiziert. Die zweite Publikation identifizierte Gewichtsstatus, gewichtsbezogene Hänseleien, depressive Symptome, Körperunzufriedenheit, Relevanz der eigenen Figur sowie das weibliche Geschlecht und einen niedrigeren Bildungsabschluss der Eltern als Prädiktoren des internalisierten Gewichtsstigmas. Die dritte Publikation verdeutlichte, dass das internalisierte Gewichtsstigma bereits ab einem geringen Ausmaß mit einem erhöhten Risiko für gestörtes Essverhalten einhergeht und mit weiteren psychosozialen Problemen assoziiert ist. Insgesamt zeigte sich, dass sowohl das erlebte als auch das internalisierte Gewichtsstigma bei Kindern und Jugendlichen über alle Gewichtsgruppen hinweg relevante Konstrukte sind, die im Entwicklungsverlauf ein komplexes Gefüge bilden. Es wurde deutlich, dass es essentiell ist, bidirektionale Wirkmechanismen einzubeziehen. Die vorliegende Dissertation liefert erste Ansatzpunkte für die Gestaltung von Präventions- und Interventionsmaßnahmen, um ungünstige Entwicklungsverläufe in Folge von Gewichtsstigmatisierung und internalisiertem Gewichtsstigma zu verhindern. N2 - Weight stigma and particularly internalized weight stigma are associated with negative consequences for physical and mental health in children and adolescents. However, as there is a lack of empirical evidence in this age group, the aim of this dissertation was to examine facilitating factors and consequences of weight-related stigma and internalized weight stigma in children and adolescents. Analyses were based on two large samples recruited from schools as part of the prospective PIER study. The first publication refers to a sample with children and adolescents aged 9 to 19 years (49.2% female) and examined the prospective bidirectional relationship between experienced weight stigma and weight status using a latent structural equation model across three points of measurements. The other two publications involved a sample of children and adolescents aged 6 to 11 years (51.1% female). The second publication used hierarchical regression to analyze which intrapersonal risk factors prospectively predicted internalized weight stigma. The third publication used ROC curves to investigate the extent to which internalized weight stigma is associated with an increased risk of psychosocial problems and disordered eating behavior. The first publication revealed that higher weight was associated with higher subsequent weight stigma and, vice versa, that weight stigma also predicted subsequent weight. The second publication identified weight, weight-related teasing, depressive symptoms, body dissatisfaction, relevance of one's own figure, female gender and lower parental education level as predictors of internalized weight stigma. The third publication illustrated that internalized weight stigma, even at low levels, is associated with an increased risk of disordered eating behaviors and is correlated with additional psychosocial problems. Overall, both experienced and internalized weight stigma were shown to be relevant constructs in children and adolescents across all weight groups, and these were related in a complex manner over the course of development. It was shown that it is essential to incorporate bidirectional mechanisms. This dissertation provides initial starting points for the design of prevention and intervention measures to prevent adverse developmental trajectories as a result of weight stigma and internalized weight stigma. KW - Stigma KW - Internalisierung KW - Gewicht KW - psychische Gesundheit KW - Kinder und Jugendliche KW - stigma KW - internalization KW - weight KW - mental health KW - children and adolescents Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-530530 ER - TY - JOUR A1 - Gmeiner, Michaela Silvia A1 - Warschburger, Petra T1 - Intrapersonal predictors of weight bias internalization among elementary school children BT - a prospective analysis JF - BMC Pediatrics N2 - Background Weight-related stigmatization is a widespread problem. Particularly the internalization of weight-related stereotypes and prejudices (weight bias internalization, WBI) is related to mental and physical health impairments. To date, little is known about the risk factors of WBI. Previous studies are mainly cross-sectional and based on adult samples. As childhood is a sensitive period for the development of a healthy self-concept, we examined predictors of WBI in children. Methods The final sample included 1,463 schoolchildren (6–11 years, 51.7% female) who took part in a prospective study consisting of three measurement waves. The first two waves delivered data on objective weight status and self-reported weight-related teasing, body dissatisfaction, relevance of one’s own figure, self-esteem and depressive symptoms; WBI was measured during the third wave. To examine predictors of WBI, we ran hierarchical regression analyses and exploratory mediation analyses. Results Lower parental education level, higher child weight status, female gender, experience of teasing, higher body dissatisfaction, higher figure-relevance, and higher depression scores were found to be predictive for higher WBI scores. Body dissatisfaction (only for girls) and the relevance of one’s own figure (both genders) mediated the association between self-esteem and WBI; no weight-related differences were observed. Conclusions Our study offers longitudinal evidence for variables that enable the identification of children who are at risk for WBI. Thus, the findings deliver starting points for interventions aimed at the prevention of adverse health developments that come along with WBI. KW - Weight bias internalization KW - Self-stigmatization KW - Weight KW - Children KW - Predictors Y1 - 2020 U6 - https://doi.org/10.1186/s12887-020-02264-w SN - 1471-2431 VL - 20 PB - BioMed Central CY - London ER - TY - GEN A1 - Gmeiner, Michaela Silvia A1 - Warschburger, Petra T1 - Intrapersonal predictors of weight bias internalization among elementary school children BT - a prospective analysis T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background Weight-related stigmatization is a widespread problem. Particularly the internalization of weight-related stereotypes and prejudices (weight bias internalization, WBI) is related to mental and physical health impairments. To date, little is known about the risk factors of WBI. Previous studies are mainly cross-sectional and based on adult samples. As childhood is a sensitive period for the development of a healthy self-concept, we examined predictors of WBI in children. Methods The final sample included 1,463 schoolchildren (6–11 years, 51.7% female) who took part in a prospective study consisting of three measurement waves. The first two waves delivered data on objective weight status and self-reported weight-related teasing, body dissatisfaction, relevance of one’s own figure, self-esteem and depressive symptoms; WBI was measured during the third wave. To examine predictors of WBI, we ran hierarchical regression analyses and exploratory mediation analyses. Results Lower parental education level, higher child weight status, female gender, experience of teasing, higher body dissatisfaction, higher figure-relevance, and higher depression scores were found to be predictive for higher WBI scores. Body dissatisfaction (only for girls) and the relevance of one’s own figure (both genders) mediated the association between self-esteem and WBI; no weight-related differences were observed. Conclusions Our study offers longitudinal evidence for variables that enable the identification of children who are at risk for WBI. Thus, the findings deliver starting points for interventions aimed at the prevention of adverse health developments that come along with WBI. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 665 KW - Weight bias internalization KW - Self-stigmatization KW - Weight KW - Children KW - Predictors Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-482303 SN - 1866-8364 IS - 665 ER - TY - JOUR A1 - Gmeiner, Michaela Silvia A1 - Warschburger, Petra T1 - Psychotherapie bei juveniler Adipositas BT - gerechtfertigt und sinnvoll? JF - Psychotherapeut N2 - Background Obesity is widespread in childhood and adolescence. Medical rehabilitation measures with a comprehensive range of treatment options represent an essential pillar of care. As obesity is associated with a wide range of psychosocial burdens, the question arises as to whether psychotherapeutic services should be given even greater consideration. Objective The main goal was to examine the rate of psychological problems among children and adolescents with obesity and their association with the weight loss course. Material and methods The sample consisted of 220 children and adolescents with obesity (8-16 years, M = 13.11 years, SD +/- 1.88 years; 54.5% female) who participated in an inpatient rehabilitation. Emotional and behavioral problems were assessed (strengths and difficulties questionnaire, SDQ via parental report) at the beginning of rehabilitation as well as 6 and 12 months after completion. Anthropometric data for determination of the weight status were collected by medical personnel of the clinics or in the follow-up by family doctors. Results Almost half of the children and adolescents (48.6%) showed abnormal values and girls in particular were affected significantly more often. The descriptive inspection after rehabilitation revealed a similarly high proportion. The presence of psychological problems had a significant negative effect on the weight course. Conclusion Psychological problems should be given greater consideration in the context of obesity therapy. On the one hand potentially burdened children should be identified by screening, on the other hand psychotherapy to reduce psychosocial strain should be an integral part of the treatment concept. N2 - Hintergrund Adipositas ist im Kindes- und Jugendalter stark verbreitet. Medizinische Rehabilitationsmaßnahmen mit ihrem umfassenden Behandlungsangebot stellen eine wesentliche Säule der Versorgung dar. Da Adipositas mit vielfältigen psychosozialen Belastungen verbunden ist, stellt sich die Frage, ob psychotherapeutische Angebote noch stärker berücksichtigt werden sollten. Fragestellung Untersucht wurde, wie verbreitet psychische Auffälligkeiten bei Kindern und Jugendlichen mit Adipositas sind und in welchem Zusammenhang sie zum Gewichtsverlauf stehen. Material und Methoden Die Stichprobe bestand aus 220 Kindern und Jugendlichen mit Adipositas (8 bis 16 Jahre, M = 13,11 Jahre; SD ± 1,88 Jahre; 54,5 % weiblich), die an einer stationären Rehabilitationsmaßnahme teilnahmen. Emotionale- und Verhaltensauffälligkeiten (Strengths and Difficulties Questionnaire, SDQ) wurden zu Rehabilitationsbeginn sowie 6 und 12 Monate nach Rehabilitationsende im Elternbericht erfasst. Zudem wurden Daten zur Bestimmung des Gewichtstatus durch das medizinische Personal der Kliniken bzw. in der Katamnese von Hausärzten erhoben. Ergebnisse Fast die Hälfte der Kinder und Jugendlichen (48,6 %) wies auffällige Werte auf; v. a. Mädchen waren signifikant häufiger betroffen. Die deskriptive Betrachtung nach Rehabilitationsende zeigte einen vergleichbar hohen Anteil. Zudem wirkte sich das Vorliegen psychosozialer Auffälligkeiten signifikant negativ auf den Gewichtsverlauf aus. Schlussfolgerung Psychische Probleme sollten im Rahmen der Adipositastherapie stärker berücksichtigt werden. Zum einen sollten evtl. belastete Kinder durch Screenings identifiziert werden, zum anderen psychotherapeutische Maßnahmen zur Reduktion psychosozialer Belastungen integraler Bestandteil der Behandlung sein. KW - child KW - adolescent KW - weight course KW - psychological problems KW - rehabilitation KW - Kind KW - Jugendlicher KW - Gewichtsverlauf KW - Psychische Auffälligkeit KW - Rehabilitation Y1 - 2020 U6 - https://doi.org/10.1007/s00278-020-00474-2 SN - 0935-6185 SN - 1432-2080 VL - 66 IS - 1 SP - 16 EP - 22 PB - Springer CY - New York ER - TY - JOUR A1 - Warschburger, Petra A1 - Gmeiner, Michaela Silvia A1 - Bondü, Rebecca A1 - Klein, Alexandra-Maria A1 - Busching, Robert A1 - Elsner, Birgit T1 - Self-regulation as a resource for coping with developmental challenges during middle childhood and adolescence BT - the prospective longitudinal PIER YOUTH-study JF - BMC Psychology N2 - Background Self-regulation (SR) as the ability to regulate one's own physical state, emotions, cognitions, and behavior, is considered to play a pivotal role in the concurrent and subsequent mental and physical health of an individual. Although SR skills encompass numerous sub-facets, previous research has often focused on only one or a few of these sub-facets, and only rarely on adolescence. Therefore, little is known about the development of the sub-facets, their interplay, and their specific contributions to future developmental outcomes, particularly in adolescence. To fill these research gaps, this study aims to prospectively examine (1) the development of SR and (2) their influence on adolescent-specific developmental outcomes in a large community sample. Methods/design Based on previously collected data from the Potsdam Intrapersonal Developmental Risk (PIER) study with three measurement points, the present prospective, longitudinal study aims to add a fourth measurement point (PIERYOUTH). We aim to retain at least 1074 participants now between 16 and 23 years of the initially 1657 participants (6-11 years of age at the first measurement point in 2012/2013; 52.2% female). The study will continue to follow a multi-method (questionnaires, physiological assessments, performance-based computer tasks), multi-facet (assessing various domains of SR), and multi-rater (self-, parent-, and teacher-report) approach. In addition, a broad range of adolescent-specific developmental outcomes is considered. In doing so, we will cover the development of SR and relevant outcomes over the period of 10 years. In addition, we intend to conduct a fifth measurement point (given prolonged funding) to investigate development up to young adulthood. Discussion With its broad and multimethodological approach, PIERYOUTH aims to contribute to a deeper understanding of the development and role of various SR sub-facets from middle childhood to adolescence. The large sample size and low drop-out rates in the first three measurements points form a sound database for our present prospective research.Trial registration German Clinical Trials Register, registration number DRKS00030847. KW - Self-regulation KW - Adolescence KW - Prospective longitudinal study KW - Mental health Y1 - 2023 U6 - https://doi.org/10.1186/s40359-023-01140-3 SN - 2050-7283 VL - 11 IS - 1 PB - Springer Nature CY - London ER - TY - JOUR A1 - Gmeiner, Michaela Silvia A1 - Warschburger, Petra T1 - Simply too much BT - The extent to which weight bias internalization results in a higher risk of eating disorders and psychosocial problems JF - Eating and weight disorders : studies on anorexia, bulimia and obesity N2 - Purpose Weight bias internalization (WBI) is associated with negative health consequences such as eating disorders and psychosocial problems in children. To date, it is unknown to what extent WBI considerably raises the risk of negative outcomes. Methods Analyses are based on cross-sectional data of 1,061 children (9-13 years, M = 11, SD = 0.9; 52.1% female) who filled in the WBI scale (WBIS-C). First, ROC analyses were run to identify critical cut-off values of WBI (WBIS-C score) that identify those who are at higher risk for psychosocial problems or eating disorder symptoms (as reported by parents). Second, it was examined whether WBI is more sensitive than the relative weight status in that respect. Third, to confirm that the cut-off value is also accompanied by higher psychological strain, high- and low-risk groups were compared in terms of their self-reported depressive symptoms, anxious symptoms, body dissatisfaction, and self-esteem. Results WBIS-C scores >= 1.55 were associated with a higher risk of disturbed eating behavior; for psychosocial problems, no cut-off score reached adequate sensitivity and specificity. Compared to relative weight status, WBI was better suited to detect disturbed eating behavior. Children with a WBIS-C score >= 1.55 also reported higher scores for both depressive and anxious symptoms, higher body dissatisfaction, and lower self-esteem. Conclusion The WBIS-C is suitable for identifying risk groups, and even low levels of WBI are accompanied by adverse mental health. Therefore, WBI is, beyond weight status, an important risk factor that should be considered in prevention and intervention. KW - Weight bias internalization KW - Self-stigmatization KW - Children KW - ROC KW - Mental KW - health Y1 - 2021 U6 - https://doi.org/10.1007/s40519-021-01170-z SN - 1590-1262 VL - 27 IS - 1 SP - 317 EP - 324 PB - Springer CY - Cham ER -