TY - JOUR A1 - Zuba, Anna A1 - Warschburger, Petra T1 - Weight bias internalization across weight categories among school-aged children BT - validation of the weight bias internalization scale for children JF - Body image : an international journal of research N2 - Anti-fat bias is widespread and is linked to the internalization of weight bias and psychosocial problems. The purpose of this study was to examine the internalization of weight bias among children across weight categories and to evaluate the psychometric properties of the Weight Bias Internalization Scale for Children (WBIS-C). Data were collected from 1484 primary school children and their parents. WBIS-C demonstrated good internal consistency (alpha = .86) after exclusion of Item 1. The unitary factor structure was supported using exploratory and confirmatory factor analyses (factorial validity). Girls and overweight children reported higher WBIS-C scores in comparison to boys and non-overweight peers (known-groups validity). Convergent validity was shown by significant correlations with psychosocial problems. Internalization of weight bias explained additional variance in different indicators of psychosocial well-being. The results suggest that the WBIS-C is a psychometrically sound and informative tool to assess weight bias internalization among children. KW - Internalization of weight bias KW - Weight stigma KW - Psychological functioning KW - Psychometric properties KW - Children Y1 - 2018 U6 - https://doi.org/10.1016/j.bodyim.2018.02.008 SN - 1740-1445 SN - 1873-6807 VL - 25 SP - 56 EP - 65 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Send, Tabea Sarah A1 - Bardtke, Svenja A1 - Gilles, Maria A1 - Wolf, Isabella Germaine A1 - Sütterlin, Marc W. A1 - Kirschbaum, Clemens A1 - Laucht, Manfred A1 - Witt, Stephanie H. A1 - Rietschel, Marcella A1 - Streit, Fabian A1 - Deuschle, Michael T1 - Stress reactivity in preschool-aged children BT - Evaluation of a social stress paradigm and investigation of the impact of prenatal maternal stress JF - Psychoneuroendocrinology N2 - Prenatal maternal stress is an established risk factor for somatic and psychological health of the offspring. A dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in offspring has been suggested as an important mechanism. However, the impact of prenatal stress on stress reactivity in preschool-aged children is not yet well understood. This is partly due to the fact that for this age group there is no stress test as well established as for older children and adults. In the present work a previously published stress test (Kryski et al., 2011) was evaluated in a large sample of 45-month-old children (n = 339). Furthermore, the relation between measures of prenatal maternal stress and cortisol reactivity was investigated. Prenatal stress was defined as psychopathology (self-report available for n = 339; expert-rating available for a subsample of n = 246) and perceived stress (n = 244) during pregnancy. The stress paradigm elicited significant increases in salivary cortisol 30 and 40 min after the test, and 60.8% of the children were classified as responders. Lower cortisol levels after the stress test were observed in the group of children with prenatal stress defined as maternal psychopathology (both self-reported and expert-rated). Maternal perceived stress as a continuous measure was not significantly associated with cortisol levels. However, when comparing children in the highest quartile of maternal perceived stress to all other children, significantly lower cortisol values were observed in the prenatally stressed group. The present study confirms the paradigm by Kryski et al. as an effective stress test for preschool-aged children. Moreover, it provides further evidence that prenatal stress impacts HPA axis reactivity. Future studies should target the timing, nature, and intensity of prenatal stressors and their effect on the stress response in offspring at different developmental stages. KW - Stress test KW - Children KW - Prenatal stress KW - Cortisol KW - HPA axis reactivity KW - Psychopathology Y1 - 2018 U6 - https://doi.org/10.1016/j.psyneuen.2018.11.002 SN - 0306-4530 VL - 101 SP - 223 EP - 231 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Warschburger, Petra A1 - Calvano, Claudia A1 - Becker, Sebastian A1 - Friedt, Michael A1 - Hudert, Christian A1 - Posovszky, Carsten A1 - Schier, Maike A1 - Wegscheider, Karl T1 - Stop the pain: study protocol for a randomized-controlled trial JF - Trials N2 - Background: Functional abdominal pain (FAP) is not only a highly prevalent disease but also poses a considerable burden on children and their families. Untreated, FAP is highly persistent until adulthood, also leading to an increased risk of psychiatric disorders. Intervention studies underscore the efficacy of cognitive behavioral treatment approaches but are limited in terms of sample size, long-term follow-up data, controls and inclusion of psychosocial outcome data. Methods/Design: In a multicenter randomized controlled trial, 112 children aged 7 to 12 years who fulfill the Rome III criteria for FAP will be allocated to an established cognitive behavioral training program for children with FAP (n = 56) or to an active control group (focusing on age-appropriate information delivery; n = 56). Randomization occurs centrally, blockwise and is stratified by center. This study is performed in five pediatric gastroenterology outpatient departments. Observer-blind assessments of outcome variables take place four times: pre-, post-, 3- and 12-months post-treatment. Primary outcome is the course of pain intensity and frequency. Secondary endpoints are health-related quality of life, pain-related coping and cognitions, as well as selfefficacy. Discussion: This confirmatory randomized controlled clinical trial evaluates the efficacy of a cognitive behavioral intervention for children with FAP. By applying an active control group, time and attention processes can be controlled, and long-term follow-up data over the course of one year can be explored. KW - FAP KW - Randomized controlled trial KW - Cognitive behavioral intervention KW - Children KW - Pain Y1 - 2014 U6 - https://doi.org/10.1186/1745-6215-15-357 SN - 1745-6215 VL - 15 PB - BioMed Central CY - London ER - TY - JOUR A1 - Warschburger, Petra T1 - SRT-Joy - computer-assisted self-regulation training for obese children and adolescents: study protocol for a randomized controlled trial JF - Trials N2 - Background: Obesity is not only a highly prevalent disease but also poses a considerable burden on children and their families. Evidence is increasing that a lack of self-regulation skills may play a role in the etiology and maintenance of obesity. Our goal with this currently ongoing trial is to examine whether training that focuses on the enhancement of self-regulation skills may increase the sustainability of a complex lifestyle intervention. Methods/Design: In a multicenter, prospective, parallel group, randomized controlled superiority trial, 226 obese children and adolescents aged 8 to 16 years will be allocated either to a newly developed computer-training program to improve their self-regulation abilities or to a placebo control group. Randomization occurs centrally and blockwise at a 1:1 allocation ratio for each center. This study is performed in pediatric inpatient rehabilitation facilities specialized in the treatment of obesity. Observer-blind assessments of outcome variables take place at four times: at the beginning of the rehabilitation (pre), at the end of the training in the rehabilitation (post), and 6 and 12 months post-rehabilitation intervention. The primary outcome is the course of BMI-SDS over 1 year after the end of the inpatient rehabilitation. Secondary endpoints are the self-regulation skills. In addition, health-related quality of life, and snack intake will be analyzed. Discussion: The computer-based training programs might be a feasible and attractive tool to increase the sustainability of the weight loss reached during inpatient rehabilitation. KW - Obesity KW - Randomized-controlled trial KW - Computer-assisted self-regulation training KW - Children KW - Adolescents KW - Weight Y1 - 2015 U6 - https://doi.org/10.1186/s13063-015-1078-2 SN - 1745-6215 VL - 16 PB - BioMed Central 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 - TY - JOUR A1 - Warschburger, Petra A1 - Kuhne, Daniela T1 - Psychosocial determinants of quality of life in parents of obese children seeking inpatient treatment JF - Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation N2 - To examine and identify predictors of parental health-related quality of life (HRQoL) in a sample of obese and very obese children participating in an inpatient program for treating obesity. KW - Health-related quality of life KW - Obesity KW - Parents KW - Children KW - Self-efficacy Y1 - 2014 U6 - https://doi.org/10.1007/s11136-014-0659-y SN - 0962-9343 SN - 1573-2649 VL - 23 IS - 7 SP - 1985 EP - 1995 PB - Springer CY - Dordrecht ER - TY - JOUR A1 - Meiser, Susanne A1 - Esser, Günter T1 - How dysfunctional are dysfunctional attitudes? BT - a threshold model of dysfunctional attitudes and depressive symptoms in children and adolescents JF - Cognitive Therapy and Research N2 - In order to clarify further the role of Beck’s vulnerability-stress model in the early development of depression, this longitudinal study tested a threshold model of dysfunctional attitudes in children and adolescents. An initially asymptomatic sample of 889 youths aged 9–18 years completed measures of dysfunctional attitudes and depressive symptoms. Twenty months later, participants reported stressful life events and current depressive symptoms. Results support a threshold view of cognitive vulnerability as only dysfunctional attitudes above a certain threshold significantly interacted with life events to predict depressive symptoms. Thus, findings suggest that dysfunctional attitudes must exceed a certain threshold to confer vulnerability to depressive symptomatology in youth. The term “dysfunctional” might therefore only apply to higher levels of the “dysfunctional attitudes” proposed by A. T. Beck. Results also indicate that studies using non-clinical samples may systematically underestimate the effect of dysfunctional attitudes when relying on conventional linear methods. KW - Cognitive vulnerability KW - Depression KW - Children KW - Adolescents KW - Dysfunctional attitudes KW - Threshold models Y1 - 2017 U6 - https://doi.org/10.1007/s10608-017-9842-0 SN - 0147-5916 SN - 1573-2819 VL - 41 SP - 730 EP - 744 PB - Springer CY - New York ER - TY - JOUR A1 - Gross, Martina A1 - Warschburger, Petra T1 - Evaluation of a cognitive-behavioral pain management program for children with chronic abdominal pain - a randomized controlled study JF - International journal of behavioral medicine : the official journal of the International Society of Behavioral Medicine N2 - Background Chronic abdominal pain (CAP) in childhood is widely prevalent and has adverse effects on mental health and quality of life. Earlier research emphasized the positive effects of psychological intervention on pain symptoms. This study describes the results of a cognitive-behavioral pain management program for children with CAP. The newly developed cognitive-behavioral group program, "Stop the pain with Happy-Pingu," includes six sessions for the children and one meeting for the parents. Purpose We hypothesized that the training would significantly reduce pain symptoms (frequency, duration, intensity, and pain-related impairment) and increase health-related quality of life compared to wait-list controls, with improvement seen both at the end of treatment and at a 3-month follow-up. Method In all, 29 children were randomized into two groups: 15 in the intervention group (IG) and 14 as the wait-list controls (WLC). An intent-to-treat analysis was performed using two-factorial multivariate analyses of variance with repeated measures. Results Children in the IG experienced both a reduction in pain (primary outcome) and an improvement in health-related quality of life (secondary outcome) as compared to the WLC. The effect sizes ranged from medium to high. Conclusion Cognitive-behavioral methods seem to be appropriate for treating children with CAP. KW - Chronic abdominal pain KW - Children KW - Cognitive-behavioral treatment Y1 - 2013 U6 - https://doi.org/10.1007/s12529-012-9228-3 SN - 1070-5503 VL - 20 IS - 3 SP - 434 EP - 443 PB - Springer CY - New York ER - TY - JOUR A1 - Gross, Martina A1 - Warschburger, Petra T1 - Chronic abdominal pain psychosocial strain and treatment-associated changes in coping JF - Verhaltenstherapie N2 - Background: Chronic abdominal pain (CAP) in childhood is a commonly occurring condition and shows a high stability. Psychosocial dysfunctioning of children, such as increased stress experience, is a burden for children and parents and complicates clinical management. Additional comorbid disorders may develop. To minimize the onset of such disorders, treatment at an early stage and taking psychosocial aspects into consideration is strongly recommended. Through this approach, the cognitive-behavioral, child-centered group program 'Stop the pain with Happy-Pingu' was developed, applied, and subsequently evaluated. What is the psychosocial situation of the affected children? Can the cognitive-behavioral group program be applied to improve psychosocial limitations? Method: The cognitive-behavioral group program comprises 6 weekly sessions for children and 1 single meeting for parents. In a randomized controlled study, the program was evaluated with 29 children aged between 6 and 12 years. The evaluation was based on a comparison between the intervention group (IG) and the waiting list control group (WLC), measured at 3 measurement points: T1 (pre), T2 (post), and T3 (3-month follow-up). Results: Emotional problems in particular can emerge in children with CAP. The program was well received, with a high level of participation through to completion. The results demonstrate that children participating in the IG experience significant stress reduction and improved psychosocial functioning compared to children participating in the WLC. The effect sizes range from medium to high. Conclusions: Drawing upon the above findings, multimodal cognitive-behavioral techniques appear to be suitable to successfully treat children with CAP. However, further controlled studies are required to identify the specific elements of the training that are most effective in reducing pain. KW - Cognitive-behavioral therapy KW - Children KW - Abdominal pain KW - Psychosocial functioning KW - Coping Y1 - 2013 U6 - https://doi.org/10.1159/000351215 SN - 1016-6262 VL - 23 IS - 2 SP - 80 EP - 89 PB - Karger CY - Basel ER - TY - JOUR A1 - Pitzer, Martina A1 - Esser, Günter A1 - Schmidt, Martin H. A1 - Hohm, Erika A1 - Banaschewski, Tobias A1 - Laucht, Manfred T1 - Child regulative temperament as a mediator of parenting in the development of depressive symptoms BT - a longitudinal study from early childhood to preadolescence JF - Journal of neural transmission N2 - Child temperament as well as parenting behaviors have been linked to adolescent depression. Beyond their main effects, the interplay between these factors is of interest. For example, in an interactive model, a differential susceptibility of temperamental variants to parenting has been suggested. However, so far, the differential susceptibility hypothesis has mostly been studied with a focus on externalizing disorders. On the other hand, parenting may shape the child’s temperament and vice versa in a transactional process. In a prospective, longitudinal at-risk sample (163 boys, 176 girls), we assessed emotional (easy–difficult) and regulative (self-control) temperament at ages 4.5, and 8 years, respectively, as well as parenting quality at age 4.5 years using the HOME inventory. Hierarchical linear regression analysis was used to investigate the prediction of depressive symptoms at age 11, measured by the Child Depression Inventory, including interaction terms between the temperament variable and parenting. We additionally tested whether parenting was mediated by child temperament. As previously reported, both self-control and parenting were longitudinally associated with preadolescent depressive symptoms. There were no interactive effects between temperament and parenting. However, the effects of parenting were partly mediated by self-control. Our data do not support a differential susceptibility of temperamental variants in the development of preadolescent depression. However, our results are in line with the assumption that parenting may shape young children’s temperament, with positive parenting in the early childhood fostering the development of regulative temperament. KW - Temperament KW - Parenting KW - Children KW - Depression KW - Parent-child-interaction Y1 - 2017 U6 - https://doi.org/10.1007/s00702-017-1682-2 SN - 0300-9564 SN - 1435-1463 VL - 124 SP - 631 EP - 641 PB - Springer CY - Wien ER - TY - JOUR A1 - Koch, Anne A1 - Pollatos, Olga T1 - Cardiac sensitivity in children: Sex differences and its relationship to parameters of emotional processing JF - Psychophysiology : journal of the Society for Psychophysiological Research N2 - In adults, the level of ability to perceive one's own body signals plays an important role for many concepts of emotional experience as demonstrated for emotion processing or emotion regulation. Representative data on perception of body signals and its emotional correlates in children is lacking. Therefore, the present study investigated the cardiac sensitivity of 1,350 children between 6 and 11 years of age in a heartbeat perception task. Our main findings demonstrated the distribution of cardiac sensitivity in children as well as associations with interpersonal emotional intelligence and adaptability. Furthermore, independent of body mass index, boys showed a significantly higher cardiac sensitivity than girls. We conclude that cardiac sensitivity in children appears to show weaker but similar characteristics and relations to emotional parameters as found in adults, so that a dynamic developmental process can be assumed. KW - Children KW - Emotional intelligence KW - Heartbeat perception KW - Heart rate variability KW - Interoceptive sensitivity Y1 - 2014 U6 - https://doi.org/10.1111/psyp.12233 SN - 0048-5772 SN - 1469-8986 VL - 51 IS - 9 SP - 932 EP - 941 PB - Wiley-Blackwell CY - Hoboken ER - TY - JOUR A1 - Warschburger, Petra A1 - Kröller, Katja T1 - "Childhood overweight and obesity maternal perceptions of the time for engaging in child weight management" JF - BMC public health N2 - Background: There is an increasing awareness of the impact of parental risk perception on the weight course of the child and the parent's readiness to engage in preventive efforts, but only less is known about factors related to the parental perception of the right time for the implementation of preventive activities. The aim of this study was to examine parental perceptions of the appropriate time to engage in child weight management strategies, and the factors associated with different weight points at which mothers recognize the need for preventive actions. Methods: 352 mothers with children aged 2-10 years took part in the study. We assessed mothers' perceptions of the actual and preferred weight status of their child, their ability to identify overweight and knowledge of its associated health risks, as well as perceptions of the right time for action to prevent overweight in their child. A regression analysis was conducted to examine whether demographic and weight related factors as well as the maternal general risk perception were associated with recognizing the need to implement prevention strategies. Results: Although most of the parents considered a BMI in the 75th to 90th percentile a valid reason to engage in the prevention of overweight, 19% of the mothers were not willing to engage in prevention until their child reached the 97th percentile. Whereas the child's sex and the identification of an elevated BMI were significant predictors for parents' recognition of the 75th percentile as right point to engage in prevention efforts, an inability to recognize physical health risks associated with overweight silhouettes emerged as a significant factor predicting which parents would delay prevention efforts until a child's BMI reached the 97th percentile. Conclusion: Parental misperceptions of overweight and associated health risks constitute unfavorable conditions for preventive actions. Feedback on the health risks associated with overweight could help increase maternal readiness for change. KW - Maternal perception KW - Need for action KW - Prevention KW - Obesity KW - Overweight KW - Children Y1 - 2012 U6 - https://doi.org/10.1186/1471-2458-12-295 SN - 1471-2458 VL - 12 IS - 12 PB - BioMed Central CY - London ER -