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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.
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.
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.
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.
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.
This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0–10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany.
This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0–10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany.
The current study explores the role of appearance-related social pressure regarding changes in body image in adolescent girls (n = 236) and boys (n = 193) over a 1-year-period. High school students aged 11-16 completed measures of body dissatisfaction (i.e., weight and muscle concerns) and appearance-related social pressure from peers and parents. Three aspects proved to be particularly crucial: Parental encouragement to control weight and shape was a strong predictor of weight concerns in boys and girls alike; influences of friends affected gender-specific body image concerns by leading to weight concerns in girls and muscle concerns in boys; finally appearance-based exclusion was a predictor of weight concerns in boys. The findings provide longitudinal evidence for the crucial impact of appearance-related social pressure and suggest that a detailed assessment of different types of social impacts can identify concrete targets for effective prevention and therapy for weight-related problems among adolescents.
Background
Appearance-related social pressure plays an important role in the development of a negative body image and self-esteem as well as severe mental disorders during adolescence (e.g. eating disorders, depression). Identifying who is particularly affected by social pressure can improve targeted prevention and intervention, but findings have either been lacking or controversial. Thus the aim of this study is to provide a detailed picture of gender, weight, and age-related variations in the perception of appearance-related social pressure by peers and parents.
Methods
1112 German students between grades 7 and 9 (mean age: M = 13.38, SD = .81) filled in the Appearance-Related Social Pressure Questionnaire (German: FASD), which considers different sources (peers, parents) as well as various kinds of social pressure (e.g. teasing, modeling, encouragement).
Results
Girls were more affected by peer pressure, while gender differences in parental pressure seemed negligible. Main effects of grade-level suggested a particular increase in indirect peer pressure (e.g. appearance-related school and class norms) from early to middle adolescence. Boys and girls with higher BMI were particularly affected by peer teasing and exclusion as well as by parental encouragement to control weight and shape.
Conclusion
The results suggest that preventive efforts targeting body concerns and disordered eating should bring up the topic of appearance pressure in a school-based context and should strengthen those adolescents who are particularly at risk - in our study, girls and adolescents with higher weight status. Early adolescence and school transition appear to be crucial periods for these efforts. Moreover, the comprehensive assessment of appearance-related social pressure appears to be a fruitful way to further explore social risk-factors in the development of a negative body image.