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Hauptziel Adipositas ist eine der Hauptindikationen in der Kinder- und Jugend-Rehabilitation. Für ältere Jugendliche und junge Erwachsene fehlen altersspezifische Therapieangebote fast vollständig. Ziel war es die Wünsche bezüglich der Inhalte und Methoden einer „perfekten Therapie“ im Rahmen eines Rehabilitationsaufenthalts zu untersuchen.
Methode Im Rahmen der YOUTH-Studie wurden 147 adipöse Jugendliche und junge Erwachsene beiderlei Geschlechts (zwischen 15 und 21 Jahren) mithilfe eines standardisierten Fragebogens befragt.
Ergebnis Insgesamt zeigten sich relativ wenige alters- und geschlechtsspezifische Unterschiede. Interdisziplinär geleitete, koedukative Gruppen mit Elterneinbindung wurden gewünscht. Wichtige Themen waren gesunde Ernährung sowie psychosoziale Aspekte. Auch der Prävention von Rückfällen wurde eine hohe Relevanz zugeschrieben.
Schlussfolgerung Psychosoziale Aspekte und die Vorbereitung auf mögliche Rückfallsituationen sollten integraler Bestandteil der Therapie sein.
Introduction: The goal of the present study was to identify the prospective relations between weight/shape and muscularity concerns and emotional problems in adolescents. Methods: Self-report data of 966 German male and female adolescents were analyzed in a cross lagged panel design. Results: Analyses of latent means revealed significant correlations between weight/shape concern and emotional problems as well as between muscularity concern and emotional problems in both genders. Moreover, weight/shape concern predicted emotional problems prospectively, but only in girls. Regarding muscularity concern, we could not find any prospective relation with emotional problems In boys or girls from the general population. Conclusions: It is assumed that as appearance is highly relevant for the self-concept in girls, concerns about the look might promote emotional problems. Thus, weight/shape concern should be addressed in the prevention of emotional problems in adolescent girls, whereas further research is necessary investigating the contribution of muscularity concern in this context.
Purpose: Dealing with a child who suffers from functional abdominal pain (FAP) is a major challenge for the child's parents. However, little is known about the quality of life (QoL) of this group of parents. Therefore, this cross-sectional study aimed to provide a comprehensive analysis of parental QoL among parents seeking treatment for their child's abdominal pain.
Methods: 133 parents of 7-13-year-old children diagnosed with FAP reported on their health-related QoL (HRQoL), as assessed by the SF-12, and on caregiver-related QoL, as assessed by two CHQ-PF50 scales (emotional impact, time impact). T tests were used to compare the parents' scores on these measures with reference scores. Subgroups which were at risk of impairment were defined by cut-off scores. Determinants of parental QoL were identified by hierarchical regression analyses.
Results: While the parents showed significantly poorer mental health compared to population-based reference samples (d = 0.33-0.58), their physical health did not differ. However, parents were severely strained with respect to the time impact and emotional impact of their child's health (d = 0.33-1.58). While 12.7-27.9% of the parents were at risk of poor HRQoL, 60.6-70.1% were highly strained due to the demands of their role as caregivers. Physical and mental health were best explained by parents' psychiatric symptoms, while parents' perception of their child's impairment additionally determined the high time and emotional impact.
Conclusions: Physical HRQoL is not impaired in the majority of parents seeking treatment for their child's functional abdominal pain. However, the time demands and worries due to the child's pain deserve specific attention. Psychosocial interventions for a child's FAP should include information provided to the parents about coping with time constraints and emotional impact. Further prospective studies are warranted.
Psychometric evaluation of the German version of the Intuitive Eating Scale-2 in a community sample
(2017)
Objective This prospective study explored bidirectional associations between attachment quality towards mother, father, and peers and disordered eating among a large population-based sample of boys and girls in the transition from preadolescence to adolescence. Specifically, we examined whether insecure attachment relationships emerged as a risk factor for or as an outcome of disordered eating. Method A population-based sample of 904 adolescent girls and boys was assessed four times, at baseline (T1; M-age = 10.8 years) and at 2-, 4-, and 6-year follow-up (T2, T3, and T4). Prospective data were analyzed using cross-lagged panel models for each attachment figure (i.e., mother, father, peers) in a multigroup design to compare genders. Results Better attachment to the mother led to less pronounced disturbed eating in girls across the entire age range and in boys across two time periods. In girls, more pronounced disordered eating at T3 predicted worse attachment to the mother at T4 and better attachment to the father at T1 predicted less disturbed eating at T2. In boys, disordered eating at T1 predicted better attachment to the father at T2. Concerning peer attachment, better attachment at T1 predicted disordered eating at T2, in boys only. No other significant cross-lagged effects emerged. Discussion These findings highlight the differential and gender-specific contribution of attachment figures to the development of disordered eating in adolescence. Programs aimed at improving communication and trust in the relationship with parents might be promising in the prevention of disordered eating and the subsequent deterioration of parent-child attachment relationships.
Intolerance to lactose or fructose is frequently diagnosed in children with chronic abdominal pain (CAP). However, the causal relationship remains a matter of discussion. A cohort of 253 patients, aged 7-12 years, presenting with unexplained CAP received standardized diagnostics. Additional diagnostic tests were performed based on their medical history and physical and laboratory investigations. Fructose and lactose hydrogen breath tests (H2BT) as well as empiric diagnostic elimination diets were performed in 135 patients reporting abdominal pain related to the consumption of lactose or fructose to evaluate carbohydrate intolerance as a potential cause of CAP. Carbohydrate malabsorption by H2BT was found in 55 (41%) out of 135 patients. An abnormal increase in H2BT was revealed in 30% (35/118) of patients after fructose consumption and in 18% (20/114) of patients after lactose administration. Forty-six percent (25/54) reported pain relief during a diagnostic elimination diet. In total, 17 patients had lactose malabsorption, 29 fructose malabsorption, and nine combined carbohydrate malabsorption. Carbohydrate intolerance as a cause of CAP was diagnosed at follow-up in only 18% (10/55) of patients with malabsorption after the elimination of the respective carbohydrate. Thus, carbohydrate malabsorption appears to be an incidental finding in children with functional abdominal pain disorders, rather than its cause. Therefore, testing of carbohydrate intolerance should only be considered in children with a strong clinical suspicion and with the goal to prevent long-term unnecessary dietary restrictions in children suffering from CAP.
Background
Benefit finding, defined as perceiving positive life changes resulting from adversity and negative life stressors, gains growing attention in the context of chronic illness. The study aimed at examining the psychometric properties of the Benefit Finding Scale for Children (BFSC) in a sample of German youth facing chronic conditions.
Methods
A sample of adolescents with various chronic conditions (N = 304; 12 – 21years) completed the 10-item BFSC along with measures of intra- and interpersonal resources, coping strategies, and health-related quality of life (hrQoL). The total sample was randomly divided into two subsamples for conducting exploratory and confirmatory factor analyses (EFA/CFA).
Results
EFA revealed that the BFSC scores had a one-dimensional factor structure. CFA verified the one-dimensional factor structure with an acceptable fit. The BFSC exhibited acceptable internal consistency (α = 0.87 – 0.88) and construct validity. In line with our hypotheses, benefit finding was positively correlated with optimism, self-esteem, self-efficacy, sense of coherence, and support seeking. There were no correlations with avoidance, wishful thinking, emotional reaction, and hrQoL. Sex differences in benefit finding were not consistent across subsamples. Benefit finding was also positively associated with age, disease severity, and social status.
Conclusions
The BFSC is a psychometrically sound instrument to assess benefit finding in adolescents with chronic illness and may facilitate further research on positive adaptation processes in adolescents, irrespective of their specific diagnosis.
Simply too much
(2022)
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.