An ecological model of weight gain among school-age children.

OBJECTIVE: Childhood obesity rates remain historically high in the United States. One way to conceptualize the many factors that contribute to obesity is through the use of an ecological model. There is a particular need to adapt and test this type of comprehensive model among vulnerable racial/ethnic and socioeconomic groups. METHOD: Using a large sample of U.S. youth (n = 8,225) drawn from the ECLS-K:2011, this project applied an ecological model of childhood obesity from kindergarten to second grade, including factors such as child physical activity, child screen time, child bedtime, family physical activity, family food insecurity, family meals, and neighborhood safety. The contributions of each of these factors across racial/ethnic, socioeconomic, and income-to-needs groups were examined concurrently and longitudinally. RESULTS: Among the full sample, the largest standardized effect on weight was for income-to-needs ratio. Moving from above to below 200% of the poverty line resulted in an increase of .12 standard deviations in BMIz. Multigroup analyses indicated that there was only a significant difference in model fit based on race/ethnicity. Among Latino youth, income-to-needs ratio was a significant negative predictor of kindergarten BMIz; however, this effect was not significant among Black/African American youth. CONCLUSIONS: Overall, income-to-needs ratio emerged as the strongest link to obesity among the early elementary school years; this was particularly present among Latino youth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining childhood obesity through the lens of developmental psychopathology: Framing the issues to guide best practices in research and intervention.

Rates of childhood overweight and obesity among youth in the United States remain historically high and can persist into adulthood, resulting in increased health care expenditures, comorbidities, and reduced quality of life. The purpose of this article is to illustrate how principles drawn from developmental psychopathology (DP) can be applied to enhance current conceptualizations of obesity risk during childhood and beyond. DP is a theoretical perspective that has reshaped the landscape of childhood mental health by using principles of developmental science to model complex processes leading to maladaptation or dysfunction with biological, psychological, and contextual roots. This article focuses on 2 broad interrelated DP tenets: (a) examination of developmental pathways considered both normative and nonnormative as well as processes of individual variation and the nature of developmental change and (b) articulation of complex transactional and transformational processes over time that incorporate both biobehavioral and social-contextual factors embedded in multilevel models. By illustrating how these DP tenets can expand on current childhood obesity knowledge, this article offers a novel perspective that closely aligns central developmental processes with childhood obesity risk and may enrich conceptual models and spark new directions for childhood obesity research, leading ultimately to more effective intervention and prevention efforts necessary to slow or, ideally, reverse, the obesity epidemic. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Moderators of Internet-Delivered Cognitive-Behavioral Therapy for Adolescents With Chronic Pain: Who Benefits From Treatment at Long-Term Follow-Up?

Cognitive behavioral therapy (CBT) is effective for pediatric chronic pain, but little is understood about which youth are most likely to benefit. The current study aimed to identify individual characteristics for which CBT yielded the greatest (and least) clinical benefit among adolescents with chronic pain participating in a multicenter randomized controlled trial of Internet-delivered CBT (WebMAP2). A total of 273 adolescents ages 11 to 17 with chronic pain (M age = 14.7; 75.1% female) were randomly assigned to Internet-delivered CBT or Internet-delivered pain education and evaluated at pretreatment, post-treatment, and 2 longer term follow-up periods (6 and 12 months). Multilevel growth models tested several adolescent- and parent-level moderators of change in pain-related disability including 1) adolescent age, sex, pain characteristics, distress, and sleep quality and 2) parent education level, distress, and protective parenting behavior. Younger adolescents (ages 11-14; vs older adolescents ages 15-17) and those whose parents experienced lower levels (vs higher levels) of emotional distress responded better to Internet CBT treatment, showing greater improvements in disability up to 12 months post-treatment. This study expands knowledge on who benefits most from Internet-delivered psychological treatment for youth with chronic pain in the context of a large multicenter randomized controlled trial, suggesting several avenues for maximizing treatment efficacy and durability in this population. PERSPECTIVE: This study identified adolescent- and parent-level predictors of treatment response to Internet-based CBT for pediatric chronic pain up to 12 months later. Younger adolescents and those whose parents had lower levels of distress may particularly benefit from this intervention. Older adolescents and those whose parents exhibit higher distress may require alternative treatment approaches.

Executive function and dietary intake in youth: A systematic review of the literature.

Despite increasing evidence that childhood obesity may be related to impairments in executive function, the evidence supporting the relation between executive function (EF) and dietary intake, a key factor linked to obesity, is mixed. Although research from the obesity literature often interprets EF as a factor that may influence dietary intake, there is also evidence that dietary intake may influence EF. Drawing on a developmental perspective, this systematic review examines the literature on the link between executive function (i.e., inhibition, working memory, and cognitive flexibility) and dietary intake in youth through the inclusion of cross-sectional, longitudinal, and intervention studies aimed at altering either dietary intake or EF as a way to influence the other. In total, 5650 studies were screened for eligibility. Twenty-six studies met inclusion criteria and were included in the review. Results indicated that the relation between executive function and dietary intake is equivocal. Although there is some support for a cross-sectional relation between executive function and dietary intake, the lack of longitudinal studies makes it difficult to make conclusions about directionality. Findings from intervention studies do not support the effectiveness of short-term manipulations on dietary intake to change subsequent EF, and few intervention studies exist that explicitly aim to "train" EF to change subsequent dietary intake. Furthermore, the wide variety of measures used to assess EF and dietary intake, and the lack of consideration of the role that weight status may play in the relation between EF and dietary intake, make overall interpretation of the literature more difficult. In sum, there is a need for more prospective research examining a variety of ages, domains of EF, and weight statuses, taking into account developmental factors.