Latent profiles of the feeding practices of caregivers of rural children with overweight and obesity and associations with child eating behaviors.

Previous research has shown that food parenting practices, which vary within the context of sociocultural factors, are associated with child weight, eating behaviors, and body dissatisfaction. While parents typically engage in multiple food parenting practices, few studies have examined what subgroups or combinations of food parenting practices are associated with child health outcomes and sociocultural factors. The current study examined profiles of food parenting practices among school-age children with overweight/obesity (OW/OB) from rural communities and examined how they may be associated with sociocultural factors, child-eating habits, and health outcomes. The study included 270 children with OW/OB aged 8-12 (Mage = 10.36 years) and their caregivers. Caregivers completed a measure assessing perceptions of their feeding practices and sociocultural questionnaires. Children completed measures assessing disordered eating habits, weight control behaviors, and body dissatisfaction. Weight status was measured for caregivers and children with height and weight measurements. Latent variable mixture modeling (LVMM) was conducted. Three profiles emerged: (a) Lower Parental Involvement, (b) Higher Parental Involvement, and (c) Mixed Parental Involvement. Lower family income and non-White child race were related to membership in the "Higher Parental Involvement" profile. After controlling for income and child race, children in the "Mixed Parental Involvement" profile reported significantly higher body dissatisfaction than children in the "Lower Parental Involvement" profile. There are subgroups of caregivers of rural children with OW/OB that demonstrate various patterns of parent feeding practices, and these subgroups differ by income, race, and child body dissatisfaction. Future research should consider how caregiver-specific feeding practices may impact child eating behaviors and their body image development, as well as the impact cultural factors may have on parent feeding practices.

Meta-analysis of lifestyle modification interventions addressing overweight and obesity in preschool-age children.

OBJECTIVE: Increased rates of pediatric obesity extend into early childhood. There have been increasing calls for intervention programs specifically designed to address obesity in preschool-age youth. A review of the literature is critical to guide intervention and future research. The objective of this study was to conduct a meta-analysis of randomized, controlled trials examining the efficacy of lifestyle modification interventions to address overweight and obesity in preschool-age children. METHOD: Six electronic databases were searched for articles through December 8, 2020. After screening articles for inclusion criteria, 14 articles with 12 randomized, controlled trials (41 effect sizes, 2,525 participants) were included in this meta-analysis. Weighted-standardized mean differences for body mass index-related variables were calculated using random-effects models to estimate effect sizes. Risk of bias assessment was conducted. RESULTS: There was a statistically significant impact of the interventions on child weight outcomes. Cohen's d was .32 (95% CI [.09, .55]). The quality of evidence was assigned a "low" GRADE rating. CONCLUSIONS: Lifestyle modification interventions for overweight and obesity in preschool-age children produce small but significant changes in child weight status. However, few new trials have been published in the last 5 years and the quality of evidence in this area is low, limiting confidence in the estimates and the power to examine potential moderator effects. Additional quality, randomized, control trials that report study information consistent with consort guidelines, use intent-to-treatment procedures, assess and report health behaviors and treatment adherence to explore mechanisms of change, and examine sustained effects of interventions are needed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Parallel Trajectories of Proactive and Reactive Aggression in Middle Childhood and Their Outcomes in Early Adolescence.

This study used an accelerated longitudinal design to investigate trajectories of proactive and reactive aggression in middle childhood and their outcomes in early adolescence. Children (N = 1420; ages 5-12; 48% female) were assessed biannually over 6 school years. Classroom teachers rated students' proactive and reactive aggression throughout grades K-5; and multi-method (teacher-report, self-report, school records) measures of peer problems, depressive symptoms, academic performance, disciplinary actions, and school absenteeism were collected throughout grades 3-5. Latent class growth models were estimated to differentiate parallel-process trajectories of proactive-reactive aggression. Class membership was then examined as a predictor of outcomes at the end of 5th grade. The best-fitting solution had four trajectory classes: (1) low aggression, 76.7%; (2) high proactive-reactive aggression, 4.7%; (3) declining aggression, 4.9%; and (4) predominantly reactive aggression, 13.7%. Most classes showed seasonal upticks in aggressive behavior in the spring semester relative to fall; these were especially pronounced for proactive aggression, both as a variable and for the proactive-reactive class. Relative to their low-aggression peers, children in any elevated-aggression class had higher levels of peer problems, depressive symptoms, and disciplinary actions and lower GPAs at the end of 5th grade. The reactive class-which on no occasion had the highest total aggression-exhibited the most consistently unfavorable pattern of outcomes across methods and measures. Findings offer new insights concerning the multifinality and heterogeneity of aggressive behavior in childhood. Research, theory, and practice could benefit from adopting person-centered conceptualizations that consider the long-term trajectories, short-term variations, and proactive vs. reactive functions of youth aggression.

Chronic Illness and Internalizing Symptomatology in a Transdiagnostic Clinical Sample of Youth.

OBJECTIVE: In research with community samples, children with chronic physical illnesses have shown elevated anxiety and depressive symptoms, compared to healthy peers. Less is known about whether physical illnesses are associated with elevated internalizing symptoms even among children referred for mental health treatment-a pattern that would indicate distinctive treatment needs among physically ill children receiving mental health care. We investigated the relationship between chronic physical illness and internalizing symptomatology among children enrolling in outpatient mental health treatment. METHOD: A total of 262 treatment-seeking children ages 7-15 and their caregivers completed a demographic questionnaire, Child Behavior Checklist, and Youth Self-Report during a pre-treatment assessment. Physical illnesses were identified through caregiver report. RESULTS: There was no overall association between the presence/absence of chronic physical illness and parent- or child-reported symptoms. However, number of chronic physical illnesses was related to parent- and child-reported affective symptoms. Children with two or more chronic physical illnesses had more severe depressive symptoms than those with fewer physical illnesses. CONCLUSION: Having multiple chronic illnesses may elevate children's risk of depression symptomatology, even in comparison to other children seeking mental health care. This suggests a need to identify factors that may exacerbate depression symptoms in physically ill children who are initiating therapy and to determine whether different or more intensive services may be helpful for this group. The findings suggest the potential utility of screening for depression in youth with chronic physical illnesses, as well as addressing mental and physical health concerns during treatment.