Child body mass index, genotype and parenting in the prediction of restrictive feeding.

BACKGROUND: Restrictive feeding is implicated in pediatric obesity, and caregivers increase controlling feeding practices on the basis of higher child weight status. However, few studies have examined how child genetic and parenting characteristics together impact restrictive feeding. OBJECTIVES: We examined whether child body mass index (BMI) status predicts caregiver use of restrictive feeding and if this association is moderated by (i) caregiver strategies to manage their children's distress and (ii) child variations in the catechol-O-methyltransferase (COMT) gene (Val158 Met, rs4680). METHODS: Participants included 126 Caucasian children (50% girls) and their caregivers who were participating in a larger study in the USA. Caregivers reported on their feeding practices and responses to child distress when children were 2.5-3.5 years of age. Child anthropometric measurements were also obtained. Restrictive feeding was assessed again 1-1.5 years later. Genomic DNA was obtained from saliva samples, and COMT-rs4680 was genotyped using TaqMan® methodology. RESULTS: Child BMI percentile predicted subsequent caregiver restrictive feeding for children who were Met/Met and who had caregivers reporting higher use of negative responses to child distress. For Val carriers, BMI percentile predicted restrictive feeding when caregivers were below the mean on these responses. CONCLUSIONS: Caregivers are at risk for use of restrictive feeding practices when their children are at higher BMI percentiles, and this association increases when caregivers use more ineffective stress regulation practices and their children are homozygous for the Met allele. Prevention programmes might focus on parenting behaviours that foster emotion regulation and consider variation in child responses to parenting.

The interaction of maternal and infant vulnerabilities on developing attachment relationships.

The present study sought to document an example of how maternal and infant vulnerabilities interact in contributing to the quality of early attachment relationships. Maternal depressive symptoms, neonatal health characteristics, and infant mother attachment were assessed for 42 preterm, low birth weight infants and 42 full-term infants at 12 months postterm. Results indicated that preterm birth moderated the relation between maternal depressive symptoms and quality of infant-mother attachment, even controlling for level of neonatal health complications. Preterm infants with more symptomatic mothers were most likely to be classified as insecurely attached to their mothers, whereas no direct relation between subclinical depressive symptoms and attachment was found for full-term infants.

Finding meaning in religious practices: the relation between religious holiday rituals and marital satisfaction.

This study examined the relation between marital satisfaction and religious holiday ritual practices. One hundred twenty couples, married 9 years on average, completed measures of religious holiday practices (current family and family-of-origin) and marital satisfaction. Couples were interviewed about how important religion was to their family life. Marital satisfaction was related to religious holiday rituals beyond a global indication of religiousness. A different pattern was found for husbands and wives, with husbands' satisfaction more closely linked to ritual meaning and wives' satisfaction associated with routine practices. Family-of-origin rituals were connected across generations. Wives' marital satisfaction was related to husbands' report of religious holiday rituals but not the converse. Results are discussed in terms of how rituals affirm relationships, connect values and beliefs, and may have differential meaning for men and women.

Family rituals as a protective factor for children with asthma.

OBJECTIVE: To examine how one aspect of family life, notably family rituals and routines, may protect children with asthma from anxiety-related symptoms. METHODS: Eighty-six families (43 children with asthma, 43 healthy comparison children) participated in the study. Children completed measures of anxiety (Revised Child Manifest Anxiety Scale) and health. Parents completed measures of stress (Parenting Stress Index), family rituals (Family Routines Questionnaire), and family health. RESULTS: Families that reported more meaning in their family routines had children who reported lower levels of anxiety. Mother endorsement of family ritual meaning and father endorsement of family ritual routine were most strongly related to lower levels of anxiety. Support for the protective function of meaningful family rituals was stronger when a general health stress model was used rather than the presence or absence of asthma alone. CONCLUSIONS: Family rituals may serve a protective function for children with asthma under conditions of heightened parenting stress.

Qualitative inquiry: an overview for pediatric psychology.

OBJECTIVE: To provide a framework for critically evaluating qualitative research to professionals interested in pediatric psychology. Qualitative methods emphasize the phenomenological experience of participants and may be pertinent to studying contextual factors that contribute to child health and well-being. METHOD: A basic overview of the types of qualitative research, methodological procedures, and ethical considerations is provided. Examples are drawn from qualitative studies that focus on child and family health. RESULTS: The article concludes with guidelines for examining qualitative research and recommendations for use in pediatric psychology. CONCLUSION: Qualitative methods have the potential to address important issues in pediatric psychology.

Family context in pediatric psychology from a transactional perspective: family rituals and stories as examples.

Reviewed the transactional model as applied to the family context of pediatric psychology. A three-part sequence of child behavior, parent behavior, and family interpretation was used to describe developmental adaptation and transitions. It was proposed that families are regulated by practices that are proximal to the child's experience and representations that are more distal to the child's experience. Family practices are examined through family routines and rituals. Family representations are examined through family stories. Case examples of low birth weight premature infants and an adolescent referred for repeated hospitalizations due to diabetic ketoacidosis were presented to illustrate the model. Guidelines for the practicing pediatric psychologist are presented to assess family organization through family rituals and family meaning-making in the telling of family stories.

Family-of-origin experiences and conflict resolution behaviors of young adult dating couples.

This study was conducted to explore the relationship among retrospective reports of family-of-origin functioning, reported perceptions of a laboratory-based conflict resolution discussion, and outsiders' ratings of communication behaviors between young adult dating couples, with a special focus on predicted gender differences. Sixty-three couples aged 18 to 24 participated in this study. A Revealed Differences task was used to elicit discussion about an issue identified as discordant for the couple on a Relationship Issue Questionnaire. Family-of-origin variables were related to both men's and women's perceptions of the conflict, as well as outsiders' ratings of their conflict resolution behaviors. However, the conflict resolution behaviors and perceptions of men and women were associated with distinctly different aspects of functioning in their families of origin. Further, women's families-of-origin factors were more prominent for the couples' communication behaviors because they indicated a greater number of significant correlations between the women's families of origin and: 1) perceptions of the conflict resolution discussion by both the men and women, and 2) the observed conflict resolution behaviors of both men and women. These findings are discussed in the context of both the relevant research and important social-political influences.

Dimensions of family rituals across two generations: relation to adolescent identity.

Family rituals are considered part of a generational process that fosters a sense of identity for individual members and is reflective of the family's shared belief system. The symbolic significance attached to family rituals is considered central to the force of family rituals. Three questions were addressed in the study: (1) Are the dimensions of family rituals viewed similarly across generations?; (2) Is level of ritualization related to adolescent identity?; (3) If there is disagreement about the relative level of ritualization in a family, is there a negative relation to adolescent identity? A total of 77 families with an adolescent member completed the Family Ritual Questionnaire, and the adolescents completed a measure of self-esteem. Results of a factor analysis demonstrated shared representation of family rituals across two generations, with one factor loading on the symbolic qualities of family rituals and the second factor loading on the routine aspects of family rituals. Positive relations were found between adolescent identity and the family's report of symbolic significance and affect associated with family rituals. A negative relation was found between mother-adolescent disagreement about family rituals and adolescent feelings of belonging. Distinguishing between meaning and routine aspects of family rituals is discussed as well as clinical implications.

Playful relationships: a contextual analysis of mother-toddler interaction and symbolic play.

The relation between social interaction and complexity of toddler's symbolic play was investigated. 57 toddlers between 15 and 24 months of age were observed under 4 conditions: (1) child play alone, (2) child play with mother, (3) child modeling mother, and (4) child play with mother following the modeling condition. Each subject was rated on complexity of play, maternal attention directing, reciprocity, and maternal intrusiveness. Significant condition effects were found in which more complex forms of play were observed when the children were playing with their mothers than when playing by themselves. Maternal intrusions and questioning were negatively related to symbolic play. Turn-taking was negatively related to simple exploratory play. Results of a sequential analysis demonstrated that turn-taking was more likely to precede symbolic play, and maternal intrusiveness was more likely to precede simple exploratory play. The role of active partnership in symbolic play development is discussed.

Family context in pediatric psychology: a transactional perspective.

The degree to which the family is seen as a significant contributor to child health conditions impacts directly on the successful functioning of the pediatric psychologist. A transactional model of family functioning is proposed for pediatric psychology. Development is considered to be the result of a three-part process that starts with child behavior that triggers family interpretation that produces a parental response. Family interpretation is presented as part of a regulatory system that includes family paradigms, family stories, and family rituals. Corresponding to the proposed three-part regulation model, three forms of intervention are discussed: remediation, redefinition, and reeducation. Clinical decision making based on this model is outlined with examples given from different treatment approaches. Implications for the treatment of families in pediatric psychology are discussed.