A Prospective Study of Individual Factors in the Development of Weight and Muscle Concerns Among Preadolescent Children

Affect, Body, and Eating Habits in Children: A Systematic Review

The present review investigates the complex associations between children's affective states, body perceptions, and eating habits, thus providing crucial insights for potential health interventions. Following PRISMA guidelines, three databases were searched for peer-reviewed studies exploring the relationship between eating habits, emotional states, and body image perceptions in a population of children (5 to 11 years old). A total of seven articles were included. Our findings revealed a pattern of associations between negative emotional states, like anxiety and depressive feelings, and maladaptive eating behaviors. Additionally, explicit influences from parental feeding practices, peer pressure, socioeconomic factors, and children's body perceptions were observed to shape eating habits, with a pronounced tendency among older girls towards dieting and food preoccupation. Our results underline the intertwining nature of age, gender, and emotional states. Furthermore, our findings accentuate the urgency for comprehensive interventions that acknowledge and address the complex interplay of emotional, familial, and socioeconomic factors alongside children's body image perceptions. The criticality of continued research, particularly ones employing longitudinal designs and diverse demographic samples, is highlighted as we strive to understand and navigate such multifaceted relationships to enhance children's health and well-being.

Development and Validation of a Short Form of the Child–Adolescent Perfectionism Scale

The objective of the present study was to develop and assess the validity of a short form of the Child–Adolescent Perfectionism Scale (CAPS). Two Portuguese samples composed of 756 adolescents were used to cross-validate the factorial structure of a nine-item Child–Adolescent Perfectionism Scale—Short Form (CAPS–SF). The CAPS–SF consists of a four-item self-oriented perfectionism subscale and a five-item socially prescribed perfectionism subscale. Both subscales demonstrated adequate internal consistency. Confirmatory factor analysis (CFA) of the CAPS–SF supported the same two-factor structure and represented a very good fit to the data for both groups. Other analyses found that the brief measure of socially prescribed perfectionism was associated with measures of distress and forms of self-criticism. The CAPS–SF appears to represent a reliable and valid alternative to the original CAPS. Overall, the CAPS-SF is considerably briefer than the original CAPS and it offers an economical and valid alternative when measuring perfectionism in children and adolescents.

A reliability generalization meta-analysis of the child and adolescent perfectionism scale

BACKGROUND

Perfectionism is a prevalent disposition of personality involved in the development and maintenance of a wide range of psychological disorders. The Child and Adolescent Perfectionism Scale (CAPS) is the most usually applied test to assess perfectionism in children and adolescents. This study aimed: (a) to conduct a reliability generalization meta-analysis to estimate the average reliability of the CAPS scores and to search for characteristics of the studies that may explain the variability among reliability estimates, and (b) to estimate the reliability induction rate of the CAPS.

METHOD

An exhaustive search allowed to select 56 studies that reported alpha coefficients with the data at hand for the CAPS.

RESULTS

The average alpha coefficients were 0.87, 0.84 and 0.83, respectively for the CAPS total score and its two subscales, Socially Prescribed Perfectionism (SPP) and Self-Oriented Perfectionism (SOP). Regarding O'Connor's version, the average reliability coefficients were 0.82, 0.74 and 0.73, respectively, for SPP, SOP-Critical and SOP-Strivings. Some study characteristics (ethnicity, language, mean age and standard deviation of the scores, psychometric vs applied) showed a statistical association with the reliability coefficients of SPP and SOP. The reliability induction rate was 29.8%.

LIMITATIONS

Due to the scarcity of studies, we could not examine the reliability scores of other versions of the CAPS and test-retest reliability.

CONCLUSIONS

In terms of reliability, the original version of the CAPS present better results than O'Connor's version. The original version of the CAPS is a reliable instrument to be employed with general research purposes, but not for clinical practice.

Low body esteem and dietary restraint among 7-year old children: The role of perfectionism, low self-esteem, and belief in the rewards of thinness and muscularity

Body image concerns and dietary restraint have been shown to emerge among young children (aged 5 to 8 years). However, to date, little is known regarding the way in which individual characteristics and endorsement of sociocultural appearance ideals are associated with these concerns and behaviors in this age group. The aim of the current study was to examine perceived rewards of thinness and muscularity as a mediator of the relationships between personality traits (perfectionism and self-esteem), and body esteem and dietary restraint among 7-year-old children. Participants were 261 children, Mage (SD) = 7.46 (0.32), assessed during interview on a range of scales measuring variables of interest. Findings revealed that, with the addition of direct pathways leading to dietary restraint, the model was a good fit to the data. Furthermore, multi-group analyses revealed no gender differences. These results highlight the role of children's individual personality characteristics as well as the degree to which they uphold thin and muscular appearance ideals in body image and eating concerns in 7 year olds. Additional efforts should be made to engage this age group with prevention resources and to target personality characteristics as well as beliefs in the rewards of appearance ideals.

Psychological predictors of body image attitudes and concerns in young children

We aimed to examine cross-sectional and longitudinal relationships between psychological characteristics, body size, and body image outcomes in 6- to 7-year-old children. Participants were 202 children (91 boys, 111 girls) assessed when 6 and 7 years old. Body image-related variables, body mass index, and psychological characteristics were assessed. Cross-sectionally in the total sample, lower self-esteem was associated with greater body dissatisfaction, internalization of appearance ideals, and rewards of muscularity. Greater perfectionism was associated with greater body dissatisfaction, dietary restraint, drive for muscularity, and rewards of thinness and muscularity. Prospectively, internalization and socially prescribed perfectionism at 6 predicted greater body dissatisfaction at 7; higher perfectionism predicted greater rewards of thinness; higher perfectionism and lower self-esteem predicted greater rewards of muscularity; and lower self-esteem and smaller perceived body size predicted higher internalization. Exploratory gender specific analyses suggest that self-esteem may play a greater role in the development of body image attitudes in girls than boys, while perfectionism appears to increase boys' vulnerability to perceive greater rewards from thinness. Findings support the inclusion of psychological characteristics in etiological models of early body image development, and highlight perfectionism, internalization of appearance ideals, and self-esteem as potential targets for preventative interventions in this age group.

An examination of risk factors that moderate the body dissatisfaction-eating pathology relationship among New Zealand adolescent girls

BACKGROUND

Eating disorders (EDs) and their subclinical variants are important health concerns for adolescent girls, and body dissatisfaction is a more common yet often debilitating experience that typically precedes the development of an ED. Despite this fact, little is known about what makes girls who are dissatisfied with their bodies more likely to engage in pathological eating behaviors. The present study explored eating pathology among a sample of adolescent girls from New Zealand and examined a variety of established risk factors that may moderate the relationship between body dissatisfaction (BD) and eating pathology.

METHODS

Adolescent girls aged between 14 and 18 (N = 231) completed questionnaires assessing eating pathology, BD, negative affect, perfectionism, self-esteem, teasing and sociocultural pressure. Regression analyses tested for moderator effects to examine which variables moderated the relationship between BD and eating pathology.

RESULTS

The analyses indicated that high levels of socially prescribed and self-oriented perfectionism, negative affect, perceived pressure from the media, and low levels of self-esteem all strengthened the relationship between BD and eating pathology.

CONCLUSIONS

The results highlight potential factors that may make adolescent girls who are dissatisfied with their bodies more susceptible to eating pathology.

Measuring perfectionism in children: a systematic review of the mental health literature

The adverse consequences of perfectionism in the lives of youth (children and adolescents) are now widely recognised, including impact on mental health and general well-being. In order to develop interventions to prevent and treat perfectionism and promote resilience for children, rigorous testing and examination of theoretical models is needed as well as having access to valid and reliable assessment tools. The aim of the current literature review was to examine the validity and reliability of the measures currently being used to measure perfectionism in children under the age of 15. A systematic review of the literature identified six instruments that had been utilised in children. Preliminary support with respect to reliability and validity was established for each of these measures, and there was evidence supporting the existence of both perfectionistic striving and perfectionistic concerns in this population. However, many of the measures lacked evaluation of key psychometric properties by independent authors. Further work distinguishing adaptive and maladaptive perfectionism will be necessary to promote future interventions and treatment in this area.

A cross-sectional model of eating disorders in Argentinean overweight and obese children

Despite the fact that past research identified childhood obesity as an antecedent of eating disorders, not all obese children further develop this pathology. With this regard, our first purpose was to isolate which characteristics differentiate overweight children who have an eating disorder from those who have not. Second, considering that there is little evidence collected in Latin American countries, we provided overweight children data from an Argentinean sample. Specifically, we investigated if weight-teasing, perfectionism, disturbed eating attitudes and behaviors, and body image dissatisfaction are related to the occurrence of an eating disorder in 100 school-aged overweight/obese children (37 girls and 63 boys; mean age 10.85, SD 0.88). Participants completed self-report instruments and were interviewed between 1 and 2 months later to confirm the presence of eating disorders. Seventeen percent participants confirmed to have an eating disorder. Further, the multivariate logistic analysis revealed that perfectionism (Exp β = 1.19) and disturbed eating attitudes and behaviors (Exp β = 4.78) were jointly associated with the presence of an eating disorder. These results were maintained even when the overall model was adjusted for covariates such as age, gender, body mass index, and school type. Weight-teasing and body image dissatisfaction did not contribute to the multivariate model. Prevalence rates of ED and model findings were discussed.

The Effect of Body Mass Index, Negative Affect, and Disordered Eating on Health-Related Quality of Life in Preadolescent Youth

OBJECTIVE

To examine the indirect effect of body mass index z-score (BMIz) on health-related quality of life (HRQOL) through disordered eating attitudes and behaviors in a community sample of preadolescent children, and the degree to which negative affect moderated the association between BMIz and disordered eating attitudes and behaviors.

METHODS

Participants included 165 children between 8 and 12 years of age (M = 9.41). HRQOL, disordered eating attitudes and behaviors, and negative affect were assessed using self-report measures. Height and weight were collected by research staff.

RESULTS

Consistent with previous research in treatment-seeking and adolescent samples, the indirect effect of BMIz on HRQOL through disordered eating attitudes and behaviors was significant. Negative affect did not moderate the relationship between BMIz and disordered eating attitudes and behaviors.

CONCLUSION

Intervening on disordered eating attitudes and behaviors in preadolescents with higher weight status is critical to prevent the risk for poor HRQOL.

Weight concerns among adolescent boys

OBJECTIVE

To investigate weight concerns among adolescent boys and relationships with health indicators and family factors.

DESIGN

Analysis of the 2010 Health Behaviour in School-aged Children survey of 10-17-year-olds.

SETTING

Schools in the Republic of Ireland.

RESULTS

Among 6187 boys, 25.1% reported a desire to lose weight (weight 'loss' concern) and 7.7% reported a desire to gain weight (weight 'gain' concern). Both types of weight concerns were associated with poor self-rated health, life satisfaction and happiness, and with more frequent emotional and physical symptoms. Family factors were associated with boys' weight concerns. In adjusted analyses, the risk of weight 'loss' concerns decreased with daily family breakfasts (OR=0.80; 95% CI 0.66, 0.97). The risk of weight 'gain' concerns decreased with frequent family evening meals (OR=0.77; 95% CI 0.60, 0.99). Ease of communication with mother was associated with a decreased risk of weight 'loss' and weight 'gain' concerns among boys (OR=0.74; 95% CI 0.60, 0.90 and OR=0.61; 95% CI 0.44, 0.82, respectively). An open father-son relationship and having a father present in the home decreased the risk of weight 'loss' concerns (OR=0.69; 95% CI 0.57, 0.82 and OR=0.81; 95% CI 0.67, 0.98, respectively).

CONCLUSIONS

Body weight concerns were reported by a sizeable minority of boys and were associated with negative health outcomes. The findings support the need to promote frequent family meals and facilitate open communication in families.

An experimental manipulation of maternal perfectionistic anxious rearing behaviors with anxious and non-anxious children

The anxious rearing model of perfectionism development proposes that children develop perfectionism in response to parental worry about their children being imperfect and parental behaviors such as overprotection from mistakes and focus on the negative consequences of mistakes. In the current study, perfectionistic rearing behaviors were experimentally manipulated during a copy task in clinically anxious children (n = 42) and non-anxious children (n = 35). Children were randomized to receive high or non-perfectionistic rearing behaviors from their parents during the copy task designed to elicit child perfectionistic behaviors. Results showed that self-reported self-oriented perfectionism (SOP) was significantly higher in the anxious group compared with the non-anxious group. All children showed an increase in observed SOP in response to high perfectionistic rearing behaviors. Despite this increase in SOP in the high perfectionistic rearing condition, it was children in the non-perfectionistic rearing condition that improved significantly in task accuracy performance. Non-anxious children declined in task-related striving for perfectionism when they experienced non-perfectionistic rearing behaviors from their parents. Anxious children, however, did not show a decline in task-related striving following non-perfectionistic rearing. Results support the perfectionistic rearing model and parental perfectionistic behaviors' impact on children's observed and self-reported SOP and task performance.

Global Self-Esteem, Appearance Satisfaction, and Self-Reported Dieting in Early Adolescence

Global self-esteem, appearance satisfaction, and self-reported dieting are interrelated. In the current study, we examine the temporal ordering of global self-esteem and appearance satisfaction across the early adolescence transition, from age 10 to age 14, as well as the independent associations of self-esteem and appearance satisfaction on self-reported dieting at age 14. Participants were 130 firstborn European American adolescents (40% girls). Adolescents who were less satisfied with their appearance at age 10 reported declines in self-esteem from age 10 to age 14. Adolescents with lower global self-esteem at age 10 did not decline in appearance satisfaction. Girls, adolescents with higher BMI scores at age 10, and adolescents who were less satisfied with their appearance at age 14 all reported more frequent dieting at age 14. Implications for etiological and intervention models of eating problems in adolescence are considered.

Bulimia nervosa symptoms in the multimodal treatment study of children with ADHD

OBJECTIVE

We investigated body image dissatisfaction and bingeing/purging characteristics of bulimia nervosa (BN) in the ongoing prospective follow-up of the Multimodal Treatment Study of Children with attention-deficit/hyperactivity disorder (ADHD).

METHOD

Participants were 337 boys and 95 girls with ADHD and 211 boys and 53 girls forming a local normative comparison group (LNCG), reassessed in midadolescence (mean age, 16.4), 8 years after original recruitment.

RESULTS

Youth with childhood ADHD showed more BN symptoms in midadolescence than did LNCG youth, and girls demonstrated more BN symptoms than did boys, with effect sizes between small and medium. Childhood impulsivity, as opposed to hyperactivity or inattention, best predicted adolescent BN symptoms, particularly for girls. Among youth with ADHD, treatment received during the follow-up period was not associated with BN pathology.

DISCUSSION

Both boys and girls with ADHD may be at risk for BN symptoms in adolescence because of the impulsivity central to both disorders.

Weight and muscularity concerns as longitudinal predictors of body image among early adolescent boys: a test of the dual pathways model

The purpose of this research was to examine the longitudinal contributions of weight loss and muscularity concerns as dual pathways to body image dissatisfaction among early adolescent boys. Study 1 included 67 boys who reported on weight loss concerns, internalized muscular ideal, BMI, and body dissatisfaction during 7th grade and 1 year later. In Study 2, 87 7th and 8th grade boys were assessed in the fall and spring of a school year. The results confirmed that although both weight and muscularity concerns were related to body dissatisfaction, concern with weight loss more strongly detracted from a positive body image than did muscularity concern. The findings are discussed in terms of potential developmental variations in the relative contribution of weight and muscularity to body dissatisfaction among adolescent boys.

The role of ethnicity and culture in body image and disordered eating among males

An increasing number of researchers have examined body image concerns, disordered eating, and other behaviors associated with increasing muscle size among men from different cultural groups. However, to date there has been no synthesis or evaluation of these studies. In this paper we specifically review studies which have included a comparison between males from different cultural groups with White males on body image concerns or other related behaviors. The groups include Blacks, Hispanic Americans, Asians, Native Americans, Pacific Islanders, and men from Middle Eastern countries. Overall, evidence suggests that males from a range of cultural groups engage in more extreme body change strategies and binge eating than Whites. On the other hand, there is no consistent pattern which summarizes the nature of body image concerns across the different cultures. Mediating and/or moderating variables are proposed to account for the inconsistent findings. These include body build, levels of acculturation, socio-economic status, media exposure, and internalization of the muscular and lean body ideal.