Evaluation of depression, anxiety symptoms, emotion regulation difficulties, and self-esteem in children and adolescents with obesity

Does attachment anxiety mediate the persistence of anxiety and depressive symptoms from adolescence to early adulthood?

OBJECTIVES

Depression and anxiety often emerge in adolescence and persist into early adulthood. Developing a greater understanding of the factors that influence their persistence may inform psychological interventions. Their association with an insecure attachment style is well established although the mediating role of attachment anxiety in the persistence of depression and anxiety over time has not been examined. This study aimed to examine if anxious attachment mediated depression and anxiety from adolescence to early adulthood.

METHODS

Data from 3,436 participants in a longitudinal birth cohort study were examined. At 14-years and 21-years, participants completed the Achenbach Youth Self Report (YSR) and the Achenbach Young Adult Self-Report (YASR) respectively. At 21-years, participants completed the Attachment Style Questionnaire (ASQ). Attachment anxiety as a mediator for the persistence of anxiety/depressive symptoms from 14- to 21-years was examined.

RESULTS

Attachment anxiety accounted for approximately 60% of the persistence of anxiety and depressive symptoms at 14- and 21- years after adjusting for covariates. Results were similar when stratifying by males and females.

CONCLUSIONS

Attachment anxiety significantly contributes to the persistence of anxiety and depressive symptoms from adolescence into early adulthood for both males and females. Incorporating interventions that address attachment anxiety in adolescents may improve the response to therapy for anxiety and depression.

Stigma assessment scale for adolescent idiopathic scoliosis: A new tool for spine deformity stigma evaluation

PURPOSE

Stigma is the negative attitudes towards an illness or difference. The literature lacks detailed scales specifically addressing stigmatization in AIS. This study aimed to develop Adolescent Idiopathic Scoliosis Stigma Assessment Scale (AIS-SAS) to measure stigmatization in AIS patients.

METHODS

In creating the AIS-SAS, we developed items via literature review and expert input, confirmed content validity, and conducted a field test for construct validity and reliability. Our experts designed 38 items in three subscales: Scoliosis, Brace, and Surgery-related stigma. Exploratory factor analysis (EFA) and convergent validity were examined for construct validity. The convergent validity of AIS-SAS was assessed through its correlations with the Rosenberg Self-Esteem Scale (RSES), SRS-22, and Spinal Appearance Questionnaire (SAQ). Reliability was gauged via internal consistency and test-retest methods.

RESULTS

Sixty-seven adolescents with AIS were included in the study. EFA results confirmed one-dimensionality for each subscale, with factor loadings from 0.51 to 0.96, leading to the removal of 8 items with loadings below 0.3 from the AIS-SAS. The final AIS-SAS has three subscales: scoliosis (18 items), brace (5 items), and surgery-related stigma (7 items). Regarding convergent validity, the scoliosis-related stigma scores significantly correlated with SRS-22 self-image (r= -0.413 p = 0.001) and SAQ-Appearance (r = 0.441 p = 0.002). The RSES-Total score shows a negative correlation with Scoliosis, Brace, and Surgery-related stigma scores: -0.500 (p < 0.001), -0.435 (p = 0.049), and  -0.498 (p = 0.042), respectively. AIS-SAS subscales showed good reliability (Cronbach-α > 0.8 ICC > 0.8).

CONCLUSION

AIS-SAS is the first valid and reliable high-quality scale assessing stigmatization from AIS, measuring scoliosis, brace, and surgery-related stigma via three subscales.

The relationship between cumulative family risk and depression in left-behind children: a moderated mediation model

BACKGROUND

This study proposed a moderated mediation model to examine the mediating role of core self-evaluation in the relationship between cumulative family risk and depression among left-behind children, and whether this process was moderated by school climate.

METHODS

A total of 415 rural left-behind children from 35 townships in Anhui Province (54.46% males; mean age = 12.53, SD = 2.27) were randomly conducted in June 2023 using convenience sampling. Data were processed and analyzed using SPSS 25.0 and PROCESS 3.3.

RESULTS

After controlling for gender, age, grade, and left-behind type, cumulative family risk positively predicted depression in left-behind children (β = 0.18, p < 0.001). Core self-evaluation fully mediated the relationship between cumulative family risk and depression in left-behind children (indirect effect = 0.10, 95%CI = [0.06, 0.15]). Moreover, school climate moderated the relationship between cumulative family risk and core self-evaluation (the first half of the mediation pathway) (β =-0.13, p < 0.01). Specifically, as the school climate level increased, cumulative family risk became more predictive of core self-evaluation (Blow = - 0.001, p > 0.05; Bhigh = - 0.26, p < 0.001).

CONCLUSION

Creating a favourable family and school climate and improving core self-evaluation are beneficial to reduce depression in left behind children.

Exenatide for obesity in children and adolescents: Systematic review and meta-analysis

Objectives: There is no curative treatment for childhood obesity. We aim to synthesize published Randomized Controlled Trials (RCTs) evidence on the efficacy of exenatide in obese children and adolescents. Methods: We conducted a comprehensive search and analysis of relevant studies in popular databases such as PubMed, Web of Science, Embase, and Cochrane Library. Our focus was on RCTs that examined the effectiveness of exenatide for treating obesity in children. We primarily assessed changes in body weight, body mass index (BMI), fasting plasma glucose (FPG), or HbA1c levels. Additionally, we considered any adverse events reported during the treatment period, with particular attention to hypoglycemia. To evaluate the quality of RCTs included in our study, we employed the Cochrane bias assessment tool. Results: Five studies met the inclusion criteria. A group of 100 children were assigned to receive treatment with exenatide. Compared with controls, exenatide therapy reduced body weight and BMI by -0.6% (95% CI -0.93, -0.27), -1.11% (95% CI -1.91, -0.31), respectively. Undesirable consequences encompass gastrointestinal symptoms, with the majority of instances being characterized by mild severity. Conclusion: Exenatide demonstrates efficacy in the treatment of pediatric and adolescent obesity. Systematic Review Registration: PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=413706.