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Rendall S, Dodd H, Harvey K. Controlling feeding practices moderate the relationship between emotionality and food fussiness in young children. Appetite 2022; 178:106259. [PMID: 35985496 DOI: 10.1016/j.appet.2022.106259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022]
Abstract
Emotional child temperament has consistently been found to be related to food fussiness. One factor that may exacerbate or reduce the risk conferred by children's emotionality is parent feeding practices during mealtimes. Specifically, the use of controlling feeding practices aimed at increasing food consumption may particularly affect children with an emotional temperament. The primary aim of this study was to investigate whether the association between child food fussiness and higher emotionality found in previous studies is moderated by maternal use of controlling feeding practices, namely verbal pressure, physical prompts and food rewards. Sixty-seven mother-child dyads were video-recorded during a meal in their home and mothers' use of controlling feeding practices during this meal were coded. Mothers completed a questionnaire assessing child temperament. Moderation analyses revealed that maternal use of verbal pressure and physical prompts moderated the relationship between higher emotionality and food fussiness, but maternal use of food rewards did not. These results indicate that the use of verbal pressure and physical prompts may have a particularly negative influence on fussy eating for children higher in emotionality.
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Affiliation(s)
- Stella Rendall
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK
| | - Helen Dodd
- College of Medicine and Health, University of Exeter, St. Lukes Campus, Heavitree Road, Efffxeter, EX1 2LU, UK
| | - Kate Harvey
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK.
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Martini MG, Barona-Martinez M, Micali N. Eating disorders mothers and their children: a systematic review of the literature. Arch Womens Ment Health 2020; 23:449-467. [PMID: 31938867 PMCID: PMC7368867 DOI: 10.1007/s00737-020-01019-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022]
Abstract
To provide an overview of the impact of maternal eating disorders (ED) on child development in a number of domains including feeding and eating behaviour, neuropsychological profile and cognitive development, psychopathology and temperament. PubMed, Embase and PsychInfo were searched for studies exploring the impact of maternal ED on children between January 1980 and September 2018. Initial search yielded 569 studies. After exclusion, 32 studies were reviewed. Overall, available evidence shows that children of mothers with ED are at increased risk of disturbances in several domains. They exhibit more difficulties in feeding and eating behaviours, display more psychopathological and socio-emotional difficulties, and they are more likely to be described as having a difficult temperament. Maternal ED have an impact on child psychological, cognitive and eating behaviours, and might affect the development of ED in the offspring. Future research should focus on resilience and on which protective factors might lead to positive outcomes. These factors can be then used as therapeutic and preventative targets.
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Affiliation(s)
- Maria Giulia Martini
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 4th Floor, 30 Guilford Street, London, WC1N 1EH, UK. .,South London and Maudsley, NHS Foundation Trust, London, UK.
| | - Manuela Barona-Martinez
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 4th Floor, 30 Guilford Street, London, WC1N 1EH UK
| | - Nadia Micali
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 4th Floor, 30 Guilford Street, London, WC1N 1EH UK ,Department of Psychiatry, University of Geneva, Geneva, Switzerland ,Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health, University Hospital Geneva, Geneva, Switzerland
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Hiremath G, Rogers E, Kennedy E, Hemler J, Acra S. A Comparative Analysis of Eating Behavior of School-Aged Children with Eosinophilic Esophagitis and Their Caregivers' Quality of Life: Perspectives of Caregivers. Dysphagia 2019; 34:567-574. [PMID: 30712065 DOI: 10.1007/s00455-019-09984-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/21/2019] [Indexed: 01/07/2023]
Abstract
Eosinophilic esophagitis (EoE) can affect eating behavior in infants and children and this may lead to stressful interactions with their caregivers and potentially impact their caregivers' quality of life. Clinical evaluation of eating behaviors can be time consuming and burdensome. Caregivers can provide a comprehensive assessment of their child's eating behavior; however, this has not been well studied in children with EoE. In a case-control study, we used Child Eating Behavior Questionnaire (CEBQ) to compare caregivers' perception of eating behaviors in children (ages 11 ± 4 years; Mean ± SD) with EoE (cEoE; N = 42) to that of non-EoE controls (cControls; N = 38), and Feeding/Swallowing Impact on Children's Caregivers Questionnaire (FS-IS) to examine the impact of EoE-related eating problems on their caregivers' quality of life. There were no differences between the cEoE and cControls perceptions of eating behaviors as assessed by CEBQ. In FS-IS, the cEoE indicated that they were worried about the way their child would breathe or if the child would choke while feeding (2.28 ± 0.16 vs. 1.25 ± 0.13; p < 0.001), and also indicated that it was hard for them to feed their child as it took a long time to prepare liquids and foods the "right" way (2.1 ± 0.20 vs. 1.17 ± 0.09; p < 0.001) when compared to cControls. Our results suggest that caregivers' perception of the eating behavior of school-aged children with and without EoE do not differ significantly, yet the perception of feeding/swallowing issues in children with EoE can negatively impact their caregivers' quality of life. Further research is needed to discern the eating behavior in children with EoE and its relationship with their caregivers' quality of life.
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Affiliation(s)
- Girish Hiremath
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Doctors Office Tower, Suite 10226, 2200, Children's Way, Nashville, TN, 37232, USA.
| | - Elizabeth Rogers
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Doctors Office Tower, Suite 10226, 2200, Children's Way, Nashville, TN, 37232, USA
| | - Elizabeth Kennedy
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Doctors Office Tower, Suite 10226, 2200, Children's Way, Nashville, TN, 37232, USA
| | - Jonathan Hemler
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Sari Acra
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Doctors Office Tower, Suite 10226, 2200, Children's Way, Nashville, TN, 37232, USA
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Abstract
BACKGROUND Anorexia nervosa (AN) is characterised by a failure to maintain a normal body weight due to a paucity of nutrition, an intense fear of gaining weight or behaviour that prevents the individual from gaining weight, or both. The long-term prognosis is often poor, with severe developmental, medical and psychosocial complications, high rates of relapse and mortality. 'Family therapy approaches' indicate a range of approaches, derived from different theories, that involve the family in treatment. We have included therapies developed on the basis of dominant family systems theories, approaches that are based on or broadly similar to the family-based therapy derived from the Maudsley model, approaches that incorporate a focus on cognitive restructuring, as well as approaches that involve the family without articulation of a theoretical approach.This is an update of a Cochrane Review first published in 2010. OBJECTIVES To evaluate the efficacy of family therapy approaches compared with standard treatment and other treatments for AN. SEARCH METHODS We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR) and PsycINFO (OVID) (all years to April 2016). We ran additional searches directly on Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Ovid Embase, and PsycINFO (to 2008 and 2016 to 2018). We searched the World Health Organization (WHO) trials portal (ICTRP) and ClinicalTrials.gov, together with four theses databases (all years to 2018). We checked the reference lists of all included studies and relevant systematic reviews. We have included in the analyses only studies from searches conducted to April 2016. SELECTION CRITERIA Randomised controlled trials (RCTs) of family therapy approaches compared to any other intervention or other types of family therapy approaches were eligible for inclusion. We included participants of any age or gender with a primary clinical diagnosis of anorexia nervosa. DATA COLLECTION AND ANALYSIS Four review authors selected the studies, assessed quality and extracted data. We used a random-effects meta-analysis. We used the risk ratio (with a 95% confidence interval) to summarise dichotomous outcomes and both the standardised mean difference and the mean difference to summarise continuous measures. MAIN RESULTS We included 25 trials in this version of the review (13 from the original 2010 review and 12 newly-included studies). Sixteen trials were of adolescents, eight trials of adults (seven of these in young adults aged up to 26 years) and one trial included three age groups: one adolescent, one young adult and one adult. Most investigated family-based therapy or variants. Reporting of trial conduct was generally inadequate, so that in a large number of studies we rated the risk of bias as unclear for many of the domains. Selective reporting bias was particularly problematic, with 68% of studies rated at high risk of bias in this area, followed by incomplete outcome data, with 44% of studies rated at high risk of bias in this area. For the main outcome measure of remission there was some low-quality evidence (from only two studies, 81 participants) suggesting that family therapy approaches might offer some advantage over treatment as usual on rates of remission, post intervention (risk ratio (RR) 3.50, 95% confidence interval (CI) 1.49 to 8.23; I2 = 0%). However, at follow-up, low-quality evidence from only one study suggested this effect was not maintained. There was very low-quality evidence from only one trial, which means it is difficult to determine whether family therapy approaches offer any advantage over educational interventions for remission (RR 9.00, 95% CI 0.53 to 153.79; 1 study, N = 30). Similarly, there was very low-quality evidence from only five trials for remission post-intervention, again meaning that it is difficult to determine whether there is any advantage of family therapy approaches over psychological interventions (RR 1.22, 95% CI 0.89 to 1.67; participants = 252; studies = 5; I2 = 37%) and at long-term follow-up (RR 1.08, 95% CI 0.91 to 1.28; participants = 200; studies = 4 with 1 of these contributing 3 pairwise comparisons for different age groups; I2 = 0%). There was no indication that the age group had any impact on the overall treatment effect; however, it should be noted that there were very few trials undertaken in adults, with the age range of adult studies included in this analysis from 20 to 27. There was some evidence of a small effect favouring family based therapy compared with other psychological interventions in terms of weight gain post-intervention (standardised mean difference (SMD) 0.32, 95% CI 0.01 to 0.63; participants = 210; studies = 4 with 1 of these contributing 3 pairwise comparisons for different age groups; I2 = 11%) . Overall, there was insufficient evidence to determine whether there were any differences between groups across all comparisons for most of the secondary outcomes (weight, eating disorder psychopathology, dropouts, relapse, or family functioning measures), either at post-intervention or at follow-up. AUTHORS' CONCLUSIONS There is a limited amount of low-quality evidence to suggest that family therapy approaches may be effective compared to treatment as usual in the short term. This finding is based on two trials that included only a small number of participants, and both had issues about potential bias. There is insufficient evidence to determine whether there is an advantage of family therapy approaches in people of any age compared to educational interventions (one study, very low quality) or psychological therapies (five studies, very low quality). Most studies contributing to this finding were undertaken in adolescents and youth. There are clear potential impacts on how family therapy approaches might be delivered to different age groups and further work is required to understand what the resulting effects on treatment efficacy might be. There is insufficient evidence to determine whether one type of family therapy approach is more effective than another. The field would benefit from further large, well-conducted trials.
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Affiliation(s)
- Caroline A Fisher
- Royal Melbourne Hospital, Melbourne HealthAllied Health ‐ PsychologyParkvilleAustralia3050
| | - Sonja Skocic
- HealthscopeThe Melbourne ClinicRichmondAustralia
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Cimino S, Cerniglia L, Porreca A, Ballarotto G, Marzilli E, Simonelli A. IMPACT OF PARENTAL BINGE EATING DISORDER: EXPLORING CHILDREN'S EMOTIONAL/BEHAVIORAL PROBLEMS AND THE QUALITY OF PARENT-CHILD FEEDING INTERACTIONS. Infant Ment Health J 2018; 39:552-568. [DOI: 10.1002/imhj.21732] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Aldridge VK, Dovey TM, El Hawi N, Martiniuc A, Martin CI, Meyer C. OBSERVATION AND COMPARISON OF MEALTIME BEHAVIORS IN A SAMPLE OF CHILDREN WITH AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDERS AND A CONTROL SAMPLE OF CHILDREN WITH TYPICAL DEVELOPMENT. Infant Ment Health J 2018; 39:410-422. [DOI: 10.1002/imhj.21722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | | | | | - Caroline Meyer
- University of Warwick and Coventry and Warwickshire Partnership NHS Trust Coventry; United Kingdom
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van Dijk M, Lipke-Steenbeek W. Measuring feeding difficulties in toddlers with Down syndrome. Appetite 2018; 126:61-65. [PMID: 29601917 DOI: 10.1016/j.appet.2018.03.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 11/29/2022]
Abstract
Early feeding problems occur frequently across the population, but have a higher incidence in children with Down syndrome (DS). Early identification can possibly be improved with the help of a valid screening instrument based on caregiver reports. In a previous study, we investigated the concurrent validity of the Dutch version of the Montreal Children's Hospital Feeding Scale (MCH-FS, SEP in Dutch) in a sample of typically developing toddlers, and we found a correlation between the score on the instrument and observed behavior during a regular meal. The current pilot study was a replication in a sample of children with DS (aged 1; 0-3; 0) and their primary caregivers (n = 32). The results showed that children in the sample did not score higher on the SEP than children in their respective norm groups. In addition, when caregivers reported more symptoms of feeding problems on the SEP, children showed more food refusal and negative affect during the observed meal. This suggests that the screening instrument is particularly associated with negative mealtime interactions. This is in contrast with earlier results, which mainly indicated a relation with eating skills.
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Affiliation(s)
- Marijn van Dijk
- Heymans Institute for Psychological Research, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Wilma Lipke-Steenbeek
- Department of Health and Social Work, Windesheim University of Applied Sciences, Campus 2, 8017 CA, Zwolle, The Netherlands.
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Dömötör S, Cserép M. Treatment methods of avoidant/restrictive food intake disorder: Review with therapeutic implications. Psihijatrija danas 2017. [DOI: 10.5937/psihdan1701005d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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9
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Nguyen AN, de Barse LM, Tiemeier H, Jaddoe VWV, Franco OH, Jansen PW, Voortman T. Maternal history of eating disorders: Diet quality during pregnancy and infant feeding. Appetite 2016; 109:108-114. [PMID: 27889494 DOI: 10.1016/j.appet.2016.11.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/09/2016] [Accepted: 11/22/2016] [Indexed: 02/06/2023]
Abstract
We studied associations of maternal history of eating disorders (EDs) with diet quality of pregnant women and their infants, and breastfeeding practices. We included 6196 mother-child pairs from Generation R, a population-based cohort in the Netherlands. Maternal history of lifetime EDs was assessed during pregnancy with a questionnaire. Dietary intake during pregnancy and in infancy was assessed with food-frequency questionnaires and diet quality scores were calculated, reflecting adherence to dietary guidelines. Breastfeeding practices were assessed with questionnaires at 2, 6, and 12 months. We observed that, after adjustment for socioeconomic and lifestyle factors, women with a history of EDs had a higher diet quality than women without a history of EDs (B = 0.24 SD, 95%CI: 0.15; 0.33). Mothers with a history of EDs were less likely to breastfeed (unadjusted OR = 0.68, 95%CI: 0.51; 0.93), although no longer statistically significant after adjustment (OR = 0.75, 95%CI: 0.55; 1.03). These findings suggest that mothers with a history of EDs seem slightly less likely to initiate breastfeeding, however, this warrants further investigation. At the age of 1 year, infants of mothers with a history of EDs had a higher diet quality (B = 0.15 SD, 95%CI: 0.02; 0.27). We conclude that mothers with a history of EDs and their infants have a relative good diet quality, although follow-up studies are needed to assess long-term associations with diet in later childhood and adolescence.
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Affiliation(s)
- Anh N Nguyen
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Lisanne M de Barse
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry / Psychology, Erasmus MC-University Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands; Department of Psychiatry, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC-University Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry / Psychology, Erasmus MC-University Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands; Institute of Psychology, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
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Lydecker JA, Grilo CM. Fathers and mothers with eating-disorder psychopathology: Associations with child eating-disorder behaviors. J Psychosom Res 2016; 86:63-9. [PMID: 27302549 PMCID: PMC4911698 DOI: 10.1016/j.jpsychores.2016.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/12/2016] [Accepted: 05/18/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. METHODS The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. RESULTS Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child's weight, and more monitoring of their child's eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child's diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. CONCLUSION Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns.
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Affiliation(s)
- Janet A Lydecker
- Department of Psychiatry, Yale School of Medicine, United States.
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, United States
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van Dijk M, Bruinsma E, Hauser MP. The relation between child feeding problems as measured by parental report and mealtime behavior observation: A pilot study. Appetite 2016; 99:262-267. [DOI: 10.1016/j.appet.2016.01.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/16/2016] [Accepted: 01/18/2016] [Indexed: 10/22/2022]
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Abstract
This study explored the neurodevelopmental outcomes of toddlers whose mothers have eating disorder histories and the contribution of maternal eating and comorbid psychopathology to the children's cognitive functioning. Twenty-nine mothers with prenatal eating disorders and their toddlers (18-42 months old) were compared to a case-control matched group of mothers with no eating psychopathology and their toddlers. Measures included current maternal eating and co-occurring psychopathology, and a developmental assessment of each child. The children of mothers with eating disorders showed delayed mental and psychomotor development. Severity of maternal eating disorder symptoms emerged as a significant predictor of child development, but other maternal psychopathology did not. Findings suggest that maternal eating disorder history may play a unique role in the development of neurodevelopmental functions in their children.
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Affiliation(s)
- Shiri Sadeh-Sharvit
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA.,b Psychology Department , Bar Ilan University , Ramat Gan , Israel
| | | | - James D Lock
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
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Abstract
Previous research suggests that parental report of children's feeding corresponds with their child's nutritional intake (Cooke et al., 2006; Ekstein et al., 2010). The current study aimed to determine whether there is a relationship between parental report of children's feeding problems and their child's nutritional intake in a non-clinical population and, in addition, to establish whether parental anxiety (Cooke et al., 2003) can predict whether parental report of feeding problems correspond with the child's intake. Sixty-one parents of children aged two to seven years completed the parent report measure; the Behavioural Paediatric Feeding Assessment Scale as well as a food diary detailing their child's intake, which was analysed using CompEAT nutritional software. They also completed the anxiety subscale of the Hospital Anxiety and Depression Scale. Previous findings of an association between parent report of feeding problems and child's intake (Cooke et al., 2006) were not replicated. However, an association was found between parents' anxiety and their reports of feeding problems. Parental anxiety was also found to independently predict whether parent report of feeding problems matched the child's intake. Findings highlight the importance of a multifactorial approach to understanding childhood feeding difficulties. This requires replication with a clinical sample.
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Affiliation(s)
- Lucy Harvey
- Great Ormond Street Hospital for Children NHS Foundation Trust, UKLoughborough University, UK
| | - Rachel Bryant-Waugh
- Great Ormond Street Hospital for Children NHS Foundation Trust, UKLoughborough University, UK
| | - Beth Watkins
- Great Ormond Street Hospital for Children NHS Foundation Trust, UK
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Sanchez K, Spittle AJ, Allinson L, Morgan A. Parent questionnaires measuring feeding disorders in preschool children: a systematic review. Dev Med Child Neurol 2015; 57:798-807. [PMID: 25809003 DOI: 10.1111/dmcn.12748] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2015] [Indexed: 01/25/2023]
Abstract
AIM Preschool feeding disorders are common and debilitating and are associated with a range of developmental and medical issues. Parent report allows assessment of feeding in a naturalistic environment over time, with advantages over time-limited, clinic-based observations. However, little is understood about the limitations and advantages of current parent-report measures. We aimed to systematically review the psychometrics and clinometrics of parent-administered feeding questionnaires. METHOD Five search engines were used to identify questionnaires that met inclusion criteria, i.e. being norm-or criterion-referenced, child focused, appropriate for preschool children, and measured two or more feeding domains (e.g. dysphagia/oral motor delay, food refusal). RESULTS In total 3535 abstracts were identified and 215 full-text articles were evaluated. Five questionnaires met the criteria. The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was the most reliable questionnaire identified, with good test-retest reliability and internal consistency. More predictive and concurrent validity data was available for the BPFAS, the Mealtime Behavior Questionnaire, and the Montreal Children's Hospital Feeding Scale than for other measures. INTERPRETATION Further research is needed on the psychometric properties of feeding questionnaires used in research and clinical practice. To date, the BPFAS has the most comprehensive reliability and validity data of any parent-administered feeding questionnaire for preschool children.
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Affiliation(s)
- Katherine Sanchez
- Murdoch Children's Research Institute, Parkville, Vic., Australia.,University of Melbourne, Parkville, Vic., Australia
| | - Alicia J Spittle
- Murdoch Children's Research Institute, Parkville, Vic., Australia.,University of Melbourne, Parkville, Vic., Australia.,The Royal Women's Hospital, Parkville, Vic., Australia
| | - Leesa Allinson
- Murdoch Children's Research Institute, Parkville, Vic., Australia.,University of Melbourne, Parkville, Vic., Australia.,The Royal Women's Hospital, Parkville, Vic., Australia
| | - Angela Morgan
- Murdoch Children's Research Institute, Parkville, Vic., Australia.,University of Melbourne, Parkville, Vic., Australia
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Sumodhee D, Payne N. Healthy eating beliefs and intentions of mothers and their adult children: An intergenerational transmission perspective. J Health Psychol 2015; 21:2775-2787. [PMID: 26060241 DOI: 10.1177/1359105315586214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined the possible intergenerational transmission of eating beliefs and intentions between 60 mothers and their adult children. Maternal restrictive feeding practices were correlated with mothers' own healthy eating attitudes and subjective norms, and with their adult children's subjective norms. Mothers' beliefs and intentions were correlated with their adult children. Adult children's intentions to eat healthily were predicted by their attitudes and perceived behavioural control, and also by their mothers' intentions and perceived behavioural control. Mothers' own beliefs and intentions may be involved in shaping their children's beliefs and intentions into adulthood but their child feeding practices may have less of an influence.
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de Barse LM, Tharner A, Micali N, Jaddoe VV, Hofman A, Verhulst FC, Franco OH, Tiemeier H, Jansen PW. Does maternal history of eating disorders predict mothers' feeding practices and preschoolers' emotional eating? Appetite 2015; 85:1-7. [DOI: 10.1016/j.appet.2014.10.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 12/13/2022]
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Braden A, Rhee K, Peterson CB, Rydell SA, Zucker N, Boutelle K. Associations between child emotional eating and general parenting style, feeding practices, and parent psychopathology. Appetite 2014; 80:35-40. [DOI: 10.1016/j.appet.2014.04.017] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 03/17/2014] [Accepted: 04/11/2014] [Indexed: 11/21/2022]
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Haycraft E, Goodwin H, Meyer C. Adolescents' level of eating psychopathology is related to perceptions of their parents' current feeding practices. J Adolesc Health 2014; 54:204-8. [PMID: 24094778 DOI: 10.1016/j.jadohealth.2013.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 07/26/2013] [Accepted: 08/08/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to examine the relationships between adolescents' eating disorder attitudes and their perceptions of the feeding practices that their parents/caregivers currently use. METHODS Boys and girls (N = 528) aged 13-15 completed self-report measures of their levels of eating psychopathology and their parents' current feeding practices and reported their own height and weight. RESULTS For girls, greater perceived pressure from parents to eat food and lower perceived parental responsibility for food were significantly related to more unhealthy eating-related attitudes. Similar to girls, lower perceived parental responsibility for food was significantly related to greater levels of eating psychopathology in boys. Greater perceived parental restriction of foods was also significantly related to greater eating psychopathology in boys. CONCLUSIONS These results suggest that adolescents' perceptions of their parents' use of more controlling feeding practices are related to greater prevalence of unhealthy eating-related attitudes. Such findings have potentially important implications for the prevention of disordered eating in adolescents.
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Affiliation(s)
- Emma Haycraft
- Loughborough University Centre for Research into Eating Disorders, Loughborough University, Loughborough, UK.
| | - Huw Goodwin
- Loughborough University Centre for Research into Eating Disorders, Loughborough University, Loughborough, UK
| | - Caroline Meyer
- Loughborough University Centre for Research into Eating Disorders, Loughborough University, Loughborough, UK
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Hoffman ER, Hodges EA, Propper C, Postage PL, Zipkin EC, Bentley ME, Ward DS, Hamer RM, Bulik CM. Behavioral and Psychophysiological Responsiveness During Child Feeding in Mothers with Histories of Eating Disorders: A Pilot Study. J Psychopathol Behav Assess 2013; 35:578-591. [PMID: 24511180 DOI: 10.1007/s10862-013-9357-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this pilot project was to describe maternal responsiveness during child feeding in mothers with eating disorder histories through the combined use of observational, self-report, and physiologic methods. For this non-randomized cohort pilot study, 25 mothers with histories of eating disorders and 25 mothers with no history of an eating disorder with children ages 6-36 months were selected such that the groups were similar based on child age group (within 6 months) and child sex. Maternal behavioral responsiveness to child cues was assessed by video-recording and behavioral coding of both a free-play and feeding episode. Physiologic engagement was assessed through measurement of respiratory sinus arrhythmia (RSA) reactivity during free-play and feeding episodes. No differences were detected in observed behavioral responsiveness during feeding or free-play in mothers with eating disorder histories compared with controls. Mothers with eating disorder histories did report more parenting stress, increased anxiety, and exhibited a blunted physiologic stress response (less RSA reactivity) during both feeding and free-play interactions with their children. These results support future larger-scale investigations of RSA reactivity in mothers with eating disorders.
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Affiliation(s)
- Elizabeth R Hoffman
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Nutrition, 2200 McGavran-Greenberg Hall CB#7461, Chapel Hill, NC 27599, USA
| | - Eric A Hodges
- University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall CB#7460, Chapel Hill, NC 27599, USA
| | - Cathi Propper
- University of North Carolina at Chapel Hill, Center for Developmental Science, 100 East Franklin Street, Suite 200 CB# 8115, Chapel Hill, NC 27599, USA
| | - Pamela L Postage
- University of North Carolina at Chapel Hill, Department of Psychiatry, 101 Manning Drive CB#7160, Chapel Hill, NC 27599, USA
| | - Elana C Zipkin
- University of North Carolina at Chapel Hill, Department of Psychiatry, 101 Manning Drive CB#7160, Chapel Hill, NC 27599, USA
| | - Margaret E Bentley
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Nutrition, 2200 McGavran-Greenberg Hall CB#7461, Chapel Hill, NC 27599, USA
| | - Dianne S Ward
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Nutrition, 2200 McGavran-Greenberg Hall CB#7461, Chapel Hill, NC 27599, USA ; University of North Carolina at Chapel Hill, Center for Health Promotion and Disease Prevention, 1700 Martin Luther King Jr. Blvd. CB#7426, Chapel Hill, NC 27599, USA
| | - Robert M Hamer
- University of North Carolina at Chapel Hill, Department of Psychiatry, 101 Manning Drive CB#7160, Chapel Hill, NC 27599, USA ; University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Biostatistics, 3101 McGavran-Greenberg Hall CB#7420, Chapel Hill, NC 27599, USA
| | - Cynthia M Bulik
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Nutrition, 2200 McGavran-Greenberg Hall CB#7461, Chapel Hill, NC 27599, USA ; University of North Carolina at Chapel Hill, Department of Psychiatry, 101 Manning Drive CB#7160, Chapel Hill, NC 27599, USA
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Mitchell GL, Farrow C, Haycraft E, Meyer C. Parental influences on children’s eating behaviour and characteristics of successful parent-focussed interventions. Appetite 2013; 60:85-94. [DOI: 10.1016/j.appet.2012.09.014] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 08/14/2012] [Accepted: 09/15/2012] [Indexed: 10/27/2022]
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Cimino S, Cerniglia L, Paciello M, Sinesi S. A six-year prospective study on children of mothers with eating disorders: the role of paternal psychological profiles. Eur Eat Disord Rev 2012; 21:238-46. [PMID: 23239014 DOI: 10.1002/erv.2218] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Several studies have suggested that maternal eating disorders (EDs) represent a significant risk factor for children's affective and behavioral development. Yet, little emphasis has been placed on the paternal role. OBJECTIVES The present longitudinal study aimed to clarify the role of maternal EDs and the influence of paternal psychological profiles on children's emotional development. METHOD Our sample was composed of N = 64 families with firstborn children selected through preschools, primary schools, and outpatient clinics in central Italy. Parents and children participated in a 6-year longitudinal protocol that included a diagnostic interview conducted by clinicians (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID-I]), a self-report (Symptom Checklist-90-Revised [SCL-90-R]), and a parental report-form questionnaire (Child Behavior Checklist [CBCL]). RESULTS The influence of mothers' EDs on their children's emotional development was confirmed. Moreover, fathers' anxiety and obsessive-compulsive problems in association with mothers' EDs and depressive symptoms influenced the onset of both internalizing and externalizing difficulties in their children over time. CONCLUSION Our results suggest that fathers' psychopathological risk affects the development of emotional problems in children with mothers who have EDs.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome.
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Haycraft E, Blissett J. Predictors of paternal and maternal controlling feeding practices with 2- to 5-year-old children. J Nutr Educ Behav 2012; 44:390-397. [PMID: 21371945 DOI: 10.1016/j.jneb.2010.03.001] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 03/09/2010] [Accepted: 03/14/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE This study aimed to identify predictors of controlling feeding practices in both mothers and fathers of young children. DESIGN Cross-sectional, questionnaire design. SETTING Nursery schools within the United Kingdom recruited participants. PARTICIPANTS Ninety-six mothers and fathers comprising 48 mother-father pairs of male and female children aged 2 to 5 years. MAIN OUTCOME MEASURES Parents' child feeding practices, eating psychopathology, general mental health symptomology, and their children's eating behaviors and temperament. ANALYSIS Preliminary correlations; stepwise regressions. RESULTS Maternal controlling feeding was predicted by children's eating behaviors (emotional over- and undereating), child temperament (sociability), and maternal general mental health symptoms. Paternal reports of children's eating behaviors (slow eating and emotional undereating) were the only significant predictors of fathers' controlling feeding practices. CONCLUSIONS AND IMPLICATIONS Mothers' and fathers' feeding practices seem to be better linked to child characteristics than to the presence of eating psychopathology symptoms. Children's emotional eating predicted all 3 controlling feeding practices in mothers and warrants further study to elucidate the causal nature of this relationship.
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Affiliation(s)
- Emma Haycraft
- Loughborough University Centre for Research into Eating Disorders, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom.
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Jones C, Bryant-Waugh R. Development and pilot of a group skills-and-support intervention for mothers of children with feeding problems. Appetite 2012; 58:450-6. [DOI: 10.1016/j.appet.2011.12.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 12/14/2011] [Accepted: 12/23/2011] [Indexed: 11/15/2022]
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Dovey TM, Martin CI. A quantitative psychometric evaluation of an intervention for poor dietary variety in children with a feeding problem of clinical significance. Infant Ment Health J 2012; 33:148-162. [PMID: 28520095 DOI: 10.1002/imhj.21315] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Few studies have been published that offer a quantitative evaluation of interventions for feeding problems of clinical significance. Twenty-four children referred to the service for clinically significant feeding problems were administered the Behavioral Pediatric Feeding Assessment Scale (BPFAS; W. Crist & A. Napier-Phillips, 2001) and the Child Feeding Assessment Questionnaire (CFAQ; G. Harris & I.W. Booth, 1992) before and after a duel targeted 16-week therapeutic intervention to improve dietary variety. Dietary variety was assessed through a food diary where only items that were accepted on more than one occasion were deemed to be part of the child's habitual diet. Results indicated that all subscales of the BPFAS and the CFAQ were responsive to the intervention, with scores falling from those of clinical significance to those more representative of non-feeding-problem children. Regression analysis indicated that children's problem scores on the BPFAS predicted 15% of the variance in increased dietary variety following the intervention. The outcome of this evaluation indicated that improving dietary variety in children with clinically significant feeding problems is challenging. With the right approach, however, large improvements can be observed relatively quickly.
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Affiliation(s)
| | - Clarissa I Martin
- Loughborough University and Staffordshire General Hospital, Stafford, Staffordshire, United Kingdom
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Abstract
OBJECTIVE Previous research has established that childhood feeding and eating problems are often related to other behavioural difficulties. Parenting practices have been implicated in both eating behaviour and broader behaviour problems. The aim of this study was to examine whether the relationship between eating and behaviour problems could be explained in part by parenting style and practices. METHODS Seventy-seven mothers of 3- to 8-year-old children completed measures of children's eating behaviours, behaviour problems, parenting style and feeding practices. RESULTS Eating behaviours (food responsiveness, emotional under-eating, fussiness) and behaviour problems (conduct problems, hyperactivity, total difficulties) were significantly correlated, but when parenting style and feeding practices were controlled for, significant associations disappeared. CONCLUSIONS Although the findings are limited because of a relatively low response rate, in non-clinical groups, the perceived commonality between eating and behaviour problems may be explained by parenting.
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Affiliation(s)
- J Blissett
- School of Psychology, University of Birmingham, Birmingham, UK.
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Watkins B, Cooper PJ, Lask B. History of Eating Disorder in Mothers of Children with Early Onset Eating Disorder or Disturbance. Eur Eat Disorders Rev 2011; 20:121-5. [DOI: 10.1002/erv.1125] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2010] [Revised: 02/28/2011] [Accepted: 03/27/2011] [Indexed: 11/11/2022]
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Micali N, Simonoff E, Stahl D, Treasure J. Maternal eating disorders and infant feeding difficulties: maternal and child mediators in a longitudinal general population study. J Child Psychol Psychiatry 2011; 52:800-7. [PMID: 21073463 DOI: 10.1111/j.1469-7610.2010.02341.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Maternal eating disorders (ED) have been shown to increase the risk of feeding difficulties in the offspring. Very few studies, however, have investigated whether the effect of a maternal ED on childhood feeding is a direct effect or whether it can be ascribed to other child or maternal factors. We aimed to determine the role of maternal anxiety and depression in mediating the risk for feeding difficulties in infants of women with ED. METHODS A prospective study comparing women with lifetime ED (441) and without any lifetime psychiatric disorder (10,461) and their infants from the Avon Longitudinal Study of Parents and Children (ALSPAC). We investigated the effect of: maternal anxiety and depression in late pregnancy (32 weeks) and the post-partum (8 weeks), child temperament and developmental status on infant feeding difficulties at 1 and 6 months. We also investigated the effect of active pregnancy ED symptoms. We tested 3 models and their fit to the data using structured equation modelling: a direct effect model, a fully mediational model and an integrated (partial meditational) model. RESULTS The integrated model including a direct effect of maternal lifetime ED on infant feeding and a mediational path via maternal distress (a latent variable combining anxiety and depression) fitted the data best. This also applied to maternal pregnancy ED symptoms. Feeding difficulties in turn increased maternal distress over time. CONCLUSIONS Lifetime ED and active pregnancy ED increase the risk for infant feeding difficulties and do so via maternal distress (i.e., depression and anxiety). This has important implications for prevention and early intervention in relation to infant feeding difficulties, as well as for future research in the field.
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Affiliation(s)
- Nadia Micali
- King's College London, Child and Adolescent Psychiatry Department, Institute of Psychiatry, London, UK.
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Haycraft E, Blissett J. The role of parents' romantic relationship warmth and hostility in child feeding practices and children's eating behaviours. Matern Child Nutr 2010; 6:266-74. [PMID: 20929498 DOI: 10.1111/j.1740-8709.2009.00212.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This research examined the associations between parents' reports of the quality of their romantic relationships with their partner/spouse, their feeding interactions with their children, and their children's eating behaviours. One hundred and fifty-six married/cohabiting mothers of young children completed self-report measures of their romantic relationship quality, child feeding practices and children's eating behaviours. Reports of a less warm, more hostile romantic relationship were associated with children's less adaptive eating behaviours. More hostile relationship quality was also related to greater restriction of their children's food intake. The quality of parents' romantic relationships is associated with parental feeding practices and children's eating behaviours. Further work should examine the emotional tone of mealtimes in order to discover whether this may be the mechanism of the relationship.
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Affiliation(s)
- Emma Haycraft
- Loughborough University Centre for Research into Eating Disorders, Loughborough University, Leicestershire, UK.
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Cobelo AW, de Chermont Prochnik Estima C, Nakano EY, Conti MA, Cordás TA. Body image dissatisfaction and eating symptoms in mothers of adolescents with eating disorders. Eat Weight Disord 2010; 15:e219-25. [PMID: 21406945 DOI: 10.1007/bf03325303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The purpose of the present study was to assess body dissatisfaction and eating symptoms in mothers of eating disorder (ED) female patients and to compare results with those of a control group. The case group consisted of 35 mothers of female adolescents (aged between 10 and 17 yrs) diagnosed with ED who attended the Interdisciplinary Project for Care, Teaching and Research on Eating Disorders in Childhood and Adolescence (PROTAD) at Clínicas Hospital Institute of Psychiatry of the Universidade de São Paulo Medical School. Demographic and socioeconomic data were collected. Eating symptoms were assessed using the Eating Attitudes Test (EAT-26) and body image was assessed by the Body Image Questionnaire (BSQ) and Stunkard Figure Rating Scale (FRS). The case group was compared to a control group consisting of 35 mothers of female adolescents (between 10 and 17 years) who attended a private school in the city of São Paulo, southeastern Brazil. With regard to EAT, BSQ and FRS scores, we found no statistically significant differences between the two groups. However, we found a positive correlation between BMI and BSQ scores in the control group (but not in the case group) and a positive correlation between EAT and FRS scores in the case group (but not in the control group). It appears to be advantageous to assess body image by combining more than one scale to evaluate additional components of the construct.
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Affiliation(s)
- A Weisz Cobelo
- PROTAD - Interdisciplinary Project for Care, Teaching, and Research on Eating Disorders in Childhood and Adolescence. Clínicas Hospital Institute of Psychiatry (HC - IPQ), Universidade de São Paulo Medical School (FMUSP), São Paulo, Brazil.
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Fabrizi A, Costa A, Lucarelli L, Patruno E. Comorbidity in specific language disorders and early feeding disorders: mother-child interactive patterns. Eat Weight Disord 2010; 15:e152-60. [PMID: 21150250 DOI: 10.1007/BF03325294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This empirical study has its main object in highlighting the role of mother-child interactive experiences in the development of affective and communicative exchanges in infancy. METHODS The study analyzed four groups of mother-child couples with children who presented a Specific Language Disorder (SLD) the first, a Feeding Disorder (FD) the second, the third an association of SLD and FD, and a fourth non clinical group. Diagnostic assessments were done through: a specific linguistic protocol, the Italian version of the Feeding Scale-Observational Scale for Mother-Infant Interactions during Feeding, specific psychodiagnostic questionnaires for mothers and children. CONCLUSION A distortion in the communication area can significantly weigh upon the quality of infant-caregiver relationship: our data on mothers of children with a SLD/FD comorbidity confirm this finding by describing their children as prone to isolation and withdrawal, thus directing their efforts and worries to a specifically communicative and relational factor.
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Abstract
OBJECTIVE This study reports 20-year outcome of bulimia nervosa (BN) and related eating disorders not otherwise specified (EDNOS) and point prevalence of BN and EDNOS for a cohort of women and men in late adolescence (mean age = 20 ± 2 years), adulthood (30 ± 2 years), and mid-life (40 ± 2 years). METHOD N = 654 women and men, 73% of those assessed in 1982, completed 20-year follow-up in a two-stage design including questionnaires and structured clinical interviews. RESULTS Approximately 75% of women with BN were in remission at 20-year follow-up, and outcome did not differ significantly between BN and EDNOS. Eating disorder point prevalence declined in women but not men from late adolescence to mid-life. DISCUSSION Despite patterns of improvement in women, 4.5% reported a clinically significant eating disorder at mid-life, suggesting the need for more research on potential risk factors in this age group, such as pressures for women to maintain a youthful appearance.
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Affiliation(s)
- Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida 32306, USA.
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Abstract
Clinicians and researchers have long recognized the existence of eating disorders in very young children, including infants whose mothers have eating disorders. This paper combines reviews of the literature relevant to the study of eating disorders from the perspectives of both research and psychoanalytic theory in order to explore the psychodynamics of the intergenerational transmission of eating-disordered pathology from mother to child. A developmental pathway as well as several mechanisms that illuminate the pathogenesis of the intergenerational transmission of eating disorders are proposed and described. Clinical-observational data from a therapeutic play nursery for mothers with eating disorders and their children are presented, and this material is examined in relation to the proposed psychodynamic pathways of transmission.
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Abstract
OBJECTIVE To review the literature related to the current DSM-IV-TR diagnostic criteria for feeding disorder of infancy or early childhood; pica; rumination disorder; and other childhood presentations that are characterized by avoidance of food or restricted food intake, with the purpose of informing options for DSM-V. METHOD Articles were identified by computerized and manual searches and reviewed to evaluate the evidence supporting possible options for revision of criteria. RESULTS The study of childhood feeding and eating disturbances has been hampered by inconsistencies in classification and use of terminology. Greater clarity around subtypes of feeding and eating problems in children would benefit clinicians and patients alike. DISCUSSION A number of suggestions supported by existing evidence are made that provide clearer descriptions of subtypes to improve clinical utility and to promote research.
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Affiliation(s)
- Rachel Bryant-Waugh
- Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
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de Lauzon-Guillain B, Romon M, Musher-Eizenman D, Heude B, Basdevant A, Charles MA. Cognitive restraint, uncontrolled eating and emotional eating: correlations between parent and adolescent. Matern Child Nutr 2009; 5:171-8. [PMID: 19292751 DOI: 10.1111/j.1740-8709.2008.00164.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to examine, in a general population, the resemblance in eating behaviour between adolescents and their parents. This study was based on the first examination of a community-based epidemiological study in Northern France. Subjects were offspring aged 14-22 years (135 boys and 125 girls) and their parents (174 fathers and 205 mothers). The Three-Factor Eating Questionnaire Revised 18-item version (TFEQ-R18) identified three aspects of eating behaviour: cognitive restraint of eating, uncontrolled eating and emotional eating. Familial resemblance in eating behaviour was measured by partial Spearman's correlations, adjusted for age and body mass index. Sons' uncontrolled eating was positively related to fathers' cognitive restraint of eating (r = 0.36), but not to fathers' uncontrolled eating (r = 0.07), nor to mothers' eating behaviour. Sons' cognitive restraint of eating was related to no parental eating behaviour scores. In daughters, cognitive restraint of eating was positively related to mothers' uncontrolled eating (r = 0.26), but not to mothers' cognitive restraint of eating (r = 0.13). Daughters' uncontrolled eating and emotional eating were positively associated with the same scores in mothers. Finally, daughters' eating behaviour was not related to fathers' eating behaviour. In conclusion, correlations in eating behaviour were higher with the parent of the same gender, and eating behaviours in adolescents seem to reflect opposition to parents' behaviour more than familial resemblance.
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Abstract
Hunger, thirst and satiety have an enormous influence on cognition, behavior and development, yet we often take for granted that they are simply inborn or innate. Converging data and theory from both comparative and human domains, however, supports the conclusion that the phenomena hunger, thirst and satiety are not innate but rather emerge probabilistically as a function of experience during individual development. The metatheoretical perspective provided by developmental psychobiological systems theory provides a useful framework for organizing and synthesizing findings related to the development of the perception of hunger, thirst and satiety, or alimentary interoception. It is argued that neither developmental psychology nor the psychology of eating and drinking have adequately dealt with the ontogeny of alimentary interoception and that a more serious consideration of the species-typical developmental system of food and fluid intake and the many modifications that have been made therein is likely necessary for a full understanding of both alimentary and emotional development.
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Haycraft E, Blissett J. Controlling feeding practices and psychopathology in a non-clinical sample of mothers and fathers. Eat Behav 2008; 9:484-92. [PMID: 18928912 DOI: 10.1016/j.eatbeh.2008.07.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Revised: 05/27/2008] [Accepted: 07/29/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To explore the relationships between controlling feeding practices and a range of mental health symptoms while considering both parent and child gender. METHOD Mothers and fathers (N=214) of children aged 18-59 months completed self-report measures of their child feeding practices, eating psychopathology and general mental health symptomology. RESULTS Feeding practices did not differ across any of the four parent-child gender dyads. Mothers' eating psychopathology scores were significantly higher than fathers' but parents did not significantly differ in the severity of their other mental health symptoms. Associations between disordered eating symptoms and controlling feeding practices were only seen in mothers of daughters and fathers of sons. In general, a range of mental health symptomologies in this non-clinical sample were related to more controlling feeding practices across all four dyads. Psychopathology was most strongly related to controlling feeding practices in parents of girls. CONCLUSION Symptoms of psychopathology may be more likely to associate with controlling feeding practices in parents of daughters due to societal values for slimness in females.
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Affiliation(s)
- Emma Haycraft
- Department of Human Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.
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Abstract
OBJECTIVE To study early adaptation to motherhood in mothers with eating disorders (ED) before pregnancy. METHOD Forty-four nulliparous nonsmoking women with ED before pregnancy (24 anorexia nervosa, 20 bulimia nervosa) and 67 controls were recruited from the same prenatal clinics. Three months after delivery, the women completed the maternal adjustment and maternal attitude questionnaire (MAMA) and were asked about mental health problems postpartum. RESULTS Ninety-two percent of mothers with ED before pregnancy reported problems regarding their maternal adjustment compared to 13% in the control group (p < 0.001), whereas there were no differences between the subgroups of ED and between those with and without verified relapse of ED during pregnancy. Fifty percent of mothers with previous ED reported that they had been in contact with health services after delivery because of depression or other mental problems and these women had significantly higher MAMA score than patients not reporting such contact with health services (p < 0.001). CONCLUSION Adjustment to motherhood was clearly impaired and related to mental problems in mothers with ED before pregnancy.
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Affiliation(s)
- Saloua Koubaa
- Department of Women and Child Health, Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
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Abstract
OBJECTIVE This study aimed to examine the interrelationships between mothers' and fathers' reports on the child-feeding questionnaire (CFQ), the BMI of parents and their children, and observations of parents' controlling feeding practices at mealtimes. METHODS AND PROCEDURES Twenty-three mothers and twenty-three fathers of children aged between 18 and 67 months reported on their child-feeding practices, on their child's height and weight, and were observed during a normal family mealtime at home. RESULTS No associations were found between mothers' reported and observed feeding practices. Fathers' reported pressure to eat and restriction were associated with more controlling observed mealtime feeding practices. Mothers and fathers did not significantly differ in their reported or observed child-feeding practices. Children's BMI was not related to maternal or paternal reported or observed feeding practices. More mealtime pressure was observed in parents with a higher BMI. DISCUSSION Fathers' self-reports of their mealtime practices are reliable. Mothers' feeding practices may differ when fathers are present and further work should examine mothers at mealtimes with and without fathers. Although children's BMI was not related to parents' use of reported or observed control, parents with a higher BMI were more controlling, highlighting the importance of considering parents' own weight in future studies.
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Affiliation(s)
- Emma L Haycraft
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
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Blissett J, Meyer C, Haycraft E. Maternal mental health and child feeding problems in a non-clinical group. Eat Behav 2007; 8:311-8. [PMID: 17606229 DOI: 10.1016/j.eatbeh.2006.11.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Revised: 06/14/2006] [Accepted: 11/06/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare the contribution of symptoms of anxiety, depression and eating psychopathology to reports of child feeding difficulties in a non-clinical group of mothers of male and female children. METHOD A community sample of 56 mothers of male children and 40 mothers of female children with a mean age of 32 months completed measures of anxiety, depression, eating psychopathology and child feeding problems. RESULTS In mothers of male children, symptoms of depression and anxiety, but not eating psychopathology, were predictors of difficult feeding interactions. In contrast, in mothers of female children, symptoms of bulimia and depression, but not anxiety, were significant predictors of reported food refusal. DISCUSSION Different aspects of psychopathological symptomology may be risk factors for reports of feeding problems dependent on the child's gender. Further work should continue to assess the nature and motivation for the controlling of feeding behaviors exhibited by mothers of children of different genders.
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Affiliation(s)
- J Blissett
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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Bryant-Waugh R, Turner H, East P, Gamble C. Developing a parenting skills-and-support intervention for mothers with eating disorders and pre-school children part 1: qualitative investigation of issues to include. Eur Eat Disorders Rev 2007; 15:350-6. [PMID: 17701941 DOI: 10.1002/erv.790] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to (i) identify themes and issues that might usefully be addressed in a skills-and-support intervention for mothers with eating disorders who have children less than 5 years of age, and (ii) determine the most appropriate format for such an intervention. METHOD Focus groups and individual interviews were conducted with seven mothers with eating disorders and pre-school children, and four local health professionals working with mothers of pre-school children. RESULTS Thematic analysis of interview transcripts revealed 10 themes: 'Passing on Traits', 'Food Preparation and Provision', 'Interactions Around Food and Mealtimes', 'Mother's Intake', 'Self Care', 'Self Identity and Parental Expectations', 'Impact on General Parent-Child Relationship', 'Need for Control', 'The Group Experience' and 'Practicalities and Format'. DISCUSSION Findings highlight a number of difficulties and concerns experienced by mothers with eating disorders who have pre-school age children. An intervention incorporating the identified themes could provide important support to this patient group and potential benefit to their offspring.
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Affiliation(s)
- Rachel Bryant-Waugh
- Hampshire Partnership NHS Trust Eating Disorder Service, Eastleigh Community Enterprise Centre, Eastleigh, Hampshire, UK.
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Blissett J, Meyer C. The mediating role of eating psychopathology in the relationship between unhealthy core beliefs and feeding difficulties in a nonclinical group. Int J Eat Disord 2006; 39:763-71. [PMID: 16868996 DOI: 10.1002/eat.20315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine whether maternal eating psychopathology mediates the relationship between unhealthy core beliefs and reports of child feeding difficulties. METHOD A community sample of 114 mothers of 65 male children and 49 female children between 4 months and 5 years completed the Eating Disorders Inventory-II, (Garner, Eating Disorder Inventory-2 Professional Manual, Odessa, 1991) the Child Feeding Assessment Questionnaire, (Harris and Booth, Monographs in Clinical Pediatrics, Vol 5, 1992) and the Young Schema Questionnaire (Short Form) (Young, Young's Schema Questionnaire: Short Form, Available in electronic form at, http://www.schematherapy.com, 1998). RESULTS Drive for thinness significantly mediated the relationship between maternal defectiveness/shame beliefs and food refusal in mothers of daughters, but no mediational relationships were found for mothers of sons in this nonclinical group. CONCLUSION Maternal drive for thinness mediates the effect of unhealthy beliefs on mothers' tendencies to report feeding difficulties in their daughters.
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Affiliation(s)
- Jackie Blissett
- School of Psychology, University of Birmingham, United Kingdom.
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Stein A, Woolley H, Cooper S, Winterbottom J, Fairburn CG, Cortina-Borja M. Eating habits and attitudes among 10-year-old children of mothers with eating disorders: longitudinal study. Br J Psychiatry 2006; 189:324-9. [PMID: 17012655 PMCID: PMC1888733 DOI: 10.1192/bjp.bp.105.014316] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Children of mothers with eating disorders are at increased risk of developmental disturbance, but there has been little research in middle childhood, when disturbed eating habits tend to emerge. AIMS To examine whether maternal eating disorders identified in the postnatal year are associated with the development of disturbed eating habits and attitudes in children at 10 years of age. METHOD Follow-up comparative study of 56 families (33 mothers with eating disorders and 23 controls). Psychopathology of children, mothers and fathers was assessed by interview, and mother-child interaction observed. RESULTS The index group of children scored higher than controls on three of four domains of eating disorder psychopathology and on a global score. Children's eating disturbance was associated with length of exposure to mothers' eating disorder and mother-child mealtime conflict at 5 years. There was some evidence of increased emotional problems in index children. CONCLUSIONS The children of mothers with eating disorders manifested disturbed eating habits and attitudes compared with controls, and may be at heightened risk of developing frank eating disorder psychopathology.
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Affiliation(s)
- Alan Stein
- Section of Child and Adolescent Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
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Blissett J, Meyer C, Haycraft E. Maternal and paternal controlling feeding practices with male and female children. Appetite 2006; 47:212-9. [PMID: 16735080 DOI: 10.1016/j.appet.2006.04.002] [Citation(s) in RCA: 175] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Revised: 03/22/2006] [Accepted: 04/11/2006] [Indexed: 11/25/2022]
Abstract
This study aimed to compare maternal and paternal feeding practices with male and female children and examine the influence of the gender of both the parent and child on the relationship between parental unhealthy eating attitudes and controlling feeding practices. One hundred and eighty-eight participants (94 co-habiting mother-father dyads, mean age 36.4 years, SD=4.9), who were the parents of 46 male and 48 female children (mean age 37.7 months, SD=12.7) completed measures of unhealthy eating attitudes and feeding practices. Mothers and fathers differed significantly in their reports of unhealthy eating attitudes but not in their restrictive or pressurising feeding practices. Mothers reported greater perceived feeding responsibility and greater monitoring of their children's food intake than fathers. Bulimia scores were correlated with controlling feeding practices in mothers of girls but not boys. Fathers' body dissatisfaction was correlated with monitoring of sons' but not daughters' food intake. These findings suggest that parental extrapolation of weight concerns may be more likely to occur within mother-daughter and father-son relationships.
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Affiliation(s)
- Jacqueline Blissett
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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Farrow C, Blissett J. Maternal cognitions, psychopathologic symptoms, and infant temperament as predictors of early infant feeding problems: a longitudinal study. Int J Eat Disord 2006; 39:128-34. [PMID: 16231348 DOI: 10.1002/eat.20220] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The current study examined the contribution of prenatal and postnatal maternal core beliefs, self-esteem, psychopathologic symptoms, and postnatal infant temperament to the prediction of infant feeding difficulties. METHOD Ninety-nine women completed questionnaires assessing their core beliefs, psychopathology, and self-esteem during pregnancy and at 6 months postpartum. At 6 months, mothers also rated their infant's temperament and feeding, and were ob-served feeding their infants. RESULTS Maternal reports of child feeding difficulties were predicted by higher levels of emotional deprivation and entitlement core beliefs and lower levels of self-sacrifice and enmeshment core beliefs during pregnancy. Postnatal social isolation core beliefs, lower maternal self-esteem, and more difficult infant temperament added significantly to the variance explained by prenatal factors. Maternal core beliefs, self-esteem, psychopathology, and infant temperament failed to significantly predict independent observations of child food refusal. CONCLUSION Maternal cognitions are implicated in the development of maternal reports of feeding difficulty.
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Affiliation(s)
- Claire Farrow
- School of Psychology, Dorothy Hodgkin Building, Keele University, Straffordshire, UK.
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Abstract
OBJECTIVE We incorporated selected items from several existing instruments to create a comprehensive multifactorial instrument to measure problematic eating behaviors in young children and to examine the prevalences and correlates of these behaviors. METHOD A community sample of young mothers (N = 93) completed the inventory of problematic eating behaviors for their 36-month-old children. RESULTS The most common child problems reported by mothers were the spitting out of food during feedings and becoming upset when food was restricted. A four-factor solution identified pickiness (e.g., child eats a limited variety of food), food refusal (e.g., child refuses to eat specific foods), struggle for control (e.g., frequent struggles with child over food), and positive parental behavior (e.g., praising child about his/her food intake) domains. Internal consistency was moderate to good for all factors. Only the struggle for control factor was related to other problematic behaviors as measured by the Child Behavior Check List (CBCL). The food refusal factor was related to mothers' lifetime history of any psychopathology. The pickiness factor was related to mothers' lifetime history of alcohol dependence. CONCLUSION Findings suggest that child clinicians should be sensitive to the quality of mother-child interactions during feeding.
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Abstract
OBJECTIVE To study the association of eating pathology between mothers and their adolescent offspring in a population sample. RESEARCH METHODS AND PROCEDURES The participants were 481 women (mean age, 47+/-SD 5 years; BMI, 25+/-4 kg/m2) and their 481 adolescent children 16 to 17 years old (BMI, 21+/-3 kg/m2) of the Stockholm Weight Development Study. Assessment methods were the Three-Factor Eating Questionnaire Revised 18 and the Eating Disorder Inventory 2. RESULTS A higher body weight was most related to cognitive restraint for adolescents and to emotional eating for adult women. A mother-daughter link could be identified for eating pathology, with the strongest link found for emotional eating. No mother-son link could be identified. Age subgroup analyses revealed a stronger mother-daughter link for body attitudes in younger mothers and for cognitive restraint in older mothers. DISCUSSION Gender differences revealed that eating pathology was shared by mothers and daughters but not by mothers and sons. A psychological strategy such as eating as a response to negative emotions was most interrelated between mothers and daughters. Younger mothers shared more attitudes toward the body with their daughters, whereas older mothers shared more restrictive eating behaviors with their daughters. The mother-daughter links found may be due to gender-specific genetic and psychological family transmission and gender-specific environmental influences. The sons' eating behaviors seem to be more independent and would be formed by other factors than for the girls.
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Affiliation(s)
- Kristina Elfhag
- Obesity Unit, M73, Karolinska University Hospital, SE-141 86 Stockholm, Sweden.
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Abstract
AIM To describe the adolescent outcome of infant refusal to eat (RTE) and to investigate early predictors of adolescent outcomes. METHODS 19 of 25 children with RTE and 35 of 42 controls were assessed at age 16. The participants rated eating attitudes and self-perceptions with a Swedish version of the Children's Eating Attitudes Test (ChEAT) and a Swedish self-perception measure. Weight and height were assessed through self-reports, and body mass index (BMI) was computed. Child and family variables measured from infancy through age 4 were used as predictors. RESULTS RTE and controls did not differ with regard to disturbed eating attitudes, BMI or self-perceptions. There were no relations between early predictors and adolescent disturbed eating for the whole sample, but breastfeeding problems and social adversity in the early years predicted negative self-perceptions, and weight at 4 y predicted adolescent BMI. For the RTE group, low birthweight predicted higher levels of disturbed eating attitudes and less positive self-perceptions. For the control group, social adversity predicted high BMI. CONCLUSION RTE does not seem to constitute a risk factor for adolescent disturbed eating. Further, there may be different risk factors for adolescent disturbed eating for children with and without RTE.
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Abstract
The current article reviews the literature on parenting among women with EDs, and outlines the process of developing an intervention addressing their parenting concerns.
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Affiliation(s)
- Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia 23284-2018, USA.
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