Child and parent psychological problems influence child weight control

This study used path analytic methods to assess the influence of child psychopathology measured using the Child Behavior Checklist and parent psychiatric symptoms measured using the Cornell Medical Index on changes in child percent overweight in obese 8- to 11-year-old children over 2 years (6 months of treatment, 18 months of follow-up) provided family-based behavioral intervention. Path analysis for the 0-6 month change showed the influence of mother and father psychiatric symptoms and child age on child anxiety/depression scores that in turn influenced child percent overweight change during treatment, accounting for 41% of the shared variance. The path analysis for follow-up change showed mother and father psychiatric symptoms influenced child social problems at the first stage, and child social problems influenced child percent overweight change, accounting for 68.5% of the shared variance. These results provide the first demonstration that both parent and child problems may influence the short- and long-term success of obese children who participate in family-based behavioral treatment programs.     

BMI correlation with psychiatric problems among 10-18 years Iranian students

Obesity and its related emotional and physical consequences are a worldwide problem. Obese individuals are usually stigmatized. This study is proposed to assess the correlation between body mass index, gender and age with psychiatric symptoms among Iranian students. A number of 9172 students aged 10-18 years (53.5% girls and 46.5% boys) from all provinces of Iran participated in this study. Data was collected using the global school based health survey questionnaire of the World Health Organization (GSHS-WHO). Overall, prevalence of predictors of having emotional problems, depression and anxiety were 27.8%, 29.7% and 11.5% respectively. Girls had significantly higher prevalence of predictors of psychiatric symptoms. Overall obesity was a protective factor against emotional problems OR (CI95%):0.79(0.65-0.98), but it was attributable to obese boys OR (CI95%):0.72(0.55-0.95). Depression and anxiety symptoms were higher in intermediate school girls and high school girls and boys. More attention should be paid to girls' psychological problems. Besides, obesity had an indirect relation with predictors of having psychiatric problems in Iranian boys and it might be due to: (1) parents' beliefs about heaviness as a predictor of healthiness, (2) boys' lower vulnerability to psychological consequences of obesity and (3) lower pressure from parents on their obese sons to lose weight.     

肥胖儿童社会适应能力与行为问题的配对研究

目的：研究肥胖儿童在社会适应及行为方面是否校非肥胖儿童存在更多的问题。方法：应用儿童行为量表（CBCL）对104名9～11岁的肥胖儿童及1：1配对的104名一般儿童进行测试。结果：肥胖儿童的社会适应能力差,其行为问题的发生率（24.0％）显著高于对照组儿童（8.7％）（P＜0.01）。行为问题的表现存在性别差异,肥胖男孩以抑郁和社交退缩为主,肥胖女孩以体诉和违纪为主。结论：肥胖在一定程度上对儿童的心理行为的发育产生了不良影响,应引起足够的重视。     

鄂尔多斯市蒙汉族5～7岁儿童心理行为发育与家庭养育环境的调查和分析

目的了解鄂尔多斯市5～7岁儿童心理行为发育状况,探讨儿童养育环境对其的影响。方法采用儿童心理行为量表（SDQ）和家庭养育环境量表对鄂尔多斯市234名5～7岁儿童进行问卷调查。结果 234名儿童的心理发育水平处于正常总体范围;不同性别儿童在行为和社会关系维度差异有统计学意义（P〈0.05）;不同民族儿童的心理行为发育差异没有统计学意义;不同家庭养育环境对儿童心理行为发育有影响,差异有统计学意义（P〈0.01）。结论儿童的心理行为发育状况与性别、家长育儿感受、养育态度、夫妻关系和家庭生活有关,而与民族无关。     

Parental Weight (Mis)Perceptions: Factors Influencing Parents’ Ability to Correctly Categorise Their Child’s Weight Status

This study investigates parents?? ability to correctly classify their child??s weight status. The influence of parent and child socio-demographic and lifestyle factors on parental misclassification of their child??s weight status is explored. A representative sample of Irish children (aged 5?C12 (n?=?596) years, aged 13?C17?years (n?=?441)) and their parents (n?=?1885) were recruited to participate in a national dietary survey. Parental perceptions of their child??s weight and their own weight were measured. Anthropometric measurements (weight and height) were objectively measured for parents and children. Body Mass Index (BMI) scores were derived and categorised as normal, overweight or obese using standard references. Over 80% of parents of overweight boys and 79.3% of parents of overweight girls reported their child??s weight was fine for his/her height and age. Furthermore, 44.4% of parents of obese boys and 45.3% of parents of obese girls felt their child??s weight was fine for their height and age. Parents were significantly less likely to be correct about their sons?? weight status and more likely to be correct the older the child. Parents were over 86% less likely to be correct about their child??s weight if their child was overweight and approximately 59% less likely to be correct if the child was obese, compared to parents of normal weight children. This research suggests that parents are failing to recognise overweight and obesity in their children with factors such as parental weight status, child??s age and gender influencing this.     

儿童单纯性肥胖与心理行为关系的研究

目的: 探讨儿童单纯性肥胖与心理行为的关系以及有效的干预措施。方法: 采用Achenbach儿童行为量表(CBCL) 父母问卷及自制的一般情况问卷对 100例肥胖儿童和 200例正常儿童进行测查, 研究其行为问题并加以比较。结果: 肥胖组行为问题发生率 37. 00%, 高于对照组的 14.50% (χ2 =19.668, P<0 .01), 且随着肥胖程度的增加, 发生的频率和种类也相应增多。肥胖组与对照组各行为因子进行比较, 4~5岁男童组不成熟因子、分裂样因子的差异有显著性 (P<0 .05); 4~5岁女童组肥胖因子的差异有高度显著性 (P<0 .01); 6 ~11岁男童组强迫性因子、体诉因子、违纪因子的差异有显著性 (P<0. 05), 攻击因子的差异有高度显著性 (P<0. 01); 6~11岁女童组性问题因子、违纪因子的差异有高度显著性 (P<0. 01)。结论: 单纯性肥胖儿童较正常儿童存在更多的行为问题, 应根据肥胖儿童的行为特征, 制定行为干预措施。     

Detecting emotional and behavioural problems in paediatric clinics

BACKGROUND: Children with chronic illness have increased rates of mental health problems and psychological difficulties often present as physical conditions. This prevalence survey aims to determine whether children attending general paediatric out-patient clinics are at increased risk of suffering from emotional and behavioural disturbance and whether there is an unmet need for psychiatric liaison to paediatric clinics. METHODS: Participants were 307 children aged 5-15 years attending a representative sample of paediatric out-patient clinics in one UK hospital. A national community sample of 10,438 children aged 5-15 years was used as a comparison group. Parental ratings of child behaviour were obtained using the Strengths and Difficulties Questionnaire (SDQ). Doctors rated the extent of any emotional difficulties using a modification of the SDQ 'impact supplement'. RESULTS: Children attending paediatric out-patient clinics were more than twice as likely (OR = 2.3, 95% CI 1.7-3.1) to score in the abnormal range of the SDQ. Of the 60 (20%) children with a probable psychiatric disorder only 15 had received specialist help from Child Mental Health Services. There were no gender differences in the profile of difficulties with emotional symptoms being particularly evident in both boys (OR = 2.85, 95% CI 1.97-4.11) and girls (OR = 3.04, 95% CI 1.92-4.70). The risk of psychiatric disorder was highest among those children with brain disorders attending neurological clinics (OR = 5.8, 95% CI 2.5-11.3). Clinicians only identified emotional or behaviour problems in a quarter of those children with parent-rated disorder. CONCLUSION: There is an increased prevalence of emotional and behavioural disturbance in children attending paediatric out-patient clinics. The SDQ could be added to routine paediatric assessments to aid appropriate referral of children with a possible psychiatric disorder to child mental health services.     

中日两国幼儿肥胖及其影响因素调查

目的为了调查中日两国幼儿肥胖发病情况及影响因素.方法 对中国上海市和日本立川市的3～4岁各1000余名幼儿测定身高和体重,并进行了肥胖及其影响因素的调查.结果 中国上海市幼儿超重率和肥胖率分别为11 .7%和4.3%,已接近于日本立川市的幼儿超重率(14.6%)和肥胖率(5.0%).幼儿出生体重过重喜食肉类和乳制品、就餐时间无规律、活动过少等因素会增加肥胖程度;双亲肥胖家庭的幼儿容易发生肥胖.结论 幼儿肥胖受到遗传和环境因素的双重影响,中国上海市幼儿肥胖已成为一个值得重视的卫生问题.     

22q11.2 deletion syndrome: behaviour problems of infants and parental stress

BACKGROUND: 22q11.2 deletion syndrome (22q11.2 DS) can be associated with a variety of somatic symptoms, developmental delays and psychiatric disorders. At present, there is little information on early behaviour problems, and nothing is known about parental stress and possible relations between these factors. Therefore, the aim of this study was to investigate behaviour problems of infants with 22q11.2 DS, and their primary caregivers' stress. METHODS: Parents of infants with 22q11.2 DS known to the German 22q11.2 deletion syndrome foundation were anonymously asked to fill out several questionnaires, e.g. the Child Behavior Checklist (CBCL) 1.5-5. RESULTS: The primary caregivers of 22/30 children [12 boys and 10 girls aged 1 year 8 months to 3 years 11 months (mean age: 2 years 9 months)] sent back filled-out questionnaires. Seventeen out of 21 children showed motor, and 15/21 language delay. Five out of 21 children were rated as clinical on at least one CBCL 1.5-5 scale. The patients' age was correlated with anxiety problems, and girls had significantly more sleep problems than boys. Compared with the general population, the primary caregivers did not experience higher levels of strain, and compared with parents of mentally and/or physically handicapped children, their parental stress was significantly lower. Parental stress and strain were correlated to a variety of child behaviour problems, e.g. externalizing and anxious/depressed behaviour. CONCLUSIONS: Longitudinal studies are required to show whether behaviour problems and parental stress worsen when 22q11.2 DS patients grow older.     

The B'Active programme for overweight primary school children in Glasgow: determining the prevalence of overweight and obesity and piloting an activity intervention

The aim of this study was to determine the prevalence of overweight and obesity in primary school children in Glasgow and to evaluate a pilot activity programme for overweight and obese children. BMI was measured in 1548 children. Overweight, obesity and severe obesity were defined as BMI > or =85th, 95th and 98th centile, respectively. Overweight and obese children were then invited to participate in a 10-week school-based activity programme. The programme was evaluated by recording weekly attendance, intensity (using the Children's Effort Rating Scale) and enjoyment (scale 1-10). Focus groups were used to explore the experiences and views of the children, teachers, coaches and parents. Of the 1548 children, 31.4% were overweight, 19.1% were obese and 12.4% were severely obese; 38% of those invited attended the activity programme. Weekly programme attendance was 83% (range 56-99%). Mean enjoyment rating (scale 1-10) was 8 for boys and 9 for girls. The intensity of activity sessions were rated 'very easy' by boys and 'just feeling a strain' by girls. Common themes emerging from the focus groups related to perceived positive and negative aspects of the programme (fun, concerns about stigmatising children); physical and psychological outcomes (fitter, more confident); and future recommendations (involve parents). In summary, the prevalence of overweight and obesity was high. The activity programme was successful in terms of attendance and enjoyment, and overall views of the initiative were positive and there was compelling support for its continuation.     

Association between overweight or obesity and household income and parental body mass index in Australian youth: analysis of the Australian National Nutrition Survey, 1995

This study is a secondary data analysis based on the 1995 Australian National Nutrition Survey (NNS). A random subsample of 1581 school children aged 7-15 years old from the NNS was studied. The results show the prevalence of overweight, obesity and combined overweight and obesity was 10.6-20.9%, 3.7-7.2% and 15.6-25.7%, respectively. The odds ratio of overweight or obese boys with highest household income was significantly smaller than those with the lowest household income. The proportion of combined overweight and obesity in children whose parents were overweight or obese was significantly greater compared with those whose parents were not. The trend of increasing prevalence of overweight or obesity among children with increasing parental body mass index (BMI) was significant after adjusting for age except the trend of father's BMI for boys. This study provided baseline data on the recent prevalence of overweight or obesity of Australian school children using new international absolute BMI cut-off points. It indicated that young school girls (7-9 years) were more likely to be overweight or obese compared with boys, the prevalence rates of overweight or obesity in older boys (13-15 year) was significantly greater than in other age groups while in girls it was the opposite. The boys with lowest household income ($0-17 500) were more likely to be overweight or obese compared with those with the highest household income (greater than $67 500). Having parents especially mothers who were overweight or obese may increase the risk of children being overweight or obese.     

应用气质困难指数筛查学前儿童行为问题的方法研究

目的 了解学龄前儿童行为问题的现状,探讨应用气质困难指数筛查学前儿童行为问题的方法,为制定学前儿童行为问题的预防和干预措施,降低儿童心理行为问题的发生提供适宜工具。方法 采用《Achenbach儿童行为量表》(Child Behavior Checklist,CBCL)、《Carey 3~7岁儿童气质问卷》分别对600名3~6岁幼儿园儿童的行为问题和气质特征进行评价分析。结果 学前儿童行为问题的的检出率为37.4%,其中男童检出率为40.5%,女童为33.1%。焦虑/抑郁、退缩、注意力、社会化问题、攻击行为因子得分,男童均显著高于女童(P均＜0.05)。气质困难指数与儿童行为总分及各行为因子得分均有显著相关(P≤0.001)。 将Achenbach CBCL作为金标准,气质困难指数(3分为临界值)筛查儿童行为问题的灵敏度为9.9 %,特异度为97.2%。 结论 学龄前儿童心理行为问题不容忽视,儿童的气质困难指数与行为问题的发生密切相关,将其作为筛查儿童行为问题的方法有较高特异度,与经典CBCL方法比较,方法简便易行易于家长接受。     

2013年西安市7岁以下儿童超重/肥胖的调查及影响因素分析

目的 了解西安市儿童超重/肥胖的发病情况,为制定有效的干预措施提供理论依据。方法 采用随机整群随机抽样的方法抽取西安市7岁以下儿童10 374人,男5 498人,女4 876人。以WHO 2007身高别体重肥胖标准作为诊断超重和肥胖的指标,并抽取3岁及以上的超重/肥胖儿童606例,选择正常体重儿童763例为对照,向以上儿童家长发放自行设计的问卷,对超重/肥胖的影响因素进行多元回归分析,以儿童是否超重/肥胖为因变量(即:是=1,否=0),儿童性别、年龄、出生体重、母亲生产方式、母乳喂养情况、父母受教育程度、家庭经济情况、儿童健康饮食情况和运动情况为自变量,进行多因素Logistic回归模型分析。结果 1)2013年7岁以下儿童的超重率为16.87%,肥胖率为8.18%。其中男童超重1 008例,超重率为18.33%,肥胖491例,肥胖率为8.93%;女童超重742例,超重率为15.21%,肥胖358例,肥胖率7.92%,男童超重/肥胖率均显著高于女童,差异均有统计学意义(χ²=17.898,8.677,P均<0.001)。2)Logistic回归分析显示:父母肥胖、家庭收入高、经常喝甜饮料、食欲好、进食速度快是儿童超重/肥胖的危险因素。父亲受教育程度高、代养人为父母是儿童超重/肥胖的保护因素。结论 西安市7岁以下儿童超重/肥胖率处于较高水平,男童高于女童。儿童超重/肥胖受多种因素共同影响。     

协同教育对单纯肥胖儿体重影响基线调查分析

目的:通过对儿童行为量表的调查分析,观察单纯肥胖儿体重影响的有关因素,为早期干预提供科学依据。方法:选择深圳市罗湖区6～12岁小学生1428例作为调查对象,由通过培训的专业医务人员将Achenbach儿童行为量表(CBCL)发放给每个学生进行测评。结果:有186例为单纯性肥胖儿童,占13.0%,其中男童139例,占74.7%,女童47例,占25.3%。这些肥胖儿均社会能力较差,行为问题较多。结论:应加强对肥胖儿童的早期干预,预防单纯性肥胖发生。     

Consultation for and identification of child and adolescent psychological problems in Dutch general practice

BACKGROUND: Child and adolescent psychological problems are rarely brought to the attention of GPs. Children and adolescents with psychological problems who do visit their GP are seldom identified as such by GPs. OBJECTIVE: To investigate in a general population sample of 2,449 Dutch children and adolescents (4-17 years) GP consultation and GP diagnoses of child psychological problems, and the influence of child and family characteristics upon these variables. METHODS: The degree to which parent, teacher, and adolescent reports of the presence of child psychological problems are in concordance with GP diagnoses of these problems was determined. Logistic regression analyses were used to examine correlates of GP consultation and psychological diagnoses. RESULTS: Approximately 80% of children and adolescents with psychological problems had visited their GP within the preceding year. GP consultation was most strongly associated with child/adolescent chronic physical disorders. Concordance between GP psychological diagnoses and parent, teacher, and adolescent reports of psychological problems was limited. Children and adolescents with psychological problems according to parent or teacher report, children with school problems, young boys, adolescents with negative health perceptions, and adolescents from single parent families were more likely to be diagnosed with psychological problems by GPs. CONCLUSION: Improving GPs' interview techniques, introducing standardised screening measures in general practice, increasing GPs' awareness of the possible presence of psychological problems in children consulting for physical problems, and strengthening collaboration between GPs and mental health professionals may increase GP identification of child psychological problems and enhance access to care for those in need.     

单纯性肥胖对初中学生心理健康的影响

目的探讨单纯性肥胖对初中学生心理健康的影响。方法采用中学生心理健康诊断测验（MHT）对776名初中学生进行测查。结果男生肥胖检出率高于女生（X^2 （3） =17．631,P=0.001）;肥胖女生的心理健康水平低于男生（X^2 （3）=20．653,P=0．000）;肥胖男生心理问题发生率与其他组男生差异无统计学意义,而超重、肥胖女生则在学习焦虑、过敏倾向、身体症状和冲动倾向等方面问题发生率较其他组女生高,差异有统计学意义;肥胖学生心理问题在年级间差异无统计学意义。结论不同营养状况的初中学生心理健康水平存在性别差异,肥胖女生心理健康水平低于男生。     

The relationship between parenting stress,parental intelligence and child behavior problems in a study of Korean preschool mothers

The current study examined the relationship between Korean mothers’ parenting stress and parental intelligence, and child behavior problems as well as the mediation effects of parental intelligence, which tested the association between parenting stress and child behavior problems. A sample of 436 typically developing children and their mothers participated and were assessed by the Parenting Stress Index—Short Form, the Parental Intelligence Scale and the K‐Child Behavior Check List. Results indicated that parenting stress, parental intelligence and child behavior problems were related; especially, parenting stress significantly predicted child behavior problems. Despite its substantive relationship, parental intelligence did not appear to mediate this relationship.     

肥胖儿童肥胖心理感受与控制体重意愿

目的了解肥胖儿童的肥胖心理感受和控制体重意愿,为研究控制肥胖儿童体重的策略和措施提供依据。方法随机抽取泰安市泰山区2个街道、4个村的6～12岁肥胖儿童205名作为调查对象。采用统一调查表进行面对面调查,同时测量儿童的身高、体重,计算BMI。结果 39.5%的肥胖儿童认为自己不胖,低年龄组认为自己不胖的比例更高(χ2=13.29,P<0.01);34.1%的肥胖儿童因为肥胖苦恼;10～12岁肥胖儿童71.9%不愿意与同学外出活动,高年龄组比低年龄组严重(χ2=120.01,P<0.01);有9.8%的肥胖儿童自行减少饭量,同意减肥的达到82.4%,希望家长帮助减肥的占79.0%。Logistic回归分析显示,导致肥胖儿童苦恼的影响因素为对自己肥胖的态度和肥胖自我感觉(P值均<0.01)。结论部分肥胖儿童没有认识到自己肥胖;已有部分认识到自己肥胖且对自己体重不满意的儿童产生了心理问题;绝大多数肥胖儿童希望减肥,但付诸行动的较少。     

Parental discipline behaviours and beliefs about their child: associations with child internalizing and mediation relationships

Introduction   Internalizing disorders of childhood are a common and disabling problem, with sufferers at increased risk of subsequent psychiatric morbidity. Several studies have found associations between parenting styles and children's internalizing, although few have considered the role of parental discipline. Parental discipline style may exert an effect on children's internalizing symptoms. Anxiety and depression are reliably found to run in families and parental anxiety has been shown to effect parenting behaviour. This study set out to examine the links between parental anxiety, parental discipline style and child internalizing symptoms.
Method   Eighty-eight parents of children aged 4–10 years were recruited through primary schools. All parents completed questionnaires including measures relating to: adult anxiety (State-Trait Anxiety Inventory – Trait version, Penn State Worry Questionnaire), parental depression (Beck Depression Inventory – Fastscreen), parental discipline (The Parenting Scale), parenting-related attributions (Parenting Attitudes, Beliefs and Cognitions Scale) and child psychological morbidity (Child Behaviour Checklist 4–18 version).
Results   Significant correlations were found between both parental anxiety and child internalizing symptoms with ineffective discipline and negative beliefs about parenting. Particularly strong correlations were found between parental anxiety and child internalizing symptoms with harsh discipline. Parents of anxious/withdrawn children were more likely to hold negative beliefs about their child. The link between parental anxiety and child internalizing symptoms was mediated by harsh discipline. The link between parental anxiety and harsh discipline was mediated by parental beliefs about the child.
Conclusion   Discipline style may be an important factor in the relationship between parent anxiety and child internalizing symptoms.     

学龄儿童行为问题与家庭环境因素对照研究

目的：探讨家庭环境对学龄儿童行为问题的影响,方法采用Achenbach儿童行为量表和儿童行为问题影响因素调查表对839名学龄儿童的许问题及其家庭环境进行调查,并用病例对照研究的方法对调查结果进行分析。结果：儿童行为问题检出约为20．385,儿童行为问题有交往不良、焦虑、社交退缩、躯体诉述、多动、抑郁及强迫性行为。儿童行为问题的影响因素为父母水平及其职业、父母之间的关系,教育孩子的方式及其教育意见的分歧程度,亲子关系和父母对孩子的期望。结论：学龄儿童行为问题与家庭环境有密切关系,为降低学龄儿童行为问题的发生率,必须重视家庭环境的作用。