Roth B, Munsch S, Meyer A, Isler E, Schneider S
Child and Adolescent Psychiatry Service of Basel-Land, Kantonsspital Bruderholz, Bruderholz, Switzerland.
Eat Weight Disord. 2008 Sep;13(3):129-36. doi: 10.1007/BF03327613.
The prevalence of childhood obesity is rapidly increasing, and many obese children suffer from emotional and behavior problems and mental disorders. Associations with social stigmatization of obesity, maternal psychopathology, socioeconomic status (SES) and resilience factors are discussed.
We hypothesize maternal psychopathology to have an impact on the psychological well-being of an obese child. We further hypothesize that competence factors within the child are important key factors that influence the way a child deals with the psychological burden of obesity.
A referred clinical sample of 59 obese children with their mothers was assessed using a structured clinical interview for DSM-IV diagnosis and questionnaires for child and maternal psychopathology, SES, body mass index (BMI), and percent overweight. Correlations, hierarchical linear and logistic regression models were used to analyze associations between mothers and child and the impact of potential predictors.
Mental disorders were found in 37.3% of the obese children in our sample. Maternal anxiety predicted the mother reported child's internalizing problems as well as the child's depression and anxiety self report scores. The mental disorder status of the mother predicted the child's internalizing problems, and maternal binge eating disorder (BED) had an impact on the mental disorder of the child. If the child's total competences were included in the hierarchical regression model they predicted the child's outcome in all three subscales of the Child Behavior Checklist (CBCL), thereby reducing the effect of maternal anxiety to influencing the child's depression score only. Neither SES nor the child's percent overweight accounted for the child's wellbeing.
Although maternal psychopathology and diagnosis of mental disorder had some impact on the psychological well-being of the child, the child's competences showed a significant negative association with the problem scales. More research on parental and children's skills and competences will highlight the complex interaction of childhood obesity, comorbidity of mental disorders, and resilience factors and will lead to additional approaches for intervention.
儿童肥胖症的患病率正在迅速上升,许多肥胖儿童存在情绪和行为问题以及精神障碍。本文讨论了肥胖的社会污名化、母亲的精神病理学、社会经济地位(SES)和恢复力因素之间的关联。
我们假设母亲的精神病理学对肥胖儿童的心理健康有影响。我们进一步假设,儿童自身的能力因素是影响儿童应对肥胖心理负担方式的重要关键因素。
对59名肥胖儿童及其母亲组成的转诊临床样本进行评估,采用结构化临床访谈进行DSM-IV诊断,并使用问卷评估儿童和母亲的精神病理学、SES、体重指数(BMI)和超重百分比。采用相关性分析、分层线性和逻辑回归模型分析母亲与孩子之间的关联以及潜在预测因素的影响。
在我们的样本中,37.3%的肥胖儿童患有精神障碍。母亲的焦虑预测了母亲报告的孩子的内化问题以及孩子的抑郁和焦虑自评分数。母亲的精神障碍状态预测了孩子的内化问题,母亲的暴饮暴食障碍(BED)对孩子的精神障碍有影响。如果将孩子总的能力纳入分层回归模型,它们可预测儿童行为检查表(CBCL)所有三个子量表中的孩子结果,从而将母亲焦虑的影响仅降低到对孩子抑郁分数的影响。SES和孩子的超重百分比均不能解释孩子的幸福感。
虽然母亲的精神病理学和精神障碍诊断对孩子的心理健康有一定影响,但孩子的能力与问题量表呈显著负相关。对父母和孩子技能与能力的更多研究将突出儿童肥胖、精神障碍共病和恢复力因素之间的复杂相互作用,并将带来更多的干预方法。