Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA.
Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA.
J Dev Behav Pediatr. 2019 Oct/Nov;40(8):622-632. doi: 10.1097/DBP.0000000000000701.
To address calls for a resilience-informed approach to understand the cause and prevention of childhood obesity, the current study aims to investigate the independent and interactive associations between household chaos, maternal emotional responsiveness, and eating behavior in early childhood.
A sample of (n = 108) families of 18- to 24-month-olds completed self-report surveys and consented to home visits as part of the larger STRONG Kids 2 (N = 468) study. Videotapes of family mealtimes were collected during home visits and coded for observed maternal emotional responsiveness. Mothers completed questionnaires assessing maternal emotional responsiveness, household chaos, and child eating behaviors. Moderation analyses assessed independent and interactive effects of chaos and emotional responsiveness on child appetite self-regulation.
In moderation analyses controlling for demographic covariates, higher levels of chaos were associated with more emotional overeating and with more food responsiveness, but only among children of mothers observed engaging in low levels of responsiveness at mealtimes. There was no association between chaos and eating behavior among children of mothers observed engaging in high levels of emotional responsiveness at mealtimes. There was also no independent or interactive association between chaos and child eating behaviors characterized by food avoidance.
Preliminary evidence suggests that maternal emotional responsiveness at mealtimes may attenuate the deleterious effects of chaos on child overeating and food responsiveness. Future research should prioritize using longitudinal designs, developing observational assessments of early childhood eating behaviors, and understanding these processes among families exposed to greater socioeconomic adversity.
为了响应呼吁，采用具有恢复力的方法来理解儿童肥胖的成因和预防措施，本研究旨在调查家庭混乱、母亲情绪反应性与幼儿期进食行为之间的独立和交互关联。
作为更大规模的 STRONG Kids 2（N=468）研究的一部分，共有 108 个 18 至 24 个月大的家庭的儿童及其父母参与了研究。在家庭访视期间收集了家庭用餐的视频，并对观察到的母亲情绪反应性进行了编码。母亲们完成了评估母亲情绪反应性、家庭混乱和儿童进食行为的问卷。采用调节分析评估了混乱和情绪反应性对儿童食欲自我调节的独立和交互影响。
在控制人口统计学协变量的调节分析中，较高水平的混乱与更多的情绪性过度进食以及更多的食物反应性相关，但仅存在于在用餐时观察到母亲反应性水平较低的儿童中。在用餐时观察到母亲情绪反应性水平较高的儿童中，混乱与进食行为之间没有关联。混乱与以食物回避为特征的儿童进食行为之间也没有独立或交互关联。
初步证据表明，在用餐时母亲的情绪反应性可能会减轻混乱对儿童过度进食和食物反应性的不良影响。未来的研究应优先采用纵向设计，开发对幼儿期进食行为的观察性评估，并在面临更大社会经济逆境的家庭中理解这些过程。
