Beth H. Garland

A comparison of Latino and Anglo socially desirable responding

Previous research suggests that Latinos tend to score higher than Anglos on psychometric indicators of socially desirable responding. The purpose of the current study was to test several methodological and cultural explanations for these group differences. Hypothesized explanations included varying levels of problems in living, measurement bias, differential structure of socially desirable responding measures, reliabilities of response style indicators, or cultural factors. Results supported previous findings that self-identified Latino (N=143) respondents score significantly higher than Anglos (N=93) on some socially desirable responding indicators. Groups did not differ in levels of psychopathology and socially desirable responding indicators demonstrated structural similarity, equivalent relations to external criteria, and equivalent reliabilities across groups. Thus, data suggest normative differences between these groups in social presentation that should be considered in culturally sensitive clinical practice.

Brief Behavioral Intervention for Young Children with Disruptive Behaviors

Parent reported behavioral difficulties in young children are relatively common. Without adequate intervention, some children will later present with more severe problem behaviors. Parent management training is one of the best methods of treatment for behavior problems; however, existing treatments can be lengthy and difficult to conduct outside of a research setting. The Brief Behavioral Intervention was designed as a briefer version of a manualized parent management training treatment package. Thirty-one parents of children aged 2–6.5 presenting with behavior problems were included in this initial study of treatment effectiveness. Based on parent and teacher report, treatment was effective in a mean of 7.2 sessions.

A Qualitative Study of the Day-to-Day Lives of Obese Mexican-American Adolescent Females

OBJECTIVE: In an effort to develop more effective weight-loss interventions, this study examined the daily experiences and personal struggles of Mexican-American adolescent females with morbid obesity. METHODS: Twenty self-identified, morbidly obese Mexican-American adolescent females and their families were interviewed about their food choices, personal and family barriers to weight loss, sources of support, previous weight-loss experience, and weight-related beliefs. Qualitative responses were coded by using framework analysis. RESULTS: Four themes emerged from the adolescent and family responses: the impact of normal adolescent development, multiple sources of excess calories, the physical and emotional burden of excess weight for the adolescent, and the magnitude of the family’s personal struggle with weight management. Multiple subthemes were also identified. CONCLUSIONS: Responses by the adolescents and their families highlighted the intersection of adolescence and Mexican-American culture and the daily challenges of obesity. Recommendations for providers include incorporating knowledge of adolescent development and culturally sensitive care into treatment recommendations.

Family factors that characterize adolescents with severe obesity and their role in weight loss surgery outcomes

To comprehensively assess family characteristics of adolescents with severe obesity and whether family factors impact weight loss outcomes following weight loss surgery (WLS).

Relations between the Test of Variables of Attention (TOVA) and the Children's Memory Scale (CMS).

Objective: There is considerable overlap in the constructs of attention and memory. The objective of this study was to examine the relationship between the Test of Variables of Attention (TOVA), a measure of attention, to components of memory and learning as measured by the Childrens Memory Scale (CMS). Method: Participants (N = 105) were consecutive referrals to an out-patient facility, generally for learning or behavior problems, who were administered both the TOVA and the CMS. Results: Significant correlations were found between the omissions score on the TOVA and subscales of the CMS. TOVA variability and TOVA reaction time correlated significantly with subscales of the CMS as well. TOVA commission errors did not correlate significantly with any CMS Index. Conclusion: Although significant, the correlation coefficients indicate that the CMS and TOVA are measuring either different constructs or similar constructs but in different ways. As such, both measures may be useful in distinguishing memory from attention problems. (J. of Att. Dis. 2007; 11(2) 167-171)

Peer Victimization in Adolescents With Severe Obesity: The Roles of Self-Worth and Social Support in Associations With Psychosocial Adjustment

Objective To examine the associations of peer victimization with internalizing symptoms, externalizing symptoms, social competence, and academic performance in a clinical sample of adolescents with severe obesity, and whether self-worth and social support affect these associations. Methods Multisite cross-sectional data from 139 adolescents before weight loss surgery ( M age = 16.9; 79.9% female, 66.2% White; M Body Mass Index [BMI] = 51.5 kg/m 2 ) and 83 nonsurgical comparisons ( M age = 16.1; 81.9% female, 54.2% White; M BMI = 46.9 kg/m 2 ) were collected using self-reports with standardized measures. Results As a group, participants did not report high levels of victimization. Self-worth mediated the effects of victimization on a majority of measures of adjustment, and further analyses provided evidence of the buffering effect of social support for some mediational models. Conclusions Self-worth and social support are important targets for prevention and intervention for both victimization and poor adjustment in adolescent severe obesity.

Comprehensive obesity evaluation and treatment of three adolescents: a case series.

Abstract Background: Adolescent obesity is a chronic disease that is impacted from each patient’s biopsychosocial milieu. Successfully treating pediatric obesity requires long-term, innovative, systematic involvement to facilitate patient and family engagement and change. Methods: Extensive chart review was done for three obese adolescents who underwent comprehensive weight management in an adolescent clinic seen within the past 5 years. The charts were reviewed starting from the time of initial contact through the last visit in the clinic. The patients are no longer receiving care within the clinic. Results: The patients presented with BMI>99th percentile, family history of obesity, severe psychosocial stressors, and multiple obesity-related comorbidities. Their treatment involved comprehensive multidisciplinary intervention in an adolescent weight management clinic within a tertiary care center. In addition to rigorous support through frequent office visits, these patients all eventually required temporary, alternative living arrangements to successfully implement recommendations. One patient resided with another family member; two went to inpatient weight management program care for 2–3 months. All subjects successfully lost weight when away from their primary residence, and they demonstrated improvement or resolution of comorbidities. Conclusions: This case series of three adolescents who underwent comprehensive obesity evaluation and treatment demonstrates multidisciplinary care across interconnected treatment programs and active engagement of family. Those who maintained successful weight loss reduced sedentary time, demonstrated family support (e.g., key members attending follow-up visits), and altered their living environment and were committed to their own health goals.

Clinical Considerations for Emerging Adults with Eating Disorders and Transition to Adult-Based Care

ABSTRACT Eating disorders most commonly emerge during middle to late adolescence and can endure over the course of young adulthood. The length and involvement of empirically supported treatments and the use of an interprofessional care team often necessitate strategic and individualized transition planning as a process prior to the transfer of care to an adult-based system/provider. This article describes clinical models and processes for transition to adult-based mental health care and reviews current research on transition in eating disorders. Clinical considerations during transition to adulthood are presented with an emphasis on developing autonomy and caregiver support, resilience and motivation, and managing longitudinal barriers. Case examples of navigating the transition process with young adults who have eating disorders are included.

Assessment of the Obese Child or Adolescent

The evaluation of a child or adolescent for obesity begins with weight and height measurements to calculate body mass index percentile. A thorough medical evaluation should be done to screen for obesity-associated medical conditions, including hypertension, dyslipidemia, fatty liver disease, prediabetes and diabetes, obstructive sleep apnea, polycystic ovary syndrome, and orthopedic conditions. Most of the obesity comorbidities known in adults also occur during childhood, and early recognition is an opportunity to protect long-term health. Obese youth seem to be at higher risk for serious mental health conditions, including depression, anxiety, and eating disorders. In addition, these children are vulnerable to psychological stress from teasing and from low self-esteem. Because intervention is primarily behavior based, evaluation of obese children and adolescents must include current, potentially modifiable lifestyle behaviors as well as an assessment of the strengths and barriers of the home and community environment.