Chris Fradkin

Associations Between Socioeconomic Status and Obesity in Diverse, Young Adolescents: Variation Across Race/Ethnicity and Gender

OBJECTIVE This study examined the association between socioeconomic status (SES) and obesity risk during early adolescence, ages 10-13 years, and whether this association is present in different racial/ethnic and gender groups during 2 time points in early adolescence. METHOD Data were from the Healthy Passages study, which enrolled 4,824 African American, Hispanic, and White 5th graders (ages 10-11) in a population-based, longitudinal study conducted in 3 U.S. metropolitan areas, and assessed them again 2 years later. Weight status was classified from measured body mass index using standard criteria into nonobese and obese (27% in 5th grade). SES was indexed based on highest education attainment in the household. RESULTS Youth in the highest SES had a significantly lower prevalence of obesity than those of lower SES at both 5th and 7th grades when disregarding race/ethnicity. Within-racial/ethnic group analyses mostly confirmed this pattern for Hispanic and White youth, but not for African American youth. When also considering gender, the SES differential in obesity risk was more pronounced among White girls and 5th-grade Hispanic boys. CONCLUSION Growing up in a high SES home, marked by having a member with at least a college degree, is associated with lower risk for obesity among Hispanic and White youth. For African American youth, there appears to be no association between SES and obesity. Thus the health advantage generally attributed to higher SES does not appear consistently across racial/ethnic groups for obesity in youth. Further research should identify influences on weight status beyond SES, especially among African American youth.

Racial/Ethnic Disparities in Health-Related Quality of Life and Health in Children Are Largely Mediated by Family Contextual Differences

OBJECTIVE To examine (1) racial/ethnic disparities in health-related quality of life (HRQOL), and overall health status among African-American, Hispanic, and white 5th graders in the general population and (2) the extent to which socioeconomic status (SES) and other family contextual variables mediate any disparities. METHODS A total of 4824 African-American, Hispanic, and white fifth-graders participating in a population-based, cross-sectional survey conducted in 3 U.S. metropolitan areas reported their own HRQOL by using the Pediatric Quality of Life Inventory Version 4.0 and supplemental personal and social well-being scales. Parents reported these childrens overall health status. SES was indexed by parent education and household income. Other family contextual variables included family structure and degree to which English is spoken at home. RESULTS Marked racial/ethnic disparities were observed across all measures of HRQOL and health status, favoring white children and especially disfavoring Hispanic children. Most of these disparities were no longer significant after adjusting for SES and other family contextual differences that were observed among these racial/ethnic groups. Only disparities in parent-reported overall health status and self-reported global self-worth remained. CONCLUSIONS Racial/ethnic disparities in childrens health status are substantial but may be mediated by corresponding disparities in SES and other family contextual variables. Race/ethnicity and family context are related to one another and should be considered jointly in efforts to reduce health disparities in children.

The Internationalization of Psychology Journals in Brazil: A Bibliometric Examination Based on Four Indices

There is considerable variability among psychology journals in Brazil, in terms of presence on the international stage. However, research as to why is very scarce. This study empirically examined the relationship between several indices of internationalization and real-world internationalization, among these journals. 661 articles from the top-17 psychology journals in Brazil were coded for: English-language text, editorial board makeup, lead author institution, and article type. Analyses revealed that successful internationalization was associated with: (i) lead author institution from a native English-speaking country; (ii) empirical articles; and (iii) editorial board members from a native English-speaking country. Use of English-language text was not associated with successful internationalization. These findings suggest that the path to internationalization for psychology journals in Brazil may depend on increased publishing of findings from English-speaking countries; or at the very least: increased collaboration between Brazilian and native English-speaking scholars.

Regular physical activity has differential association with reduced obesity among diverse youth in the United States.

This study examined whether daily or almost daily lower-intensity physical activity was associated with reduced obesity, among 4824 African American, Hispanic, and White youth assessed in fifth and seventh grades. Regular lower-intensity physical activity was associated with reduced obesity only among Hispanic and White males and only in seventh grade, and not among youth in fifth grade, females, or African American males or females. Findings from this study suggest that the reduced obesity risk generally attributed to physical activity may not be consistent across racial/ethnic and gender groups of early adolescents.

Obesity and Overweight Among Brazilian Early Adolescents: Variability Across Region, Socioeconomic Status, and Gender

Introduction As with most emerging nations, Brazil lacks up-to-date data on the prevalence of obesity and overweight among its children. Of particular concern is the lack of data on children in early adolescence, considered by many to be the crucial stage for weight-related healthcare. Objective To assess regional, socioeconomic, and gender differences in the prevalence of obesity and overweight among Brazilian early adolescents. Methods A cross-sectional study was conducted on a racially diverse sample of students aged 10–13 years, from schools in three geographic regions (north, northeast, south) (N = 1,738). Data on gender, age, race, socioeconomic status (SES), weight, and height were obtained. Weight class was calculated from age- and gender-adjusted body mass index, based on children’s weight and height. Bivariate and multivariable analyses, with post hoc tests, were conducted to estimate differences between groups and were corrected for multiple comparisons. Procedures were approved by institutional review boards at study sites. Results Analyses revealed a higher prevalence of obesity and/or overweight among: (1) children of higher SES; (2) children in southern Brazil; (3) males; and (4) Black females. Conclusion The most salient predictor of weight risk among Brazilian early adolescents is higher SES. This finding is consistent with previous findings of an inverse social gradient, in weight risk, among emerging-nation population groups.

The pre-cloak superhero: a tool for superhero play and intervention

Abstract Since the early 1940s, superheroes have been used by educators and clinicians to instill community and confidence; resiliency and courage; tolerance and sharing among children. Through superhero play, the early childhood classroom has become a laboratory filled with capes and costumes. In the therapist’s milieu, the empowered superhero provides a model for children to aspire to. But both of these environments – the classroom and the counselor’s office – use the fully powered superhero. While the literature attests to health benefits provided through use of the empowered superhero, this article draws attention to a resource often overlooked: the pre-empowered, pre-cloak superhero. As many popular superheroes (~86%) were orphaned or abandoned, prior to acquiring superpowers, the article focuses on the adversities they share with these two specific groups of vulnerable children. With orphaned and abandoned children as the treatment group of focus, the article proposes environments for pre-cloak interventions. In addition, the article proposes a dual-stage program, which would combine pre-cloak interventions with superhero play. For the educator and clinician, possibility awaits through this expansion of the superhero palette.

Commentary: Are Children Like Werewolves? Full Moon and Its Association with Sleep and Activity Behaviors in an International Sample of Children

A recent article by Chaput and colleagues (1) provides evidence that if a relationship exists between lunar cycle and sleep duration and physical activity in children, its association is rather weak and less-than-meaningful. Using an international sample of 9- to 11-year olds (n = 5812), monitored by accelerometers, Chaput and his team found no relationship between lunar cycle and physical activity, and a minimal effect between lunar cycle and sleep duration (~5 min/night less sleep under full moon vs. new moon). While this relationship has been studied in the past, this is the first time it has been studied among a diverse pediatric sample of this size. The authors’ findings are important because they provide further evidence against the notion of a so-called lunar effect, a phenomenon that purports increased violence, crime, and birth-rate, occurring in the full moon phase. While this concept may seem far-fetched to some, to many people it is not. In fact, according to a survey of 325 people (2), 140 (43%) thought that “lunar phenomena could alter personal behavior” [(3), p. 149]. Interestingly, this belief was most popular among the health professionals, including social workers, clinical psychologists, and nurses’ aides, surveyed in the sample. A separate survey was consistent with these findings. In an examination of lunar cycle on emergency medicine personnel (n = 50), Danzl (4) found that 80% of the emergency department nurses and 64% of the physicians believed that lunar cycle impacts patients. Among the nurses, 92% found higher stress on lunar shifts and expressed desire for financial compensation. Though these anecdotal findings have been empirically debunked (5–11), the portent of the full moon lingers on. To date, the literature on lunar cycle–sleep relationship has been inconsistent in its findings. Among a sample of adults (n = 205), Della Monica and colleagues (12) found a lunar class × sex interaction, with women with reduced sleep, and men with increased REM sleep, in relation to the full moon phase. A study by Turanyi and colleagues (13) found reduced deep sleep and sleep efficiency, occurring at the full moon phase. In contrast, several studies (14, 15) have shown no sleep effect at all, occurring at the full moon phase. And in one of the few studies using children (n = 795), Sjodin and colleagues (16) found longer sleep length and reduced activity, both occurring at the full moon phase. With respect to these works, the study by Chaput and colleagues (1) is the largest of its kind, in terms of sample size and geographic scope. Another strength of the Chaput and colleagues study (1) is its interpretation of statistical results. Although the association between lunar cycle and sleep duration was statistically significant at p < 0.01, the authors actually point out that such a result, i.e., a 5-min reduction at full moon compared with new moon, is not clinically relevant. They explain correctly that a large sample size tends to increase the likelihood of finding a statistically significant result (17, 18). Their discussion demonstrates an intellectual rigor that needs to be highlighted, because too often it is tempting to interpret a statistically significant result as a meaningful and relevant discovery. Rather, Chaput and his team downplay their findings – findings that could have been interpreted as a robust relationship between lunar cycle and sleep duration. In their closing remarks, Chaput and colleagues (1) stress their need to delve much deeper, in terms of future research. In particular, they mention testing the relationship between the full moon on subgroups of vulnerable children, including “those with mental disorders and physical ailments” [(1), p. 5]. While this is an expected course to take, the authors should remember that sleep problems are associated with many physical ailments, which in turn can be cormorbid with mental disorders (19). What is needed, therefore, is a better understanding of the impact of mental and physical comorbidities on sleep parameters as potential third and confounding variables. We recommend this step prior to the proposed testing of the lunar cycle–sleep relationship among samples of vulnerable children. But regardless of their tack, movement forward with this work has the potential to unearth interesting findings, in particular, if the authors have a sample of the size and the diversity as the one they used in this study. Another aspect of this study worth mentioning again is its geographical diversity in sampling. It is unusual to encounter a study that has such diversity in sampling, not just racially, ethnically, and economically but also geographically. The authors’ finding of no differences across the study sites (i.e., geographically) suggests the findings are consistent, independent of location, for children in this age group (9–11 years) around the world. In conclusion, Chaput and colleagues (1) have moved us one step closer, in our understanding of lunar cycle, sleep, and activity. Other methods of assessment, such as forced desynchrony protocols (20), will allow exploring other questions on the impact of lunar cycle on behavior. These methods may contribute to debunking long-held myths, or possibly confirming lay beliefs.

The use of cartoon illustration for the assessment of social science concepts

The assessment of conceptual knowledge presents a challenge, particularly at the university level, at which large class size precludes individual assessment for assessment through multiple-choice examinations. This practitioner essay sets forth an alternative format: the use of cartoon illustration as a tool for the assessment of students’ conceptual knowledge. The context is an upper-division (third- and fourth-year students) psychology class at an American public research university. Student artwork is included, past research is discussed, and implications for the future are considered.

Superhero therapy: a hero’s journey through Acceptance and Commitment Therapy

for Pastoral Care (NAPCE) when it was set up in the early 1980s. It is, therefore, in places a rather angry book, and rightly so. But it is, ultimately, a positive and encouraging book which sets out the case for schools to re-orientate and transform curricula and pedagogy by embracing the capacity for love and empathy in policy and practice. This is not impossible; as Waters says of the curriculum: ‘It is not a case of writing a new curriculum but more of reassessing the message of much of the content to make sure compassion is the driver’ (p. 121). It is encouraging also to read of the many charities, organizations and networks which take a similar line (such as Human Scale Education and the Jubilee Centre for Character and Virtues at the University of Birmingham), to find many references to a substantial literature advocating compassionate approaches and to find in Appendix 2, a directory of web-based resources for schools seeking to transform their practice. In his Introduction, Coles states that ‘the audience for this book is purposefully wide’ including policy-makers, teachers and ‘all those who work in schools’, while also being of interest to the general reader (p. xxii). I hope it will find such a readership and that it will have a real impact.