Leentje Vervoort

Food Approach and Food Avoidance in Young Children: Relation with Reward Sensitivity and Punishment Sensitivity.

It has recently been suggested that individual differences in Reward Sensitivity and Punishment Sensitivity may determine how children respond to food. These temperamental traits reflect activity in two basic brain systems that respond to rewarding and punishing stimuli, respectively, with approach and avoidance. Via parent-report questionnaires, we investigate the associations of the general motivational temperamental traits Reward Sensitivity and Punishment Sensitivity with Food Approach and Food Avoidance in 98 preschool children. Consistent with the conceptualization of Reward Sensitivity in terms of approach behavior and Punishment Sensitivity in terms of avoidance behavior, Reward Sensitivity was positively related to Food Approach, while Punishment Sensitivity was positively related to Food Avoidance. Future research should integrate these perspectives (i.e., general temperamental traits Reward Sensitivity and Punishment Sensitivity, and Food Approach and Avoidance) to get a better understanding of eating behavior and related body weight.

Use of Fitness and Nutrition Apps: Associations With Body Mass Index, Snacking, and Drinking Habits in Adolescents

Background Efforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking. Objectives This study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio. Methods Cross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. Results A total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the frequency of using nutrition and for the zBMI (b=−0.03 [0.02], P=.04) and the healthy snack ratio (b=−0.84 [0.37], P=.03). Attitude to eat healthy for appearance mediated both the fitness app use frequency-zBMI (a × b=0.02 [0.01], P=.02) and the nutrition app use frequency-zBMI (a × b=0.04 [0.01], P=.001) associations. No mediation was observed for the associations between the frequency of use of fitness or nutrition apps and the healthy snack or beverage ratio. Conclusions Commercial fitness and nutrition apps show some association with healthier eating behaviors and BMI in adolescents. However, effective behavior change techniques should be included to affect key determinants of healthy eating.

Using a gamified monitoring app to change adolescents’ snack intake: the development of the REWARD app and evaluation design

BackgroundAs the snacking pattern of European adolescents is of great concern, effective interventions are necessary. Till now health promotion efforts in children and adolescents have had only limited success in changing adolescents’ eating patterns and anthropometrics. Therefore, the present study proposes an innovative approach to influence dietary behaviors in youth based on new insights on effective behavior change strategies and attractive intervention channels to engage adolescents. This article describes the rationale, the development, and evaluation design of the ‘Snack Track School’ app. The aim of the app is to improve the snacking patterns of Flemish 14- to 16-year olds.MethodsThe development of the app was informed by the systematic, stepwise, iterative, and collaborative principles of the Intervention Mapping protocol. A four week mHealth intervention was developed based on the dual-system model with behavioral change strategies targeting both the reflective (i.e., active learning, advance organizers, mere exposure, goal-setting, monitoring, and feedback) and automatic processes (i.e., rewards and positive reinforcement). This intervention will be evaluated via a controlled pre-post design in Flemish schools among 1400 adolescents.DiscussionWhen this intervention including strategies focused on both the reflective and automatic pathway proves to be effective, it will offer a new scientifically-based vision, guidelines and practical tools for public health and health promotion (i.e., incorporation of learning theories in intervention programs).Trial registrationNCT02622165 registrated November 15, 2015 on clinicaltrials.gov.

The Role Behavioral of Activation and Inhibition in Explaining Adolescents’ Game Use and Game Engagement Levels

According to Gray’s reinforcement sensitivity theory, variations in the functioning of two neuropsychological systems, the behavioral approach (BAS) and inhibition (BIS) system, can result in individual differences in personality. Several studies have looked at associations between personality and media use but media research integrating BAS and BIS is scarce. The current cross-sectional survey study (n = 1016) representative for Belgian adolescents investigated associations between BAS and BIS and game use and game engagement in adolescents. Results showed that BAS was positively associated with playing both violent and nonviolent games. BIS was negatively associated with violent game use while it was positively associated with nonviolent games. Also, BAS was positively associated with game engagement. No association was found between BIS and game engagement. Game engagement was shown to mediate the relationship between BAS and playing both violent and nonviolent games. Based on these results, the present study argues that integrating the reinforcement sensitivity theory in media research makes an important contribution to the understanding of the link between personality and game engagement and game use.

Reward sensitivity and body weight: the intervening role of food responsive behavior and external eating

BACKGROUND During the last three decades, the prevalence of childhood overweight and obesity has increased worldwide. It is well established that different child-related factors such as food approach behaviors (i.e. eating behaviors that imply movements towards food) contribute to the development of overweight. However, research is lacking on the underlying mechanisms leading to food approach behaviors, which in turn lead to overweight. SUBJECT/METHODS Via parent-report questionnaires, we investigated the relation between the personality trait reward sensitivity and body weight in a convenience sample of 211 children aged 2.5-9 years. We further investigated the intervening role of food approach behaviors in the association between reward sensitivity and body weight. RESULTS Unexpectedly, there was no direct association between reward sensitivity and body weight. Despite the absence of a direct effect, a significant indirect association was found between reward sensitivity and body weight through the intervening food approach variables (i.e. food responsive behavior and external eating). CONCLUSIONS These results highlight the importance of the focus on eating behaviors as well as trait characteristics in prevention programs for overweight.

A Reinforcement Sensitivity Perspective on Adolescents’ Susceptibility to the Influence of Soap Opera Viewing on Alcohol Attitudes

Previous research found support for an association between exposure to alcohol-related media content and alcohol attitudes, intentions and behavior. Nevertheless, research on what makes young people susceptible to the occurrence of this relationship is scarce. The current study examined the behavioral activation (BAS) and inhibition system (BIS) as moderators of the relationship between soap opera viewing and alcohol attitudes. A cross-sectional survey was carried out among a sample of 922 adolescents (Mage = 14.96 years, SD = .85, 56% girls). Regression analyses showed no association between total television viewing and alcohol attitudes, but did confirm that soap opera viewing is associated with positive attitudes towards alcohol use. Moderation analyses indicated that BAS did not moderate this relationship, while BIS did; the relationship between soap opera viewing and positive attitudes toward alcohol was only significant for adolescents with a low BIS-profile. These results provide support for the premise that an elevated BIS protects adolescents from the effect of soap opera viewing frequency on their alcohol attitudes.

Parent-reported BIS/BAS scales for children : factor structure and measurement invariance across age and gender

The present study examined the factor structure and measurement invariance of the Behavioral Inhibition System/Behavioral Approach System (BIS/BAS) scales parent-report in children and adolescents (N = 1,444, 58% girls) across age (Group 1, 2-5 years; Group 2, 6-9 years; Group 3, 10-13 years; Group 4, 14-18 years old) and gender. The results consistently underscored a four-factor structure, resembling the original factor structure, with one BIS-factor and three BAS-factors. Multigroup confirmatory factor analysis showed full measurement invariance across gender as well as across Group 1 and 2, and Group 2 and 3. Strong measurement invariance was found across Group 3 and 4, Group 1 and 3, and Group 2 and 4. Configural and metric invariance was found across Group 1 and 4. Hence, mean-level BIS/BAS scores can be compared across gender and age although comparison between preschool children (Group 1) and late secondary school children (Group 4) should be done with caution.

How can classical conditioning learning procedures support the taste development in toddlers (REWARD)

Purpose The strongest barrier for vegetable consumption in children is their preference for these foods. Surveys show that vegetables are children’s least liked food category. Also, food neophobia is common during childhood, affecting 8% to 50% of children. The development of food preferences can be seen as a learning process, as such it is assumable that classical conditioning via associative learning can enhance or impede this process. We want to study the applicability of this theoretical framework in the acquisition of food preferences. Moreover, we will study differential effects of associative learning taking into account individual differences in children’s reward sensitivity (RS). In this poster, we describe the design of a study that aims to examine how positive stimuli influence children’s willingness to taste and the liking of an unliked food item and how this is interrelated with RS. Methods and design This study is designed as a prospective observational study of 45 children in day care (aged 24-30 months) and their parents and caregivers. The children will be randomly allocated to three conditions (a neutral condition, a positive condition or a controlgroup) and will be exposed to an unliked food item from the category of (cooked) vegetables. The neutral condition consists of ‘mere exposure’. The positive condition is operationalized based on focusgroups with parents and caregivers determining cues and techniques facilitating children’s eating development. Children’s liking and usual intake of the vegetable will be assessed before (pre test). The manipulation includes a three week exposure(+stimuli) intervention consisting of 9 tasting trials (3/week). During each trial, children’s willingness to taste will be observed. Their liking will be measured using a 3‐point visual ‘faces’ scale: ‘yummy’ (smiling), ‘just okay’ (neutral face) and ‘yucky’ (frowning) on trial 3, 6 and 9. After the intervention phase, the child’s usual vegetable liking and intake will be assessed, 5 weeks from baseline (post test) and 3 months from baseline (follow‐up 1). This replicates the procedure described by Anzman‐Frasca et al. (2011). The child’s RS will be assessed by the BIS/BAS Questionnaire (Carver & White, 1994). Both parents and caregivers will be asked to fill out this questionnaire. Discussion This study can provide knowledge of how (1) RS may predict change in willingness to taste and liking behavior of vegetables; and (2) the tasting and liking process can develop faster when the child is exposed to positive stimuli via the process of associative learning (compared to mere exposure and the control group). This could lead to more successful interventions tailored to individual characteristics of children.

Reward Sensitivity, Punishment Sensitivity and weight status in children. Crosssectional and longitudinal associations.

Understanding eating behavior is not possible without studying individual reward circuits. Reward Sensitivity (RS) and Punishment Sensitivity (PS) are psychological concepts reflecting sensitivity of the neurological Behavioral Approach (BAS) and Inhibition (BIS) Systems respectively (Gray, 1987). Under normal circumstances, BIS and BAS independently drive behavior, but in extreme cases, one overactive system suppresses the other (Corr, 2001, 2002; Vervoort, Wolters, Hogendoorn, de Haan, Boer, & Prins, 2010). While research provides evidence for the role of RS and PS in several behaviors and psychological problems, little is known about their implications for eating behavior and obesity. Cross-sectional studies in adults (Davis & Fox, 2008) and children (Verbeken, Braet, Lammertyn, Goossens & Moens, 2012) support a dynamic vulnerability model of the association between self-reported RS and bodyweight. We extend this research, by describing cross-sectional and longitudinal associations between RS and measured bodyweight and exploring the role of PS in the association between RS and bodyweight. Cross-sectional and longitudinal associations of RS and weight outcomes are tested by fitting quadratic regression models of RS on weight measures, controlling for gender and age effects. The cross-sectional associations are studied in a Flemish sample of 10–15 year olds, the longitudinal associations are studied in Dutch youngsters participating in the TRAILS study.