Sarah Bergmann

Maternal Weight Predicts Children's Psychosocial Development via Parenting Stress and Emotional Availability

Introduction: Maternal obesity has been shown to be a risk factor for obesity in children and may also affect childrens psychosocial outcomes. It is not yet clear whether there are also psycho-emotional mechanisms explaining the effects of maternal weight on young childrens weight and psychosocial development. We aimed to evaluate whether maternal body mass index (BMI), mother–child emotional availability (EA), and maternal parenting stress are associated with childrens weight and psychosocial development (i.e., internalizing/externalizing symptoms and social competence) and whether these predictors interact with each other. Methods: This longitudinal study included three assessment points (~11 months apart). The baseline sample consisted of N = 194 mothers and their children aged 5–47 months (M = 28.18, SD = 8.44, 99 girls). At t1, we measured maternal weight and height to calculate maternal BMI. We videotaped mother–child interactions, coding them with the EA Scales (fourth edition). We assessed maternal parenting stress with the Parenting Stress Index (PSI) short form. At t1 to t3, we measured height and weight of children and calculated BMI–SDS scores. Childrens externalizing and internalizing problems (t1–t3) and social competence (t3, N = 118) were assessed using questionnaires: Child Behavior Checklist (CBCL 1.5–5), Strengths and Difficulties Questionnaire (SDQ: prosocial behavior), and a checklist for behavioral problems at preschool age (VBV 3–6: social-emotional competence). Results: By applying structural equation modeling (SEM) and a latent regression analysis, we found maternal BMI to predict higher BMI–SDS and a poorer psychosocial development (higher externalizing symptoms, lower social competence) in children. Higher parenting stress predicted higher levels of externalizing and internalizing symptoms and lower social competence. Better maternal EA was associated with higher social competence. We found parenting stress to serve as a mediator in the association between maternal weight and childrens psychosocial outcomes. Moreover, children of mothers with an elevated BMI were at greater risk of lower social competence only when their mothers showed low levels of maternal EA (moderation). Conclusion: Interventional studies are needed that investigate the causal pathways between parenting stress, mother–child interaction quality and child outcomes. These aspects might be targets to improve the psychosocial development of the offspring of overweight or obese mothers.

Emotional availability of father–child dyads versus mother–child dyads in children aged 0–3 years

This article explores differences in emotional availability (EA) between mothers and fathers and effects of child sex and child age in a sample of 48 families with typically developing children aged 7 months to 3 years 10 months. We videotaped mother–child and father–child free-play interactions and coded them with the fourth edition of the EA scales (Biringen, 2008). The results indicate that mothers are more emotionally available than fathers, which emerges from slight differences in sensitivity, structuring, and nonintrusiveness. Especially when interacting with young children, fathers scored lower on sensitivity and structuring, whereas mothers were equally sensitive and provided optimal structuring toward all children regardless of their age. Further, girls did not differ from boys with respect to EA, but parents provided more optimal structuring toward older children and older children showed higher levels of responsiveness and involvement than younger children. Implications and prospects for future studies are discussed.

Insatiable insecurity: maternal obesity as a risk factor for mother–child attachment and child weight

Childhood obesity has become a rising health problem, and because parental obesity is a basic risk factor for childhood obesity, biological factors have been especially considered in the complex etiology. Aspects of the family interaction, e.g., mother–child attachment, have not been the main focus. Our study tried to fill this gap by investigating whether there is a difference between children of obese and normal weight mothers in terms of mother–child attachment, and whether mother–child attachment predicts child’s weight, in a sample of 31 obese and 31 normal weight mothers with children aged 19 to 58 months. Mother–child attachment was measured with the Attachment Q-Set. We found that (1) children of obese mothers showed a lower quality of mother–child attachment than children of normal weight mothers, which indicates that they are less likely to use their mothers as a secure base; (2) the attachment quality predicted child`s BMI percentile; and (3) the mother–child attachment adds incremental validity to the prediction of child’s BMI beyond biological parameters (child’s BMI birth percentile, BMI of the parents) and mother’s relationship status. Implications of our findings are discussed.

Breastfeeding in Obese versus Normal-Weight German Mothers of Various Socioeconomic Status

Background: To a large extent, breastfeeding practices depend on cultural norms. It is thus of particular importance to examine these practices in various settings, especially when considering the effect of complex factors, such as body mass index (BMI) or socioeconomic status. Objective: This study aimed to compare the breastfeeding practices of obese mothers with those of normal weight, taking into account social and economic status. Methods: Obese (BMI ≥ 30 kg/m2) and normal-weight (18.5 kg/m2 ≤ BMI < 25 kg/m2) mothers with children between the ages of 6 months and 3 years were recruited for this study in Leipzig, Germany, via newspaper ads and other means. Kaplan-Meier curves for portraying breastfeeding over time were analyzed using Cox regression after checking the proportional hazards model. Results: Eighty obese and 70 normal-weight mothers were recruited. Significantly fewer obese mothers breastfed (84%) than normal-weight mothers (96%) (95% confidence interval [CI] for the difference is 3 to 22 percentage points, P = .02). Even after adjusting for the level of education and family income, breastfeeding duration was significantly shorter (2.7 months; 95% CI, 0.8-4.6 months; P = .005) in the obese group than in the normal-weight group. Conclusion: Our findings demonstrate that even at the earliest stages, breastfeeding behavior of obese mothers differs from that of normal-weight mothers.

Parent–child interaction during feeding or joint eating in parents of different weights

The current study investigates parent-child interaction during feeding or during joint eating, and aimed to explore differences in feeding interactions between mothers and fathers, as well as between overweight, obese and not overweight parents. 148 mothers and 148 fathers with children aged between 7 and 47months were observed during feeding of or joint eating with their child in the laboratory. The videotaped mother-child and father-child dyads were coded using the Chatoor Feeding Scale. This scale consists of 5 subscales: Dyadic Reciprocity, Dyadic Conflict, Talk and Distraction during Feeding, Struggle for Control, and Non-Contingency. Compared to mothers, fathers showed higher readings on the Talk and Distraction scale; in all other subscales no differences were found. The comparison between overweight, obese and not overweight mother-child dyads revealed no significant differences. Differences in father-child dyads between overweight, obese and not overweight fathers were identified in the subscale Struggle for Control: overweight fathers were marked by a higher amount of Struggle for Control than obese and not overweight fathers. Taken together, differences found in the present observational study are small to moderate, and thus the current results support extant literature demonstrating that there are no differences in feeding behaviour between mothers and fathers or between obese and non-obese parents.

Latent trajectories of internalizing symptoms from preschool to school age : A multi-informant study in a high-risk sample

Recent proposals suggest early adversity sets in motion particularly chronic and neurobiologically distinct trajectories of internalizing symptoms. However, few prospective studies in high-risk samples delineate distinct trajectories of internalizing symptoms from preschool age onward. We examined trajectories in a high-risk cohort, oversampled for internalizing symptoms, several preschool risk/maintenance factors, and school-age outcomes. Parents of 325 children completed the Strengths and Difficulties Questionnaire on up to four waves of data collection from preschool (3-5 years) to school age (8-9 years) and Preschool Age Psychiatric Assessment interviews at both ages. Multi-informant data were collected on risk factors and symptoms. Growth mixture modelling identified four trajectory classes of internalizing symptoms with stable low, rising low-to-moderate, stable moderate, and stable high symptoms. Children in the stable high symptom trajectory manifested clinically relevant internalizing symptoms, mainly diagnosed with anxiety disorders/depression at preschool and school age. Trajectories differed regarding loss/separation experience, maltreatment, maternal psychopathology, temperament, and stress-hormone regulation with loss/separation, temperament, maternal psychopathology, and stress-hormone regulation (trend) significantly contributing to explained variance. At school age, trajectories continued to differ on symptoms, disorders, and impairment. Our study is among the first to show that severe early adversity may trigger a chronic and neurobiologically distinct internalizing trajectory from preschool age onward.

Cause or consequence? Investigating attention bias and self-regulation skills in children at risk for obesity

Impaired self-regulation, especially in food-specific situations, has been linked to childhood obesity. These deficits may be acquired during the development of obesity rather than being a prerequisite thereof. The current study, hence, focused on an at-risk population versus controls. Normal-weight children of obese and normal-weight parents were tested regarding attentional flexibility, emotion regulation, and inhibitory control. A sample of 50 preschoolers of obese parents (n=25) or normal-weight parents (n=25) participated in this study. Through eye-tracking, attentional bias for food cues was measured during a visual probe task using food and toy images. Emotion regulation was assessed during a distress-evoking task, and inhibitory control was examined through a delay-of-gratification task. Both tasks are standardized and were conducted in non-food contexts. Results showed no significant group differences in overall attentional bias to food images over toy images. However, children of normal-weight parents showed a preference for toy images. Regarding emotion regulation, children in the risk group expressed significantly less overall emotional distress. In addition, less gaze aversion and bodily sadness could be observed in this group. No differences were found for inhibitory control. Findings suggest that general deficits in self-regulation are not yet present in normal-weight children at risk for obesity. Instead, they might develop as a by-product of unhealthy weight gain. Results indicate, however, that children of obese parents are less emotionally expressive compared with children of normal-weight parents. Furthermore, children of normal-weight parents appeared to be more interested in toy images than in food images.

Maternal mentalization affects mothers’ – but not children’s – weight via emotional eating

ABSTRACT Previous research on childhood obesity has shown that maternal obesity is an important risk factor for this malady. Because biological and environmental factors are able to explain the transgenerational transmission of obesity only in part, psychological risk factors (e.g., emotional eating) have become more important in recent research. As maternal mentalization – which lays the foundation for the child’s ability to regulate his/her emotions – has not yet been investigated, we examined the effects of mentalization on maternal and childhood obesity. By investigating groups of obese (n = 30) and normal-weight (n = 30) mothers and their children aged 18 to 55 months, we found, contrary to our expectations, that obese mothers’ mentalization (Reflective Functioning Scale) was similar to that of mothers with normal weight and that mentalization showed no direct effect on the child’s weight. However, we found hints of an indirect influence of mentalization via emotional eating on mothers’ but not on children’s weight and via mother–child attachment (Attachment Q-Set) on children’s weight. Possible reasons for these inconclusive effects are discussed.

Grundlagen und psychosomatische Aspekte der kindlichen Adipositas

In den letzten Jahrzehnten kam es sowohl in Deutschland als auch weltweit zu einer Verdopplung bis Verdreifachung der Pravalenzraten fur kindliche Adipositas. Die Entstehung einer Adipositas im Kindesalter wird auf eine Vielzahl von genetischen, biologischen und psychischen Komponenten sowie Umweltfaktoren zuruckgefuhrt, die sich innerhalb eines komplexen Wirkungsgefuges gegenseitig beeinflussen. Adipose Kinder und Jugendliche sind korperlichen, gesundheitlichen sowie psychosozialen Risiken ausgesetzt. Psychische Auffalligkeiten konnen infolge einer Adipositas entstehen, aber auch im Vorfeld zur Entstehung einer Adipositas beitragen. Psychiatrische Komorbiditaten sind bei Kindern und Jugendlichen, die aufgrund ihres Gewichts Hilfe in Anspruch nehmen, hoch, was eine interdisziplinare Behandlung notwendig macht. Ebenso scheint die Entwicklung zielgruppenspezifischer Praventionsmasnahmen notwendig zu sein. Eine bariatrische Operation sollte als mogliche Option nur bei extrem adiposen Patienten mit erheblicher somatischer Komorbiditat in Betracht gezogen werden. Das Ziel bleibt die Entwicklung langfristig wirksamer Interventions- und Praventionsprogramme sowie die Entstigmatisierung von Adiposen.

Triadic interaction of adolescent mothers, fathers, and infants: An exploratory study

This paper explores triadic interaction in a sample of adolescent mothers, their partners, and their infants (19 families). We collected data during an extensive, semistructured interview one month after the infants birth, and observed the triadic interaction during a play situation four months postpartum, using the Lausanne Trilogue Play paradigm (LTP, 1999). In the play situations, 14 out of 19 families showed dysfunctional family alliances. High maternal maturity in resolving developmental tasks specific for the period of adolescence predicted higher levels of family alliances. We found that having parental role models was positively associated with functional family alliances. The high proportion of dysfunctional family alliances in this exploratory study sample may accentuate the need for further research on resources of both fathers and mothers that foster positive family functioning.