The Association of Maternal Psychopathology and Family Socioeconomic Status with Psychological Problems in Obese Children

Abstract

EPSTEIN, LEONARD H, MICHELLE D MYERS,KATARINA ANDERSON. The association of maternal psychopathology and family socioeconomic status with psychological problems in obese children. Obes Res, 1996;4:65-74. In an earlier study we found parental psychiatric symptoms to be a better correlate of behavioral problems in obese children than either child or parental obesity. This study sought to extend this research by assessing the association of general maternal distress, specific maternal psychopathology, family socioeconomic status and child obesity with the psychological problems of 152 children seeking treatment for obesity in two cohorts. Child psychological problems were measured using the Child Behavior Checklist/4-18 (CBCL) in each cohort. In sample 1 maternal general psychiatric symptoms were measured using the Cornell Medical Index (psychiatric subscales) and the Inventory of Interpersonal Problems whereas specific psychopathology was assessed with the Beck Depression Inventory and the Bulimia Test. In sample 2 the Symptom Checklist-90 and Binge Eating Scale provided general and specific measures of psychopathology. In the combined sample, 58% percent of the boys and 44 % of the girls met criteria on at least one CBCL behavioral problem scale, with Social Problems the most prevalent problem in both boys and girls. For both samples, child obesity did not account for any variance in child psychosocial problems beyond that accounted for by maternal psychopathology and family SES. Family SES accounted for a significant increment in variance in child behavioral problems in only two scales. This study systematically replicates previous research, adding support for a broader conceptualization of factors that influence psychological problems in obese treatment-seeking children than one which focuses on child obesity.

The association of parental characteristics and psychological problems in obese youngsters

“…A pilot study by Epstein et al 2 suggested that, apart from parental obesity, parental psychiatric symptoms are much more related to the child's psychological problems than the child's overweight. These results were replicated by Epstein et al 6 for maternal distress. Recently, Zeller et al 7 confirmed and elaborated these findings in children as well as in adolescents, seeking treatment at an outpatient pediatric weight control clinic by collecting data from different informants.…”

“…31,32 Moreover, using the same cutoffs for the CBCL as Epstein et al 6 and according to gender, between 41.4 and 53.1% of the youngsters seeking weight-loss treatment showed considerable adjustment problems, whereas their parents scored higher than a representative norm group on psychiatric symptoms. Compared with the study of Epstein et al, 6 the present study even found a larger percentage of parents exceeding clinical cutoffs for psychiatric symptoms (59.6% of mothers and 35.7% of fathers) than Epstein et al 6 (27.6% of mothers). However, children in this study were older and not enrolled in a treatment research trial.…”

“…Again, as shown in previous research, psychological symptoms of parents were more strongly related to children's problem behavior than the child's percentage overweight. 2,6,7 About 16% of the variance in children's Internalizing problems (medium effect size f 2 ¼ 0.19) and about 13% of children's Externalizing problems (medium effect size f 2 ¼ 0.15) was explained by psychological distress of the mother. Similar results were found by Epstein et al 6 and Zeller et al 7 Furthermore, maternal psychopathology not only had a direct effect on the child's problem behavior, the effect was also partly mediated by a particular parenting style, namely Inconsistent discipline.…”

Avaliação de depressão, problemas de comportamento e competência social em crianças obesas

“…Convém salientar que esse dado é compatível com a literatura, que aponta que problemas comportamentais são encontrados, com maior frequência, entre as crianças obesas, quando avaliadas pelos pais ou professores (Epstein et al, 1996;Stradmeijer et al, 2000). Esses resultados evidenciam a necessidade de implementar estratégias específicas de tratamento, como o atendimento psicológico a essas crianças, enfocando a diminuição de tais problemas, e orientações específicas aos pais, com o objetivo de ensinar estratégias adequadas para lidarem com os filhos.…”

Teasing and social rejection among obese children enrolling in family-based behavioural treatment: effects on psychological adjustment and academic competencies

“…Among those are the child's referral status, gender and age, degree of overweight, socio-economic status (SES), level of physical activity, parental psychological adjustment and last but not least level of teasing and social rejection. In general, the trends emerging from both clinical and community studies are that children seeking treatment, children who are older and girls in particular, 1 children with lower SES, 2,9 children who have parents who report worse psychological adjustment for themselves 2,[9][10][11][12][13] and children who report experiencing teasing or social rejection [14][15][16] seem to be at risk for higher rates of psychological adjustment than those who do not report experiencing teasing or social rejection. However, a higher degree of overweight has not been associated with an increased risk of psychological maladjustment in clinical samples of obese children, 2,9-11 although this association has been commonly observed among community-based samples.…”