Caroline Braet

Bio: Caroline Braet is an academic researcher from Ghent University. The author has contributed to research in topics: Overweight & Eating disorders. The author has an hindex of 52, co-authored 302 publications receiving 9429 citations. Previous affiliations of Caroline Braet include Ghent University Hospital.

Psychological Aspects of Childhood Obesity: A Controlled Study in a Clinical and Nonclinical Sample

Abstract: Explored the relationship between obesity and psychosocial adjustment in a combined clinical and nonclinical sample of 139 obese children and 150 non-obese children (ages from 9 to 12 years and matched for age, socioeconomic status, and gender) who filled out the Perceived Competence Scale for Children; their parents completed the Child Behavior Checklist. All obese children, independent of their help-seeking status, reported more negative physical self-perceptions than their nonobese peers and they scored lower on general self-worth. According to their parents, the obese children of the clinical sample appeared to have more behavior problems. Findings suggest that psychopathology depends on a clinical obese status, and they provide evidence for a psychosocial at-risk profile for a subgroup of obese children.

Assessing depression in youth: relation between the Children's Depression Inventory and a structured interview.

Abstract: This study examined the utility of the Children's Depression Inventory (CDI) for predicting a diagnosis of a depressive disorder derived from the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) Child Edition (KID-SCID). The participants were 80 referred children and adolescents with a mean age of 12.21 years (range = 8 to 18 years). A categorical approach by means of a receiver-operating characteristics (ROC) analysis was used to examine the adequacy of cutoff scores for screening purposes. The results indicated that for the suggested cutoff scores of 13 and 19, the CDI has satisfactory ROCs. A cutoff score of 16 showed an optimal relation between sensitivity and specificity. The results from logistic regression indicated that the CDI total score is predictive of a depressive disorder. The CDI also differentiated a depressive disorder from an anxiety disorder and a disruptive behavior disorder. Those results provide support for the usefulness of the CDI as a screening tool for detecting depressive disorders in children and adolescents.

Loss of control over eating in overweight youngsters: The role of anxiety, depression and emotional eating

Abstract: The current study investigated loss of control (LC) over eating and the role of anxiety, depression and emotional eating in a sample of both treatment seeking (N = 115) and non-treatment seeking (N = 73) overweight youngsters (aged 8-18) using a semi-structured clinical interview and self-report questionnaires. It was found that treatment seekers reported twice as much LC (40%) compared to non-treatment seekers (21%). Cross-sectional prediction models indicated that increased anxiety was associated with emotional eating and LC. Emotional eating tended to mediate the relationship between anxiety and LC. Increased depression was associated with emotional eating but not with LC. Especially overweight treatment seekers turn out to be at risk for LC. Because LC may develop as a result of inadequate coping with negative emotions like anxiety, obesity treatment should focus on teaching more effective coping strategies. Longitudinal research is recommended to further elaborate affect regulation and LC.

mice: Multivariate Imputation by Chained Equations in R

Abstract: The R package mice imputes incomplete multivariate data by chained equations. The software mice 1.0 appeared in the year 2000 as an S-PLUS library, and in 2001 as an R package. mice 1.0 introduced predictor selection, passive imputation and automatic pooling. This article documents mice, which extends the functionality of mice 1.0 in several ways. In mice, the analysis of imputed data is made completely general, whereas the range of models under which pooling works is substantially extended. mice adds new functionality for imputing multilevel data, automatic predictor selection, data handling, post-processing imputed values, specialized pooling routines, model selection tools, and diagnostic graphs. Imputation of categorical data is improved in order to bypass problems caused by perfect prediction. Special attention is paid to transformations, sum scores, indices and interactions using passive imputation, and to the proper setup of the predictor matrix. mice can be downloaded from the Comprehensive R Archive Network. This article provides a hands-on, stepwise approach to solve applied incomplete data problems.

Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report

Abstract: To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child’s obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient’s age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.

Obesity in children and young people: a crisis in public health.

Abstract: Ten per cent of the world’s school-aged children are estimated to be carrying excess body fat (Fig. 1), with an increased risk for developing chronic disease. Of these overweight children, a quarter are obese, with a significant likelihood of some having multiple risk factors for type 2 diabetes, heart disease and a variety of other co-morbidities before or during early adulthood. The prevalence of overweight is dramatically higher in economically developed regions, but is rising significantly in most parts of the world. In many countries the problem of childhood obesity is worsening at a dramatic rate. Surveys during the 1990s show that in Brazil and the USA, an additional 0.5% of the entire child population became overweight each year. In Canada, Australia and parts of Europe the rates were higher, with an additional 1% of all children becoming overweight each year. The burden upon the health services cannot yet be estimated. Although childhood obesity brings a number of additional problems in its train – hyperinsulinaemia, poor glucose tolerance and a raised risk of type 2 diabetes, hypertension, sleep apnoea, social exclusion and depression – the greatest health problems will be seen in the next generation of adults as the present childhood obesity epidemic passes through to adulthood. Greatly increased rates of heart disease, diabetes, certain cancers, gall bladder disease, osteoarthritis, endocrine disorders and other obesityrelated conditions will be found in young adult populations, and their need for medical treatment may last for their remaining life-times. The costs to the health services, the losses to society and the burdens carried by the individuals involved will be great. The present report has been written to focus attention on the issue and to urge policy-makers to consider taking action before it is too late. Specifically, the report: