Showing papers by "Caroline Braet published in 2016"

Middle Childhood Support-Seeking Behavior During Stress: Links With Self-Reported Attachment and Future Depressive Symptoms.

Abstract: This study tested whether children's more anxious and avoidant attachment is linked to decreased support-seeking behavior toward their mother during stress in middle childhood, and whether children's decreased support-seeking behavior enhances the impact of experiencing life events on the increase of depressive symptoms 18 months later. Ninety-eight 8- to 12-year-old children filled out questionnaires assessing their level of anxious and avoidant attachment and depressive symptoms. Children's support-seeking behavior was observed through measuring the time children waited before calling for their mother's help while carrying out a stressful task. Results supported the hypothesis that more anxiously or avoidantly attached children waited longer before seeking maternal support. Moreover, waiting longer was related to increased depressive symptoms at follow-up in children who reported more experienced life events.

Sensitivity to reward is associated with snack and sugar-sweetened beverage consumption in adolescents

Abstract: High intake of palatable foods, such as energy-dense snacks and sugar-sweetened beverages (SSBs), is common among adolescents. An individual’s sensitivity to reward (SR) may influence these intakes. The main objective of this study was to investigate the association between SR and both snack and SSB intake among adolescents. A representative cross-sectional survey was conducted among 1104 14- to 16-year-olds (mean age = 14.7 ± 0.8 years; 50.9 % boys; 18.0 % overweight) in Flanders. Daily intakes were measured by a food frequency questionnaire. SR was assessed using the behavioral activation system (BAS) scales. Multilevel regression analyses (two level: adolescent school) were conducted using STATA version 13. BAS drive was positively associated with daily intakes of SSBs (13.79 %, p < 0.01), unhealthy snacks (5.42 %, p < 0.001), and energy and nutrients derived from SSBs (p < 0.001) and snacks (p < 0.01). BAS reward responsiveness (RR) was only positively associated with intake of unhealthy snacks (3.85 %, p < 0.05), healthy snacks (6.41 %, p < 0.05), and fat (4.05 %, p < 0.01) and Na (3.89 %, p < 0.05) from snacks. Interaction effects of gender and BAS RR (p < 0.05) were found. Significant positive associations between BAS RR and daily intakes of energy from snacks (6.48 %, p < 0.01) and fat from snacks (7.22 %, p < 0.001) were found only for girls. SR was associated with snack and SSB consumption in adolescents, especially in girls. These findings suggest that SR should be taken into account when designing interventions to improve the snack and SSB intake of adolescents.

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

Abstract: 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.

Perceived effective and feasible strategies to promote healthy eating in young children: focus groups with parents, family child care providers and daycare assistants

Abstract: The aim of the current study is to identify strategies to promote healthy eating in young children that can be applied by caregivers, based on their own perceptions of effectiveness and feasibility. Whereas previous research mainly focused on parental influences on children’s eating behavior, the growing role of other caregivers in the upbringing of children can no longer be denied. Four focus groups were conducted with three types of caregivers of post-weaning children under 6 years old: parents (n = 14), family child care providers (n = 9), and daycare assistants (n = 10). The audiotaped focus group discussions were transcribed and imported into Nvivo 10.0 for thematic analysis. The behaviors put forward by the caregivers were categorized within three broad dimensions: global influences, general behaviors, and specific feeding practices. Perceived effective strategies to promote healthy eating behavior in children included rewards, verbal encouragement, a taste-rule, sensory sensations, involvement, variation, modeling, repeated exposure, and a peaceful atmosphere. Participants mainly disagreed on the perceived feasibility of each strategy, which largely depended on the characteristics of the caregiving setting (e.g. infrastructure, policy). Based on former research and the current results, an intervention to promote healthy eating behaviors in young children should be adapted to the caregiving setting or focus on specific feeding practices, since these involve simple behaviors that are not hindered by the limitations of the caregiving setting. Due to various misconceptions regarding health-promoting strategies, clear instructions about when and how to use these strategies are necessary.

Sensitivity to reward and adolescents’ unhealthy snacking and drinking behavior: the role of hedonic eating styles and availability

Abstract: Although previous research found a positive association between sensitivity to reward (SR) and adolescents’ unhealthy snacking and drinking behavior, mechanisms explaining these associations remain to be explored. The present study will therefore examine whether the associations between SR and unhealthy snack and/or sugar-sweetened beverage (SSB) intake are mediated by external and/or emotional eating and if this mediation is moderated by availability at home or at school. Cross-sectional data on snacking, availability of snacks at home and at school, SR (BAS drive scale) and external and emotional eating (Dutch eating behavior questionnaire) of Flemish adolescents (n = 1104, mean age = 14.7 ± 0.8 years; 51 % boys; 18.0 % overweight) in 20 schools spread across Flanders were collected. Moderated mediation analyses were conducted using generalized structural equation modeling in three steps: (1) direct association between SR and unhealthy snack or SSB intake, (2) mediation of either external or emotional eating and (3) interaction of home or school availability and emotional or external eating. Partial mediation of external eating (a*b = 0.69, p < 0.05) and of emotional eating (a*b = 0.92, p < 0.01) in the relation between SR and intake of unhealthy snacks was found (step 2). The relation between SR and SSB intake was not mediated by external or emotional eating (step 2). No moderation effects of home or school availability were found (step 3). Our findings indicate that the association between SR and the consumption of unhealthy snacks is partially explained by external and emotional eating in a population-based sample of adolescents irrespective of the home or school availability of these foods.

Getting to the Heart of Emotion Regulation in Youth: The Role of Interoceptive Sensitivity, Heart Rate Variability, and Parental Psychopathology

Abstract: Emotion regulation and associated autonomic activation develop throughout childhood and adolescence under the influence of the family environment. Specifically, physiological indicators of autonomic nervous system activity such as interoceptive sensitivity and vagally mediated heart rate variability (HRV) can inform on emotion regulation. Although the effect of parental emotion socialization on emotion regulation appears to be influenced by autonomic processes, research on physiological regulation and the influence of parental factors remains scarce. This study investigated the relationship between self-reported habitual emotion regulation strategies and HRV at rest as well as interoceptive sensitivity in forty-six youngsters (27 female; age: M = 13.00, SD = 2.13). Secondly, the association between these autonomic correlates and parental psychopathology was also studied. Whereas better interoceptive sensitivity was related to reduced maladaptive emotion regulation, specifically rumination, high HRV was related to more use of external emotion regulation strategies (i.e., support seeking). In addition, increased HRV and decreased interoceptive sensitivity were associated with maternal internalizing and there was evidence for a possible mediation effect of HRV in the relationship between maternal internalizing and child external emotion regulation. This study elucidates the link between cognitive emotion regulation strategies and underlying physiological regulation in adolescents but also indicates a putative influence of maternal internalizing symptoms on emotion regulation in their offspring.

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

Abstract: As 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. The 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. When 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). NCT02622165 registrated November 15, 2015 on clinicaltrials.gov.

Associations Between Temperament, Emotion Regulation, and Depression in Youth: The Role of Positive Temperament

Abstract: For a long time, associations between temperamental reactivity, emotion regulation (ER) strategies, and depression in youth were studied with a primary focus on the adverse impact of the negative emotionality (NE) temperament dimension and maladaptive ER strategies. The current study aims to answer the question whether positive emotionality (PE) and adaptive ER strategies also play a role in these associations. In a convenience sample of 176 youth (9–18 years; M = 13.58, SD = .94) data were obtained on NE and PE, the use of both maladaptive and adaptive ER strategies, and depressive symptoms. Results indicate that higher levels of NE and lower levels of PE were both associated with more depressive symptoms. Additionally, we found the interaction of NE and PE to be significantly related to depressive symptoms, with lower levels of PE being a vulnerability factor, facilitating the relationship between higher levels of NE and symptoms. Third, higher levels of NE were associated with the use of more maladaptive ER strategies, but were unrelated to adaptive ER strategies. There was no association between PE, and either maladaptive or adaptive ER strategies. Fourth, higher levels of maladaptive ER strategies, and lower levels of adaptive ER strategies were both associated with higher levels of depressive symptoms. Finally, no evidence was found for the mediation of ER strategies in the relationship between temperamental reactivity and depressive symptoms. Current study findings underline the need of identifying resilience factors for depression in youth. Insight into such factors is pivotal for the successful development and implementation of prevention and intervention programs.

Can we link emotional eating with the emotion regulation skills of adolescents

Abstract: Objective: A recent cross-sectional study showed that maternal rejection is associated with emotional eating of obese youngsters seeking treatment, and that this relation is mediated by maladaptive emotion regulation (ER) of the youngsters. We wanted to build on this study and investigate the relation between parental rejection, maladaptive ER and emotional eating in a community sample using longitudinal data.Design: Participants were 81 youngsters between the ages of 10 and 16 years. Participants completed questionnaires assessing maternal and paternal rejection, ER strategies and emotional eating, at two time moments (M = 71 days between time moments). Latent change models were used to estimate level and change of each variable.Results: Results showed that the levels of maternal rejection, maladaptive ER and emotional eating were related. The indirect effect of the level of maternal rejection on the level of emotional eating through the level of maladaptive ER was marginally significant. On average, mat...

Psychometric Properties of the BIS/BAS Scales and the SPSRQ in Flemish Adolescents

Abstract: Objective: Gray’s Reinforcement Sensitivity Theory (RST) is a frequently used model of personality that is relevant to the period of adolescence. However, the psychometric properties of the most frequently used questionnaires to measure the RST-constructs, namely the Behavioural Inhibition System and Behavioural Activation System Scales (BIS/BAS Scales) and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), are rarely examined in samples of adolescents. Therefore, the goal of the present study was to examine the two-factor structure, reliability and convergent validity of the BIS/BAS Scales and SPSRQ in a Flemish adolescent community sample. Method: A sample of 579 adolescents (39.5% boys; 14–19 years) was recruited. The proposed two-factor structure was assessed using Exploratory Structural Equation Modeling. Reliability was evaluated using internal consistency and construct validity was examined with the correlations between the two questionnaires and with the Temperament and Character Inventory–short form (TCI-SF). Results: After the removal of problematic items, and the addition of correlated errors, all indices indicated a good fit for the two-factor structure of the modified BIS/BAS Scales. For the modified SPSRQ, three fit indices indicated a good model fit, while a fourth fit index was slightly below the cut-off score of an adequate model fit. Internal consistency of both questionnaires was sufficient. In general, the associations with scales of the TCI-SF were as expected, with positive correlations between BIS-related scales, and between BAS-related scales of all three instruments. Discussion: In Flemish adolescents, the use of a two-factor model to analyze data gathered with the modified BIS/BAS Scales or modified SPSRQ seems appropriate.

Lack of Trust in Maternal Support is Associated with Negative Interpretations of Ambiguous Maternal Behavior

Abstract: Attachment theory assumes that children who lack trust in maternal availability for support are more inclined to interpret maternal behavior in congruence with their expectation that mother will remain unavailable for support. To provide the first test of this assumption, early adolescents (9–13 years old) were asked to assess whether ambiguous interactions with mother should be interpreted in a positive or a negative way. In our sample (n = 322), results showed that early adolescents’ lack of trust in their mother’s availability for support was related to more negative interpretations of maternal behavior. The associations remained significant after controlling for depressive mood. The importance of these findings for our understanding of attachment theory, attachment stability, and clinical practice are discussed.

Attachment Anxiety and Depressive Symptoms in Middle Childhood: the Role of Repetitive Thinking about Negative Affect and about Mother

Abstract: Two studies with two independent samples aimed to investigate whether repetitive thinking about negative affect (RTna) and repetitive thinking about mother (RTm) can be mechanisms in the association between attachment anxiety and depressive symptoms in middle childhood. In Study 1 (N = 381) and Study 2 (N = 157) 9- to 12-year-olds completed self-report questionnaires measuring attachment, RTna and depressive symptoms. In Study 2, additionally, a questionnaire was developed to measure RTm, and a compound score for self- and mother-reported depressive symptoms was calculated. Results showed positive associations between attachment anxiety, RTna and RTm, and self-reported depressive symptoms and depressive symptoms agreed upon by mother and child. RTna and RTm mediated the relationship between attachment anxiety and these depressive symptoms. RTm mediated this relationship even beyond RTna for the multi-informant compound score. Thus, RTna and RTm seem to be independent mechanisms explaining the association between attachment anxiety and depressive symptoms in middle childhood.

The Role of Attachment Anxiety in Maternal Attentional Processing of their Child’s Face: An Eye-Tracking Study

Abstract: Although mother's attention to offspring is deemed important to support their offspring's secure attachment development, little research tested this association. The current study aimed to test the hypothesis that how mothers orient their attention to their offspring is linked to differences in offspring's attachment style. Additionally, we tested whether this association depended on which emotions children express. 29 mothers participated with their offspring (48.3% girls; ages 9 to 15 years, M = 10.93, SD = 1.67). Across two experimental blocks, eye movements were recorded as mothers viewed photographs of offspring and unfamiliar children showing neutral (block 1) and facial expressions of fearful, happy and sad (block 2). Offspring's self-reported attachment anxiety was related to increased maintained attention of the mother on the offspring's neutral face, while more attachment security was related to reduced maintained attention. With regard to emotional faces, mothers of more anxiously attached chil...

Psychological Treatment of Childhood Obesity: Main Principles and Pitfalls

Abstract: The Ecological Systems Theory is an interesting framework that captures the multicausal interaction of hereditary, environmental and child characteristics that place a child at risk for overweight [1]. This theory serves as a guideline for the multidisciplinary assessment of obesity in childhood (see chapter X) and for the treatment. The benefits of a multidisciplinary approach focusing on healthy eating habits, moderate exercise and cognitive-behavioural modification are well established [2]. Several studies have shown positive and encouraging outcomes in short-term. This chapter will provide an overview of the main principles of the cognitive behavioural lifestyle program for obese children. Thereby, both working with children as well as how to involve parents will be addressed. However, also pitfalls in treatment need to be considered. To this day, obesity interventions, especially for adolescents and adults are also characterized by limited weight changes, relapse and a large drop-out (for adolescents, see [3]; for adults, see [4]). This chapter will focus on drop-out and will address some structural actions to overcome it.

Food : treat or threat or treatment? Reward and punishment in eating behavior and interventions to change them

Abstract: The reinforcing value of food is a strong determinant of food intake, often overriding homeostatic signals of deprivation and satiety. For most people, food is a treat (reward), however, for some (e.g., people with eating disorders), it can be a threat (punishment). Individual differences in reward and punishment processing (sensitivity to reward and punishment) are related to food reinforcement. Insight on the reinforcing characteristics of food might be of crucial interest for interventions (treatment) aiming to improve eating behaviour and diet quality.