Showing papers by "Caroline Braet published in 2018"
TL;DR: The findings suggest that targeting adaptive ER skills, such as distraction, acceptance, and cognitive reappraisal, may be an important strategy to prevent or treat psychological problems in early adolescents.
Abstract: Recent research suggests that impaired emotion regulation (ER) may play an important role in the development of youth psychopathology. However, little research has explored the effects of ER strategies on affect in early adolescents. In Study 1 (n = 76), we examined if early adolescents are able to use distraction and whether the effects of this strategy are similar to talking to one’s mother. In Study 2 (n = 184), we compared the effects of distraction, cognitive reappraisal, acceptance, and rumination. In both studies, participants received instructions on how to regulate their emotions after a standardised negative mood induction. In general, the results indicated that distraction, but also cognitive reappraisal and acceptance, had promising short-term effects on positive and negative affect in early adolescents. These findings suggest that targeting adaptive ER skills, such as distraction, acceptance, and cognitive reappraisal, may be an important strategy to prevent or treat psychological pro...
35 citations
TL;DR: The current study evaluated the feasibility, acceptability and initial effectiveness of the training and explores if these characteristics helps obese youngsters to maintain weight-loss once they return home at the end of their inpatient treatment program.
30 citations
TL;DR: Investigation in youngsters between the age of 10 and 17 years finds that daily stress is significantly associated with trajectories of desire to eat motives and hunger eating motives, and indicates the importance of looking into the daily relationship between stress and eating behavior parameters, as both are related with change over and within days.
Abstract: BACKGROUND: Overweight and obesity are growing problems, with more attention recently, to the role of stress in the starting and maintaining process of these clinical problems. However, the mechanisms are not yet known and well-understood; and ecological momentary analyses like the daily variations between stress and eating are far less studied. Emotional eating is highly prevalent and is assumed to be an important mechanism, as a maladaptive emotion regulation strategy, in starting and maintaining the vicious cycle of (pediatric) obesity. OBJECTIVES: The present study aims to investigate in youngsters (10 – 17 years) the daily relationship between stress and the trajectories of self-reported eating behavior (desire to eat motives; hunger eating motives and snacking) throughout one week; as well as the moderating role of emotion regulation and emotional eating in an average weight population. METHOD: Participants were 109 average weighted youngsters between the age of 10 and 17 years (Mage = 13.49; SD = 1.64). The youngsters filled in a trait-questionnaire on emotion regulation and emotional eating at home before starting the study, and answered an online diary after school time, during seven consecutive days. Desire to eat motives, hunger eating motives and snacking were assessed daily for seven consecutive days. RESULTS: Using multilevel analyses results revealed that daily stress is significantly associated with trajectories of desire to eat motives and hunger eating motives. No evidence was found for the moderating role of maladaptive emotion regulation in these relationships; marginally significant evidence was found for the moderating role of emotional eating in the trajectories of desire to eat and snacking. DISCUSSION These results stress the importance of looking into the daily relationship between stress and eating behavior parameters, as both are related with change over and within days. More research is needed to draw firm conclusion on the moderating role of emotion regulation strategies and emotional eating.
28 citations
TL;DR: It was revealed that low PE was significantly related to higher depressive symptoms among youth and that a lack of total adaptive ER abilities mediated this relationship, and clinical practitioners should focus on alleviating negative emotions and enhancing positive emotions, especially among youth low in PE.
Abstract: Objectives Low positive emotionality (PE) represents a temperamental vulnerability to depression in youth. Until now, little research has examined the mechanisms linking PE to depressive symptoms. Starting from integrated cognitive-affective models of depression, we aimed to study adaptive emotion regulation (ER) as a key underlying mechanism in the temperament-depression relationship. Methods This study investigated whether adaptive ER strategies mediate the association between PE and depressive symptoms in a large community-based sample of youth, using a cross-sectional design. Participants were 1,655 youth (54% girls; 7-16 years, M = 11.41, SD = 1.88) who filled out a set of questionnaires assessing temperament, adaptive ER strategies, and depressive symptoms. Results Results revealed that low PE was significantly related to higher depressive symptoms among youth and that a lack of total adaptive ER abilities mediated this relationship. More specifically, the infrequent use of problem-solving appeared to be of significant importance. Problems in positive refocusing and a deficient use of forgetting mediated the relationships between low PE and high negative emotionality (NE) in predicting depressive symptoms. Reappraisal and distraction were not significant mediators. Conclusion Results highlight the need to account for temperamental PE and adaptive ER strategies when studying youth depression. The findings contribute to a more nuanced understanding on the differential role of temperamental risk factors for developing depressive symptoms at an early stage and advocate for greater attention to adaptive ER strategies. Practitioner points Clinical interventions for youth depression may be improved by incorporating adaptive emotion regulation (ER) strategies and enhancing positive emotions. Youth low in positive emotionality (PE) may especially benefit from learning adaptive ER skills. Clinical practitioners should focus on alleviating negative emotions and enhancing positive emotions, especially among youth low in PE.
27 citations
TL;DR: In this paper, the authors examined whether early maladaptive schemas (EMS) moderate the predictive association between bullying victimization and depressive symptoms in adolescents, and found that the severity of depressive symptoms at T1 and T2 was higher when bullying victimisation was high than when it was low.
Abstract: This study examined whether early maladaptive schemas (EMS) moderate the predictive association between bullying victimization and depressive symptoms in adolescents. For this purpose, a sample of 572 adolescents (314 males; Mage = 15.78, SDage = 0.94) completed measures of bullying victimization and EMS (Disconnection and Rejection, Impaired Autonomy and Other-Directedness domains) at the beginning of the study, and measures of depression in four consecutive waves every 4 months. Latent growth curve modelling was used to test the study hypothesis. The results indicated that both bullying victimization and EMS significantly predict a higher level of depressive symptoms. All schema domains moderated the association between bullying victimization and level of depressive symptoms. In addition, Disconnection and Rejection and Other-Directedness moderated the predictive association between bullying victimization and the trajectory of symptoms. Namely, in adolescents who scored high in theses schema domains, the level of depressive symptoms at T1 and T2 was higher when bullying victimization was high than when it was low. These findings suggest that EMS are relevant and make adolescents vulnerable when faced with bullying victimization.
23 citations
TL;DR: The intervention was not able to improve adolescents’ snack choices, due to low reach and exposure, and future interventions should consider multicomponent interventions, teacher engagement, exhaustive participatory app content development and tailoring.
Abstract: Objective Adolescents' snacking habits are driven by both explicit reflective and implicit hedonic processes. Hedonic pathways and differences in sensitivity to food rewards in addition to reflective determinants should be considered. The present study evaluated the feasibility and impact of a mobile phone-delivered intervention, incorporating explicit reflective and implicit rewarding strategies, on adolescents' snack intake. Design Adolescents (n 988; mean age 14·9 (sd 0·70) years, 59·4 % boys) completed a non-randomized clustered controlled trial. Adolescents (n 416) in the intervention schools (n 3) were provided with the intervention application for four weeks, while adolescents (n 572) in the control schools (n 3) followed the regular curriculum. Outcomes were differences in healthy snacking ratio and key determinants (awareness, intention, attitude, self-efficacy, habits and knowledge). Process evaluation data were collected via questionnaires and through log data of the app. Results No significant positive intervention effects on the healthy snack ratio (b=-3·52 (se 1·82), P>0·05) or targeted determinants were observed. Only 268 adolescents started using the app, of whom only fifty-five (20·5 %) still logged in after four weeks. Within the group of users, higher exposure to the app was not significantly associated with positive intervention effects. App satisfaction ratings were low in both high and low user groups. Moderation analyses revealed small positive intervention effects on the healthy snack ratio in high compared with low reward-sensitive boys (b=1·38 (se 0·59), P Conclusions The intervention was not able to improve adolescents' snack choices, due to low reach and exposure. Future interventions should consider multicomponent interventions, teacher engagement, exhaustive participatory app content development and tailoring.
19 citations
TL;DR: Interference and inhibition toward angry and happy stimuli in dysphoric adolescents compared to nondysphoric adolescents are investigated to confirm the existence of a bias toward angry faces in dysphoria adolescents and indicate a higher inhibition of angry Faces in dysphorific adolescents comparedTo examine interference and inhibition of emotional information in girls, a Negative Affective Priming task was used.
Abstract: Cognitive theories emphasize the importance of attentional biases in the development and maintenance of depression. Noteworthy, recent studies indicate that depression-related biases only occur in later stages of attentional processing. This is consistent with the idea that attention is a multicomponent process, consisting of at least two mechanisms: selection and inhibition. Therefore, this study aims to investigate interference and inhibition toward angry and happy stimuli in dysphoric adolescents compared to nondysphoric adolescents. To examine interference and inhibition of emotional information in 21 dysphoric (17 girls) and 28 nondysphoric adolescents (17 girls), 10-16 years of age, a Negative Affective Priming task was used. In this task, a target has to be evaluated as positive or negative while ignoring a distractor. As expected, dysphoric adolescents showed both higher interference from and higher inhibition of angry stimuli relative to nondysphoric adolescents. In contrast, happy stimuli did not lead to interference and consequently did not have to be inhibited in either group. Finally, a positive relation was found between interference and the subsequent inhibition of emotional stimuli. These observations confirm the existence of a bias toward angry faces in dysphoric adolescents and indicate a higher inhibition of angry faces in dysphoric adolescents compared to nondysphoric adolescents. The obtained results are different from those of similar previous studies in depressed or dysphoric adults using sad faces or negatively valenced words and might reveal important emotion-specific or age-specific inhibitory biases.
17 citations
TL;DR: In this article, the authors investigated whether attachment anxiety and attachment avoidance might play a differential contributing role in the development of bulimic symptoms, through assumed differences in adopting specific maladaptive emotion regulation strategies in a sample of adolescents.
Abstract: Following the theoretical propositions of the Emotion Regulation model of attachment, the current study investigated whether attachment anxiety and attachment avoidance might play a differential contributing role in the development of bulimic symptoms, through assumed differences in adopting specific maladaptive emotion regulation strategies in a sample of adolescents. Developmentally appropriate self-report questionnaires were administered to a community sample of 397 adolescents (Mean age: 14.02; 62.7% female) and this at 2 time points with a 1-year time lag. Results provided longitudinal evidence for the Emotion Regulation model of attachment in confirming the differential contributing role of the attachment dimensions on the development of bulimic symptoms in a sample of adolescents. More specifically, attachment anxiety seemed to be related to bulimic symptoms through rumination, while attachment avoidance through emotional control. These results may have clinical implications for assessment and treatment of bulimic symptoms in adolescents.
16 citations
TL;DR: If found effective, Boost camp will have the potential to increase adolescent’s ER and well-being, and reduce the risk to become adults in need, and the presented paper describes the Boost camp program and the clustered RCT design to evaluate its effectiveness.
Abstract: The transition from childhood into adolescence can be considered as a critical developmental period. Moreover, adolescence is associated with a decreased use of adaptive emotion regulation strategies and an increased use of maladaptive emotion regulation strategies increasing the risk of emotional problems. Targeting emotion regulation is therefore seen as an innovative prevention approach. The present study aims to evaluate the effectiveness of Boost camp, an innovative school-based prevention program targeting ER, on adolescents’ emotion regulation skills and emotional wellbeing. Also secondary outcomes and possible moderators will be included. The aim is to reach 300 adolescents (16 class groups, 6 schools) in their first year of high school. A clustered Randomized Controlled Trial (RCT) with two conditions, intervention (n = 150) and control (n = 150), will be set up. Adolescents in the intervention condition will receive 14 lessons over the course of 2 days, followed by Booster sessions, and will be compared with adolescents in a non-intervention control group. The outcomes will be measured by self-report questionnaires at baseline, immediately after Boost camp, and at three and 6 months follow-up. Data-collection is planned to be completed in May 2018. Data-analyses will be finished the end of 2018. The presented paper describes the Boost camp program and the clustered RCT design to evaluate its effectiveness. It is expected that Boost camp will have beneficial effects. If found effective, Boost camp will have the potential to increase adolescent’s ER and well-being, and reduce the risk to become adults in need. The trials is registered on the 13th of June 2017 in ISRCTN registry [ISRCTN68235634].
16 citations
TL;DR: In this paper, the authors evaluated if experiences with maternal support modulate children's state trust in mother's availability and found that the impact of interactions with a support providing mother on the activation of trust states was investigated.
Abstract: Attachment representations have traditionally been considered a stable trait, although evidence is found that attachment varies over time and situations conditional upon exposure to life-events and diverse contextual factors. This suggests that attachment consists of both trait and state like components. The current study aimed to evaluate if experiences with maternal support modulate children’s state trust in mother’s availability. For this purpose, we set up an experimental procedure. First, children watched a negative mood inducing video to activate negative emotions. In the following experimental phase, mothers were randomly assigned to one of three conditions. In condition one, mothers were instructed to provide secure base support to the distressed child. In the second condition, mother was only physically present and did not offer the child emotional support. In the last condition, children had no contact with mother. After this experimental phase, all mothers were instructed to provide secure base support in the recovery phase to study if secure base support could restore the decreased trust states. In total, 120 mother-child dyads participated the study. Results indicated that distressed children whose mother was absent or only physically available during the experimental phase, had significantly lower scores on state trust in comparison with children who did receive secure base support. After receiving secure base care, no more differences in state-trust across the secure base support and non-support conditions were found. Temperament could not explain these effects, pointing at the impact of interactions with a support providing mother on the activation of trust states.
15 citations
TL;DR: Not obesity alone but obesity with binge eating was specifically associated with a mechanism often reported in ADHD, namely delay discounting, however, this effect may be more driven by inattention.
Abstract: There may be shared neuropsychological dysfunctions in ADHD and obesity. This study tested a neuropsychological model of ADHD (reward/executive dysfunctioning) in individuals with obesity. Furthermore, the association between co-morbid binge eating and reward/executive dysfunction was explored. Reward/executive dysfunctioning was assessed using both neuropsychological measures and questionnaires in individuals (aged 17–68) with obesity (N = 39; mean BMI = 39.70) and normal weight (N = 25; mean BMI = 22.94). No significant differences emerged between individuals with and without obesity on the outcome measures. However, individuals with obesity and binge eating showed significantly more self-reported delay discounting and inattention than those individuals with obesity but without binge eating. When controlling for inattention, this difference in delay discounting was no longer significant. Not obesity alone but obesity with binge eating was specifically associated with a mechanism often reported in ADHD, namely delay discounting. However, this effect may be more driven by inattention.
TL;DR: WELCOME aims to train youngsters’ executive functions to facilitate effects on weight loss, psychological and medical comorbidities and to enhance the long-term effects by continuing the training in the daily home context with booster sessions, and to investigate its effects until a 6-month follow-up.
Abstract: Obesity is a widespread problem that not only leads to medical and psychological diseases in adults, but also in children and adolescents at an early stage in life. Because of its global burden on both the individual and society, it is necessary to develop effective evidence-based treatments. Current “Multidisciplinary Obesity Treatments” (MOT) already provide significant weight loss, but still leave room for more long-lasting improvements. In this protocol paper, we outline the research goals of the WELCOME trial, based on a substantial proof of concept. In this Randomized Controlled Trial (RCT) – conducted in both an inpatient and two outpatient treatment settings – existing MOT will be supplemented with an Executive Function (EF) training and compare effects on various parameters in an experimental versus an active control group of obese youngsters (8–18 years old). WELCOME aims to (a) train youngsters’ executive functions to facilitate effects on weight loss, psychological and medical comorbidities, (b) to enhance the long-term effects by continuing the training in the daily home context with booster sessions, and (c) to investigate its effects until a 6-month follow-up. In comparison to the active control group, better progress is expected in the experimental group on following variables: weight, psychological comorbidities (unhealthy eating behavior, internalizing symptoms, impaired self-esteem) and medical comorbidities (metabolic syndromes, endothelia dysfunction, tonsillar hypertrophy and sleep obstruction). It is stated that this EF-training for enhancing self-control abilities is necessary for a long-lasting effect of childhood obesity treatment interventions. The Study Procotol was registered on 10/05/2017 (n° ISRCTN14722584
).
TL;DR: More research is needed before firm conclusions can be drawn about the clinical usefulness of CBM for weight control in childhood obesity, as changes over time were not significantly different between conditions for the measures of automatic processes, craving, and weight loss maintenance.
Abstract: Childhood obesity treatment programs only result in moderate outcomes in the short term and do not reduce risk for future weight gain. Therefore, in the current study, Approach Avoidance Training (AAT) with motivational game elements will be added to an inpatient childhood obesity program with the aim of improving outcomes. Forty-one children (10–15 years) in the final months of an inpatient treatment program were randomised to either the AAT plus care-as-usual condition group or to a care-as-usual-only control group. During the 10 sessions, the children were trained to approach healthy food stimuli and to avoid unhealthy food stimuli. Treatment outcomes were child performances on tasks of AAT, implicit attitudes and attentional bias, self-report ratings on craving symptoms, and weight loss maintenance after leaving the clinic (12-week follow-up). Changes over time were not significantly different between conditions for the measures of automatic processes, craving, and weight loss maintenance. Possible accounts for the null findings, including sample size, influence of game elements, point of time in therapeutic process, limitations of the setting, and the control group are discussed. More research is needed before firm conclusions can be drawn about the clinical usefulness of CBM for weight control in childhood obesity.
TL;DR: It is demonstrated that depressed adolescents do not show a preferential processing of angry faces but rather fail to show a positivity bias as seen in healthy adolescents, which supports the theoretical notion that a depressive disorder is characterized by a blunted reactivity toward positive information.
TL;DR: In this paper, a transactional model including children's emotional reactivity, maternal responsiveness, and attachment-related interpretation bias was used to explain childhood externalizing, internalizing, and total problem behaviors.
Abstract: The current study tested a transactional model including children’s (N = 122, 10–13 years old) emotional reactivity, maternal responsiveness, and attachment-related interpretation bias to explain childhood externalizing, internalizing, and total problem behaviors. Children’s emotional reactivity was related to externalizing, internalizing, and total problem behaviors. Maternal responsiveness was related to externalizing and total problem behaviors. Attachment-related interpretation bias was not directly related to any type of problem behavior. In line with the transactional model’s prediction, a three-way interaction between these factors was found for internalizing and total problem behaviors, suggesting that children, who are more emotionally reactive, experience little maternal responsiveness, are more vulnerable to experience distress, and have learned to interpret mother’s ambiguous behavior as unsupportive, are most at risk to display internalizing and total problem behaviors. Results suggest that attachment-related interpretation bias appears to play a role in childhood problem behaviors in the presence of other risk factors.
TL;DR: This article investigated the effectiveness of different strategies to increase the willingness to taste, liking and consumption of a disliked vegetable in preschool children, and the moderating role of reward sensitivity, and found that children liked and consumed the disliked vegetable significantly increased in the three active strategies.
TL;DR: For example, the authors found that children tend to have a narrower attentional field around the mother for children completing the more stimulus-driven task and this effect was linked with the interaction between children's age and self-reported trust in maternal support.
Abstract: Attentional processes in children are tuned toward their mother. It is unclear whether this is a cognitively controlled or more automatic, stimulus-driven process. Therefore, 172 children (age 9–13) were assigned to either a cognitively controlled or a stimulus-driven task measuring the breadth of their attentional field around their mother. Results demonstrated a narrower field around the mother for children completing the more stimulus-driven task. Moreover, only for the stimulus-driven task, this effect was linked with the interaction between children's age and self-reported trust in maternal support. More trust was linked with a narrower attentional field around the mother in younger children, but with a less narrow field in older children. This resembles the expected age-related shift toward increased autonomy and points at stimulus-driven attentional processes.
TL;DR: It is evidenced that parental modelling is not often used to enhance tasting behavior in children, and parental encouragement was frequently observed, especially in parents of younger children and of healthy-weight children.
TL;DR: The findings indicated altered WM performance in the context of emotional distractors in adolescents with DS and may contribute to theoretical knowledge and early prevention of youth depression.
Abstract: It has been suggested that altered processing of emotion during cognitive control plays an important role in the etiology of depressive symptoms. The current study investigates the influence of emotional stimuli on working memory (WM) in adolescents with dysphoric symptomatology (DS). Twenty-five adolescents with DS and 40 adolescents with no dysphoric symptomatology (NDS) completed a memory-guided eye movement task. This task assessed the influence of irrelevant affective information on WM processes during high and low cognitive load. Latency analyses showed that, in the high load WM condition, negative distractors disturbed WM performance in adolescents with NDS, but not in adolescents with DS. Accuracy analyses revealed that adolescents with NDS had higher accuracy rates in the presence of positive distractors relative to negative and neutral distractors, and in comparison to adolescents with DS. The findings indicated altered WM performance in the context of emotional distractors in adolescents with DS and may contribute to theoretical knowledge and early prevention of youth depression.
TL;DR: It is suggested that the family climate may have an impact on the eating style of the youngsters after weight loss treatment and that maladaptive emotion regulation partially mediated the association between maternal rejection and the youngsters’ emotional eating style.
Abstract: ObjectiveThe main objective of the study was to examine the relationships between parental rejection, maladaptive emotion regulation strategies, and the emotional eating style of youngsters who finished an inpatient multidisciplinary weight loss treatment program and were back in their home environment.MethodParticipants were 52 youngsters (age 11–17 years) with an average percent over ideal BMI of 186.11% (SD = 27.54) before treatment and 136.37% (SD = 19.65) at a mean follow-up of 4 months. Participants completed questionnaires assessing maternal and paternal rejection, maladaptive emotion regulation strategies, and emotional eating. Data were analysed using bootstrapping procedure.ResultsMediation analyses showed that maladaptive emotion regulation partially mediated the association between maternal rejection and the youngsters’ emotional eating style. Paternal rejection was directly related to emotional eating.ConclusionThe results suggest that the family climate may have an impact on the eating style of the youngsters after weight loss treatment.