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.

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mice: Multivariate Imputation by Chained Equations in R

Attachment--and loss.

Emotion-regulation strategies across psychopathology: A meta-analytic review.

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.

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

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:

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-789X.2004.00133.x

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

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.

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Feasibility and Effectiveness of Adding an Approach Avoidance Training With Game Elements to a Residential Childhood Obesity Treatment — A Pilot Study

The effect of parental rejection on the emotional eating behaviour of youngsters: A laboratory-based study

Understanding the cognitive processing of attachment-relevant information has become a major focus of attachment research. Previous research demonstrated links between attachment and memory for attachment-related information, but results were contradictory and did not control for mood-effects. The current study aimed to provide a conceptual framework to capture inconsistencies. A straightforward memory bias hypothesis was derived and tested. Fifty children (aged 10-12) completed questionnaires assessing confidence in maternal support and depressive symptoms, and a memory task in which they recalled positive and negative words that referred to previous interactions with mother. Less confidence in maternal support and more depressive symptoms were linked to a more negative mother-related memory bias. The effect of confidence in maternal support remained marginally significant when controlling for depressive symptoms, explaining the initial effect of depressive symptoms. These findings support attachment theory's hypothesis that attachment-relevant information is processed in an attachment expectation-congruent way.

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Attachment-related expectations and mother-referent memory bias in middle childhood

Objective: This study explored the role of emotion regulation (ER) as a moderator in the stressor-adjustment outcome relationship while identifying the relevant stressors.

Methods: In 214 adolescents (10-18 years; 51.4% boys), stressors (parent and peer relations, negative events), psychological outcomes (adolescent perceived stress, psychopathology symptoms, negative affect), and biological measures related to the stress response (hair cortisol [HC], heart rate variability [HRV]) as well as ER strategies-maladaptive (MalER), adaptive (AdER), and their ratio (Mal/AdER)-were measured and analyzed via linear regression, adjusted for age, sex, and socioeconomic status.

Results: Parental rejection and bullying were the stressors with the strongest association with psychological outcomes (beta range = vertical bar 0.217-0.352 vertical bar, p < .05). In addition, parental rejection was associated with HC (beta = 0.242, p = .035), whereas none of the stressors were associated with HRV. MalER was linked to all, and AdER to most psychological outcomes (beta range = vertical bar 0.21-0.49 vertical bar, p < .05). MalER, but not AdER, was associated with HC (beta = 0.25, p = .009), whereas none of the ER strategy types were associated with HRV. Moreover, several associations between stressors and psychological outcomes were moderated by MalER and Mal/AdER, whereas AdER's role as a moderator was not confirmed.

Conclusions: The study confirmed that adolescents' stressors are associated with both psychological and physiological outcomes and moderated by MalER or Mal/AdER. The lack of moderation by AdER directs toward the maladaptive shift theory. Investigations through a longitudinal, rather than a cross-sectional design, could further elucidate the current observations. Moreover, training in how to use ER effectively has a potential of increasing adolescents' stress resilience.

The Moderating Role of Emotion Regulation in the Association Between Stressors With Psychological and Biological Measures in Adolescence.

Zusammenfassung. Die vorliegende Studie untersucht, ob adipose Kinder und Jugendliche im Vergleich zu Normalgewichtigen eine negativere Selbstbewertung und mehr depressive Symptome aufweisen. Des Weiteren wird untersucht, ob sich eine depressive Symptomatik - sofern diese innerhalb der adiposen Gruppe nachgewiesen werden kann - durch ein negatives Selbstkonzept erklaren lasst. Bei insgesamt 151 Kindern und Jugendlichen im Alter von 9 bis 17 Jahren (75 adipose, 76 normalgewichtige Kinder) und deren Eltern wurden anhand verschiedener Fragebogen depressive Symptome sowie Selbst- und Fremdeinschatzungen zu Kompetenzen und Verhaltenstendenzen der Kinder zu verschiedenen (Lebens-) Bereichen erhoben. Die statistischen Analysen ergaben signifikant negativere Selbstbewertungen der adiposen Kinder und Jugendlichen in Bezug auf den athletischen Bereich als einer speziellen Komponente des Selbstkonzeptes. Fur den globalen Depressionswert fanden sich keine Unterschiede zwischen adiposen und normalgewichtigen Kindern u...

Caroline Braet

Papers

Feasibility and Effectiveness of Adding an Approach Avoidance Training With Game Elements to a Residential Childhood Obesity Treatment — A Pilot Study

The effect of parental rejection on the emotional eating behaviour of youngsters: A laboratory-based study

Attachment-related expectations and mother-referent memory bias in middle childhood

The Moderating Role of Emotion Regulation in the Association Between Stressors With Psychological and Biological Measures in Adolescence.

Depression und Selbstwertgefühl bei adipösen Kindern und Jugendlichen