Examining Factors that Contribute to Behavior Problems in Youth with High Body Weight

• In Event: Poster Session 12
  In Poster Session: PS 12 Topic - Developmental Psychopathology

Abstract

INTRODUCTION: Adolescence as a developmental period is often marked by an increase in internalizing and externalizing behavior problems. These behavior problems may be exacerbated in the context of external and internal stigma experienced due to having a high body weight. Past research has shown that aspects of the caregiver-child relationship have a strong influence on adolescent behavior problems, but minimal empirical attention has been given to how these factors impact the behavior of youth with body mass index (BMI) above the 95th percentile. The current study examined associations among caregiver-youth communication, family-focused weight-related quality of life, resilience resources from caregivers, and BMI on behavior problems of adolescents with high body weights (i.e., BMI >95th percentile).
METHOD: Participants included 32 Black-identified youth aged 11-17 (Mage =14.19, SD=1.94; 69% female; MBMIZ =2.59, SD=0.42) and one of their primary caregivers (total sample N = 64). All participants were receiving services at a pediatric healthy lifestyle clinic in the U.S. Midsouth. Height and weight were obtained from medical chart review and used to calculate gender- and age-adjusted BMI z-scores. Adolescents and caregivers completed self-report measures to assess psychosocial functioning, stress, and weight-related health concerns. The present study utilized youth scores from the Achenbach Youth Self-Report (YSR), Child and Youth Resilience Measure (CYRM) Caregiver subscale, Parent-Adolescent Communication Scale (PACS), and Impact of Weight on Quality of Life-Family Relations subscale (IWQOL-FR). Caregiver ratings of child functioning were used, including the Achenbach Child Behavior Checklist (CBCL), CYRM-Person Most Knowledgeable (CYRM-PMK), PACS, and IWQOL-FR. Two linear regression models were conducted to examine factors associated with behavior problems. The youth model was used to examine associations between youth-reported behavior problems (YSR), youth-reported family factors (CYRM, PACS, IWQOL-FR), and BMIz. The caregiver model was used to examine associations between caregiver-reported youth behavior problems (CBCL), caregiver-reported family factors (CYRM-PMK, PACS, IWQOL-FR), and BMIz.
RESULTS: The youth regression model was significant [F(4, 28)=7.39, p<.001, Adj. R2=67.9%]. In this model, more positive communication was associated with fewer behavior problems (β=-.98, p<.001). The caregiver regression model was also significant [F(4, 28)=4.90, p=.004, Adj. R2=34.2%]. In this model, better weight-related quality of family life was associated with fewer behavior problems (β=-.56, p=.001).
CONCLUSIONS: Study findings indicate that adolescents and caregivers have different perspectives on what contributes to behavior problems during adolescence. For youth, addressing the quality of communication between them and their caregivers may contribute to fewer behavioral difficulties; whereas from caregivers’ perspectives addressing their thoughts and feelings about the youth’s weight may support fewer behavioral challenges. Results underscore the value of a family systems approach to addressing internalizing and externalizing symptoms among adolescents with high body weight seeking services in a healthy lifestyle clinic.

Authors

• Kathryn H Howell, University of Memphis
  Presenting Author

• Idia Thurston, Texas A & M University
  Non-Presenting Author