Factores de riesgo para el sobrepeso en edades tempranas: diseño longitudinal con preescolares españoles

Previous studies have shown that there are several significant early-life risk factors associated with childhood overweight. However, research has mainly focused on school-aged children. The aim of this study is to identify risk factors in early life for overweight in a community sample of Spanish preschoolers. A sample of 622 three-year-olds was monitored until the age of 5, and their height and weight were registered annually. Overweight status was defined by World Health Organization standards. A large set of risk factors including sociodemographic variables, family structure, pregnancy, birth, postnatal period, school and neighborhood were measured through semi-structured interviews. Stepwise logistic regressions created predictive models with the best predictors of overweight for each age group. This is the first longitudinal study to examine a large set of risk factors among Spanish preschoolers. Several potential early risk factors in preschool children were associated with later overweight: high birth weight, ethnicity, excess screen time, low attention span, maternal smoking during pregnancy, inconsistent discipline, fewer rules, corporal punishment and parents psychopathology. Among them, the most powerful factor was high birth-weight (odds ratio = 1.89 at age 3, 1.87 at age 4, and 2.35 at age 5), underlining the importance of weight monitoring from postpartum and routine screening for overweight in children who have high birth weight. With the increasing prevalence of overweight in children at early ages, understanding the determinants for overweight risk becomes crucial for public health professionals and policy-makers in order to implement effective prevention and intervention programs ResumenDiferentes estudios han mostrado una asociación clara en­tre determinados factores de riesgo en edad temprana y so­brepeso en la infancia. Sin embargo, hasta ahora la inves­tigación solo se ha centrado en niños en edad escolar. El objetivo de este estudio es el de examinar en niños prees­colares los factores de riesgo para el sobrepeso en una muestra comunitaria de niños españoles. En el presente es­tudio se seleccionó una muestra de 622 niños de 3 años de edad a los que se siguió anualmente hasta los 5 años. El peso y la talla fueron registrados anualmente y el sobre­peso fue definido siguiendo los criterios definidos por la Organización Mundial de la Salud. A través de una entre­vista semi-estructurada, se analizaron diversos factores de riesgo tales como estructura familiar, embarazo, parto, pe­ríodo post-natal, escuela y vecindario. Las regresiones lo­gísticas múltiples permitieron crear modelos predictivos que seleccionaron los mejores predictores de sobrepeso para cada grupo de edad. El presente estudio es el primer estudio longitudinal en examinar diferentes factores de riesgo para el sobrepeso en niños españoles con edad preescolar. Diferentes factores de riesgo están asociados a un posterior sobrepeso: mayor peso al nacer, etnia, uso ex­cesivo de pantallas, capacidad de atención baja, madre fu­madora durante el embarazo, disciplina inconsistente, cas­tigo físico y psicopatología parental. De entre ellos, el fac­tor más importante fue: mayor peso al nacer (razón de pro­babilidades = 1.89 a los 3 años, 1.87 a los 4 años y 2.35 a los 5 años), subrayando la importancia de monitorizar el peso del niño desde el post-parto y realizar cribados ruti­narios de sobrepeso en aquellos niños que nacieron con un peso elevado. La prevalencia cada vez mayor de sobrepeso en niños cada vez más pequeños hace que la comprensión e identificación de los factores de riesgo relacionados con el sobrepeso sea crucial para que los profesionales públi­cos de salud y los responsables políticos implementen pro­gramas de prevención e intervención efectivos.AbstractPrevious studies have shown that there are several significant early-life risk factors associated with childhood overweight. However, research has mainly focused on school-aged children. The aim of this study is to identify risk factors in early life for overweight in a community sample of Spanish preschoolers. A sample of 622 three-year-olds was monitored until the age of 5, and their height and weight were registered annually. Overweight status was defined by World Health Organization standards. A large set of risk factors including sociodemographic variables, family structure, pregnancy, birth, postnatal period, school and neighborhood were measured through semi-structured interviews. Stepwise logistic regressions created predictive models with the best predictors of overweight for each age group. This is the first longitudinal study to examine a large set of risk factors among Spanish preschoolers. Several potential early risk factors in preschool children were associated with later overweight: high birth weight, ethnicity, excess screen time, low attention span, maternal smoking during pregnancy, inconsistent discipline, fewer rules, corporal punishment and parents psychopathology. Among them, the most powerful factor was high birth-weight (odds ratio = 1.89 at age 3, 1.87 at age 4, and 2.35 at age 5), underlining the importance of weight monitoring from postpartum and routine screening for overweight in children who have high birth weight. With the increasing prevalence of overweight in children at early ages, understanding the determinants for overweight risk becomes crucial for public health professionals and policy-makers in order to implement effective prevention and intervention programs

The relationship between weight status and emotional and behavioral problems in Spanish preschool children

Objective: To examine cross-sectional and longitudinal associations between behavioral problems and weight status, considering body mass index (BMI) z-scores and overweight status, in a community sample of preschoolers. Methods: The Strengths and Difficulties Questionnaire and the Diagnostic Interview for Children and Adolescents were administered to 611 parents. Adjusted general linear models and binary logistic regressions were used. Results Children who were overweight and had a higher BMI were at increased risk of peer problems and attention-deficit/hyperactivity disorder (ADHD) symptoms. Prospective analyses showed that a higher BMI at the age of 3 years was predictive of peer problems at ages 4 and 5 years and hyperactivity and ADHD symptoms at the age of 4 years. Conclusion: This is the first study using a diagnostic-based instrument that shows a relationship between weight status and ADHD symptoms in preschoolers. Overweight children might benefit from screening for behavioral disorders and peer relationship problem

Food addiction in Bulimia Nervosa: Analysis of body composition, psychological and problematic foods profile

IntroductionFood Addiction (FA) has been related with eating disorders (ED), especially Bulimia Nervosa (BN). BN + FA may have different physical characteristics than patients with BN without the comorbidity, such as body mass index (BMI) or body composition, and psychological as emotion regulation. However, the relationship between psychological and physical aspects, connected by problematic food and its influence on body composition, has been barely studied. Therefore, the aims of the present study are: Aims(a) To explore the differences in body composition between FA positive (FA+) and negative (FA-) in women with BN; (b) to identify problematic relationship with certain food types, according with the foods mentioned in the YFAS scale questionnaire, between FA+ and FA- patients; (c) to know the psychological characteristic differences between FA+ and FA- patients, considering emotion regulation, personality traits and general psychopathological state; (d) to identify the relationship between physical and psychological traits, and the identified problematic foods, in patients with BN and FA. MethodologyN = 81 BN women patients, with a mean age of 29.73 years +/- 9.80 SD, who completed the questionnaires: Yale Food Addiction Scale V 1.0 (YFAS 1.0), Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90 Items-Revised (SCL-90-R), and Difficulties in Emotion Regulation Strategies (DERS). YFAS problematic foods were grouped considering their principal nutrients sources. Body composition and difference in metabolic age was determined using bioimpedance analyzer. ResultsThe 88% of patients with BN presented FA+. Patients with BN who were FA+ self-reported more problematic relationships with sweets and starches. Also presented higher emotion regulation difficulties, general psychopathology and eating symptomatology severity, than those without FA. Finally, emotional regulation difficulties were positively associated with higher eating disorder symptomatology and more types of foods self-reported as problematic, which increased indirectly fat mass. ConclusionThe results suggest that BN + FA presented more eating and psychopathology symptomatology and higher problems with specific food types. As well, the path analysis emphasized that emotion regulation difficulties might be related with problematic food relationship in BN, impacting over the ED severity. ImplicationsThe results may impact the development of precise therapies for patients with BN + FA

Food addiction in eating disorders: a cluster analysis approach and treatment outcome

Background: A first approach of a phenotypic characterization of food addiction (FA) found three clusters (dysfunctional, moderate and functional). Based on this previous classification, the aim of the present study is to explore treatment responses in the sample diagnosed with Eating Disorder(ED) of different FA profiles. Methods: The sample was composed of 157 ED patients with FA positive, 90 with bulimia nervosa (BN), 36 with binge eating disorder (BED), and 31 with other specified feeding or eating disorders (OSFED). Different clinical variables and outcome indicators were evaluated. Results: The clinical profile of the clusters present similar characteristics with the prior study, having the dysfunctional cluster the highest ED symptom levels, the worse psychopathology global state, and dysfunctional personality traits, while the functional one the lowest ED severity level, best psychological state, and more functional personality traits. The dysfunctional cluster was the one with lowest rates of full remission, the moderate one the higher rates of dropouts, and the functional one the highest of full remission. Conclusions: The results concerning treatment outcome were concordant with the severity of the FA clusters, being that the dysfunctional and moderate ones had worst treatment responses than the functional one

Emotion regulation as a transdiagnostic factor in eating disorders and gambling disorder: Treatment outcome implications

Background: A first approach addressed to ascertain whether emotion regulation (ER) could be a transdiagnostic construct between eating disorders (EDs) and gambling disorder (GD) (through a joint clinical clustering analysis of both disorders) was performed by Munguia et al. (2021). Both conditions were represented by a severe, moderate, and low ER profile subgroups, according to the degree of ER difficulties. Results showed a linear relationship between the severity of ER difficulties and the severity of the disorder and the psychopathological state. Aims: Based on the aforementioned cross-sectional study, the objective of this longitudinal research was to explore the treatment response of the different ER subgroups. Methods: 459 adult patients (n = 277 ED; n =182 GD) were included. Several clinical variables, as well as outcome indicators (after completing 16 weeks of cognitive-behavioral therapy), were evaluated. Results: The three subgroups found in the previous cross-sectional study were taken for the performance of the present research. ED and GD distribution in each subgroup replicates the one exposed by Mungula et al. (2021), as well as their characterization, considering psychopathology, disorder severity and personality traits. The low ER subgroup reported a better response to treatment, whereas the severe group had the highest rates of non-remission and dropouts. Conclusions: Our results suggest that greater difficulties in ER lead to poorer treatment outcomes. Therefore, tailored treatments for patients with poor ER abilities would be recommended to improve adherence and treatment outcomes

A predictive model of perceived stress during the first wave of the COVID-19 pandemic in university students Ecuadorians

Background and objectivesThe situation caused by the confinement due to the COVID-19 pandemic and the mobility restriction implemented by governments worldwide had a significant impact on people’s routines. Stressors are known to increase emotional imbalance, uncertainty, and frustration in the general population. This study explores the factors that predispose to the risk of perceived stress from COVID-19 and determines the underlying mediating mechanisms in the Ecuadorian population.MethodThe cross-sectional study an incidental non-probabilistic sample of n = 977 participating student volunteers from the four regions of the Republic of Ecuador (68.6% women and 31.4% men). Data on emotional regulation (ERQ), perceived stress (PSS), active procrastination (APS), diagnosis and symptoms related to COVID-19, social isolation, coexistence, and a sociodemographic questionnaire (biological sex, marital status, and age) were recruited. Statistical analysis was based on a structural equation model.ResultsThe risk of suffering perceived stress in the COVID-19 pandemic was higher for single women who have lived longer in social isolation, have lived with more people, have poor emotional regulation and high rates of procrastination. This structural model is similar in all Ecuadorian regions χ2 = 21.54 (p = 0.760), RMSEA = 0.001 (95%CI, 0.00–0.02), CFI = 0.998; TLI = 0.999; SRMR = 0.020.DiscussionAlthough our findings are consistent and revealing for the scientific community, the lack of discrimination of the data due to strict isolation measures, taken at different periods by the Ecuadorian government against positive cases of COVID-19, is discussed. The research was applied to the university population, it would be representative to extend the study to schools and colleges.ConclusionWe consider this work as a starting point for the creation of preventive models against perceived stress in the university environment in the event of health emergencies

Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study

Background and Aims: COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout. Methods: The sample consisted of n=86 adults, mostly men (n=79, 91.9%) and with a mean age of 45years old (SD=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown). Results: The risk of dropout during the complete observational period was R=32/86=0.372 (37.2%), the Incidence Density Rate (IDR) ratio T2/T1 being equal to 0.052/0.033=1.60 (p=0.252). Shorter treatment duration (p=0.007), lower anxiety (p=0.025), depressive symptoms (p=0.045) and lower use of adaptive coping strategies (p=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment Baenas et al. Lockdown and GD: Treatment Dropout Frontiers in Psychology | www.frontiersin.org 2 December 2021 | Volume 12 | Article 761802 (p=0.001) and higher employment concerns (p=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (p=0.005 and p<0.001, respectively). Conclusion: The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations

Subtyping treatment-seeking gaming disorder patients

Background and aims: Gaming Disorder (GD) is characterized by a pattern of persistent and uncontrolled gaming behavior that causes a marked impairment in important areas of functioning. The evolution of the worldwide incidence of this disorder warrants further studies focused on examining the existence of different subtypes within clinical samples, in order to tailor treatment. This study explored the existence of different profiles of patients seeking treatment for GD through a data-driven approach. Methods: The sample included n = 107 patients receiving treatment for GD (92% men and 8% women) ranging between 14 and 60 years old (mean age = 24.1, SD = 10). A two-step clustering analysis approach explored the existence of different underlying GD profiles based on a broad set of indicators, including sociodemographic features, clinical course of the condition (e.g., onset or evolution), psychopathological symptoms, and personality traits. Results: Two GD profiles emerged. The first cluster grouped together patients who presented with a lower psychological impact (n = 72, 66.1%), whereas the second cluster comprised patients with a higher psychological impact (n = 35, 32.7%). Cluster comparisons revealed that those patients presenting the higher impact were older, with a later onset of pathological gaming patterns, and more pronounced psychopathological symptoms and dysfunctional personality profiles. Conclusions: GD severity is influenced by specific demographic, clinical, and psychopathological factors. The identification of two separate profiles provides empirical evidence that contributes to the conceptualization of this disorder, as well as to the development of reliable and valid screening tools and effective intervention plans focused on the precise characteristics of the treatment-seeking patients

Phenotype of gambling disorder patients with lotteries as a preferred form of gambling

Lottery gambling can become an addictive behavior which can significantly interfere with daily functioning. The objectives of this work were to estimate the prevalence of lottery gambling, to assess the profile related to this gambling type in a large clinical sample of patients who met criteria for gambling disorder (GD), and to compare this profile with the other two non-strategic forms of gambling (slot-machines and bingo). Sample included n = 3,531 patients consecutively attended for treatment-seeking due to gambling-related problems. All the participants met criteria for GD and were into the range of 18 to 85 years old. Sociodemographic variables, GD severity, psychopathological state, and personality traits were assessed. Statistical comparisons between the groups defined by the patients' gambling preference (lotteries versus other gambling activities) were conducted, with chi-square test and analysis of variance. The prevalence of lotteries as the only gambling activity was 2.5%, 8.9% for lottery gambling as primary activity with other secondary gambling types, and 20.6% for lotteries as primary or secondary gambling activity. Lottery gambling and bingo gambling were more prevalent among women (bingo included the highest percentage of women). Compared to slot machine gambling, lotteries and bingo grouped older patients and those with later age of onset of the gambling-related problems. Bingo gambling showed the highest psychological distress and the most dysfunctional personality traits. This study shows the high frequency of lottery gambling among treatment-seeking for GD patients, and it provides empirical evidence about the profile associated with this gambling activity compared to other non-strategic gambling forms. The likelihood of lottery gambling is higher for women, patients married or living with a stable partner, and those within higher social position indexes