The daily relation between parental rejection and emotional eating in youngsters : a diary study

KEY POINTS Cross-sectional survey studies have demonstrated significant associations between parental rejection and peer rejection on the one hand and disturbed eating in youngsters, like emotional eating, on the other hand. In this study, we wanted to expand our knowledge on these relationships by investigating the daily fluctuations in these variables. Youngsters completed a 7-day diary to assess daily parental rejection, peer rejection and emotional eating. Using multilevel analyses, our results showed that daily variations in parental rejection were related to daily variations in emotional eating of the youngsters. This highlights the importance of addressing the parent-child relationship in interventions for emotional eating in youngsters.Background: This study investigated the daily relation between parental rejection and peer rejection on the one hand and emotional eating in youngsters on the other hand.Methods: Participants (N = 55) between the ages of 11 and 15 years completed a 7-day diary. A multilevel design was used to examine day-to-day within-person relationships between parental and peer rejection (measured by CHS) and emotional eating (measured by DEBQ-C) of youngsters.Results: The results showed that daily variations in parental rejection were related to daily variations in emotional eating of the youngsters. Daily peer rejection was only marginally significantly related to the emotional eating of the youngsters.Conclusions: These results indicate that especially parental rejection, and to a lesser extent peer rejection, are associated with the emotional eating of youngsters. The findings highlight the importance of addressing the parent-child relationship in interventions for emotional eating in youngsters

Stress and eating behavior : a daily diary study in youngsters

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 (ER) 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 1 week; as well as the moderating role of emotion regulation and emotional eating in an average weight population. Methods: Participants were 109 average weighted youngsters between the age of 10 and 17 years (M-age = 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 ER 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 ER strategies and emotional eating

Emotion regulation training in the treatment of obesity in young adolescents : protocol for a randomized controlled trial

Background: The prevalence rates of childhood obesity are increasing. The current multidisciplinary treatments for (childhood) obesity are effective but only moderately and in the short term. A possible explanation for the onset and maintenance of childhood obesity is that it reflects a maladaptive mechanism for regulating high levels of stress and emotions. Therefore, the current RCT study aims to test the effectiveness of adding an emotion regulation training to care as usual (multidisciplinary obesity treatment) in young inpatients (10–14) involved in an obesity treatment program compared to care as usual alone. The research model for this RCT study states that when high levels of stress are regulated in a maladaptive way, this can contribute to the development of obesity. Methods: The current study will recruit 140 youngsters (10–14 years) who are involved in an inpatient multidisciplinary obesity treatment (MOT) program. After giving consent to participate in the study, youngsters will be randomly assigned, during consecutive waves, to one of two conditions: care as usual (receiving MOT) or intervention (receiving MOT in addition to emotion regulation training). The training itself consists of 12 weekly sessions, followed by a booster session after 3 and 5 months. The participants will be tested pretraining, posttraining, and at 6 months’ follow-up. We hypothesize that, compared to the control condition, youngsters in the intervention condition will (1) use more adaptive emotion regulation strategies and (2) report less emotional eating, both primary outcome measures. Moreover, on the level of secondary outcome measures, we hypothesize that youngsters in the intervention condition, compared with the control condition, will (3) report better sleep quality, (4) undergo improved weight loss and weight loss maintenance, and (5) experience better long-term (6-months) psychological well-being. Discussion: This study will add to both the scientific and clinical literature on the role of emotion regulation in the development and maintenance of different psychopathologies, as emotion regulation is a transdiagnostic factor. Trial registration: The RCT study protocol is registered at ISRCTN Registry, with study ID “ISRCTN 83822934.” Registered on 13 December 2017

Training self-compassion : exploring the effects on adolescents’ physiological and self-reported stress responses

Objectives Previous studies demonstrated that self-compassion may generate positive effects on adults' mental health through its impact on stress responses. As adolescence is characterized by elevated levels of stress, self-compassion may be particularly relevant for this age group. The aim of this study was to assess the immediate effects of a brief training in self-compassion on adolescents' stress recovery following a validated stress induction. Methods Fifty-three adolescents between 11 and 18 years old (64% girls) were randomly assigned to a self-compassion group or a control group prior to undergoing a three-phase experiment (i.e., baseline, stress induction, and instruction phase). Adolescents in the self-compassion group received a brief training in self-compassion before the start of the experiment and were asked to use the learned technique during the instruction phase. Adolescents in the control group did not receive a training and were provided with neutral instructions during the instruction phase. Physiological stress outcomes (i.e., salivary cortisol, heart rate, and heart rate variability) and self-reported stress outcomes (i.e., self-reported affect) were compared between groups. Results The main results revealed no clear differences between both groups pertaining physiological and self-reported stress responses. Conclusions The current findings could not provide evidence for the beneficial effects of a brief self-compassion training among adolescents, and even suggest that it may have detrimental effects on the physiological stress response. Findings are discussed within a developmental framework and important considerations for further research are noted

Emotional eating after manipulating emotion regulation : a laboratory study in adolescents

It is often assumed that emotional eating occurs when an individual is unable to utilise emotion regulation (ER) to cope with stress. In this stress exposure study, we explored whether manipulating participants' ER strategies (rumination or self-compassion) influenced their stress-related affect and food consumption. Fifty-three adolescents (M-age = 14.72) were included; half of the participants were instructed to use rumination as their ER strategy, and half were instructed to use self-compassion. We could not demonstrate that the ER strategies differently affected stress-related affect. However, we did find that increased Happiness following ER self-compassion predicted reduced High-Fat Sweet food consumption, whereas increased Happiness following ER rumination instead led to greater High-Fat Sweet food consumption. In participants who ruminated, food consumption reduced feelings of Frustration, but not Boredom or Happiness. Post-hoc exploration revealed that only ER self-compassion, not ER rumination, normalised levels of stress-related affect. The results highlight the need for more research into the complex relationship between ER strategies, affect states, and food types in their effect on emotional eating

The cortisol stress response in youth with overweight and obesity: Influence of psychosocial variables

Background: Despite previous research pointing out a bifurcation in cortisol stress reactivity, it is not yet clear if all variables explaining inter-individual differences in stress responses are captured. Objectives: To explore which (psychosocial and demographic) variables predict the cortisol response after a standardized stress-and affective state (SAS)-induction in youth with overweight and obesity. Methods: As part of a randomized control trial (SRCTN83822934) investigating the effects of emotion regulation (ER)-training on top of a 10-month inpatient multidisciplinary obesity treatment, 79 children and adolescents (9-15 years) with moderate obesity (M adjusted BMI = 154.35% overweight, SD = 24.57) completed a SAS-induction before leaving the clinic. Results: Those whose cortisol levels decreased (N = 59.5%) from baseline to reactivity showed higher levels of alexithymia than increasers (p = 0.049). Attachment avoidance was a significant positive predictor of relative cortisol decrease after SAS-induction (p = 0.001). Age was significantly related to less cortisol decrease (p = 0.006). No significant effect of ER-intervention group on relative cortisol change was found. ConclusionsThe current study provides evidence for a bifurcation in cortisol stress reactivity in youth with obesity. Our data further suggested that psychosocial variables (alexithymia and attachment avoidance) influence the cortisol stress response. Future research should further explore whether the attenuators are a more vulnerable group

Haalbaarheid van een emotieregulatietraining bij jonge adolescenten met obesitas

Recent onderzoek toont aan dat een gebrek aan adequate emotieregulatie (ER) aan de basis ligt van emotioneel eten. De huidige studie heeft als doel de haalbaarheid te onderzoeken van een twee uur durende ER-training bij adolescenten (N = 50) die opgenomen zijn in een residentieel behandelprogramma voor obesitas (M_leeftijd = 12,26). Deelnemers werden willekeurig toegewezen aan een van drie condities waarin ze één adaptieve ER-strategie (afleiding, cognitieve herbeoordeling of acceptatie) aangeleerd kregen. Doorheen de training scoorden adolescenten hun gevoelens aan de hand van visuele analoge schalen (VAS). De deelnemers kregen twee filmpjes te zien. Het eerste omvatte psycho-educatie en het tweede een mood-inductie, met de vraag nadien de geleerde ER-strategie toe te passen. Gedurende de vijf volgende dagen werd de aangeleerde strategie verder getraind aan de hand van een huiswerkopdracht. Zowel adolescenten, trainers als hulpverleners van het residentieel centrum vulden na de training een vragenlijst rond haalbaarheid in. Uit de resultaten blijkt dat adolescenten in staat zijn om adaptieve ERstrategieën aan te leren. In alle condities werd na het gebruik van de aangeleerde strategie een significante daling van negatief affect en een significante stijging van positief affect gevonden. Verder was het haalbaar deze training te implementeren boven op de reeds lopende behandeling en werd dit positief beoordeeld door zowel de adolescenten als de trainers, maar werden de trainingssessies als te lang bevonden. Adolescenten uit de conditie ‘cognitieve herbeoordeling’ gaven gemiddeld meer aan te veel persoonlijke informatie te moeten delen dan jongeren in de twee andere condities. Hulpverleners binnen het residentieel centrum gaven eveneens aan de training een meerwaarde te vinden, maar merkten hierbij op dat de praktische organisatie belastend is. Ten slotte vormt het volhouden van het huiswerk een aanzienlijke barrière voor de interventie. Op basis van deze resultaten werd een 12 weken durende ER-training ontwikkeld

A brief emotion regulation training in children and adolescents with obesity : a feasibility study

Background: Recent studies emphasize the role of emotion dysregulation as an underlying mechanism initiating and maintaining emotional eating in obesity. Since multidisciplinary obesity treatment (MOT) does not directly address emotion regulation (ER), the current study aimed to investigate the feasibility of an ER training in children and adolescents with obesity on top of MOT. Feasibility was evaluated multi-informant on relevant parameters e.g. practicability, satisfaction, change in affect and homework compliance.Methods: Participants (N = 50, M_age = 12.26, 60.7 % girls) with obesity received a brief ER training and were assigned to one out of three conditions to learn one specific ER strategy (i.e., Cognitive reappraisal, Distraction or Acceptance). Afterwards the ER strategy was further trained by a homework assignment during 5 consecutive days. Children and adolescents, trainers and as well as the educators of the treatment center completed a feasibility questionnaire. Results: The training was positively evaluated by different informants for 11 out of 19 feasibility criteria. Only one implementation barrier was reported regarding homework compliance. Furthermore, some important considerations could be taken into account e.g. session length and motivation.Conclusions: Reports suggest that, with some modifications, it is feasible to implement an ER training on top of MOT. In addition, future training protocols should focus on other essential components of ER (e.g., emotional awareness, emotional flexibility)