Psychosocial and familial impairment among overweight youth with social problems.
OBJECTIVE
Emerging research indicates that overweight children with social impairments are less responsive to weight control interventions over the long term. A better understanding of the breadth and psychosocial correlates of social problems among overweight youth is needed to optimize long-term weight outcomes.


METHODS
A total of 201 overweight children, aged 7-12 years, participated in a randomized controlled trial of two weight maintenance interventions following family-based behavioral weight loss treatment. Children with HIGH (T ≥ 65) versus LOW (T<65) scores on the Child Behavior Checklist Social Problems subscale were compared on their own and their parents' pre-treatment levels of psychosocial impairment using multivariate analysis of variance. Hierarchical regression was used to identify parent and child predictors of social problems in the overall sample.


RESULTS
HIGH (n = 71) children evidenced greater eating disorder psychopathology and lower self-worth, as well as a range of interpersonal difficulties, compared with LOW children (n = 130; ps<0.05). Compared with parents of LOW children, parents of HIGH children reported greater levels of their own general psychopathology (p<0.05). Parent psychopathology significantly added to the prediction of social problems in the full sample beyond child sex and z-BMI (ps<0.01).


CONCLUSIONS
A substantial minority of overweight youth experience deficits across the social domain, and such deficits appear to be associated with impairment in a broad range of other psychosocial domains. Augmenting weight loss interventions with specialized treatment components to address child and parent psychosocial problems could enhance socially-impaired children's long-term weight outcomes and decrease risk for later development of psychiatric disturbances.
Department of Psychology, Washington University, School of Medicine, St Louis, Missouri 63110, USA. goldscha@psychiatry.wustl.edu
Andrea B
AB
Goldschmidt
Meghan M
MM
Sinton
Vandana Passi
VP
Aspen
Tiffany L
TL
Tibbs
Richard I
RI
Stein
Brian E
BE
Saelens
Fred
F
Frankel
Leonard H
LH
Epstein
Denise E
DE
Wilfley
D000328:Adult; D001521:Behavior Therapy; D002648:Child; D005195:Family Relations; D001068:Feeding and Eating Disorders / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology*; D050177:Overweight / Q000523:psychology*; D011581:Psychological Tests; D011584:Psychology; D015203:Reproducibility of Results; D012649:Self Concept; D012919:Social Behavior; D012940:Social Problems