title: Maternal and family factors and child eating pathology: risk and protective relationships.
abstract: BACKGROUND
  Previous studies have found associations between maternal and family factors and child eating disorder symptoms. However, it is not clear whether family factors predict eating disorder symptoms specifically, or relate to more general child psychopathology, of which eating disorder symptoms may be one component. This study aimed to identify maternal and family factors that may predict increases or decreases in child eating disorder symptoms over time, accounting for children's body mass index z-scores and levels of general psychological distress.
  
  
  METHODS
  Participants were 221 mother-child dyads from the Childhood Growth and Development Study, a prospective cohort study in Western Australia. Participants were assessed at baseline, 1-year follow-up and 2-year follow-up using interview and self-report measures. Children had a mean age of 10 years at baseline and 46% were male. Linear mixed models and generalised estimating equations were used to identify predictors of children's eating disorder symptoms, with outcome variables including a global index of eating disorder psychopathology, levels of dietary restraint, levels of emotional eating, and the presence of loss of control ('binge') eating.
  
  
  RESULTS
  Children of mothers with a current or past eating disorder reported significantly higher levels of global eating disorder symptoms and emotional eating than other children, and mothers with a current or past eating disorder reported significantly more concern about their children's weight than other mothers. Maternal concern about child weight, rather than maternal eating disorder symptoms, was significant in predicting child eating disorder symptoms over time. Family exposure to stress and low maternal education were additional risk factors for eating disorder symptoms, whilst child-reported family satisfaction was a protective factor.
  
  
  CONCLUSIONS
  After adjusting for relevant confounding variables, maternal concern about child weight, children's level of family satisfaction, family exposure to stress, and maternal education are unique predictors of child eating disorder symptoms.
authors.affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, Australia ; School of Psychology, The University of Western Australia, Crawley, WA, Australia.
authors.forename: Karina L
authors.initials: KL
authors.lastname: Allen
authors.affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, Australia.
authors.forename: Lisa Y
authors.initials: LY
authors.lastname: Gibson
authors.affiliation: School of Psychology, The University of Western Australia, Crawley, WA, Australia.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: McLean
authors.affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, Australia ; Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Subiaco, Australia.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Davis
authors.affiliation: School of Psychology, The University of Western Australia, Crawley, WA, Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Byrne
keywords: Children; Eating disorders; Family; Family factors and eating pathology; Loss of control eating; Protective factors; Risk factors; Running head