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- Genre: Doctoral Dissertation
Description
Pediatric obesity is a public health concern due to its elevated prevalence rates and its relation to concurrent and long-term physical and psychosocial consequences. Pediatric obesity has been found to be associated with problem behaviors, albeit with inconsistent findings. The mechanism of this relation is unclear. It is possible that they have a shared etiology. Self-regulation and parenting practices are two factors that have been implicated in the development of problem behaviors and are garnering evidence for their relation with pediatric obesity. The goal of the present study was to examine whether self-regulation (SREC), positive behavior support (PBSEC), and coercive limit-setting (CLSEC) in early childhood are shared etiological factors of pediatric obesity and problem behaviors. Using multinomial logistic regression the likelihood of belonging to four outcome groups (Comorbid, Problem behavior only, Overweight only, and Typically developing) at age 10 based on these factors was assessed. Analyses controlled for intervention group assignment, child gender, child African-American or Bi-racial, child Hispanic, cumulative risk, child body size impression at age 2, and parent body size impression at baseline. In the models examining SREC alone, for every 1 standard deviation increase in SREC, there was a reliable reduction in the odds of the child belonging to the comorbid and problem behavior only groups at age 10, compared to the typically developing group (OR = 0.386, 95% CI [0.237, 0.628], OR = 0.281, 95% CI [0.157, 0.503], respectively). This relation was maintained when SREC was in the same model as PBSEC and CLSEC. PBSEC and CLSEC alone did not impact the likelihood of belonging to any of the outcome groups. A significant interaction was found between SREC and CLSEC, such that at high levels of both SREC and CLSEC the odds of a child belonging to the overweight only group at age 10 increased, compared to the typically developing group. Results highlight CLSEC as a parenting practice that may place a highly regulated child at risk for becoming overweight. Overall, the findings suggest that problem behaviors and pediatric obesity do not have a shared etiology.
ContributorsMontano, Zorash (Author) / Dishion, Thomas J (Thesis advisor) / Gonzales, Nancy (Committee member) / Perez, Marisol (Committee member) / Enders, Craig (Committee member) / Arizona State University (Publisher)
Created2016
Description
Disordered weight control behaviors (DWCB) are a pervasive and serious public health issue associated with a wide variety of psychological and physiological problems. Using the transdiagnostic cognitive behavioral model and an intersectional framework, this study uses latent class analysis to examine DWCB in a national longitudinal sample (N = 2,874) of late adolescents and emerging adults (19-22 years) with focus on gender and race/ethnicity. Three latent classes were identified cross-sectionally across all timepoints: A restriction behaviors group, a combined restriction and compensatory behaviors group, and a group exhibiting low DWCB. Women of all racial/ethnic groups were consistently more likely than were men to classify in the restriction behaviors class, and Black and Hispanic women were more likely to classify in the combined behaviors class in waves 6 and 7. Longitudinally, two classes were identified: A low stable and a higher stable class. Women of all racial/ethnic groups were more likely to classify in the high stable class compared with White men, however, no other racial/ethnic differences emerged. Hispanic men were more likely to classify in the high stable group. This study highlights the utility of transdiagnostic, intersectional, cross-sectional, and longitudinal approaches to studying DWCB in nonclinical populations. More work is needed to examine the influence of restriction and combined DWCB behaviors on adolescent and emerging adult development and functioning. In addition, this work underlines the need for more nuanced measurement of disordered eating pathology in national studies and epidemiological research. Finally, this study demonstrates the need for continual focus on intersectionality frameworks and the addition of cultural and identity-related variables in disordered eating research to promote wellbeing, health, and equity for all individuals.
ContributorsYu, Kimberly (Author) / Perez, Marisol (Thesis advisor) / Edwards, Michael (Committee member) / Su, Jinni (Committee member) / Wolchik, Sharlene (Committee member) / Arizona State University (Publisher)
Created2023
Description
Elevated rates of exposure to multi-level chronic stressors (e.g., poverty, discrimination, acculturative stress) place low-income, Mexican-origin individuals in the United States at elevated risk for adverse psychological and physical health across the lifespan. Despite exposure to contextual risk factors, many individuals maintain positive biobehavioral health. In particular, despite greater exposure to sociodemographic risk factors, more recently immigrated Mexican-origin individuals in the U.S. may demonstrate more positive biobehavioral health, warranting consideration of specific cultural values and practices that confer and maintain positive health across generations. Parental cultural socialization is an understudied mechanism in promotive pathways of parent-child processes and child biobehavioral health. Across three generations of Mexican-origin families in the United States – maternal grandmothers, mothers, children – the current study (1) identified a multidimensional measure of child biobehavioral health across psychological and biological indicators, (2) evaluated the intergenerational transmission of grandmother-mother cultural socialization, (3) evaluated the effect of maternal cultural socialization on child-perceived parenting and child biobehavioral health, and (4) evaluated child cultural orientation as a moderator of the effect of maternal cultural socialization on child-perceived parenting and child biobehavioral health. Findings highlight the complex and nuanced relations among parental cultural socialization, individual cultural orientation, child perceptions of parenting, and child biobehavioral health among low-income, Mexican-origin families in the United States.
ContributorsCurci, Sarah Gianna (Author) / Luecken, Linda J (Thesis advisor) / Perez, Marisol (Committee member) / Cruz, Rick (Committee member) / Grimm, Kevin (Committee member) / Arizona State University (Publisher)
Created2024
Description
There is a need to reinvent evidence-based interventions (EBIs) for pediatric anxiety problems to better address the demands of real-word service delivery settings and achieve public health impact. The time- and resource-intensive nature of most EBIs for youth anxiety has frequently been noted as a barrier to the utilization of EBIs in community settings, leading to increased attention towards exploring the viability of briefer, more accessible protocols. Principally, this research reports between-group effect sizes from brief-interventions targeting pediatric anxiety and classifies each as well-established, probably efficacious, possibly efficacious, experimental, or questionable. brief interventions yielded an overall mean effect size of 0.19 on pediatric anxiety outcomes from pre to post. Effect sizes varied significantly by level of intervention: Pre to post-intervention effects were strongest for brief-treatments (0.35), followed by brief-targeted prevention (0.22), and weakest for brief-universal prevention (0.09). No participant or other intervention characteristic emerged as significant moderators of effect sizes. In terms of standard of evidence, one brief intervention is well-established, and five are probably efficacious, with most drawing on cognitive and behavioral change procedures and/or family systems models. At this juncture, the minimal intervention needed for clinical change in pediatric anxiety points to in-vivo exposures for specific phobias (~3 hours), cognitive-behavioral therapy (CBT) with social skills training (~3 hours), and CBT based parent training (~6 hours, eight digital modules with clinician support). This research concludes with a discussion on limitations to available brief EBIs, practice guidelines, and future research needed to capitalize on the viability of briefer protocols in enhancing access to, and impact of, evidence-based care in the real-world.
ContributorsStoll, Ryan (Author) / Pina, Armando A. (Thesis advisor) / Gonzales, Nancy (Committee member) / MacKinnon, David (Committee member) / Perez, Marisol (Committee member) / Arizona State University (Publisher)
Created2019
Description
Familism values have been shown to have a multitude of benefits for Mexican American youth. Understanding different pathways of the adoption of familism values from adolescence and young adulthood, and predictors of these pathways, is critical. The current study assessed different classes of change in familism values across five waves from fifth grade to young adulthood, and fifth-grade predictors of these profiles, among a sample of 749 Mexican American youth. Univariate and growth mixture modeling was used to determine classes of familism change and found two classes—one class that showed small, insignificant declines across adolescence that accelerated into young adulthood and one class that showed significant declines across adolescence that stabilized and increased into young adulthood. The three-step procedure was then used to examine the following fifth-grade predictors of familism classes: family conflict, family cohesion, harsh parenting, parental acceptance, economic hardship, and perceived ethnic discrimination. Family conflict and perceived ethnic discrimination were significant predictors of familism class membership. Greater family conflict predicted a greater probability of being in the class of significant declines in familism across adolescence that stabilized and increased into young adulthood. Greater perceived ethnic discrimination predicted a greater probability of being in the class of small, insignificant decreases across adolescence that accelerated into young adulthood. Gender moderated the impact of family cohesion. For females, greater father-reported family cohesion predicted a greater probability of being in the class with significant declines during adolescence that stabilized and increased into young adulthood. For males, greater father-reported family cohesion predicted a greater probability of being in the class with slight, insignificant declines in adolescence that accelerated into young adulthood. Youth nativity moderated the impact of maternal acceptance. For youth born in the U.S., greater mother-reported acceptance predicted a greater probability of being in the class of slight, insignificant declines across adolescence that accelerated into young adulthood. For youth born in Mexico, greater mother-reported acceptance predicted a greater probability of being in the class of significant declines in familism across adolescence that stabilized and increased into young adulthood. Limitations and implications for prevention and future research are discussed.
ContributorsJenchura, Emily C. (Author) / Gonzales, Nancy A. (Thesis advisor) / Knight, George P (Committee member) / Grimm, Kevin J. (Committee member) / Perez, Marisol (Committee member) / Arizona State University (Publisher)
Created2019
Description
Obesity is associated with many well-established health risks as well as high annual public health costs. Intervening in the trajectory of obesity becomes significantly more difficult after a child has reached obesity. Therefore, it is crucial to understand the processes that influence weight early in life. Parents serve as one of the main influences on child health, have a significant impact on the weight of their offspring, and are often incorporated into childhood obesity prevention programs. However, the mutual influence that parents and children have on each other is not accounted for. Using an Actor-Partner Interdependence model, the current study 1) examined the effect of children’s and mother’s temperament (e.g., negative affectivity, effortful control, and impulsivity) on their own weight as well as the weight of the other dyad member, 2) explored the effect of the interaction between mother and child temperament on both members’ weight, 3) assessed the effect of mother’s approach to food on mother and child weight, and 4) investigated how temperament might moderate the relationships between mother’s approach to food and mother and child weight. The sample consisted of 220 mother-child dyads. Children ranged from 4 to 6 years of age. Mothers completed self-report questionnaires on their own temperament and approach to food as well as their child’s temperament. Weight measures were assessed in the laboratory for both mother and child. Results indicated children’s impulsivity was related to their mother’s higher weight. The interaction between mother and child temperament was not significantly associated with weight. However, the interaction between child impulsivity and mother’s approach to food was significant; the effect of the mother’s approach to food on her own weight depended on their child’s impulsivity behaviors. Specifically, mothers’ approach to food on her own weight was nonsignificant when her child showed higher levels of impulsivity. The association of mother’s approach to food with her own weight was stronger when her child exhibited average to low impulsivity levels. This investigation of the influence of mother and child on each other’s weight is well-placed for translation into later obesity preventative and intervention efforts for family systems.
ContributorsOhrt, Tara (Author) / Perez, Marisol (Thesis advisor) / Luecken, Linda (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Iida, Masumi (Committee member) / Arizona State University (Publisher)
Created2021