Quality of Early Maternal-Child Relationship and Risk of Adolescent Obesity

Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA.
PEDIATRICS (Impact Factor: 5.3). 12/2011; 129(1):132-40. DOI: 10.1542/peds.2011-0972
Source: PubMed

ABSTRACT The goal of this study was to determine whether obesity in adolescence is related to the quality of the early maternal-child relationship.
We analyzed data from 977 of 1364 participants in the Study of Early Child Care and Youth Development. Child attachment security and maternal sensitivity were assessed by observing mother-child interaction at 15, 24, and 36 months of age. A maternal-child relationship quality score was constructed as the number of times across the 3 ages that the child was either insecurely attached or experienced low maternal sensitivity. Adolescent obesity was defined as a measured BMI ≥95th percentile at age 15 years.
Poor-quality maternal-child relationships (score: ≥3) were experienced by 24.7% of children compared with 22.0% who, at all 3 ages, were neither insecurely attached nor exposed to low maternal sensitivity (score: 0). The prevalence of adolescent obesity was 26.1%, 15.5%, 12.1%, and 13.0% for those with risk scores of ≥3, 2, 1, and 0, respectively. After adjustment for gender and birth weight, the odds (95% confidence interval) of adolescent obesity was 2.45 (1.49-4.04) times higher in those with the poorest quality early maternal-child relationships (score: ≥3) compared with those with the highest quality (score: 0). Low maternal sensitivity was more strongly associated with obesity than insecure attachment.
Poor quality of the early maternal-child relationship was associated with a higher prevalence of adolescent obesity. Interventions aimed at improving the quality of maternal-child interactions should consider assessing effects on children's weight and examining potential mechanisms involving stress response and emotion regulation.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Child obesity continues to be a prevalent public health issue. This meta-analysis synthesized 17 studies investigating the association between levels of psychological stress experienced by mothers and the body mass index of their children. The overall standardized mean difference effect size was positive and significantly different from zero in cross-sectional d = 0.20 (k = 14, 95% confidence interval [CI]: 0.06, 0.34) and longitudinal studies d = 0.18 (k = 5, 95% CI: 0.00, 0.351) and had significant heterogeneity in both (cross-sectional, Q[13] = 193.00, P < 0.001; longitudinal, Q[4] = 29.46, P < 0.001). In longitudinal studies, effect sizes were larger when children also would have experienced the stressor, Q(6) = 4.68, P < 0.05, for toddlers than infants, Q(4) = 5.04, P < 0.05, and in higher quality studies, Q(4) = 14.58, P < 0.05. Results highlight the potential benefits of including a parent stress management component in childhood obesity prevention programmes. © 2015 World Obesity.
    Obesity Reviews 05/2015; 16(5):351-61. DOI:10.1111/obr.12262 · 7.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The goal of this study was to test 3 serial mediation models of how caregiver adult attachment style influences children's food consumption through its influence on emotion regulation. Three mediators that have been shown to increase the risk for pediatric obesity and that are likely to be influenced by negative emotion regulation strategies in everyday family interactions were chosen: (1) caregiver feeding practices (2) family mealtime routines, and (3) child television (TV) viewing. A total of 497 primary caregivers of 2.5- to 3.5-year-old children reported on their own attachment style, typical responses to their children's negative affect, feeding styles, mealtime and TV viewing routines, and their children's consumption of healthful and unhealthful foods. Insecure mothers were more likely to use punishing or dismissing responses to their children's negative affect, and negative emotion regulation predicted the increased use of emotion-related feeding styles and fewer mealtime routines. These variables, in turn, were found to predict children's unhealthful food consumption, documenting serial mediational influences. With respect to TV viewing, caregiver insecurity influenced child food consumption indirectly through its direct effect on child TV viewing. Taken together, these data suggest that insecure attachment may put parents at a risk for using negative emotion regulation strategies in response to their children's distress, which may also have important implications for the interpersonal environment surrounding food and the development of children's early eating behaviors.
    Journal of developmental and behavioral pediatrics: JDBP 01/2014; 35(1):50-61. DOI:10.1097/01.DBP.0000439103.29889.18 · 2.12 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Within the research area on the determinants of childhood obesity, a relatively new approach is the use of attachment theory to explore the mechanisms underlying children's obesity risk, especially considered as emotion regulation strategies in parent-child relationship. Few are the empirical researches that have addressed this issue. The empirical investigations have used self-report measures to assess adult attachment. In attachment studies, the use of interview methods and/or performance-based instruments is advised to evaluate the entire range of possible adult attachment patterns and comprehensively explain the emotional strategies, correlates, and consequences of individual differences in attachment system functioning. The aim of this study was to explore the extent to which both parents' attachment patterns serve as self-regulative mechanisms related to childhood overweight/obesity by the Adult Attachment Projective Picture System (AAP) in a sample of 44 mothers and fathers of children referred for obesity. Insecure attachment was found as a risk factor both for mothers and fathers. Also unresolved/disorganization was found to play a significant role in childhood obesity. The role of father's attachment was explored and findings suggested considering it in etiology and treatment of childhood obesity.
    Frontiers in Psychology 07/2014; 5:791. DOI:10.3389/fpsyg.2014.00791 · 2.80 Impact Factor


Available from