Parents' cognitions and expectations about their pre-school children: the contribution of parental anxiety and child anxiety

This study investigated the relative associations between parent and child anxiety and parents' cognitions about their children. One hundred and four parents of children aged 3-5 years completed questionnaires regarding their own anxiety level, their child's anxiety level and their cognitions about the child, specifically parents' expectations about child distress and avoidance, and parents' perceived control over child mood and behaviour. Both parent anxiety and parent report of child anxiety were significantly associated with parents' cognitions. Specifically, parent report of child anxiety correlated significantly with parent locus of control generally and, more specifically, with parental expectations and perceived control of child anxious mood and behaviour. Parent anxiety correlated significantly with locus of control and parents' expectations of child anxious mood and behaviour. Furthermore, when both child and parent anxiety were taken into account, only parental anxiety remained significantly associated with parental locus of control and perceived control of child anxious behaviour. For parents' perceived control of child anxious mood, only child anxiety remained significantly associated. The results suggest that parents' perceived control over their children's behaviour may primarily reflect parental anxiety, rather than child anxiety. Parental anxiety may, therefore, present an important target for interventions that aim to change parent's cognitions and behaviour.

Family treatment of child anxiety: outcomes, limitations and future directions

Anxiety of childhood is a common and serious condition. The past decade has seen an increase in treatment-focussed research, with recent trials tending to give greater attention to parents in the treatment process. This review examines the efficacy of family-based cognitive behaviour therapy and attempts to delineate some of the factors that might have an impact on its efficacy. The choice and timing of outcome measure, age and gender of the child, level of parental anxiety, severity and type of child anxiety and treatment format and content are scrutinised. The main conclusions are necessarily tentative, but it seems likely that Family Cognitive Behaviour Therapy (FCBT) is superior to no treatment, and, for some outcome measures, also superior to Child Cognitive Behaviour Therapy (CCBT). Where FCBT is successful, the results are consistently maintained at follow-up. It appears that where a parent is anxious, and this is not addressed, outcomes are less good. However, for children of anxious parents, FCBT is probably more effective than CCBT. What is most clear is that large, well-designed studies, examining these factors alone and in combination, are now needed.

Determinants of healthy eating: a cross-national study on motives and barriers

The paper investigates the impact of motives and barriers to healthy eating on individuals' healthy eating intention and behaviour using a cross-national design. Data were collected from the UK and the Czech Republic via a self-completion questionnaire. Findings highlight the significance of intrinsic motives and psychological barriers in predicting both intention and healthy eating behaviour for both UK and Czech consumers, albeit their weight as well as the variance captured by these factors differs across the two national cultures. Findings also indicate that physical barriers are in fact unimportant when it comes to adopting a healthy eating diet. These findings are discussed in the light of previous research, while their implications for policy makers and researchers are highlighted.

Let’s look at leeks! Picture books increase toddlers’ willingness to look at, taste and consume unfamiliar vegetables

Repeatedly looking at picture books about fruits and vegetables with parents enhances young children’s visual preferences towards the foods in the book (Houston-Price et al, 2009) and influences their willingness to taste these foods (Houston-Price, Butler & Shiba, 2009). This article explores whether the effects of picture book exposure are affected by infants' initial familiarity with and liking for the foods presented. In two experiments parents of 19- to 26-month-old toddlers were asked to read a picture book about a liked, disliked or unfamiliar fruit or vegetable with their child every day for two weeks. The impact of the intervention on both infants’ visual preferences and their eating behaviour was determined by the initial status of the target food, with the strongest effects for foods that were initially unfamiliar. Most strikingly, toddlers consumed more of the unfamiliar vegetable they had seen in their picture book than of a matched control vegetable. Results confirm the potential for picture books to play a positive role in encouraging healthy eating in your children.

The impact of obesity-related single nucleotide polymorphisms on appetite and energy intake: a pilot study

An increasing number of studies have reported a heritable component for the regulation of energy intake and eating behaviour, although the individual polymorphisms and their ‘effect size’ are not fully elucidated. The aim of the present study was to examine the relationship between specific SNP and appetite responses and energy intake in overweight men. In a randomised cross-over trial, forty overweight men (age 32 (sd 09) years; BMI 27 (sd 2) kg/m2) attended four sessions 1 week apart and received three isoenergetic and isovolumetric servings of dairy snacks or water (control) in random order. Appetite ratings were determined using visual analogue scales and energy intake at an ad libitum lunch was assessed 90 min after the dairy snacks. Individuals were genotyped for SNP in the fat mass and obesity-associated (FTO), leptin (LEP), leptin receptor (LEPR) genes and a variant near the melanocortin-4 receptor (MC4R) locus. The postprandial fullness rating over the full experiment following intake of the different snacks was 17·2 % (P= 0·026) lower in A carriers compared with TT homozygotes for rs9939609 (FTO, dominant) and 18·6 % (P= 0·020) lower in G carriers compared with AA homozygotes for rs7799039 (LEP, dominant). These observations indicate that FTO and LEP polymorphisms are related to the variation in the feeling of fullness and may play a role in the regulation of food intake. Further studies are required to confirm these initial observations and investigate the ‘penetrance’ of these genotypes in additional population subgroups.

Cognitive behaviour therapy for eating disorders

The eating disorders provide one of the strongest indications for cognitive behaviour therapy (CBT). This bold claim arises from two sources: first, the fact that eating disorders are essentially cognitive disorders and second, the demonstrated effectiveness of CBT in the treatment of bulimia nervosa, which has led to the widespread acceptance that CBT is the treatment of choice. In this paper the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. A brief summary of the evidence for this account and of the data supporting the efficacy and effectiveness of this form of treatment will be provided. Challenges for the future development and dissemination of the treatment will be identified.

Young adults and the 5 a day campaign: perceived benefits and barriers of eating more fruits and vegetables

Although consuming adequate amounts of fruits and vegetables reduces the risk of developing chronic diseases, it is widely recognized that young adults’ intakes are currently well below the Department of Health’s recommended five portions a day, with men consuming even less than women. One approach in the UK has been to introduce health campaigns such as the 5 A DAY programme; however, little is currently known about how well their messages are understood amongst young adults. This study examined current knowledge of the 5 A DAY message in young adults, as well as the perceived benefits and remaining barriers towards consuming more fruits and vegetables. In total, four focus groups were conducted using male (n = 22) and female (n = 18) students at the University of Reading. Content analysis revealed that while participants were aware of the 5 A DAY recommendation, there was widespread confusion regarding the detail. In addition, men were less accepting of the message than women, reporting greater disbelief and a lack of motivation to increase intake. Finally, a range of barriers was reported by participants of both genders, despite the perceived beneficial effects for health and appearance. The results illustrate a considerable gap between awareness and knowledge of the 5 A DAY message, and underscore the challenge that changing behaviour in young adults represents. As well as stepping up education- and skill-based health campaigns, more targeted gender specific interventions will be needed to achieve sustained increases in fruit and vegetable intake.

The effect of incremental replacement of wheat with soya hulls in diets for Jersey cows on lactational performance, diet digestibility and feeding behaviour

Eight Jersey cows were used in two balanced 4 x 4 Latin Squares to investigate the effects of replacement of dietary starch with non-forage fibre on productivity, diet digestibility and feeding behaviour. Total-mixed rations consisted of maize silage, grass silage and a soyabean meal-based concentrate mixture, each at 250g/kg DM, with the remaining 250g consisting of cracked wheat/soya hulls (SH) in the ratios of 250:0, 167:83; 83:167 and 0:250 g, respectively, for treatments SH0, SH83, SH167 and SH250. Starch concentrations were 302, 248, 193 and 140g/kg DM, and NDF concentrations were 316, 355, 394 and 434g/kg DM, for treatments SHO, SH83, SH167 and SH250, respectively. Total eating time increased (p < 0.05) as SH inclusion increased, but total rumination time was unaffected. Digestibility of DM, organic matter and starch declined (p < 0.01) as SH inclusion increased, whilst digestibility of NDF and ADF increased (p < 0.01). Dry-matter intake tended to decline with increasing SH, whilst bodyweight, milk yield and fat and lactose concentrations were unaffected by treatment. Milk protein concentration decreased (p < 0.01) as SH level increased. Feed conversion efficiency improved (p < 0.05) as SH inclusion rose, but it was not possible to determine whether this was due to the increased fibre levels alone, or the favourable effect on rumen fermentation of decreasing starch levels. (c) 2006 Elsevier B.V. All rights reserved.

Children's representation of family mealtime in the context of maternal eating disorders

Background Recent research provides evidence for specific disturbance in feeding and growth in children of mothers with eating disorders. Aim To investigate the impact of maternal eating disorders during the post-natal year on the internal world of children, as expressed in children's representations of self and their mother in pretend mealtime play at 5 years of age. Methods Children of mothers with eating disorders (n = 33) and a comparison group (n = 24) were videotaped enacting a family mealtime in pretend play. Specific classes of children's play representations were coded blind to group membership. Univariate analyses compared the groups on representations of mother and self. Logistic regression explored factors predicting pretend play representations. Results Positive representations of the mother expressed as feeding, eating or body shape themes were more frequent in the index group. There were no other significant group differences in representations. In a logistic regression analysis, current maternal eating psychopathology was the principal predictor of these positive maternal representations. Marital criticism was associated with negative representations of the mother. Conclusions These findings suggest that maternal eating disorders may influence the development of a child's internal world, such that they are more preoccupied with maternal eating concerns. However, more extensive research on larger samples is required to replicate these preliminary findings.

Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression 2. Impact on the mother-child relationship and child outcome

Background: Postnatal depression is associated with adverse child cognitive and socio-emotional outcome. It is not known whether psychological treatment affects the quality of the mother-child relationship and child outcome. Aims: To evaluate the effect of three psychological treatments on the mother-child relationship and child outcome. Method: Women with post-partum depression (n=193) were assigned randomly to routine primary care, non-directive counselling, cognitive-behavioural therapy or psychodynamic therapy The women and their children, were assessed at 43, [8 and 60 months post-partum. Results: Indications of a positive benefit were limited. All three treatments had a significant benefit on maternal reports of early difficulties in relationships with the infants, counselling gave better infant emotional and behaviour ratings at 18 months and more sensitive early mother-infant interactions. The treatments had no significant impact on maternal management of early infant behaviour problems, security of infant-mother attachment. Infant cognitive development or any child outcome at 5 years. Conclusions: Early intervention was of short-term benefit to the mother-child relationship and infant behaviour problems. More-prolonged intervention may be needed. Health visitors could deliver this.

Discrepancy between parental reports of infants' receptive vocabulary and infants' behaviour in a preferential looking task

Two experiments are described which explore the relationship between parental reports of infants' receptive vocabularies at 1; 6 (Experiment 1a) or 1-3, 1;6 and 1;9 (Experiment 1b) and the comprehension infants demonstrated in a preferential looking task. The instrument used was the Oxford CD1, a British English adaptation of the MacArthur-Bates CD1 (Words & Gestures). Infants were shown pairs of images of familiar objects, either both name-known or both name-unknown according to their parent's responses on the CD1. At all ages, and on both name-known and name-unknown trials, preference for the target image increased significantly from baseline when infants heard the target's label. This discrepancy suggests that parental report underestimates infants' word knowledge.

A preliminary evaluation of cognitive-behaviour therapy for clinical perfectionism: a case series

Objective: The construct of 'clinical perfectionism' has been developed in response to criticisms that other approaches have failed to yield advances in the treatment of the type of self-oriented perfectionism that poses a clinical problem. The primary aim of this study was to conduct a preliminary investigation into the efficacy of a theory-driven, cognitive-behavioural intervention for 'clinical perfectionism'. Design. A multiple baseline single case series design was used. Method: A specific, 10-session cognitive-behavioural intervention to address clinical perfectionism in eating disorders was adapted to allow its use in nine patients referred with a range of axis I disorders and clinical perfectionism. Results: The intervention led to clinically significant improvements in self-referential perfectionism from pretreatment to follow-up for six of the nine participants on two perfectionism measures and for three of the nine participants on the measure of clinical perfectionism. Statistically significant improvements from pre- to post-intervention for the group as a whole were found on all three measures. The improvements were maintained at follow-up. Conclusions: The finding that clinical perfectionism is improved in the majority of participants is particularly encouraging given that perfectionism has traditionally been viewed as a personality characteristic resistant to change. These preliminary findings warrant replication in a larger study.

The impact of parents' expectations on parenting behaviour: an experimental investigation

Over-involved parenting is commonly hypothesized to be it risk factor for the development of anxiety disorders in childhood. This parenting style may result from parental attempts to prevent child distress based on expectations that the child will be unable to cope in a challenging situation. Naturalistic studies are limited in their ability to disentangle the overlapping contribution of child and parent factors in driving parental behaviours. To overcome this difficulty, an experimental study was conducted in which parental expectations of child distress were manipulated and the effects on parent behaviour and child mood were assessed. Fifty-two children (aged 7 - 11 years) and their primary caregiver participated. Parents were allocated to either a "positive" or a "negative" expectation group. Observations were made of the children and their parents interacting whilst completing a difficult anagram task. Parents given negative expectations of their child's response displayed higher levels of involvement. No differences were found on indices of child mood and behaviour and possible explanations for this are considered. The findings are consistent with suggestions that increased parental involvement may be a "natural" reaction to enhanced perceptions of child vulnerability and an attempt to avoid child distress.