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Project AHEAD ("ADHD Heterogeneity of Executive Function and Emotion Regulation Across Development")

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Early childhood behavioral and neurobiological profiles in the prediction of obesity: The role of self-regulation and the caregiving environment

  • More Info - Early childhood behavioral and neurobiological profiles in the prediction of obesity

    Summary of Aims

    While the prevalence rates of pediatric obesity have plateaued in recent years, a staggering 35% of school age children remain classified as overweight/obese (OV/OB). In collaboration with Drs. Anthony Dick and Catherine Coccia, the current study focuses on developing behavioral phenotypes based on self-regulation processes (i.e., EF, ER, and RS), which will then be examined within a neurobehavioral vulnerability model of eating. Longitudinal studies are desperately needed that a) comprehensively measure behavioral phenotypes using multiple levels of analyses (i.e., behavioral, neurobiological, pathophysiological), b) examine the extent to which such phenotypes relate to obesogenic mechanisms (e.g., self-regulation of energy intake, healthy-habits) and subsequent weight trajectories and c) examine how environmental factors (e.g., parenting) can contribute to and moderate the link between phenotypes and weight outcomes. We leverage the ongoing data collection as part of award R01MH112588 (PI Graziano/Dick), which is measuring young children’s (ages 4-6) self-regulation processes at a behavioral, neuropsychological, and neurobiological level via task-based functional and structural MRI. The proposed ancillary study seeks to further collect a) obesogenic mechanistic measures such as self-regulation of energy intake (via observed eating) and healthy-habits (i.e., physical activity, dietary habits), b) parenting measures related to feeding (observed mealtime interactions), and c) weight-related outcomes (i.e., BMI and % body fat) across two yearly time points. As seen in our model (Figure 1), this study will first develop behavioral phenotypes based on EF, ER, and RS (aim 1) and then use such phenotypes to predict obesogenic mechanisms (aim 2a) and subsequent weight trajectories (aim 2b). We will then examine the extent to which parenting (aim 3a) and the home environment (aim 3b) moderate the link between phenotypes and both obesogenic mechanisms and later weight trajectories.  

    Summary of Background

    Broadly speaking, work by PI Graziano among others have documented self-regulation (SR) as an important mechanism for understanding the development of pediatric obesity as well as its shared co-morbidities with other mental health disorders (e.g., Attention-Deficit/Hyperactivity Disorder [ADHD] [18-22]. Within the cognitive domain, some studies suggest that poor executive function (EF) is associated with obesity. These studies, however, tend to be cross-sectional in nature and have focused primarily on adolescents and adults [32-33, 43-46]. Additionally, given the non-unitary nature of EF, a more refined and extensive measurement of EF is needed given that several domains of EF may be implicated in eating behaviors including a) inhibitory control, b) cognitive flexibility, and c) working memory. Within the emotional/affective domain, some studies have documented the role of emotion regulation and reactivity (ER) in the development of obesity. For example, individuals tend to overeat during periods of emotional arousal and/or stress. PI Graziano also documented, in one of the few longitudinal studies, that poor ER in toddlerhood predicted BMI at age 10 [47]. Finally, within the motivational/learning domain, reward sensitivity (RS) has emerged as a critical underlying process in terms of contributing to overeating and food preferences. For example, functional neuroimaging work, done primarily with adults and older teens, has documented that individuals who are OB display hyper activation in brain regions implicated in reward processing (e.g., nucleus accumbens) when presented with high fat foods [62]. Thus, despite the identification of three viable underlying SR processes (EF, ER, and RS) that are associated with obesity, there are several critical limitations. These include:

    • Lack of integration of these three SR processes when examining weight outcomes, as most studies have examined each of these SR processes in isolation, 2) Lack of longitudinal studies, which are needed to disentangle whether potential SR deficits are risk factors for the development of obesity or a consequence of it, 3) lack of comprehensive measurement of these SR processes in terms of integrating behavioral measures, neuropsychological, and neurobiological markers, 4) lack of studies examining the predictive association of SR processes as they relate to observed obesogenic mechanisms (e.g., SR of energy intake, healthy-habits) and 5) how environmental factors (e.g., parenting, home environment) can contribute to and moderate the link between SR phenotypes and weight outcomes.

    Summary of Sample

    Participants will be 288 young children ages 4-6 who are already participating in grant R01MH112588 (PI Graziano and Dick). Half of these participants will have ADHD confirmed via a gold standard assessment including a diagnostic interview and parent/teacher ratings on symptoms of ADHD as well as behavioral impairment. Participants are currently being recruited from Miami-Dade County Schools in the city of Miami, FL. The Center for Children and Families (CCF) has a collaborative relationship with Miami-Dade County Schools, which represents an ideal location to conduct this research as it is the 4th largest school district in the nation with over 75,000 children ages 4-6. The ethnic and economic diversity of the Miami-Dade County represents another advantage of this project’s setting. According to district data, approximately 70% are Latinos while approximately 27% of public school students are eligible for free or reduced school lunch. This sample composition helps to enroll a diverse group of participants to maximize the external validity of the study. Families will be excluded if child has dietary or exercise restrictions, a pervasive developmental disorder, has an IQ<70, is on psychotropic medication which may affect weight loss/gain, and parent/child is currently enrolled in a weight control program.

  • Publications
Evaluating Parenting Programs at the Lotus House Women's Homeless Shelter