Obesity and Psychopathology: Longitudinal Study of Youth

描述(申请人提供)：肥胖和精神疾病是美国目前面临的两个最大的健康问题，它们在人类痛苦、医疗保健成本和生产力损失方面给社会带来了巨大的负担。肥胖症已知的心理社会后果包括教育程度降低和结婚率降低。在接受肥胖症治疗的成年人中，共病的精神病理增加。对肥胖儿童的普遍耻辱表现为取笑和增加的社会压力。然而，肥胖后的心理结果的流行病学还没有得到很好的表征，肥胖和精神病理学之间的联系经常在临床样本中进行评估，或者使用横断面研究设计。 拟议的分析利用了从儿童到成年早期心理健康决定因素的纵向社区研究的综合数据，以表征肥胖的具体心理后果及其与青春期相对体重的关系，并评估精神病理学在肥胖发展中的作用。精神病理学是根据标准的《精神疾病诊断和统计手册》(DSM)诊断标准以及症状量表进行评估的。通过纵向统计建模，将评估青少年相对体重与焦虑症、情绪障碍和整体精神病理学的双向关联。将考察中介和调节因素在多大程度上促进青少年肥胖症的发展并影响随后的精神病理学。相对体重将根据自我报告的身高和体重计算出的身体质量指数(BMI)进行评估。疾病控制中心的BMI增长参考将被用来确定特定年龄和性别的BMI z得分。肥胖将被定义为BMI指数高于疾病预防控制中心生长参考第85个百分位数。了解肥胖的心理后果将使预防和治疗工作能够越来越有重点地研究，以减少肥胖和精神疾病造成的心理和身体痛苦。

DESCRIPTION (provided by applicant): Obesity and mental illness are two of the largest health issues the United States is currently facing, and their burden to society in human suffering, health care costs, and lost productivity is immense. The known psychosocial consequences of obesity include reduced educational attainment and lower rates of marriage. In adults presenting for the treatment of obesity, co-morbid psychopathology is increased. Widespread stigmatization of obese children is manifested through teasing and increased social stress. Nonetheless, the epidemiology of psychological outcomes subsequent to obesity has not been well characterized, and associations between obesity and psychopathology have frequently been assessed in clinical samples, or have used cross-sectional study designs. The proposed analyses make use of comprehensive data, from a longitudinal community study of determinants of psychological health from childhood to early adulthood, to characterize the specific psychological consequences of obesity and associations with relative weight during adolescence, and to assess the role of psychopathology on the development of obesity. Psychopathology is assessed based on standard Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria as well as by symptom scales. With longitudinal statistical modeling, the bi-directional associations of adolescent relative weight with anxiety disorders, mood disorders, and overall psychopathology will be assessed. The extent to which mediating and moderating factors contribute to the development of adolescent obesity and influence subsequent psychopathology will be examined. Relative weight will be assessed based on body mass index (BMI) calculated from self-reported height and weight. The Centers for Disease Control's BMI growth reference will be used to determine age- and sex-specific BMI z-scores. Obesity will be defined as a BMI score above the 85th percentile from the CDC growth reference. Understanding the psychological consequences of obesity will allow for increasingly focused research in prevention and treatment efforts aimed at reducing psychological and physical suffering from obesity and from mental illness.