Enhancing Emotion Regulation to Support Weight Control Efforts in Adolescents with Overweight and Obesity

项目摘要/摘要 青少年与超重作斗争的比例非常高，在12-15岁的青少年中占38.7% 16-19岁的人中有41.5%的人符合超重或肥胖的标准。虽然已经有相当多的关注 针对儿童肥胖症的综合行为干预，经验证据较少 展示了对青少年进行干预的有效性。此外，结果也有很大的差异。 青少年体重控制治疗的有限影响可能归因于这些干预措施未能 明确阐述成功减肥所必需的关键机制。值得注意的是，青少年患有 研究发现，情绪调节较差的人会消耗饮食质量较低的食物，并会花费更多时间 比他们的同龄人更久坐不动。青少年情绪调节不良的问题也一直存在 体重增加更快，BMI更高。年超重/肥胖青少年数据 孩之宝儿童医院(N=124)的一项门诊体重管理计划表明，其中82%的人 年轻人报告的情绪调节得分与有严重心理健康问题的年轻人相当； 此外，情绪失调与BMI之间也存在正相关。 寻求治疗的样本。尽管建立了这些关系，但针对情绪调节的干预措施 青少年肥胖症患者缺乏营养。为了填补这一空白，我们的实验室开发并试行了一名青少年 体重控制干预(HealthTRAC)结合了两种有效的干预措施，一种针对情绪 一是调控技能培养，二是注重行为体重控制。小规模飞行员的初步发现 试验是有希望的，并表明开发的HealthTRAC干预是可接受的，可行的交付， BMI显著降低(d=.58)，情绪调节技能显著提高(d=.20-.35) 相对于标准的行为体重控制(SBWC)条件。拟议的多点试验建立在这些基础上 之前的发现，并将评估开发的HealthTRAC干预措施在改善 情绪调节技巧和降低青少年BMI。我们建议招收200名青少年(每个网站100名) 在13-17岁之间接受HealthTRAC或SBWC。青少年将被随机 分配到现场内的治疗条件。干预组件将在27.5小时内直接交付 联系时间跨越12个月。所有青少年将在随机化之前立即接受评估(基线) 干预后(4个月)，在完成维护课程(12个月)和18个月后 在开始干预之后。从这个项目中获得的信息将扩展我们对如何 提高情绪调节能力可以加强青少年体重控制干预。

PROJECT SUMMARY/ABSTRACT The prevalence of adolescents struggling with excess weight is remarkably high, with 38.7% of 12-15 year-olds and 41.5% of 16-19 year-olds meeting criteria for overweight or obesity. While considerable attention has been given to comprehensive behavioral interventions to address obesity in children, there is less empirical evidence demonstrating efficacy of interventions with adolescents. Additionally, there is great variability in outcomes. Limited impact of adolescent weight control treatment may be attributable to the failure of these interventions to explicitly address key mechanisms that are necessary for successful weight loss. Notably, adolescents with poorer emotion regulation have been found to consume foods of lower diet quality and report greater time spent in sedentary behavior than their peers. Poor emotion regulation among adolescents has also been associated with more rapid weight gain and higher BMI. Data from adolescents with overweight/obesity from an outpatient weight management program at Hasbro Children's Hospital (N=124) indicate that 82% of these youth report emotion regulation scores that are comparable to youth with significant mental health problems; furthermore, there is a positive association between emotional dysregulation and BMI within this same treatment-seeking sample. Despite these established relationships, interventions targeting emotion regulation in adolescents with obesity are lacking. To fill this gap, our laboratory developed and piloted an adolescent weight control intervention (HealthTRAC) that combines two efficacious interventions, one targeting emotion regulation skill building, the other focused on behavioral weight control. Preliminary findings from the small pilot trial are promising and indicate that the developed HealthTRAC intervention is acceptable, feasible to deliver, and results in significant reduction in BMI (d=.58) and improvement in emotion regulation skills (d=.20-.35) relative to a standard behavioral weight control (SBWC) condition. The proposed multi-site trial builds on these previous findings and will evaluate the efficacy of the developed HealthTRAC intervention on improving emotion regulation skills and reducing adolescent BMI. We propose to enroll 200 adolescents (100 per site) between the ages of 13-17 years of age to receive either HealthTRAC or SBWC. Adolescents will be randomly assigned to treatment condition within site. Intervention components will be delivered in 27.5 hours of direct contact time across 12 months. All adolescents will be assessed prior to randomization (baseline), immediately following the intervention (4 months), upon completion of maintenance sessions (12 months) and 18 months after the start of intervention. The information gained in this project will extend our understanding of how improving emotion regulation abilities can enhance adolescent weight control interventions.