Influence of maternal reflective functioning on mothers’ and children's weight: A follow‐up study

Abstract

Based on cross-sectional research linking poor reflective functionining (RF) to eating disorders, the current follow-up study tested whether maternal RF would explain the variance of mothers' and children's weight beyond the effects of maternal emotional dysregulation. During pregnancy (Time 1 [T1]), 51 women were administered the Difficulties in Emotion Regulation Scale (DERS) and interviewed using the Adult Attachment Interview (AAI). Seven months after delivery (Time 2 [T2]), motherbaby dyads who remained in the study (n = 44) were videotaped (Feeding Scale) during their feeding interaction. Last (Time 3 [T3]), the weight of the 34 children who were still in the study was collected at 3 years of age. Maternal AAI-RF at T1 did not correlate with the DERS at T1 nor with the quality of the feeding interacions at T2. However, it correlated, significantly, with maternal body mass index (BMI) at T1, r = −.298, P = .034, and marginally significantly with baby's BMI at T3, r = −.296, P = .089. Moreover, multiple regression models showed a trend indicating that maternal AAI-RF might explain the variance of mothers' and children's weight beyond the effects of maternal emotional dysregulation. These findings suggest that working on maternal mentalization might contribute to helping prevent childhood obesity from pregnancy. K E Y W O R D Sfeeding interactions, mother-baby interations, obesity, reflective function RESUMEN Objetivo: con base en la investigación de naturaleza transversal que conecta el pobre funcionamiento con reflexión (RF) con los trastornos de alimentación, el presente estudio de seguimiento examinó si el RF materno podría explicar la variación del peso de las madres y de los niños más allá de los efectos de la desregulación emocional materna.Método: durante el embarazo (T1), a 51 mujeres se les administró la Escala de Regulación de las Dificultades en la Emoción (DERS) y se les entrevistó usando la Entrevista de la Afectividad Adulta (AAI). Siete meses después del parto (T2), las díadas mamá-bebé que permanecían en el estudio (n = 44) fueron grabadas en video (Escala de Alimentación) durante su interacción de alimentación. Por último (T3), se determinó el peso de los 34 niños que aún estaban en el estudio a los tres años de edad.Resultados: la información materna de AAI-RF al T1 no se correlacionó con DERS al T1, ni tampoco con la calidad de las interacciones de alimentación al T2. Sin embargo, sí se correlacionó, significativamente, con BMI materno al T1 (r = −.298, p = .034), y marginalmente significativo, con el BMI del bebé al T3 (r = −.296, p = .089). Es más, los modelos de regresión múltiple mostraron una tendencia indicando que la AAI-RF materna pudiera explicar la variación del peso de las madres y de los niños más allá de los efectos de la desregulación emocional materna.Conclusiones: estos resultados sugieren que trabajar en la mentalización materna pudiera contribuir a ayudar a prevenir la obesidad en la niñez desde el embarazo. PA L A B R A S C L AV E Sfunción de reflexión, obesidad, interacc...

Relation between Attachment and Obesity in Preschool Years: A Systematic Review of the Literature

“…Five studies were cross-sectional and three studies were longitudinal. Across studies, the total number of participants showed great variability, with a sample size ranging from 51 [76] to 6650 participants [24]. Regarding the participating children's gender, four studies included more girls than boys, two studies included more boys, and two studies did not report on gender.…”

“…Four studies [28,72,76,77] examined adult attachment, three studies [24,25,29] examined caregiver-child attachment and one study [78] assessed both adult attachment and caregiver-child attachment. The studies used psychometrically valid measures to assess attachment, conceptualized as either dimensional scores of attachment (n = 8), or categorical, in terms of a specific attachment style (n = 2).…”

Obese Adolescents Have Reduced Mentalizing Ability

“…Although reflective function (RF), a highly complex mental process, is acquired after the ability to regulate emotions, these two abilities are considered to be evolutionarily interrelated [49]. Moreover, the ability to reflect on mental states enables one to communicate with their emotions in new ways [50].…”

“…In addition to predicting the development of ED symptoms [42,51], degree of mentalization has been associated with the formation of physical complaints and somatization [48,52,53] that have been identified as potential core predictors of obesity [54][55][56]. Numerous studies have confirmed the existence of insecure attachment and impaired RF in people with EDs [50,[57][58]. The prevalence of insecure attachment among obese patients is also reported to be higher than the general population [59][60].…”

“…It was suggested in one study [56] that obese patients appeared to have difficulty in reflecting on their conditions or identifying the obesity-induced impacts on their personal and social adjustment, and it was hypothesized that the capacity of obese individuals to self-monitor might be impaired owing to low reflective function [56]. Impaired mothers' RF was also predictive of children's obesity [61][62]. In one study [63] overweight women both with and without BED showed reduced reflective function, while other studies have studied RF in obesity associated with EDs, and the study of RF among the non-Eating Disordered obese population is a neglected area of research.…”