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Improving Emotion Regulation Skills Among Adolescents Attempting to Lose Weight

13 ottobre 2020 aggiornato da: Rhode Island Hospital

Enhancing Emotion Regulation Among Overweight and Obese Adolescents Attempting to Lose Weight

While the prevalence of overweight and obesity among children and adolescents has plateaued, national data indicate that approximately 35% of children and adolescents continue to struggle with overweight/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 and limited impact of adolescent weight control interventions which may be attributable to the failure of these interventions to explicitly address emotion regulation abilities that are necessary for weight loss. Notably, adolescents with poorer general emotion regulation have been found to consume more snack/junk food and report greater amounts of sedentary behavior. Poor emotion regulation among adolescents has also been associated with more rapid weight gain and greater BMI. This project adapts a previously validated Emotion Regulation intervention (TRAC) for at-risk adolescents, targeting sexual risk reduction, to focus on weight loss among a sample of overweight and obese adolescents (ages 12 to 18). While sexual risk and weight management are distinct health behaviors, this same model of emotion regulation could be applied to overweight/obese adolescents attempting to lose weight. In fact, data from overweight/obese adolescents attending a past outpatient weight management program (N=124) indicate that 82% of these youth report emotion regulation scores that are comparable to youth with significant mental health problems. Furthermore, higher levels of emotional dysregulation was associated with greater BMI within this same sample. These data suggest that emotion regulation is related to health decision making and will be relevant to the majority of overweight/obese adolescents seeking to lose weight. The current study will be carried out across Phase 1a and 1b. During Phase 1a, the initial acceptability and feasibility of the adapted intervention (HEALTH TRAC) with eight adolescents in an open pilot trial will be evaluated. During Phase 1b, 48 adolescents between the ages of 13-17 years will be randomized to receive either the HEALTH TRAC or standard behavioral weight control intervention (SBWC) and examine the impact on emotion regulation abilities and BMI status over an eight-month period. The information gained in this project will improve understanding of strategies to improve weight loss outcomes among overweight/obsess adolescents and how improving emotion regulation abilities can enhance these interventions.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Effettivo)

41

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Stati Uniti
    • Rhode Island
      • Providence, Rhode Island, Stati Uniti, 02903
        • Coro Building

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 13 anni a 17 anni (Bambino)

Accetta volontari sani

Sì

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • 13-17 years of age
  • > 85th percentile for BMI but < a BMI of 50
  • speak English
  • agree to participation and randomization

Exclusion Criteria:

  • they are currently in another weight loss program
  • have a medical condition that precludes participation in physical activity or adherence to dietary recommendations
  • are developmentally delayed such that the intervention will not be appropriate
  • are in treatment for a major psychiatric disorder.
  • cannot understand English

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Separare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: SBWC+ER
Participants randomized to the Standard Behavioral Weight Control and Emotional Regulation (SBWC+ER) condition receive a 14-session intervention that is comprised of 12 consecutive weekly sessions and 2 booster sessions delivered at weeks 14 and 16. They receive the same information as the Standard Behavioral Weight Control group, but weekly sessions also include elements of TRAC, and it is designed to help teach emotion regulation skills to decrease overeating and sedentary behaviors and increase the likelihood of maintaining diet and exercise behaviors that are taught as part of SBWC interventions.
Comportamentale: ER
Emotion regulation content
Comportamentale: SBWC
Comparatore attivo: SBWC
Participants randomized to the Standard Behavioral Weight Control (SBWC) condition receive a 14-session intervention that is comprised of 12 consecutive weekly sessions and 2 booster sessions delivered at weeks 14 and 16. The intervention includes a dietary plan, a fitness plan, behavioral weight control management that includes self-monitoring, goal-setting, stimulus control strategies, and planning, as well as parental involvement.
Comportamentale: SBWC

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
BMI decrease
Lasso di tempo: baseline, 4 months, and 8 month follow up
A significant decrease in participant BMI due to weight loss
baseline, 4 months, and 8 month follow up

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Emotion Regulation
Lasso di tempo: baseline, 4 month, and 8 month follow up
Difficulties in Emotion Regulation Scale (DERS)- a 36-item questionnaire designed to assess multiple aspects of emotion regulation (scale: 1 strongly disagree- 5 strongly agree). Measure yields a total score as well as six scales derived through factor analysis: (1. Nonacceptance of emotional response, 2. Difficulties engaging in goal directed behavior [goals], 3. Impulse control difficulties [impulse], 4. Lack of emotion awareness [awareness], 5. Limited access to emotion regulation strategies [strategies] 6. Lack of emotional clarity [clarity] ).
baseline, 4 month, and 8 month follow up
Emotion Regulation Strategy Usage
Lasso di tempo: baseline, 4 month, and 8 month follow up
Emotion Regulation Behavior Scale (ERBS)- assesses use of emotion regulation strategies taught in intervention. items include "in the last week, when you were having a strong feeling (e.g., sad, upset, etc.) how often did you...get away from whatever was causing your feeling?..."participants respond on a scale of 1 (never) to 5 (all the time) across 8 items, with higher scores indicating more regulatory behaviors (range: 8-40)
baseline, 4 month, and 8 month follow up
Emotion Regulation
Lasso di tempo: baseline, 4 month, and 8 month follow up
Affect Dysregulation Scale (ADS)- 24 item scale adapted from the clinician-rated Affect Regulation and Experience q-sort questionnaire, modified with 6-items used to assess frequency of difficulty with affect regulation on 4-point Likert, with higher scores indicating more difficulty with affect (range: 6-36)
baseline, 4 month, and 8 month follow up
Emotion Regulation
Lasso di tempo: baseline, 4 month, and 8 month follow up

Toronto Alexithymia Scale (TAS)- "20 item instrument that is one of the most commonly used measures of alexithymia. Alexithymia refers to people who have trouble identifying and describing emotions and who tend to minimize emotional experience and focus attention externally.

3 subscales: 1-difficulty describing emotions (5 items-2,4,11,12,17), 2- difficulty identifying emotions (7 items-1,3,6,7,9,13,14), and 3- the tendency of individuals to focus their attention externally (8 items-5,8,10,15,16,18,19,20) "

(Likert scale: 1 completely disagree - 5 completely agree) (Total range: 20-200)
baseline, 4 month, and 8 month follow up
Distress Tolerance
Lasso di tempo: baseline and 4 months
Behavior Indicator of Resiliency to Distress (BIRD)- Manipulation/measure of distress-tolerance. The first level of the BIRD test lasts 3 minutes. The level begins with a 5 second latency between dot presentations and changes this latency based on performance (correct answers will reduce the latency by 0.5 seconds whereas incorrect answers or non-responses increase the latency by 0.5 seconds). At the conclusion of this level an average latency is calculated to index skill level. The second level lasts five total minutes. Following a brief rest period the final level begins and lasts for 5 minutes. At all points in the final level the participant will have an escape option. The "quit game" on the screen can be clicked at any time. Therefore making the total time for this game roughly 10-15 minutes long. (Amstadter et al, 2011)
baseline and 4 months
Emotion Regulation
Lasso di tempo: baseline, 4 month, and 8 month follow up
Emotions as a Child scale- "examines parental emotional socialization from both parent and child perspectives across 45-items. This measure generates 5 subscales of emotion socialization including parental encouragement of emotion expression, parental punishing of responses, parental neglect, parental matching, and parental overriding of child's emotions. Reliability of subscales range from .80 to .87"
baseline, 4 month, and 8 month follow up
Emotion Regulation
Lasso di tempo: baseline, 4 month, and 8 month follow up
Emotion Regulation Checklist (ERC)- "is an instrument for the hetero-evaluation of the level of emotion regulation of children by means of two scales, Emotion Regulation (ER) and Emotional Lability/ Negativity. 24 items that are assessed on a four point Likert scale (1=never, 2=sometimes, 3=often, and 4= almost always). The ERC comprises two scales: one scale contains 8 items to assess ER, while the other scale contains 15 items that measure emotional liability/negativity, including lack of flexibility, emotional activation, reactivity, anger dysregulation, and mood reliability. (L/N α = .96; ER α = .83), and the two scales are significantly correlated (r = -.50, p < .001). One single measurement of ER is generated from the overall scores in both sub-scales (α = .89; Shields & Cicchetti, 1997)."
baseline, 4 month, and 8 month follow up
Emotional Eating
Lasso di tempo: baseline, 4 month, and 8 month follow up
Emotional Eating Scale (EES)- "25 item self report measure used to assess the propensity to cope with negative affect by eating. Subjects rate their desire to eat in response to each emotion on 5 point scale from "1"I have no desire to eat"" through "5"I have a very strong desire to eat""" (Range 25- 125, with higher scores indicating more coping with affect by eating)
baseline, 4 month, and 8 month follow up
Eating Disorders
Lasso di tempo: baseline, 4 month, and 8 month follow up
Eating Disorder Examination Questionnaire (EDEQ)- " 28 item questionnaire that has 2 additional questions for males and 5 additional questions for females. Used to measure eating disorder psychopathology, with higher scores indicating higher eating disorder psychopathy. Provides a measure of the range and severity of eating disorder features. Also has the ability to generate operational eating disorder diagnoses. Used to screen potential participants [Subscales: Restraint (items 1,2,3,4,5), Eating concern (items 7,9,19,20,21), Shape concern (items 6,8,10,11,23,26,27,28), Weight Concern (8,12,22,24,25) ]
baseline, 4 month, and 8 month follow up
Eating Habits Confidence
Lasso di tempo: baseline to 8 months
Eating Habits Confidence Questionnaire (EHCQ)- "27-item scale questionnaire asks participants to rate confidence in their ability to adhere to specific dietary behaviors. Response set consisted of a 5 point-linkert type scale ranging from 1, ""I know I cannot"" to 5, ""I know I can."" Possible scores of this survey range from 27 to 135, with higher scores indicating higher self-efficacy.
baseline to 8 months
Eating Behavior
Lasso di tempo: baseline, 4 months, and 8 months
Eating Behaviors Inventory- "Instrument for assessing behaviors that have been theoretically implicated in weight loss (self monitoring of food intake and of weight, refusing offers of food, eating at only one place, shopping from a list) 30 items are included that are each rate with a 5 point scale according to how often it was true for the respondent. Items were scored such that the higher scores always reflected more appropriate eating patterns." (Total range: 30- 150)
baseline, 4 months, and 8 months
Accelerometer (physical activity)
Lasso di tempo: baseline and 4 months
Majority of studies say at least 5 days per week for at least 8 hours per day to receive accurate data on PA. Device used to measure physical activity using criteria such as time spent in activities performed for various intensities and for the prediction of energy expenditure.
baseline and 4 months

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Rhode Island Hospital

Investigatori

  • Investigatore principale: Wendy Hadley, PhD, University of Oregon

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

1 dicembre 2016

Completamento primario (Effettivo)

1 giugno 2019

Completamento dello studio (Effettivo)

1 luglio 2019

Date di iscrizione allo studio

Primo inviato

11 dicembre 2017

Primo inviato che soddisfa i criteri di controllo qualità

5 gennaio 2018

Primo Inserito (Effettivo)

8 gennaio 2018

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

19 ottobre 2020

Ultimo aggiornamento inviato che soddisfa i criteri QC

13 ottobre 2020

Ultimo verificato

1 maggio 2019

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • 1R21DK108164-01A1 (Sovvenzione/contratto NIH degli Stati Uniti)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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