Research report

Associations between child emotional eating and general parentingstyle feeding practices and parent psychopathologyAbby Braden a Kyung Rhee a Carol B Peterson b Sarah A Rydell c Nancy Zucker deKerri Boutelle af

a Department of Pediatrics University of California San Diego CA USAb Department of Psychiatry University of Minnesota Minneapolis MN USAc School of Public Health University of Minnesota Minneapolis MN USAd Psychiatry and Behavioral Science Duke University School of Medicine Durham NC USAe Psychology and Neuroscience Department Duke University Durham NC USAf Department of Psychiatry University of California San Diego CA USA

A R T I C L E I N F O

Article historyReceived 14 July 2013Received in revised form 17 March 2014Accepted 11 April 2014Available online 26 April 2014

KeywordsEmotional eatingParentingChild obesity

A B S T R A C T

Emotional eating is the tendency to eat in response to negative emotions Prior research has identified arelationship between parenting style and child emotional eating but this has not been examined in clin-ical samples Furthermore the relationship between specific parenting practices (eg parent feeding prac-tices) and child emotional eating has not yet been investigated The current study examined relationshipsbetween child emotional eating and both general and specific parenting constructs as well as maternalsymptoms of depression and binge eating among a treatment-seeking sample of overweight childrenParticipants included 106 motherndashchild dyads who attended a baseline assessment for enrollment in abehavioral intervention for overeating Ages of children ranged from 8 to 12 years old Mothers com-pleted self-report measures of their childrsquos emotional eating behavior their own feeding practices andsymptoms of depression and binge eating Children completed a self-report measure of their mothersrsquogeneral parenting style A stepwise regression analysis was conducted to identify the parent variable thatwas most strongly related to child emotional eating controlling for child age and gender Emotional feedingbehavior (ie a tendency to offer food to soothe a childrsquos negative emotions) was the parent factor mostsignificantly related to child emotional eating Findings suggest that emotional feeding practices in parentsmay be related to emotional eating in children Treatment with overweight children who engage in emo-tional eating may be improved by targeting parent feeding practices

copy 2014 Elsevier Ltd All rights reserved

Introduction

Emotional eating or eating in response to negative emotionalstates has been identified as an ldquoobesogenicrdquo trait that contrib-utes to weight gain and ultimately obesity (Croker Cooke amp Wardle2011) in both children (Braet amp Van Strien 1997) and adults (Geliebteramp Aversa 2003) In one sample of children enrolled in a healthyeating and activity intervention 63 endorsed emotional eating(Shapiro et al 2007) Children who eat for emotional reasons mayeat in response to feelings of anger anxiety frustration or depres-sion (Tanofsky-Kraff et al 2007) and emotional eating may func-tion as an ldquoescaperdquo from negative affect (Heatherton amp Baumeister1991) Emotional eating appears to be associated with overeating(Van Strien Engels Van Leeuwe amp Snoek 2005) and eating foods

high in energy density (Nguyen-Michel Unger amp Spruijt-Metz 2007)among adolescents Among children emotional eating is associ-ated with eating in the absence of hunger (Moens amp Braet 2007)and loss of control eating a symptom of eating disorder psycho-pathology (Goossens Braet Van Vlierberghs amp Mels 2009) Despitethis the relationship between emotional eating and weight statusamong children is unclear A comparison of emotional eating amongsamples of underweight normal weight overweight and obese chil-dren indicated that emotional eating was most prevalent in the obeseclinical sample (Croker et al 2011) Other studies have confirmeda significant positive relationship between emotional eating and BMIin children (Braet amp Van Strien 1997 Webber Hill Saxton VanJaarsveld amp Wardle 2008) however this relationship was not sup-ported in two additional samples (van Strien amp Bazelier 2007 vanStrien amp Oosterveld 2008)

Since parents are the primary socialization agents of their chil-dren it seems likely that aspects of parent behavior may be relatedto emotional eating in children Substantial evidence indicates that

Corresponding authorE-mail address abradenucsdedu (AL Braden)

httpdxdoiorg101016jappet2014040170195-6663copy 2014 Elsevier Ltd All rights reserved

Appetite 80 (2014) 35ndash40

Contents lists available at ScienceDirect

Appetite

journal homepage wwwelseviercom locate appet

parenting has a powerful impact on child body weight food choicesand physical activity (Sleddens Gerards Thijs de Vries amp Kremers2011) in addition to genetic factors that influence weight status andeating Recent research has emphasized the importance of exam-ining parenting and obesity-related behaviors in children (Poweret al 2013) In this literature distinctions have been made betweengeneral parenting styles and specific feeding practices (PatrickHennessy McSpadden amp Oh 2013) General parenting styles de-scribe how parents interact with their children (eg level of warmthacceptance and control) and specific feeding practices address whatparents do to influence their childrenrsquos eating behavior (eg lim-iting sweets) Among children emotional eating may be related toboth general parenting style and specific feeding practices

Three previous studies have examined the relationship betweenchild emotional eating and parenting style all in nonclinical samplesof children Among children aged 8ndash11 children who endorsed emo-tional eating tended to perceive their parents as ldquodisregardingrdquo andtheir relationship with their parents as ldquocontradictoryrdquo (SchuetzmanRichter-Appelt Schulte-Markwort amp Schimmelmann 2008) Tophamet al (2011) found that parents who tended to minimize their chil-drenrsquos negative emotions (eg ldquoI tell my child not to make a big dealout of missing the partyrdquo) were likely to have children who wereengaging in emotional eating Similarly among Dutch adoles-cents emotional eating was related to low maternal support highpsychological control and high behavioral control (Snoek EngelsJanssens amp Van Strien 2007) Although these three studies supportthe potential impact of general parenting style on emotional eatingin nonclinical samples of children examination of parenting styleand emotional eating in a treatment-seeking overweight sampleof children has not been conducted

In addition to general parenting style emotional eating in chil-dren may be related to specific feeding practices Parenting prac-tices related to childrenrsquos eating behaviors (ie feeding practices)have been investigated as relevant factors associated with childweight and eating habits (Hurley Cross amp Hughes 2011) Al-though parents may be well-intentioned certain feeding practicesmay inadvertently promote child weight gain by removing the childrsquosopportunity to learn to eat based on physical cues of hunger andsatiety (Birch amp Fisher 1998) For example using food as a rewardto shape a childrsquos behavior (eg offering a cookie if the child eatseverything on the dinner plate) may decrease the childrsquos ability toself-regulate hisher intake based on satiety and rely instead on ex-ternal cues of when and what to eat (Birch Birch Marlin amp Kramer1982 Birch McPhee Shoba Steinberg amp Krehbiel 1987 Newmanamp Taylor 1992) Furthermore children whose parents offer food asan emotional regulation strategy may be prone to overeating Resultsfrom an experimental study showed that children whose mothersoffered food for emotion regulation consumed more cookies in a labparadigm as compared with children whose mothers did not useemotional feeding practices (Blissett Haycraft amp Farrow 2010) Inthese circumstances it is possible that children could learn to as-sociate food with pleasure potentially leading to an increased re-liance on food as an emotion regulation strategy and a decreasedtendency to eat based on nutritional needs

Another parent-related factor that may be associated with emo-tional eating in children is maternal psychopathology Maternal psy-chopathology significantly impacts child development includingchild behavioral and emotional functioning (Goodman et al 2011)and child eating behaviors more specifically Maternal psychopa-thology including eating disorders depression and anxiety is as-sociated with child feeding problems (Coulthard Blissett amp Harris2004 Coulthard amp Harris 2003) and this relationship has been foundin children as young as age 4 (Whelan amp Cooper 2000) Specificeating disorder symptoms including maternal disinhibited eatinghunger body dissatisfaction bulimic symptoms restraint and drivefor thinness are associated with child eating behavior in the first 5

years of life (Stice Agras amp Hammer 1999) Similarly overeatingbehavior in mothers (eg binge eating and night eating) has beenfound to be significantly related to unhealthy eating patterns in chil-dren including binge eating and night eating (Lamerz et al 2005)Furthermore observed rates of maternal psychopathology are highin samples of obese treatment-seeking children For example in onesample of obesity treatment-seeking families 25 of the mothersendorsed moderate levels of binge eating (Epstein Myers ampAnderson 1996) while in another sample 8 of mothers en-dorsed high levels of depression (Epstein et al 1996) Interest-ingly maternal depression and binge eating were more stronglyassociated with child psychosocial functioning than the childrsquos over-weight status (Epstein et al 1996) Given the association betweenmaternal psychopathology and general child feeding problems andthe high rates of maternal binge eating and depression in samplesof overweight children maternal psychopathology may also be animportant factor related to child emotional eating Children who areexposed to psychopathology in their parents may observe parentseating in response to their own negative emotions contributing tochild emotional eating and eventual overweight

Given the high rates of emotional eating in treatment-seekingoverweight samples of children and its association with other eatingdisorder behaviors there is a need to further evaluate factors thatmay be related to its development To date there is no publishedresearch that examines child emotional eating and general parent-ing style in a clinical sample of overweight children Additionallyprior research has not investigated the relationship between childemotional eating and specific parent feeding practices as well asparent psychopathology Based on these gaps in the literature theprimary aim of the present study is to 1) Identify the parent vari-able (ie general parenting style parent feeding practices and ma-ternal binge eating and depression) that is most strongly related tochild emotional eating Clarification of parent-level factors that areassociated with child emotional eating may highlight interventionand prevention targets

Method

Participants

Participants included 106 motherndashchild dyads who were part ofa larger sample (n = 117) of parentndashchild dyads who attended a base-line assessment for enrollment in a behavioral intervention for over-eating (NCT01442142) (Boutelle et al 2011) In the present studyparentndashchild dyads with a participating father (n = 11) were ex-cluded in order to control for any effects of parent gender Ages ofthe children ranged from 8 to 12 years Participants were re-cruited from Minneapolis Minnesota with the use of direct mail-ings media announcements advertisements and physician referralsAfter completing an initial phone screen potential participants wereinvited to attend the baseline assessment if the parent reported thattheir child was overweight or obese (BMI percentile gt 85th) andhad high eating in the absence of hunger (Boutelle et al 2011 2014)Eating in the absence of hunger was screened over the phone byasking the parent two questions 1) ldquoImagine your child just fin-ished a meal How often does your child start or keep eating becausethe food looks tastes or smells so goodrdquo 2) ldquoAfter a full meal howoften does your child start or keep eating because others are stilleatingrdquo These questions were borrowed from a parent self-reportversion of the Eating in the Absence of Hunger Questionnaire(Shomaker et al 2010) Exclusion criteria included concurrent en-rollment in a weight loss program use of medications that affect-ed appetite and the presence of a psychiatric diagnosis that couldinterfere with treatment (eg eating disorder substance depen-dence) The study was approved by the University of Minnesota

36 A Braden et alAppetite 80 (2014) 35ndash40

Institutional Review Board Parents provided written informed con-sents and children provided assents

Measures

AnthropometryStandardized measurement procedures were implemented Chil-

drenrsquos weight were measured using a calibrated scale and heightwas measured with a standard stadiometer Height and weight weremeasured in duplicate and an average measurement for each wascalculated Body mass index (BMI) percentile scores based on thechildrsquos gender and age were calculated using recommendations fromthe Center for Disease Control growth charts (Kuczmarski et al2000)

DemographicsDemographic information was collected for each parentndashchild

dyad participating in the study including ethnicity marital statusparent education and income level

Measures completed by the parent

Emotional Overeating Subscale of the Child Eating BehaviorQuestionnaire (CEBQ)

The Emotional Overeating Subscale of the Child Eating Behav-ior Questionnaire (CEBQ Wardle Guthrie Sanderson amp Rapoport2001) was used to assess child emotional eating The CEBQ is a 35-item parent-report measure that was designed to measure individ-ual differences in child eating behaviors The CEBQ has demonstratedgood internal consistency and testndashretest reliability (Wardle et al2001) The CEBQ yields eight subscales representing eating stylespurported to contribute to underweight and overweight The Emo-tional Overeating Subscale is comprised of the mean of four itemsand item scores range from never (1) to always (5) Sample itemsinclude ldquomy child eats more when worriedrdquo and ldquomy child eats morewhen annoyedrdquo The Emotional Overeating Subscale is signifi-cantly related to higher BMI z-scores among children (Viana Sindeamp Saxton 2008) and has demonstrated stability throughout child-hood (Ashcroft Semmler Carnell van Jaarsveld amp Wardle 2008)In the current study Cronbachrsquos alpha for the emotional eatingsubscale was 75

Parent Feeding Style Questionnaire (PFSQ)The Parent Feeding Style Questionnaire (PFSQ Wardle Sanderson

Guthrie Rapoport amp Plomin 2002) is a 27-item parent-reportmeasure that assesses parent feeding practices The PFSQ includesfour subscales control over eating (eg ldquoI decide how many snacksmy child should haverdquo) promptingencouragement (eg ldquoI praisemy child if heshe eats a new foodrdquo) instrumental feeding (eg ldquoIreward my child with something to eat when heshe is wellbehavedrdquo) and emotional feeding (eg ldquoI give my child some-thing to eat to make himher feel better when heshe has been hurtrdquo)Response options include ldquoI never do I rarely do I sometimes doI often do and I always dordquo and scores range from 1 to 5 with higherscores reflecting a higher frequency of the feeding behavior occur-ring The PFSQ has demonstrated adequate internal consistency andtestndashretest reliability (Carnell amp Wardle 2007 Wardle et al 2002)In the current study PFSQ subscales demonstrated good internal con-sistency emotional feeding α = 88 instrumental feeding α = 78control α = 76 and encouragement α = 76

Center for Epidemiologic Studies of Depression Scale (CES-D)The Center for Epidemiologic Studies of Depression Scale (CES-

D Radloff 1977) is a widely used self-report measure of depres-sion that was administered to parents in the current study The CES-Dincludes 20-items evaluating feelings and behaviors from the past

week including ldquoI thought my life had been a failurerdquo and ldquoI feltlonelyrdquo Response options range from ldquorarely or none of the timerdquoto ldquoall of the timerdquo Higher scores indicate greater symptoms of de-pression In the present sample internal consistency for the CES-Dwas good α = 87

Binge Eating Scale (BES)The Binge Eating Scale (BES Gormally Black Daston amp Rardin

1982) is a 16-item measure that evaluates behaviors thoughts andfeelings associated with a binge episode In the present study theBES was administered to parents to evaluate symptoms associatedwith binge eating disorder Possible scores range from 0 to 46 withhigher scores indicating more severe symptoms of binge eating TheBES has demonstrated good interrater reliability distinguishingbetween groups classified by trained interviewers as having no symp-toms of binge eating (scores lt17) moderate binge eating (scores ge18and le26) and severe binge eating (scores ge27 Gormally et al 1982)Higher scores on the BES are significantly related to higher levelsof psychiatric symptoms (Telch amp Agras 1994) Cronbachrsquos alpha forthe BES in the current sample was 89

Measures completed by the child

Child Report of Parent Behavior Inventory (CRPBI-30)The Child Report of Parent Behavior Inventory (CRPBI-30) is a 30-

item child self-report measure in which children endorse items thatdescribe parent behavior Children are asked to report on mothersand fathers separately In the present study children were askedto report parenting style as opposed to parents because child per-ceptions of parenting style are associated with child food and ac-tivity outcomes whereas parent perceptions of parenting style arenot (Taylor Wilson Slater amp Mohr 2011) The scale was adapted fromthe original 108-item original measure (Schludermann ampSchludermann 1988) The first subscale Psychological Control versusPsychological Autonomy measures the degree to which a parentemploys guilt love withdrawal avoidance and other psychologi-cal methods with the intent to control child behaviors The paren-tal Acceptance versus Rejection subscale evaluates child perceptionof the parentndashchild relationship along those domains The thirdsubscale Firm versus Lax Control examines the level of parental in-volvement and influence that parents have in the childrsquos life Inter-nal consistency was adequate for all three subscales in the presentsample psychological control vs psychological autonomy α = 79acceptance vs rejection α = 85 firm control vs lax control α = 79Responses range on a three-point scale from ldquonot likerdquo to ldquoa lot likerdquoto describe how closely the statement matches the parentrsquos behav-ior The CRPBI has adequate testndashretest reliability and construct va-lidity (Collins amp Repinski 1990 Schludermann amp Schludermann1988) Previous investigations have used the CRPBI-30 in samplesof children aged 7ndash15 (Yeganeh Beidel amp Turner 2006) and 8ndash10(Ryan Schechter amp Brennan 2012)

Procedures

After completing the initial phone screen motherndashchild dyadswere scheduled for an on-site assessment to provide informedconsent and evaluate eligibility for the intervention The on-site as-sessment consisted of anthropometric measures interviews self-report questionnaires and behavioral tasks Mothers and childrencompleted computer versions of the self-report questionnaires

Statistical analyses

Descriptive statistics were initially calculated to examine sampledemographics and means and standard deviations for study mea-sures Correlations and t-tests were used to examine associations

37A Braden et alAppetite 80 (2014) 35ndash40

between child emotional eating and demographic characteristicsin order to identify variables to control for in the regression modelsNext intercorrelations were calculated between parenting con-structs to examine whether any variables were correlated above 7Due to the high intercorrelation between emotional feeding and in-strumental feeding instrumental feeding was not included in thefinal regression analysis A stepwise regression model was per-formed to identify the parent variables most significantly associ-ated with child emotional eating controlling for child age and genderThe criterion for statistical significance was set at P lt 05 All cal-culations were performed using SPSS 200 (wwwSPSScom)

Results

Preliminary analyses examined characteristics of the studysample Just over half of the child participants were female (547)with an average age of 1034 (SD = 131) years and BMI percentileof 9726 (SD = 244) The majority (708) of participating mothersidentified themselves as white and married or partnered (67) Overhalf (594) of the mothers stated that they had a bachelorrsquos degreeor higher Approximately half of the mothers reported a yearly house-hold income below 75000 dollars 396 reported a yearly house-hold income of ge75000 dollars and 760 did not report incomedata Average BMI of participating mothers was 3161 (SD = 707)Most (6923) mothers denied binge eating symptoms almost one-quarter (2308) endorsed moderate binge eating symptoms andfew (769) reported severe symptoms of binge eating

Means and standard deviations were calculated for study mea-sures (see Table 1) Next we evaluated associations between childemotional eating and demographics (child BMI percentile agegender parent BMI) Emotional eating was significantly related toolder age (r = 20 P lt 05) Emotional eating was not significantlyrelated to child BMI percentile (r = minus03 P = 73) or parent BMI (r = 13P = 19) Parents were significantly more likely to endorse emotion-al eating in girls (M = 291 SD = 76) as opposed to boys (M = 255SD = 70 t(104) = minus249 P = 01) Intercorrelations were also calcu-lated between parenting constructs Emotional feeding and instru-mental feeding were highly correlated (r = 72 P lt 001)

A stepwise regression analysis was calculated to examine asso-ciations between general parenting style feeding practices mater-nal psychopathology and child emotional eating controlling for childage and gender The final model from the stepwise analysis in-cluded two predictor variables emotional feeding and child genderEmotional feeding behavior accounted for 148 (Adjusted R2 = 15)of the variance in child emotional eating The inclusion of childgender added an additional 57 of the variance (R2 change = 06)The final model that included emotional feeding and child genderaccounted for 195 (Adjusted R2 = 20) of the variance in child emo-tional eating which was significant (F = 1094 P = 00) Significant vari-ables are shown in Table 2

Discussion

The current study examined associations between child emo-tional eating and general parenting style maternal feeding prac-tices and maternal psychopathology in a sample of overweighttreatment-seeking children When all relevant variables were enteredinto a regression model controlling for child age and gender an emo-tional feeding style was the only parent factor significantly associ-ated with child emotional eating

The present study builds on previous literature by examining as-sociations between child emotional eating general and specific par-enting constructs and maternal psychopathology in a clinical sampleof overweight children In the regression analysis after control-ling for child age and gender emotional feeding was the parent-related variable most significantly associated with child emotionaleating Previous research has found similar relationships betweenemotional feeding practices and child eating behavior as well In asample of 6 to 7-year-old Dutch children an emotional feeding stylewas related to increased snacking in children (Sleddens KremersDe Vries amp Thijs 2010) In another sample of 3- to 5-year-old chil-dren emotional feeding predicted consumption of more cookies inthe eating in the absence of hunger paradigm and consumption waseven greater when the child experienced a negative mood induc-tion (Blissett et al 2010) These studies suggest that parents whooffer food to soothe their childrenrsquos emotions may be unintention-ally teaching them to eat food when they are not physically hungrythereby contributing to weight gain Our study extends these pre-vious findings by demonstrating that emotional feeding practicesin mothers may be closely related to emotional eating behaviors inchildren after accounting for additional parent factors known to beassociated with child eating disturbances (ie depression and bingeeating) (Coulthard et al 2004 Coulthard amp Harris 2003) Our find-ings suggest that parent emotional feeding practices are closelylinked with a childrsquos tendency to use food to soothe emotions It ispossible that children who are most susceptible to the immediatemood enhancing effect of food elicit and reinforce emotional feedingbehaviors in their parents Thus parents may learn that their childis highly motivated to obtain food for pleasure or that food has acalming effect on the child resulting in increased reliance on en-couraging food when the child is distressed Nevertheless our find-ings suggest that it may be useful for parents to modify their useof emotional feeding strategies given its relationship with child emo-tional eating However longitudinal studies are needed to examinethe causal pathway linking child emotional eating and parent emo-tional feeding style particularly since the findings of the currentstudy are based on cross-sectional data

In the current study child emotional eating was not associatedwith general parenting style The lack of association between childemotional eating and parenting style is somewhat surprising giventhat previous studies have demonstrated a relationship between emo-tional eating and general parenting styles as reported by both chil-dren (Schuetzman et al 2008 Snoek et al 2007) and parents(Topham et al 2011) However most of these studies were con-ducted in nonclinical samples of children who were normal weightto obese Thus parenting style may be highly relevant to child eatingbehavior among community samples of children but less so amongtreatment-seeking populations Present findings provide further

Table 1Means and standard deviations for study measures

Measure M SD

Emotional Overeating Subscale of the CEBQ 275 75Center for Epidemiologic Studies of Depression Scale (CES-D) 1150 900Binge Eating Scale (BES) 1288 853Parent Feeding Style Questionnaire

Control feeding 480 341PromptingEncouragement feeding 342 62Instrumental feeding 646 235Emotional feeding 839 304

Child Report of Parent Behavior Inventory (CRPBI-30)Psychological control vs autonomy 2237 447Parental acceptance vs rejection 1284 358Firm vs lax control 1914 330

Table 2Stepwise regression analysis examining relationships between child emotional eatingand parent variables controlling for child age and gender

Predictor variable B P

Emotional feeding 40 00Child gender 24 02

Note General child age parenting style maternal psychopathology and addition-al feeding variables were not significant in this model

38 A Braden et alAppetite 80 (2014) 35ndash40

Institutional Review Board Parents provided written informed con-sents and children provided assents

Measures

AnthropometryStandardized measurement procedures were implemented Chil-

drenrsquos weight were measured using a calibrated scale and heightwas measured with a standard stadiometer Height and weight weremeasured in duplicate and an average measurement for each wascalculated Body mass index (BMI) percentile scores based on thechildrsquos gender and age were calculated using recommendations fromthe Center for Disease Control growth charts (Kuczmarski et al2000)

DemographicsDemographic information was collected for each parentndashchild

dyad participating in the study including ethnicity marital statusparent education and income level

Measures completed by the parent

Emotional Overeating Subscale of the Child Eating BehaviorQuestionnaire (CEBQ)

The Emotional Overeating Subscale of the Child Eating Behav-ior Questionnaire (CEBQ Wardle Guthrie Sanderson amp Rapoport2001) was used to assess child emotional eating The CEBQ is a 35-item parent-report measure that was designed to measure individ-ual differences in child eating behaviors The CEBQ has demonstratedgood internal consistency and testndashretest reliability (Wardle et al2001) The CEBQ yields eight subscales representing eating stylespurported to contribute to underweight and overweight The Emo-tional Overeating Subscale is comprised of the mean of four itemsand item scores range from never (1) to always (5) Sample itemsinclude ldquomy child eats more when worriedrdquo and ldquomy child eats morewhen annoyedrdquo The Emotional Overeating Subscale is signifi-cantly related to higher BMI z-scores among children (Viana Sindeamp Saxton 2008) and has demonstrated stability throughout child-hood (Ashcroft Semmler Carnell van Jaarsveld amp Wardle 2008)In the current study Cronbachrsquos alpha for the emotional eatingsubscale was 75

Parent Feeding Style Questionnaire (PFSQ)The Parent Feeding Style Questionnaire (PFSQ Wardle Sanderson

Guthrie Rapoport amp Plomin 2002) is a 27-item parent-reportmeasure that assesses parent feeding practices The PFSQ includesfour subscales control over eating (eg ldquoI decide how many snacksmy child should haverdquo) promptingencouragement (eg ldquoI praisemy child if heshe eats a new foodrdquo) instrumental feeding (eg ldquoIreward my child with something to eat when heshe is wellbehavedrdquo) and emotional feeding (eg ldquoI give my child some-thing to eat to make himher feel better when heshe has been hurtrdquo)Response options include ldquoI never do I rarely do I sometimes doI often do and I always dordquo and scores range from 1 to 5 with higherscores reflecting a higher frequency of the feeding behavior occur-ring The PFSQ has demonstrated adequate internal consistency andtestndashretest reliability (Carnell amp Wardle 2007 Wardle et al 2002)In the current study PFSQ subscales demonstrated good internal con-sistency emotional feeding α = 88 instrumental feeding α = 78control α = 76 and encouragement α = 76

Center for Epidemiologic Studies of Depression Scale (CES-D)The Center for Epidemiologic Studies of Depression Scale (CES-

D Radloff 1977) is a widely used self-report measure of depres-sion that was administered to parents in the current study The CES-Dincludes 20-items evaluating feelings and behaviors from the past

week including ldquoI thought my life had been a failurerdquo and ldquoI feltlonelyrdquo Response options range from ldquorarely or none of the timerdquoto ldquoall of the timerdquo Higher scores indicate greater symptoms of de-pression In the present sample internal consistency for the CES-Dwas good α = 87

Binge Eating Scale (BES)The Binge Eating Scale (BES Gormally Black Daston amp Rardin

1982) is a 16-item measure that evaluates behaviors thoughts andfeelings associated with a binge episode In the present study theBES was administered to parents to evaluate symptoms associatedwith binge eating disorder Possible scores range from 0 to 46 withhigher scores indicating more severe symptoms of binge eating TheBES has demonstrated good interrater reliability distinguishingbetween groups classified by trained interviewers as having no symp-toms of binge eating (scores lt17) moderate binge eating (scores ge18and le26) and severe binge eating (scores ge27 Gormally et al 1982)Higher scores on the BES are significantly related to higher levelsof psychiatric symptoms (Telch amp Agras 1994) Cronbachrsquos alpha forthe BES in the current sample was 89

Measures completed by the child

Child Report of Parent Behavior Inventory (CRPBI-30)The Child Report of Parent Behavior Inventory (CRPBI-30) is a 30-

item child self-report measure in which children endorse items thatdescribe parent behavior Children are asked to report on mothersand fathers separately In the present study children were askedto report parenting style as opposed to parents because child per-ceptions of parenting style are associated with child food and ac-tivity outcomes whereas parent perceptions of parenting style arenot (Taylor Wilson Slater amp Mohr 2011) The scale was adapted fromthe original 108-item original measure (Schludermann ampSchludermann 1988) The first subscale Psychological Control versusPsychological Autonomy measures the degree to which a parentemploys guilt love withdrawal avoidance and other psychologi-cal methods with the intent to control child behaviors The paren-tal Acceptance versus Rejection subscale evaluates child perceptionof the parentndashchild relationship along those domains The thirdsubscale Firm versus Lax Control examines the level of parental in-volvement and influence that parents have in the childrsquos life Inter-nal consistency was adequate for all three subscales in the presentsample psychological control vs psychological autonomy α = 79acceptance vs rejection α = 85 firm control vs lax control α = 79Responses range on a three-point scale from ldquonot likerdquo to ldquoa lot likerdquoto describe how closely the statement matches the parentrsquos behav-ior The CRPBI has adequate testndashretest reliability and construct va-lidity (Collins amp Repinski 1990 Schludermann amp Schludermann1988) Previous investigations have used the CRPBI-30 in samplesof children aged 7ndash15 (Yeganeh Beidel amp Turner 2006) and 8ndash10(Ryan Schechter amp Brennan 2012)

Procedures

After completing the initial phone screen motherndashchild dyadswere scheduled for an on-site assessment to provide informedconsent and evaluate eligibility for the intervention The on-site as-sessment consisted of anthropometric measures interviews self-report questionnaires and behavioral tasks Mothers and childrencompleted computer versions of the self-report questionnaires

Statistical analyses

Descriptive statistics were initially calculated to examine sampledemographics and means and standard deviations for study mea-sures Correlations and t-tests were used to examine associations

37A Braden et alAppetite 80 (2014) 35ndash40

between child emotional eating and demographic characteristicsin order to identify variables to control for in the regression modelsNext intercorrelations were calculated between parenting con-structs to examine whether any variables were correlated above 7Due to the high intercorrelation between emotional feeding and in-strumental feeding instrumental feeding was not included in thefinal regression analysis A stepwise regression model was per-formed to identify the parent variables most significantly associ-ated with child emotional eating controlling for child age and genderThe criterion for statistical significance was set at P lt 05 All cal-culations were performed using SPSS 200 (wwwSPSScom)

Results

Preliminary analyses examined characteristics of the studysample Just over half of the child participants were female (547)with an average age of 1034 (SD = 131) years and BMI percentileof 9726 (SD = 244) The majority (708) of participating mothersidentified themselves as white and married or partnered (67) Overhalf (594) of the mothers stated that they had a bachelorrsquos degreeor higher Approximately half of the mothers reported a yearly house-hold income below 75000 dollars 396 reported a yearly house-hold income of ge75000 dollars and 760 did not report incomedata Average BMI of participating mothers was 3161 (SD = 707)Most (6923) mothers denied binge eating symptoms almost one-quarter (2308) endorsed moderate binge eating symptoms andfew (769) reported severe symptoms of binge eating

Means and standard deviations were calculated for study mea-sures (see Table 1) Next we evaluated associations between childemotional eating and demographics (child BMI percentile agegender parent BMI) Emotional eating was significantly related toolder age (r = 20 P lt 05) Emotional eating was not significantlyrelated to child BMI percentile (r = minus03 P = 73) or parent BMI (r = 13P = 19) Parents were significantly more likely to endorse emotion-al eating in girls (M = 291 SD = 76) as opposed to boys (M = 255SD = 70 t(104) = minus249 P = 01) Intercorrelations were also calcu-lated between parenting constructs Emotional feeding and instru-mental feeding were highly correlated (r = 72 P lt 001)

A stepwise regression analysis was calculated to examine asso-ciations between general parenting style feeding practices mater-nal psychopathology and child emotional eating controlling for childage and gender The final model from the stepwise analysis in-cluded two predictor variables emotional feeding and child genderEmotional feeding behavior accounted for 148 (Adjusted R2 = 15)of the variance in child emotional eating The inclusion of childgender added an additional 57 of the variance (R2 change = 06)The final model that included emotional feeding and child genderaccounted for 195 (Adjusted R2 = 20) of the variance in child emo-tional eating which was significant (F = 1094 P = 00) Significant vari-ables are shown in Table 2

Discussion

The current study examined associations between child emo-tional eating and general parenting style maternal feeding prac-tices and maternal psychopathology in a sample of overweighttreatment-seeking children When all relevant variables were enteredinto a regression model controlling for child age and gender an emo-tional feeding style was the only parent factor significantly associ-ated with child emotional eating

The present study builds on previous literature by examining as-sociations between child emotional eating general and specific par-enting constructs and maternal psychopathology in a clinical sampleof overweight children In the regression analysis after control-ling for child age and gender emotional feeding was the parent-related variable most significantly associated with child emotionaleating Previous research has found similar relationships betweenemotional feeding practices and child eating behavior as well In asample of 6 to 7-year-old Dutch children an emotional feeding stylewas related to increased snacking in children (Sleddens KremersDe Vries amp Thijs 2010) In another sample of 3- to 5-year-old chil-dren emotional feeding predicted consumption of more cookies inthe eating in the absence of hunger paradigm and consumption waseven greater when the child experienced a negative mood induc-tion (Blissett et al 2010) These studies suggest that parents whooffer food to soothe their childrenrsquos emotions may be unintention-ally teaching them to eat food when they are not physically hungrythereby contributing to weight gain Our study extends these pre-vious findings by demonstrating that emotional feeding practicesin mothers may be closely related to emotional eating behaviors inchildren after accounting for additional parent factors known to beassociated with child eating disturbances (ie depression and bingeeating) (Coulthard et al 2004 Coulthard amp Harris 2003) Our find-ings suggest that parent emotional feeding practices are closelylinked with a childrsquos tendency to use food to soothe emotions It ispossible that children who are most susceptible to the immediatemood enhancing effect of food elicit and reinforce emotional feedingbehaviors in their parents Thus parents may learn that their childis highly motivated to obtain food for pleasure or that food has acalming effect on the child resulting in increased reliance on en-couraging food when the child is distressed Nevertheless our find-ings suggest that it may be useful for parents to modify their useof emotional feeding strategies given its relationship with child emo-tional eating However longitudinal studies are needed to examinethe causal pathway linking child emotional eating and parent emo-tional feeding style particularly since the findings of the currentstudy are based on cross-sectional data

In the current study child emotional eating was not associatedwith general parenting style The lack of association between childemotional eating and parenting style is somewhat surprising giventhat previous studies have demonstrated a relationship between emo-tional eating and general parenting styles as reported by both chil-dren (Schuetzman et al 2008 Snoek et al 2007) and parents(Topham et al 2011) However most of these studies were con-ducted in nonclinical samples of children who were normal weightto obese Thus parenting style may be highly relevant to child eatingbehavior among community samples of children but less so amongtreatment-seeking populations Present findings provide further

Table 1Means and standard deviations for study measures

Measure M SD

Emotional Overeating Subscale of the CEBQ 275 75Center for Epidemiologic Studies of Depression Scale (CES-D) 1150 900Binge Eating Scale (BES) 1288 853Parent Feeding Style Questionnaire

Control feeding 480 341PromptingEncouragement feeding 342 62Instrumental feeding 646 235Emotional feeding 839 304

Child Report of Parent Behavior Inventory (CRPBI-30)Psychological control vs autonomy 2237 447Parental acceptance vs rejection 1284 358Firm vs lax control 1914 330

Table 2Stepwise regression analysis examining relationships between child emotional eatingand parent variables controlling for child age and gender

Predictor variable B P

Emotional feeding 40 00Child gender 24 02

Note General child age parenting style maternal psychopathology and addition-al feeding variables were not significant in this model

38 A Braden et alAppetite 80 (2014) 35ndash40

between child emotional eating and demographic characteristicsin order to identify variables to control for in the regression modelsNext intercorrelations were calculated between parenting con-structs to examine whether any variables were correlated above 7Due to the high intercorrelation between emotional feeding and in-strumental feeding instrumental feeding was not included in thefinal regression analysis A stepwise regression model was per-formed to identify the parent variables most significantly associ-ated with child emotional eating controlling for child age and genderThe criterion for statistical significance was set at P lt 05 All cal-culations were performed using SPSS 200 (wwwSPSScom)

Results

Preliminary analyses examined characteristics of the studysample Just over half of the child participants were female (547)with an average age of 1034 (SD = 131) years and BMI percentileof 9726 (SD = 244) The majority (708) of participating mothersidentified themselves as white and married or partnered (67) Overhalf (594) of the mothers stated that they had a bachelorrsquos degreeor higher Approximately half of the mothers reported a yearly house-hold income below 75000 dollars 396 reported a yearly house-hold income of ge75000 dollars and 760 did not report incomedata Average BMI of participating mothers was 3161 (SD = 707)Most (6923) mothers denied binge eating symptoms almost one-quarter (2308) endorsed moderate binge eating symptoms andfew (769) reported severe symptoms of binge eating

Means and standard deviations were calculated for study mea-sures (see Table 1) Next we evaluated associations between childemotional eating and demographics (child BMI percentile agegender parent BMI) Emotional eating was significantly related toolder age (r = 20 P lt 05) Emotional eating was not significantlyrelated to child BMI percentile (r = minus03 P = 73) or parent BMI (r = 13P = 19) Parents were significantly more likely to endorse emotion-al eating in girls (M = 291 SD = 76) as opposed to boys (M = 255SD = 70 t(104) = minus249 P = 01) Intercorrelations were also calcu-lated between parenting constructs Emotional feeding and instru-mental feeding were highly correlated (r = 72 P lt 001)

A stepwise regression analysis was calculated to examine asso-ciations between general parenting style feeding practices mater-nal psychopathology and child emotional eating controlling for childage and gender The final model from the stepwise analysis in-cluded two predictor variables emotional feeding and child genderEmotional feeding behavior accounted for 148 (Adjusted R2 = 15)of the variance in child emotional eating The inclusion of childgender added an additional 57 of the variance (R2 change = 06)The final model that included emotional feeding and child genderaccounted for 195 (Adjusted R2 = 20) of the variance in child emo-tional eating which was significant (F = 1094 P = 00) Significant vari-ables are shown in Table 2

Discussion

The current study examined associations between child emo-tional eating and general parenting style maternal feeding prac-tices and maternal psychopathology in a sample of overweighttreatment-seeking children When all relevant variables were enteredinto a regression model controlling for child age and gender an emo-tional feeding style was the only parent factor significantly associ-ated with child emotional eating

The present study builds on previous literature by examining as-sociations between child emotional eating general and specific par-enting constructs and maternal psychopathology in a clinical sampleof overweight children In the regression analysis after control-ling for child age and gender emotional feeding was the parent-related variable most significantly associated with child emotionaleating Previous research has found similar relationships betweenemotional feeding practices and child eating behavior as well In asample of 6 to 7-year-old Dutch children an emotional feeding stylewas related to increased snacking in children (Sleddens KremersDe Vries amp Thijs 2010) In another sample of 3- to 5-year-old chil-dren emotional feeding predicted consumption of more cookies inthe eating in the absence of hunger paradigm and consumption waseven greater when the child experienced a negative mood induc-tion (Blissett et al 2010) These studies suggest that parents whooffer food to soothe their childrenrsquos emotions may be unintention-ally teaching them to eat food when they are not physically hungrythereby contributing to weight gain Our study extends these pre-vious findings by demonstrating that emotional feeding practicesin mothers may be closely related to emotional eating behaviors inchildren after accounting for additional parent factors known to beassociated with child eating disturbances (ie depression and bingeeating) (Coulthard et al 2004 Coulthard amp Harris 2003) Our find-ings suggest that parent emotional feeding practices are closelylinked with a childrsquos tendency to use food to soothe emotions It ispossible that children who are most susceptible to the immediatemood enhancing effect of food elicit and reinforce emotional feedingbehaviors in their parents Thus parents may learn that their childis highly motivated to obtain food for pleasure or that food has acalming effect on the child resulting in increased reliance on en-couraging food when the child is distressed Nevertheless our find-ings suggest that it may be useful for parents to modify their useof emotional feeding strategies given its relationship with child emo-tional eating However longitudinal studies are needed to examinethe causal pathway linking child emotional eating and parent emo-tional feeding style particularly since the findings of the currentstudy are based on cross-sectional data

In the current study child emotional eating was not associatedwith general parenting style The lack of association between childemotional eating and parenting style is somewhat surprising giventhat previous studies have demonstrated a relationship between emo-tional eating and general parenting styles as reported by both chil-dren (Schuetzman et al 2008 Snoek et al 2007) and parents(Topham et al 2011) However most of these studies were con-ducted in nonclinical samples of children who were normal weightto obese Thus parenting style may be highly relevant to child eatingbehavior among community samples of children but less so amongtreatment-seeking populations Present findings provide further

Table 1Means and standard deviations for study measures

Measure M SD

Emotional Overeating Subscale of the CEBQ 275 75Center for Epidemiologic Studies of Depression Scale (CES-D) 1150 900Binge Eating Scale (BES) 1288 853Parent Feeding Style Questionnaire

Control feeding 480 341PromptingEncouragement feeding 342 62Instrumental feeding 646 235Emotional feeding 839 304

Child Report of Parent Behavior Inventory (CRPBI-30)Psychological control vs autonomy 2237 447Parental acceptance vs rejection 1284 358Firm vs lax control 1914 330

Table 2Stepwise regression analysis examining relationships between child emotional eatingand parent variables controlling for child age and gender

Predictor variable B P

Emotional feeding 40 00Child gender 24 02

Note General child age parenting style maternal psychopathology and addition-al feeding variables were not significant in this model

38 A Braden et alAppetite 80 (2014) 35ndash40

evidence that general parenting style and parent feeding practicesare unique constructs that have differential impacts on child eatingbehaviors and weight outcomes While some studies highlight theimportance of general parenting style in the development of obesityor other weight-related eating behaviors (Rhee Lumeng AppuglieseKaciroti amp Bradley 2006) this study suggests that parent feedingpractices specifically emotional feeding are more salient and maybe more proximal to the understanding of emotional eating

This study adds to the current literature around emotional eatingby examining both parenting constructs and parent psychopathol-ogy including specific parent feeding practices general parentingstyle and maternal symptoms of depression and binge eating Fur-thermore the present study examined these relationships in a sampleof overweight treatment-seeking children who are likely at highrisk for emotional eating Study limitations include the cross-sectional design which does not allow for interpretation of cau-sality and how parenting factors and child emotional eating relateover time In addition the study is limited by the use of self-report measures completed by both children and their mothers Inthe current study child emotional eating was assessed with the useof a parent self-report measure which may be subject to bias Al-though this may be a limitation childrenrsquos reporting of their ownemotional eating could be affected by difficulties understanding emo-tional eating questions and poor self-awareness Furthermoremothers frequently observe their childrenrsquos eating behavior outsideof a laboratory setting and may be able to report on it more accu-rately than using a one-time assessment using a laboratory-basedprocedure In addition general parenting style was reported by chil-dren which may be another limitation of the study findingsHowever child perceptions of parenting style are more closely linkedwith weight related outcomes than parent reported parenting style(Taylor et al 2011) suggesting that child perceptions are integralto the understanding of child behavior

In conclusion child emotional eating appears to be closely as-sociated with their motherrsquos emotional feeding practices Future re-search should utilize longitudinal designs to elucidate the causaldirection of these relationships Findings have implications for clin-ical interventions and prevention programs targeting childhoodobesity Clinicians may consider focusing on the assessment andtreatment of emotional eating in children a behavior that contrib-utes to obesity over time An emotional feeding style should be ad-dressed among parents of overweight children particularly becauseof its relationship to emotional eating and subsequent weight gainmaking treatment of obesity difficult Clinicians can also validatethe difficulty inherent in feeding a child who is highly motivatedby food and eating In addition interventions can directly addresschild emotional eating behavior by teaching children alternativeadaptive strategies of managing negative affect Finally preven-tion programs to educate parents about effective feeding practicesmay also be beneficial in reducing the onset of emotional overeat-ing among children

References

Ashcroft J Semmler C Carnell S van Jaarsveld C H amp Wardle J (2008) Continuityand stability of eating behaviour traits in children European Journal of ClinicalNutrition 62 985ndash990

Birch L Birch D Marlin D amp Kramer L (1982) Effects of instrumental consumptionon childrenrsquos food preference Appetite 3(2) 125ndash134

Birch L L amp Fisher J O (1998) Development of eating behaviors among childrenand adolescents Pediatrics 101(2) 539ndash549

Birch L McPhee L Shoba B C Steinberg L amp Krehbiel R (1987) ldquoClean up yourplaterdquo Effects of child feeding practices on the conditioning of meals size Learningand Motivation 18(3) 301ndash317

Blissett J Haycraft E amp Farrow C (2010) Inducing preschool childrenrsquos emotionaleating Relations with parental feeding practices The American Journal of ClinicalNutrition 92 359ndash365

Boutelle K N Zucker N L Peterson C B Rydell S A Cafri G amp Harnack L(2011) Two novel treatments to reduce overeating in overweight children Arandomized controlled trial Journal of Consulting and Clinical Psychology 79(6)759ndash771

Boutelle K N Zucker N Peterson C B Rydell S Carlson J amp Harnack L J (2014)An intervention based on Schachterrsquos externality theory for overweight childrenThe regulation of cues pilot Journal of Pediatric Psychology 39(4) 405ndash417

Braet C amp Van Strien T (1997) Assessment of emotional externally induced andrestrained eating behaviour in nine to twelve-year-old obese and non-obesechildren Behavior Research and Therapy 35(9) 863ndash873

Carnell S amp Wardle J (2007) Associations between multiple measures of parentalfeeding and childrenrsquos adiposity in United Kingdom preschoolers Obesity 15(1)137ndash144

Collins W A amp Repinski D J (1990) Relationships during adolescence Continuityand change in interpersonal perspective In R Montemayor G R Adams amp T PGullota (Eds) Personal relationships during adolescence (pp 7ndash36) Thousand OaksCA Sage

Coulthard H Blissett J amp Harris G (2004) The relationship between parental eatingproblems and childrenrsquos feeding behavior A selective review of the literatureEating Behaviors 5(2) 103ndash115

Coulthard H amp Harris G (2003) Early food refusal The role of maternal moodJournal of Reproductive and Infant Psychology 21(4) 335ndash345

Croker H Cooke L amp Wardle J (2011) Appetitive behaviors of children attendingobesity treatment Appetite 57 525ndash529

Epstein L H Myers M D amp Anderson K (1996) The association of maternalpsychopathology and family socioeconomic status with psychological problemsin obese children Obesity Research 4(1) 65ndash74

Geliebter A amp Aversa A (2003) Emotional eating in overweight normal weightand underweight individuals Eating Behaviors 3(4) 341ndash347

Goodman S H Rouse M H Connell A M Robbins Broth M Hall C M amp HeywardD (2011) Maternal depression and child psychopathology A meta-analyticreview Clinical Child and Family Psychology Review 14 1ndash27

Goossens L Braet C Van Vlierberghs L amp Mels S (2009) Loss of control over eatingin overweight youngsters The role of anxiety depression and emotional eatingEuropean Eating Disorders Review 17(1) 68ndash78

Gormally J Black S Daston S amp Rardin D (1982) The assessment of binge eatingseverity among obese persons Addictive Behaviors 7(1) 47ndash55

Heatherton T F amp Baumeister R F (1991) Binge eating as escape from self-awareness Psychological Bulletin 110(1) 86ndash108

Hurley K M Cross M B amp Hughes S O (2011) A systematic review of responsivefeeding and child obesity in high-income countries The Journal of Nutrition 141(3)495ndash501

Kuczmarski R J Ogden C L Grummer-Strawn L M Flegal K M Guo S S WeiR et al (2000) CDC growth charts United States Advance Data 314 1ndash27

Lamerz A Kuepper-Nybelen J Bruning N Wehle C Trost-Brinkhues GBrenner H et al (2005) Prevalence of obesity binge eating and night eatingin a cross-sectional field survey of 6-year-old children and their parents in aGerman urban population The Journal of Child Psychology and Psychiatry 46(4)385ndash393

Moens E amp Braet C (2007) Predictors of disinhibited eating in children with andwithout overweight Behaviour Research and Therapy 45(6) 1357ndash1368

Newman J amp Taylor A (1992) Effect of a means-end contingency on young childrenrsquosfood preferences Journal of Experimental Child Psychology 53(2) 200ndash216

Nguyen-Michel S T Unger J B amp Spruijt-Metz D (2007) Dietary correlates ofemotional eating in adolescence Appetite 49(2) 494ndash499

Patrick H Hennessy E McSpadden K amp Oh A (2013) Parenting styles and practicesin childrenrsquos obesogenic behaviors Scientific gaps and future research directionsChildhood Obesity 9(s1) Sndash73

Power T G Sleddens E F Berge J Connell L Govig B Hennessy E et al (2013)Contemporary research on parenting Conceptual methodological andtranslational issues Childhood Obesity 9(s1) S-87

Radloff L S (1977) The CES-D scale A self-report depression scale for research inthe general population Applied Psychological Measurement 1(3) 385ndash401

Rhee K E Lumeng J C Appugliese D Kaciroti N amp Bradley R H (2006) Parentingstyles and overweight status in first grade Pediatrics 6(1) 2047ndash2054

Ryan S R Schechter J C amp Brennan P A (2012) Perinatal factors parentingbehavior and reactive aggression Does cortisol reactivity mediate thisdevelopmental risk process Journal of Abnormal Child Psychology 40(8) 1211ndash1222

Schludermann E H amp Schludermann S M (1988) Childrenrsquos report on parentbehavior (CRPBI-108 CRPBI-30) for older children and adolescents WinnipegMB Canada University of Manitoba

Schuetzman M Richter-Appelt H Schulte-Markwort M amp Schimmelmann G E(2008) Associations among the perceived parent-child relationship eatingbehavior and body weight in preadolescents Results from a community-basedsample Journal of Pediatric Psychology 33 772ndash782

Shapiro J R Woolsen S L Hamer R M Kalarchian M A Marcus M D amp BulikC M (2007) Evaluating binge-eating disorder in children Development of thechildrenrsquos binge eating disorder scale (C-BEDS) The International Journal of EatingDisorders 40 82ndash89

Shomaker L B Tanofsky-Kraff M Elliott C Wolkoff L E Columbo K MRanzenhofer L M et al (2010) Salience of loss of control for pediatric bingeepisodes Does size really matter The International Journal of Eating Disorders43(8) 707ndash716

39A Braden et alAppetite 80 (2014) 35ndash40

Sleddens E F C Gerards S M P L Thijs C de Vries N K amp Kremers S P F (2011)General parenting child overweight and obesity-inducing behaviors A reviewInternational Journal of Pediatric Obesity 6(2) e12ndashe27

Sleddens E F C Kremers S P J De Vries N K amp Thijs C (2010) Relationshipbetween parent feeding styles and eating behaviours of Dutch children aged 6-7Appetite 54 30ndash36

Snoek H M Engels R C M E Janssens J M A M amp Van Strien T (2007) Parentalbehaviour and adolescentsrsquo emotional eating Appetite 49 223ndash230

Stice E Agras W S amp Hammer L D (1999) Risk factors for the emergence ofchildhood eating distrubances A five-year prospective study The InternationalJournal of Eating Disorders 25 375ndash387

Tanofsky-Kraff M Theim K R Yanovski S Z Bassett A M Burns N P RazenhoferL M et al (2007) Validation of the emotional eating scale adapted for use inchildren and adolescents (EES-C) The International Journal of Eating Disorders40(3) 232ndash240

Taylor A Wilson C Slater A amp Mohr P (2011) Parent-and child-reportedparenting Associations with child weight-related outcomes Appetite 57(3)700ndash706

Telch C F amp Agras W S (1994) Obesity binge eating and psychopathology Arethey related The International Journal of Eating Disorders 15 53ndash61

Topham G L Hubbs-Tait L Rutledge J M Page M C Kennedy T S Shriver LH et al (2011) Parenting styles parent response to child emotion and familyemotional responsiveness are related to child emotional eating Appetite 56261ndash264

van Strien T amp Bazelier F G (2007) Perceived parental control of food intake isrelated to external restrained and emotional eating in 7ndash12-year-old boys andgirls Appetite 49(3) 618ndash625

van Strien T amp Oosterveld P (2008) The childrenrsquos DEBQ for assessment ofrestrained emotional and external eating in 7-to 12-year-old children TheInternational Journal of Eating Disorders 41(1) 72ndash81

Van Strien T Engels R Van Leeuwe J amp Snoek H (2005) The Stice model ofovereating Tests in clinical and non-clinical samples Appetite 45 205ndash214

Viana V Sinde S amp Saxton J C (2008) Childrenrsquos eating behaviour questionnaireAssociations with BMI in Portuguese children The British Journal of Nutrition100(2) 445ndash450

Wardle J Guthrie C A Sanderson S amp Rapoport L (2001) Development of thechild eating behaviour questionnaire Journal of Child Psychiatry and Psychology42(7) 963ndash970

Wardle J Sanderson S Guthrie C A Rapoport L amp Plomin R (2002) Parentalfeeding style and the inter-generational transmission of obesity risk ObesityResearch 10(6) 453ndash462

Webber L Hill C Saxton J Van Jaarsveld C H M amp Wardle J (2008) Eatingbehaviour and weight in children International Journal of Obesity 33(1) 21ndash28

Whelan E amp Cooper P J (2000) The association between childhood feedingproblems and maternal eating disorder A community study PsychologicalMedicine 30(1) 69ndash77

Yeganeh R Beidel D C amp Turner S M (2006) Selective mutism More than socialanxiety Depression and Anxiety 23(3) 117ndash123

40 A Braden et alAppetite 80 (2014) 35ndash40