Psychological Adjustment of Obese Youth Presenting for Weight Management Treatment

OBJECTIVE: To determine the prevalence of psychological maladjustment in clinic-based treatment-seeking obese children and adolescents (BMI > or = 95th percentile) and the degree to which maternal, demographic, and youth factors correlate to the youths' psychological adjustment. RESEARCH METHODS AND PROCEDURES: Anthropometrics, demographics (race, sex, insurance status), measures of youth psychological adjustment (self- and mother-report; Behavior Assessment System for Children), and maternal self-report of psychological distress (Symptom Checklist 90-Revised) were collected from 121 obese children and adolescents (55% white, 45% black) and their mothers. RESULTS: Approximately one-third of youths self-reported some psychological maladjustment, but two-thirds of youth were described by their mothers as experiencing some degree of psychological maladjustment. Adjustment difficulties were specific to social functioning, low self-esteem, and internalizing symptoms. Forty-one percent of mothers of child participants and 56% of mothers of adolescent participants reported clinically significant psychological distress. Youth self-report and mother-report of youths' psychological difficulties were often most strongly associated with mothers' level of psychological distress and/or family socioeconomic status rather than to youth characteristics (e.g., percent overweight, race). DISCUSSION: Psychological maladjustment levels among obese youth and their mothers were higher in this clinic-based sample than in treatment research-based samples. Present correlate findings extended to obese adolescents and reaffirm a potent association between youth self-report of their own psychological adjustment and their mother's level of psychological distress. Demographic characteristics and youth weight status were not consistent correlates of youths' psychological functioning. Findings have implications for the translation of empirically supported pediatric obesity interventions to clinic-based treatment samples.