General Academic Pediatric Fellow University of Rochester Medical Center Rochester, New York, United States
Background: The bidirectional association of child and parent/caregiver mental health is well documented, with emerging evidence to suggest that household environment may influence these relations. Children and adults with obesity are at greater risk for experiencing anxiety and depression. Understanding how household chaos interacts with mental health may inform the use of targeted approaches for child obesity treatment. Objective: To examine how household chaos moderates the relationship between parent/caregiver mental health and child emotional health in a sample of treatment-seeking families with obesity. Design/Methods: We examined screening/baseline data of a pragmatic randomized trial, beginning 2019, across three diverse geographic regions in the US. Linear regressions predicting child emotional health (Pediatric Symptom Checklist 17; PSC-17, parent report) were used to examine the associations among parent depression (Patient Health Questionnaire; PHQ-9), parent anxiety (Generalized Anxiety Disorder-7; GAD-7), household chaos (The confusion, hubbub, and order scale-short form; CHAOS), and household income (demographic survey, using 2023 US federal poverty level, higher- ≥$30,000, lower- ≤$29,999) as independent variables. Results: A total of N=1123 parents were included in the analyses. Parent anxiety (p <.001) and parent depression (p <.001) were positively associated with poor child emotional health. When household chaos was added to the model, all variables remained positively related (p <.001). Household chaos moderated (strengthened) the relationship between parent depression (p <.001) and child emotional health. When stratified by income, parent/caregiver anxiety was positively related with child emotional health (p <.001) among those with lower income (n=210), whereas for those with higher income (n=912), parent depression and anxiety were both positively associated with child emotional health (p <.001), and household chaos moderated (strengthened) the relationship between parent depression and child emotional health.
Conclusion(s): Assessing and addressing parent/caregiver and child mental and emotional health as well as household chaos may be important individualized targets within child obesity treatment. Additionally, household income should be considered as a factor contributing to the family’s emotional health. These factors may relate to individual and family coping skills, dynamics, and resources that could be contributing to weight pattern and management.
