Executive function phenotypes in pediatric obesity
Funding information: Agency for Healthcare Research and Quality; University of Alabama at Birmingham, Grant/Award Number: K12HS023009; University of Alabama at Birmingham Nutrition Obesity Research Center, Grant/Award Number: P30DK056336; University of Florida Center for Pediatric Psychology and Family Studies, Grant/Award Number: no grant number assigned
Summary
Objective
To comprehensively examine the behavioral phenotypes of children with and without executive function (EF) impairments in a clinical sample of youth with obesity.
Methods
Youth aged 8 to 17 years (Mean age = 12.97) attending a medical clinic for obesity and their caregivers (N = 195 dyads) completed a battery of behavioral questionnaires. Caregiver-proxy report of EF was assessed using the Behavior Rating Inventory of Executive Function. Latent Class Analysis was conducted to identify EF groupings. Analysis of variance and chi-square tests were conducted to examine associations between EF groups and behavioral phenotypes.
Results
Four latent classes of EF impairment were identified (No/Low Impairment; Behavioral Regulation Impairment; Metacognition Impairment; Global Impairment). There was an overall positive pattern of associations between these EF groups and behavioral/emotional symptoms, such that behavioral/emotional symptoms tended to increase with EF impairment.
Conclusions
Children with obesity and EF impairment demonstrate a dysregulated behavioral phenotype ranging from internalizing to externalizing behavioral and weight-related symptoms. This phenotype framework may be clinically beneficial for utilizing screening/assessment results to develop, tailor, and/or match treatment approaches in pediatric obesity.
