Weight and Psychological Problems in 10–17-year-old German Pupils
Abstract
Eight hundred and seventy-four pupils 10–17 years of age completed the Youth Self-Report (YSR). At least one of their parents completed the Child Behavior Checklist (CBCL) and one of their teachers completed the Teacher Report Form (TRF). Socio-demographic data and information about height and weight were also collected. Body mass index (BMI)-defined underweight, normal-weight and overweight groups did not differ in socioeconomic status, age or gender. The mean CBCL, TRF and YSR scores for all of the groups were within the normal range. The CBCL, TRF and YSR mean scores for overweight subjects were significantly higher than for underweight pupils. The lowest CBCL, YSR and TRF mean scores were found for participants with a normal BMI. Overweight children and adolescents are at greater risk of psychosocial problems than normal- or underweight pupils.Acknowledgements: Julia Arnold, Ingeborg Andreae de Hair, Birgitta Purk, Martin Breitmeyer, Julia Köhler, Gerlinde Plege, Martin Ruppel, Heide Lange, Barbara Karwowski, Daniela Fernahl and Svenja Schildknecht collected the data. Christiane Tilly helped to supervise diploma students and kept the files. We thank all pupils, parents, teachers and headmasters who co-operated with us in this study. Professor Philip Graham kindly made helpful comments on an earlier draft.
Overweight, children, adolescents, psychosocial problems, epidemiology
A recent nationwide survey1 has demonstrated the increasing prevalence of overweight children and adolescents in Germany. In this article we report on a study of the relationship between body mass index (BMI) and sociodemographic variables and psychosocial problems in 10–17-year-old German pupils.
Sampling and Methods
Sample of Subjects
The study recruited 1,057 pupils from primary, basic, high, grammar, comprehensive and Rudolf Steiner schools in the German state North Rhine–Westphalia. The proportion of pupils from different types of schools is roughly representative of the German school system. Concerns raised by the data protection agency mean that we do not have data on the number of non-participants in the schools who also took part. It is likely that immigrant families are under-represented as the ability of the pupil and at least one of his or her parents to read German was necessary for participation. All subjects and the parents of legal minors gave written informed consent. Thereafter, pupils completed the questionnaires during class, and parents and teachers did so at home.
We report here on 874 participants on whom information was provided by themselves, their parents and their teachers. The mean age of this subsample was 12.96 years (standard deviation [SD] 1.7) and socioeconomic status (SES) was as follows: high SES 12.2%, middle SES 71.7% and low SES 16.0%. The study was approved by the Ethical Committee of Münster University.
Measures
Methods used to gain information included the Child Behavior Checklist (CBCL),2 the Youth Self-Report (YSR)3 and the Teacher Report Form (TRF).4 The CBCL form for parents2,5 was designed to assess problem behaviour in four- to 18-year-old children. It is one of the most established inventories in research and clinical practice with children and adolescents. The German version of the CBCL contains 112 items describing typical behavioural and emotional problems, each to be rated according to a zero- to two-point scale ranging from ‘not true’ (0) to ‘somewhat or sometimes true’ (1) to ‘very often true or often true’ (2).
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