Skip to main content
PMC home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2014 Mar 9.
Published in final edited form as: Eat Behav. 2011 Jan 25;12(2):156–159. doi: 10.1016/j.eatbeh.2011.01.004

Psychometrics of the Eating in Emotional Situations Questionnaire (EESQ) among low-income Latino elementary-school children

Brandi Y Rollins a, Nathaniel R Riggs b, Donna Spruijt-Metz b, Arianna D McClain b, Chih-Ping Chou b, Mary Ann Pentz b
PMCID: PMC3947794  NIHMSID: NIHMS277997  PMID: 21385647

Abstract

The current study examines the psychometric properties of the Eating in Emotional Situations Questionnaire (EESQ) and the frequency of eating in emotional situations among 159 low-income Latino fourth graders. The EESQ assesses eating in emotional situations that are emotion-driven (“I eat when I am lonely”) and context-driven (“I eat when I get a really bad grade”). Internal consistencies for the EESQ subscales and total scale ranged from .70 to .86. Criterion validity of the EESQ was established by statistically significant correlations between the EESQ subscales and total scale, and uncontrollable eating, external eating, and junk food intake. Eating in emotional situations was common in the sample; almost one-half reported eating in at least 3 of the 11 types of emotional situations (e.g. when stressed, sad, bored) and 28% reported eating in at least 6 types. Overall, these findings provide support for the internal consistency and validity of the EESQ in low-income Latino children, and suggest that eating in emotional situations is moderately present in this demographic. Future studies are needed to validate the EESQ in other ethnic groups and examine the longitudinal tracking of eating in emotional situations among Latino youth.

Keywords: Eating in Emotional Situations Questionnaire (EESQ), emotional eating, children, Latino, Hispanic

1. Introduction1

Emotional eating refers to eating in response to emotional distress (Ganley, 1989) and has been linked to external eating (i.e., eating in response to external cues; van Strien & Oosterveld, 2008), loss of control while eating (Goossens, Braet, Van Vlierberghe, & Mels, 2009), and greater daily energy intake (Braet & Van Strien, 1997) and consumption of energy-dense foods among youth (Nguyen-Michel, Unger, & Spruijt-Metz, 2007). Emotional eating is relatively low in preadolescent children (e.g. Carper, Orlet Fisher, & Birch, 2000; van Strien & Oosterveld, 2008); however, limited research has been conducted among low-income Latino children.

Low-income Latino children are a “unique” group in which to study emotional eating because they are likely experience emotional distress in response to the acculturative process (e.g. competing demands from their own culture and the dominant culture; Suarez-Morales, Dillon, & Szapocznik, 2007; Buriel, Perez, De Ment, Chavez, & Moran, 1998) and living in poverty (Aber, Bennett, Conley, & Li, 1997, Weisskirch & Alva, 2002). Together, these experiences may put them at-risk for emotional eating. One study using a predominately Latina adolescent sample found that 22% were classified as emotional eaters (Nguyen-Michel, Unger, & Spruijt-Metz, 2007); however, the incidence of emotional eating in low-income Latino children has yet to be studied.

The objectives of the current study were to describe the frequency of eating in emotional situations (EES) among a sample of low-income Latino elementary school children, and present the psychometrics for a new child measure of EES referred to as the Eating in Emotional Situations Questionnaire (EESQ). Criterion validity of the EESQ was investigated using measures of uncontrollable eating, external eating, and food intake.

2. Method

2.1. Participants

All data were drawn from a obesity prevention pilot study (Riggs, Kobayakawa-Sakuma, & Pentz, 2007) conducted at 5 schools in Orange County, CA. Fourth-grade students completed one of four survey versions at baseline; each survey version contained items common to all versions as well as items unique to each version. Only children who completed the EESQ were included in the present study (n = 184); however, note that a limited sample completed the external eating (n = 70) and junk food (n = 89) subscales. All surveys were administered aloud in English by a trained data collector. Of the 184 study participants, 12 were excluded because they were not Latino and 13 due to missing data; the final sample consisted of 159 children (age: M = 9.4, SD = 0.6). The sample was 45.0% male and 57.9% reported participating in the free or reduced lunch program. All procedures were approved by the University of Southern California Institutional Review Board.

2.3. Measures

2.3.1. Eating in Emotional Situations Questionnaire (EESQ)

The EESQ is an 11-item measure developed by the authors to assess underlying dimensions of EES that were commonly reported in focus groups and interviews, conducted among an ethnically diverse group of girls (n = 102) and boys (n = 28), aged 11 to 17 years. Children were questioned on social and environmental cues to eating, and reasons for eating. Interviews lasted 50–75 minutes and were used to generate the scale items. The EESQ (see Table 1) assesses dimensions of eating in emotional situations that are emotion-driven (e.g. “I eat when I am lonely”) and context-driven (“I eat when I have a hard test coming up”). Response options were 0 = “no” and 1 = “yes”.

Table 1.

Frequency of eating in emotional situations (EES) and factor loadings for second-order confirmatory dichotomous factor analysis of the Eating in Emotional Situations Questionnaire (EESQ) using a sample of low-income Latino children (n = 159)

First-order factors 2nd-order factor
Frequency (%)a Emotion-driven EES Context-driven EES Total EES
I eat when I am really sad. 19.5 .84
I eat when I am anxious. 33.3 .80
I eat when I am nervous. 29.6 .82
I eat when I am really mad. 18.9 .80
I eat when I am lonely. 23.3 .93
I eat when I am bored. 50.3 .75
I eat when I have a fight with my friends/family/boyfriend/girlfriend. 22.0 .68
I eat when I have a hard test coming up. 52.8 .75
I eat when I get a really bad grade. 15.1 .79
I eat when I feel like I can’t get stuff done. 29.6 .82
I eat when my friends talk me into it. 25.3 .72
Emotion-driven EESb .93
Context-driven EESc .96
Variance explained .68 .57 .90
Open in a new tab
a

Frequency of “yes” responses.

b

Emotion-driven EES refers to eating in emotional situations that are driven by psychological states such as loneliness and anger.

c

Context-driven EES refers to eating in emotional situations that driven by contextual cues such as receiving a bad grade or preparing for a hard test.

2.3.2. External and uncontrollable eating

Uncontrollable eating was assessed using one item from the Meanings of Eating Questionnaire (MOE; McClain et al., submitted): “I eat because I can’t stop eating” (1 = “never”, 2 = “sometimes”, and 3 = “often”). In addition, external eating was assessed using one item taken from the Dysregulation Inventory (DI; Mezzich, Tarter, Giancola, & Kirisci, 2002): “I will pick up and eat food just because I happen to see it” (1 = “never”, 2 = “sometimes”, and 3 = “often”).

2.3.4. Food frequency

Fruit and vegetable intake items were adapted from the validated Youth Risk Behavior Survey (YRBS; Centers for Disease Control and Prevention, 2005; Eaton et al., 2006). Two items assessed fruit intake over the past week (e.g., “How often did you eat any fruit, fresh, or canned”), and three items assessed vegetable intake (e.g., “How often do you eat green salad”). These items were included on all versions of the student survey, though two different response scales (adapted from the YRBS) were used. Because the response scales were similar, the scales were recoded to 1 = “less than once a week,” 2 = “1–3 times a week,” 3 = “4–6 times a week,” 4 = “once a day,” and 5 = “2 or more of these a day”. An exploratory factor analysis on the 5 fruit and vegetable items yielded 2 factors with eigenvalues exceeding 1: fruit intake (2 items) and vegetable intake (3 items). Mean scores for the scales were computed, and internal consistencies ranged from moderate to good (fruit intake: α = .43, vegetable intake: α =.62).

To measure junk food intake, 5 items (e.g., “How often do you drink soda – not diet (1 can or glass)”) were taken from a validated food frequency questionnaire (Willett et al., 1985). These items have been used in previous studies to measure junk food intake (Nguyen-Michel et al., 2007). Item response options were 1 = “less than once a week,” 2 = “once a week,” 3 = “2–3 times a week,” 4 = “4–6 times a week,” 5 = “once a day,” and 6 = “2 or more of these a day.” The internal consistency of this scale was .77.

2.3.5. Demographics

Children reported their ethnicity, gender, and age, and indicated whether they received free or reduced lunch, which was used as a proxy for household income. At the time of data collection, a child was eligible for the National School Lunch Program if his/her family’s income was lower than 130% of the poverty level (United States Department of Agriculture, Food and Nutrition Service, 2008).

2.4. Statistical analysis

All statistics and sample descriptives were computed using SAS version 9.1 (SAS Institute Inc., Cary, NC, USA), unless mentioned otherwise. To evaluate the construct validity of the EESQ, a confirmatory dichotomous second-order factor model (Muthen & Muthen, 2001) was performed in Mplus 4.1 (Muthen and Muthen, Los Angeles, CA, USA). We expected a two-factor model comprising the emotion- and context-driven dimensions of EES, and a second-order factor reflecting EES itself. The model was evaluated using the χ2 test, comparative fit index (CFI), and root means square error of approximation (RMSEA) model fit indices. The EESQ subscales for emotion- and context-driven EES were computed by summing the dichotomous responses for each of the subscale items; a total EES scale was computed by summing all of the EESQ items. Criterion validity of the EESQ was evaluated using Pearson correlations and Student t-tests.

3. Results

3.1. Factor structure of the EESQ

Confirmatory dichotomous (second-order) factor analysis was used to evaluate the hypothesized factor structure of the EESQ and indicated that the model adequately fit the data (χ2 = 45.05, p = 0.39; CFI = .999; RMSEA =.017). As shown in Table 1, the EES factor explained 93% of the variance in factor 1 and 96% in factor 2. Factor 1, referred to as emotion-driven EES, contained 6 items and described eating in response to psychological distress (e.g. anxiety). Factor 2, referred to as context-driven EES, contained 5 items and described emotional eating triggered by contextual cues (e.g. receiving a bad grade). The factors for emotion and context-driven EES were highly correlated (r = .89, p < 0.001). Internal consistencies for the emotion- and context-driven subscales were .81 and .70, respectively, and the EESQ total scale had an internal consistency of .86.

3.2. Incidence of eating in emotional situations (EES)

On average, EES was low but common among the sample (M = 3.2, SD = 3.1; Table 1). Almost half (47.8%) of the sample reported eating in three or more emotional situations and 28.3% to eating in six or more emotional situations.

3.3. Criterion validity of the EESQ

Criterion validity of the EESQ was evaluated by correlating the EESQ scales with the food frequency and eating behavior measures, stratified by gender. As shown in Table 4, there was a positive correlation between uncontrollable eating and all the EESQ scales in boys and girls. In addition, junk food intake correlated with all the EESQ scales in boys only, whereas external eating correlated with scores on the EESQ total scale and context-driven subscale in girls only. No significant associations between the EESQ scales, and fruit and vegetable intake were observed. In addition, the EESQ scales were not associated with gender, or free or reduced lunch.

4. Discussion

The current study demonstrates good psychometric properties of the EESQ among low-income Latino school children. Compared to pre-existing measures (e.g., van Strien & Oosterveld, 2008), the EESQ is innovative in that it assesses eating in a variety of emotional situations that are driven by psychological states and contextual cues. In addition, the current study found that eating in emotional situations (EES) was moderately common in low-income Latino boys and girls, a group high at-risk for obesity (Ogden et al., 2010).

Though we present evidence for the factor structure of the EESQ, the subscales for context- and emotion-driven EES were highly correlated and may represent one dimension of EES. This is not surprising, given that distressing external events (e.g. preparing for a test) typically lead to negative emotional states (e.g. anxiety). However, the correlation observed between external eating and context-driven EES subscale in girls, which was absent for emotion-driven EES, suggests that this subscale may be sensitive to measuring eating in response to distressful external cues. Thus, the EES context-driven subscale, in particular, may complement pre-existing surveys used to assess emotional eating in children.

EES was common in the current sample of low-income Latino pre-adolescents. Almost 50% of the sample reported eating in ≥3 types of emotional situations and almost 25% to eating in ≥6 emotional situations. In contrast, past studies suggest that emotional eating is relatively uncommon among Caucasian and European children (e.g., Carper et al., 2000); although, it’s difficult to compare the incidence of EES observed in the current study to past studies due to measurement differences. However, given that low-income Latino children may experience emotional distress due to the acculturative process and poverty, it’s possible that emotional eating is more prevalent in this demographic compared to their racial counterparts. Future research is needed.

The EESQ scales were found to have criterion validity with several obesity-related eating behaviors. In agreement with past studies (Goossens et al., 2009; Wardle et al., 1992), EES was positively associated with uncontrollable eating. In addition, frequent EES was related to consuming greater amounts of junk food, though this finding was only present in boys. Intake of salty, energy-dense foods has been linked to emotional eating among a predominately Latino sample of adolescents (Nguyen-Michel et al., 2007), though the relation was stronger in boys. Taken together, the relation between emotional eating and unhealthy food intake may be stronger among Latino males. Lastly, context-driven EES was associated with external eating in girls only; however, the non-significant finding in boys may have been due to the limited sample size for this correlation coefficient (n = 36).

The current study should be considered in light of its limitations. The current study focused on Latinos as one group, and did not account for differences between ethnic subgroups. In addition, we attempted to establish criterion validity with measures of uncontrollable eating and external eating that have not been validated. However, the significant findings between these variables and the EESQ scales are promising and provide preliminary evidence for the EESQ’s criterion validity.

5. Conclusions

The EESQ showed good psychometrics and can be used to measure EES elicited by psychological states and external cues in low-income Latino children in the 4th grade and on. In addition, the current study provides evidence for the moderate frequency of EES among young low-income Latino children, a group high at-risk for obesity.

Table 2.

Correlations between eating in emotional situations (EES), eating behaviors, and food intake among low-income Latino children (n = 159), in addition to the means and standard deviations (sd) of these variables among the boys (n = 71) and girls (n = 88)

Emotion-drivena EES
Context-drivenb EES
Total EES
Mean (sd)c
Boys Girls Boys Girls Boys Girls Boys Girls
Uncontrollable eating .36** .33** .44*** .31** .44*** .35** 1.4 (0.6) 1.2 (0.5)
External eatingd .16 .25 .25 .57*** .23 .45** 1.4 (0.6) 1.1 (0.4)
Fruit intake .02 .01 .01 .09 .02 .05 3.4 (1.1) 3.3 (1.2)
Vegetable intake −.04 .004 .04 .03 −.01 .02 2.6 (1.1) 2.6 (1.0)
Junk food intakee .42* .06 .45** .12 .46** .09 2.0 (0.8) 1.9 (0.8)
Emotion-driven EES 1.9 (1.9) 1.6 (1.9)
Context-driven EES 1.5 (1.6) 1.5 (1.4)
Total EES 3.4 (3.2) 3.1 (3.1)
Open in a new tab
*

p < 0.05;

**

p < 0.01;

***

p < 0.001

a

Emotion-driven EES refers to eating in emotional situations that are driven by psychological states such as loneliness and anger.

b

Context-driven EES refers to eating in emotional situations that driven by contextual cues such as receiving a bad grade or preparing for a hard test.

c

No significant mean differences by gender were observed.

d

Only data for 70 children were available for this scale (boys: n = 36, girls: n = 34) because the scale was only included on version 2 of the student survey.

e

Only data for 89 children were available for this scale (boys: n = 35, girls: n = 54) because the scale was only included on version 1 of the student survey.

Research Highlights.

  • EESQ measures emotional eating caused by distressful events and psychological states

  • Emotional eating is common among low-income Latino elementary-school children

Acknowledgments

Role of funding sources

This study was supported by funding from the NICHD/NIDA Grant HD052107-0182, Ruth L. Kirschstein National Research Service Award NHLBI Grant 1 F31 HL092721-01, and the Pennsylvania State University Bunton Waller Fellowship Award.

Footnotes

1

EESQ, Eating in Emotional Situations Questionnaire; EES, Eating in Emotional Situations.

Contributors

Authors Riggs, Spruit-Metz, Chou, and Pentz designed the study. All authors participated in measurement development. Rollins conducted the statistical analyses with the assistance of authors Riggs, Spruit-Metz, Chou, and Pentz. Rollins wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript.

Conflict of interest

All authors declare that they have no conflict of interest.

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

References

  1. Aber JL, Bennett NG, Conley DC, Li J. The effects of poverty on child health and development. Annual Reviews of Public Health. 1997;18:463–483. doi: 10.1146/annurev.publhealth.18.1.463. [DOI] [PubMed] [Google Scholar]
  2. Aber JL, Brown JL, Jones SM. Developmental trajectories toward violence in middle childhood: Course, demographic differences, and response to school-based intervention. Developmental Psychology. 2003;39:324–348. doi: 10.1037//0012-1649.39.2.324. [DOI] [PubMed] [Google Scholar]
  3. Baughcum AE, Burklow KA, Deeks CM, Powers SW, Whitaker RC. Maternal feeding practices and childhood obesity: A focus group study of low-income mothers. Archives of Pediatrics & Adolescent Medicine. 1998;152:1010–1014. doi: 10.1001/archpedi.152.10.1010. [DOI] [PubMed] [Google Scholar]
  4. Berry JW. Acculturation and psychological adaptation: An overview. In: Bouvry AM, van de Vijver FJR, Schmitz P, editors. Journeys into cross-cultural psychology. Lisse, Netherlands: Swets & Zeitlinger; 1994. pp. 129–141. [Google Scholar]
  5. Braet C, Claus L, Goossens L, Moens E, Van Vlierberghe L, Soetens B. Differences in eating style between overweight and normal-weight youngsters. J Journal of Health Psychology. 2008;13:733–743. doi: 10.1177/1359105308093850. [DOI] [PubMed] [Google Scholar]
  6. Braet C, Van Strien T. Assessment of emotional, externally induced and restrained eating behaviour in nine to twelve-year-old obese and non-obese children. Behaviour Research and Therapy. 1997;35:863–873. doi: 10.1016/s0005-7967(97)00045-4. [DOI] [PubMed] [Google Scholar]
  7. Brooks-Gunn J, Klebanov PK, Liaw FR. The learning, physical, and emotional environment of the home in the context of poverty: The Infant Health and Development Program. Children and Youth Services Review. 1995;17(1–2):251–276. [Google Scholar]
  8. Buriel R, Perez W, De Ment TL, Chavez DV, Moran VR. The relationship of language brokering to academic performance, biculturalism, and self-efficacy among Latino adolescents. Hispanic Journal of Behavioral Sciences. 1998;20:283–297. [Google Scholar]
  9. Carper JL, Orlet Fisher J, Birch LL. Young girls’ emerging dietary restraint and disinhibition are related to parental control in child feeding. Appetite. 2000;35:121–129. doi: 10.1006/appe.2000.0343. [DOI] [PubMed] [Google Scholar]
  10. Centers for Disease Control and Prevention. [Accessed October 2009.];2005 Youth Risk Behavior Survey. 2005 Retrieved from www.cdc.gov/yrbss.
  11. Connell CM, Prinz RJ. The impact of childcare and parent-child interactions on school readiness and social skills development for low-income African American children. Journal of School Psychology. 2002;40:177–193. [Google Scholar]
  12. de Lauzon-Guillain B, Romon M, Musher-Eizenman D, Heude B, Basdevant A, Charles MA. Cognitive restraint, uncontrolled eating and emotional eating: Correlations between parent and adolescent. Maternal and Child Nutrition. 2009;5:171–178. doi: 10.1111/j.1740-8709.2008.00164.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. DeNavas-Walt C, Proctor BD, Smith JC. Income, poverty, and health insurance coverage in the United States: 2008. 2009 Available for download from the US Census Bureau at: http://www.census.gov/prod/2009pubs/p60-236.pdf.
  14. Eaton DK, Kann L, Kinchen S, Ross J, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Shanklin S, Lim C, Grunbaum JA, Wechsler H. Youth risk behavior surveillance--United States, 2005. Journal of School Health. 2006;76:353–372. doi: 10.1111/j.1746-1561.2006.00127.x. [DOI] [PubMed] [Google Scholar]
  15. Elfhag K, Linne Y. Gender differences in associations of eating pathology between mothers and their adolescent offspring. Obesity Research. 2005;13:1070–1076. doi: 10.1038/oby.2005.125. [DOI] [PubMed] [Google Scholar]
  16. Elfhag K, Tholin S, Rasmussen F. Consumption of fruit, vegetables, sweets and soft drinks are associated with psychological dimensions of eating behaviour in parents and their 12-year-old children. Public Health Nutrition. 2008;11:914–923. doi: 10.1017/S1368980008002371. [DOI] [PubMed] [Google Scholar]
  17. Field AE, Peterson KE, Gortmaker SL, Cheung L, Rockett H, Fox MK, Colditz GA. Reproducibility and validity of a food frequency questionnaire among fourth to seventh grade inner-city school children: Implications of age and day-to-day variation in dietary intake. Public Health Nutrition. 1999;2:293–300. doi: 10.1017/s1368980099000397. [DOI] [PubMed] [Google Scholar]
  18. Ganley RM. Emotion and eating in obesity: A review of the literature. International Journal of Eating Disorders. 1989;8:343–361. [Google Scholar]
  19. Goossens L, Braet C, Van Vlierberghe L, Mels S. Loss of control over eating in overweight youngsters: The role of anxiety, depression and emotional eating. European Eating Disorders Review. 2009;17:68–78. doi: 10.1002/erv.892. [DOI] [PubMed] [Google Scholar]
  20. Halvarsson K, Sjoeden PO. Psychometric properties of the Dutch Eating Behaviour Questionnaire (DEBQ) among 9–10-year-old Swedish girls. European Eating Disorders Review. 1998;6:115–125. [Google Scholar]
  21. Harshaw C. Alimentary epigenetics: A developmental psychobiological systems view of the perception of hunger, thirst and satiety. Developmental Review. 2008;28:541–569. doi: 10.1016/j.dr.2008.08.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Hill AJ, Weaver CF, Blundell JE. Food craving, dietary restraint and mood. Appetite. 1991;17:187–197. doi: 10.1016/0195-6663(91)90021-j. [DOI] [PubMed] [Google Scholar]
  23. Jahnke DL, Warschburger PA. Familial transmission of eating behaviors in preschool-aged children. Obesity (Silver Spring) 2008;16:1821–1825. doi: 10.1038/oby.2008.255. [DOI] [PubMed] [Google Scholar]
  24. Killgore WD, Yurgelun-Todd DA. Affect modulates appetite-related brain activity to images of food. International Journal of Eating Disorders. 2006;39:357–363. doi: 10.1002/eat.20240. [DOI] [PubMed] [Google Scholar]
  25. Macht M. How emotions affect eating: A five-way model. Appetite. 2008;50:1–11. doi: 10.1016/j.appet.2007.07.002. [DOI] [PubMed] [Google Scholar]
  26. McClain A, Pentz MA, Nguyen-Rodriguez S, Chou CP, Shin HS, Riggs N, Weigensberg MJ, Spruijt-Metz D. Measuring the meaning of eating behavior in Latino children. 2010. Manuscript submitted for publication. [Google Scholar]
  27. Mezzich AC, Tarter RE, Giancola PR, Kirisci L. The Dysregulation Inventory: A new scale to assess the risk for substance use disorder. Journal of Child and Adolescent Substance Abuse. 2001;10:35–43. [Google Scholar]
  28. Muthen BO. Dichotomous factor analysis of symptom data. Sociological Methods and Research. 1989;18:19–65. [Google Scholar]
  29. Muthen L, Muthen BO. Mplus: Statistical analysis with latent variables. User’s guide. Los Angeles: Muthen & Muthen; 2001. [Google Scholar]
  30. Muthen L, Muthen BO. Mplus (Version 4.1) [computer software] Los Angeles, CA: Muthen & Muthen; 2006. [Google Scholar]
  31. Nguyen-Michel ST, Unger JB, Spruijt-Metz D. Dietary correlates of emotional eating in adolescence. Appetite. 2007;49:494–499. doi: 10.1016/j.appet.2007.03.005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007–2008. Journal of the American Medical Association. 2010;303:242–249. doi: 10.1001/jama.2009.2012. [DOI] [PubMed] [Google Scholar]
  33. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003–2006. Journal of the American Medical Association. 2008;299:2401–2405. doi: 10.1001/jama.299.20.2401. [DOI] [PubMed] [Google Scholar]
  34. Riggs NR, Kobayakawa-Sakuma KL, Pentz MA. Preventing risk for obesity by promoting self-regulation and decision-making skills: Pilot results from the PATHWAYS to health program (PATHWAYS) Evaluation Review. 2007;31:287–310. doi: 10.1177/0193841X06297243. [DOI] [PubMed] [Google Scholar]
  35. SAS Institute Inc. SAS (Version 9) [computer software] Cary, NC: SAS Institute Inc; [Google Scholar]
  36. Schacht M, Richter-Appelt H, Schulte-Markwort M, Hebebrand J, Schimmelmann BG. Eating Pattern Inventory for Children: A new self-rating questionnaire for preadolescents. Journal of Clinical Psychology. 2006;62:1259–1273. doi: 10.1002/jclp.20300. [DOI] [PubMed] [Google Scholar]
  37. Snoek HM, Engels RC, Janssens JM, van Strien T. Parental behaviour and adolescents’ emotional eating. Appetite. 2007;49:223–230. doi: 10.1016/j.appet.2007.02.004. [DOI] [PubMed] [Google Scholar]
  38. Snoek HM, van Strien T, Janssens JM, Engels RC. The effect of television viewing on adolescents’ snacking: Individual differences explained by external, restrained and emotional eating. Journal of Adolescent Health. 2006;39:448–451. doi: 10.1016/j.jadohealth.2005.12.020. [DOI] [PubMed] [Google Scholar]
  39. Steinegger C, Dorn L, Goody C, Khoury PR, Daniels SR. Emotional eating in adolescent females. Journal of Adolescent Health. 2005;36:152–152. [Google Scholar]
  40. Suarez-Morales L, Dillon FR, Szapocznik J. Validation of the acculturative stress inventory for children. Cultural Diversity and Ethnic Minority Psychology. 2007;13:216–224. doi: 10.1037/1099-9809.13.3.216. [DOI] [PubMed] [Google Scholar]
  41. United States Department of Agriculture, Food and Nutrition Service. [Accessed October 2009.];School meals: National School Lunch Program. 2008 Retrieved from USDA Food and Nutrition Service website: http://www.fns.usda.gov/cnd/Governance/notices/iegs/IEGs.htm.
  42. van Strien T, Bazelier FG. Perceived parental control of food intake is related to external, restrained and emotional eating in 7–12-year-old boys and girls. Appetite. 2007;49:618–625. doi: 10.1016/j.appet.2007.03.227. [DOI] [PubMed] [Google Scholar]
  43. van Strien T, Oosterveld P. The children’s DEBQ for assessment of restrained, emotional, and external eating in 7-to 12-year-old children. International Journal of Eating Disorders. 2008;41:72. doi: 10.1002/eat.20424. [DOI] [PubMed] [Google Scholar]
  44. Wardle J, Marsland L, Sheikh Y, Quinn M, Fedoroff I, Ogden J. Eating style and eating behaviour in adolescents. Appetite. 1992;18:167–183. doi: 10.1016/0195-6663(92)90195-c. [DOI] [PubMed] [Google Scholar]
  45. Weisskirch RS, Alva SA. Language brokering and the acculturation of Latino children. Hispanic Journal of Behavioral Sciences. 2002;24:369. [Google Scholar]
  46. Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE. Reproducibility and validity of a semiquantitative food frequency questionnaire. American Journal of Epidemiology. 1985;122:51–65. doi: 10.1093/oxfordjournals.aje.a114086. [DOI] [PubMed] [Google Scholar]

RESOURCES