. 2012 Sep 13;10(1):18–43. doi: 10.1111/j.1740-8709.2012.00452.x

Table 3.

Studies examining the relationship between maternal psychopathology and maternal child feeding practice (N = 9)

Reference Country	Participant characteristics; study design	Study aim(s)	Measures of maternal child feeding practices	Measures of maternal psychopathology correlates	Findings
Blissett & Haycraft (2008) UK	n = 48 pairs of cohabiting parents (96 parents; 48 mothers) Mean mother age = 35.7 years Mean father age = 37.1 years Mean child age = 41.6 months Questionnaires Cross‐sectional	To investigate the associations between parenting styles, parent child feeding practices and parent BMI.	Monitoring, restriction and pressure to eat subscales on the CFQ (Birch et al. 2001).	The bulimia, drive for thinness and body dissatisfaction subscales on the EDI‐2 Garner 1991).	Maternal bulimia was positively associated with restriction (r = 0.24, P < 0.05). No other maternal variables were related to maternal child feeding practices.
Blissett & Haycraft (2011) UK	n = 23 pairs of cohabitating parents (46 parents; 23 mothers) Mean mother age = 36 years Mean father age = 37 years Mean child age = 37 months Home observations; questionnaires Cross‐sectional	This study aimed to examine whether eating disorder symptoms of mothers and fathers showed a relationship with the observed feeding practices and observed children's eating behaviour.	Video recorded home observations of a normal mealtime were coded using the FMCS (Haycraft and Blissett 2008b). The FMCS measures parental verbal pressure to eat, physical prompts to eat, restriction and use of incentives.	Drive for thinness, bulimia and body dissatisfaction scales on the EDI‐2 Garner 1991).	Maternal bulimia was related to greater use of verbal pressure to eat (r = 0.47, P < 0.05). Restriction, physical prompts to eat, and incentives were not related to maternal bulimia. Maternal drive for thinness was related to greater used of physical prompts to eat (r = 0.42, P < 0.05), and verbal pressure to eat (r = 0.36, P < 0.05), yet not restriction or incentives. Maternal body dissatisfaction was positively related to use of restriction (r = 0.39, P < 0.05), and verbal pressure to eat (r = 0.57, P < 0.01). In contrast, maternal body dissatisfaction was not related to use of physical prompts or incentives for their child to eat.
Blissett et al. (2006) UK	n = 94 pairs of cohabitating parents (188 parents) Mean parent age = 36.4 years Mean child age = 37.7 months Questionnaires Cross‐sectional	To compare paternal and maternal child feeding practices for sons and daughters.	Perceived feeding responsibility, restriction, monitoring and pressure to eat subscales from the CFQ (Birch et al. 2001).	Bulimia, drive for thinness and body dissatisfaction scales from the EDI‐2 Garner 1991).	Maternal bulimia was positively related to her use of restriction of her daughter's intake (r = 0.34, P < 0.01). No other maternal variables were related to maternal child feeding practices among daughters. No maternal variables were related to maternal child feeding practices among sons.
De Lauzon‐Guillain et al. (2009) US and France	n = 219 parents (US 97; France 122) Mean father age: US 36.4 years; France 37.8 years Mean mother age not reported Mean child age: US 5 years; France 5.5 years Questionnaires Cross‐sectional	To investigate and compare some of the possible motivators of parental child feeding practices in two samples; one from the US and one from France.	Nine domains from the CFPQ (Musher‐Eizenman & Holub 2007): monitoring, emotional regulation, reward, child control, teaching about nutrition, encouraging balance and variety, restriction for weight reasons, restriction for health reasons, and modelling healthful eating habits.	Parental restrained uncontrolled and emotional eating on the Dutch Eating Behaviour Questionnaire (Van Strien et al. 1986).	Parental restrained eating was related to greater use of monitoring (β = 0.3, P < 0.01), and restriction for weight purposes (β = 0.2, P < 0.001). Parental uncontrolled eating was associated with greater use of restriction for health reasons (β = 0.3, P < 0.001), emotional regulation (β = 0.2, P < 0.001), and encouragement of balance and variety in diet (β = −0.1, P < 0.05). Parental emotional eating was related to greater use of incentives (β = 0.2, P < 0.001). Monitoring, emotional regulation, child control, teaching about nutrition, encouraging balance and variety, restriction for weight reasons, restriction for health reasons, and modelling healthful eating habits were not related to parental emotional eating.
Francis et al. (2001) USA	n = 197 mothers Mean mother age = 35.4 years Mean daughter age = 5.4 years Questionnaires; objective measurement of weight and height Cross‐sectional	To explore the role of child and maternal characteristics on maternal use of restriction of energy‐dense foods and pressure to eat when feeding their daughter. This was achieved by examining structural equation models for maternal restriction and pressure to eat, which included the following variables: maternal weight concern and restraint, daughters’ adiposity, perceptions of daughters’ weight, concern for daughters’ weight, family income, maternal education, maternal depression and general parenting style.	Restriction and pressure to eat scales on the CFQ (Birch et al. 2001).	Weight Concern Scale (Killen et al. 1994). Three‐Factor Eating Questionnaire's (Stunkard & Messick 1985) restraint scale. Height and weight data was collected by trained staff and then BMI was calculated. Centre for Epidemiologic Studies (Radloff 1977) depression scale.	Maternal weight concern and restraint had a positive relationship with restriction among non‐overweight mothers (β = 0.22, P < 0.05) and overweight mothers (β = 0.28, P < 05). Maternal depression was also related to greater restriction among non‐overweight mothers (β = 0.33, P < 05). No other variables were related to restriction among overweight and non‐overweight mothers Maternal weight concern/restraint and maternal depression were not associated with pressure to eat among overweight mothers.
Haycraft & Blissett (2008a) UK	n = 214 parents (107 mothers) Mean mother age = 35 years Mean father age = 37 years Mean child age = 41 months for girls; 42 months for boys Questionnaires Cross‐sectional	To investigate the role of parent and child gender in the relationship between parental controlling feeding practices and mental health.	Pressure to eat and restriction scales from the CFQ (Birch et al. 2001).	Drive for thinness, bulimia and body dissatisfaction scales in the EDI‐2 Garner 1991). BSI's (Derogatis 1993) somatisation, obsession‐compulsion, interpersonal insensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism subscales as well as the subsequently calculated Global Severity Index (a measure of current and past level of symptomology, as determined by distress intensity and number of symptoms).	Maternal bulimia was associated positively with restriction of daughter's food intake (r = 0.32, P < 0.01). No other variables were related to maternal restriction of daughter's food intake. Maternal use of pressure for her daughter to eat was correlated positively with maternal depression (r = 0.26, P < 0.05), hostility (r = 0.23, P < 0.05), psychoticism (r = 0.31, P < 0.01) and Global Severity Index scores (r = 0.27, P < 0.05). No other variables were related to maternal pressure for her daughter to eat. > Greater maternal interpersonal insensitivity (r = 0.27, P < 0.05) and Global Severity Index scores (r = 0.30, P < 0.05) were associated with pressure for her son to eat. No other variables were related to maternal pressure for her son to eat. Maternal restriction of her son's food intake was correlated positively with maternal phobic anxiety (r = 0.28, P < 0.05). No other variables were related to maternal restriction of her son's food intake.
Haycraft & Blissett (2011) UK	n = 96 parents (48 mothers) Mean mother age = 35 years Mean father age = 37 years Mean child age = 42 months Living in West Midlands or Cambridge; UK Questionnaires Cross‐sectional	To investigate predictors of controlling feeding practices by parents of preschoolers.	The CFQ's (Birch et al. 2001) monitoring, pressure to eat and restriction scales.	Drive for thinness, bulimia and body dissatisfaction scales from the EDI‐2 Garner 1991). The BSI's Global Severity Index (Derogatis 1993).	Maternal eating psychopathology and general psychopathology were not related to maternal monitoring or restriction. Maternal use of pressure for her child to eat was related positively to maternal general psychopathology (r = 0.38, P < 0.01). Maternal eating psychopathology was not correlated with pressure to eat.
Hughes et al. (2008) USA	n = 718 parents (92.7% mothers) Mean parent age = 31.6 years Mean child age = 4.4 years 43% African‐American; 29.1% Hispanic; 27.9% Caucasian Questionnaires; objective collection of child and parent weight and height Cross‐sectional	To investigate differences among parental affect and child temperament associated with parental feeding styles used by low‐income families.	Demandingness and responsiveness scales in the CFSQ (Hughes et al. 2005) to generate 4 parent feeding styles; authoritative, authoritarian, indulgent or uninvolved.	The trait versions of the positive and negative affect scales of the Positive and Negative Affect Schedule (Watson et al. 1988).	Negative parental affect was lower among parents with an indulgent feeding style (mean = 19.2) than parents with an authoritarian feeding style (mean = 21.1, P < 0.05). Parents with an uninvolved feeding style tended to have lower positive affect (mean = 32.9) than parents with an authoritative feeding style (mean = 36.5, P < 0.05) or indulgent feeding style (mean = 36.0, P < 0.05).
Ystrom et al. (2012) Norway	n = 14 122 Mean mother age: 33 years Child age range: 6 months to 3 years Questionnaires Longitudinal (measurements taken at 6 months, 18 months and 3 years post‐partum).	To investigate the role of maternal negative affectivity, external parental locus of control and control‐orientated child feeding practices in child food intake.	The restriction and pressure to eat scales of the CFQ (Birch et al. 2001).	Negative affectivity was assessed using a combination of measures. These included anxiousness/depression scales on the short version of the Hopkins Symptom Checklist (Strand et al. 2003), anger subscale of the Differential Emotions Scale (Izard et al. 1993) and the short version of the Rosenberg Self‐Esteem Scale (Rosenberg 1989).	Using structural equation modelling, maternal negative affectivity was related positively to external parental locus of control (β = 0.55, P < 0.01), which in turn was related to pressure to eat (β = 0.29, P < 0.01) and restriction (β = 0.34, P < 0.01).

Reference

Country

Participant characteristics; study design

Study aim(s)

Measures of maternal child feeding practices

Measures of maternal psychopathology correlates

Findings

Blissett & Haycraft (2008)

n = 48 pairs of cohabiting parents (96 parents; 48 mothers)

Mean mother age = 35.7 years

Mean father age = 37.1 years

Mean child age = 41.6 months

Questionnaires

Cross‐sectional

To investigate the associations between parenting styles, parent child feeding practices and parent BMI.

Monitoring, restriction and pressure to eat subscales on the CFQ (Birch et al. 2001).

The bulimia, drive for thinness and body dissatisfaction subscales on the EDI‐2 Garner 1991).

Maternal bulimia was positively associated with restriction (r = 0.24, P < 0.05).

No other maternal variables were related to maternal child feeding practices.

Blissett & Haycraft (2011)

n = 23 pairs of cohabitating parents (46 parents; 23 mothers)

Mean mother age = 36 years

Mean father age = 37 years

Mean child age = 37 months

Home observations; questionnaires

Cross‐sectional

This study aimed to examine whether eating disorder symptoms of mothers and fathers showed a relationship with the observed feeding practices and observed children's eating behaviour.

Video recorded home observations of a normal mealtime were coded using the FMCS (Haycraft and Blissett 2008b). The FMCS measures parental verbal pressure to eat, physical prompts to eat, restriction and use of incentives.

Drive for thinness, bulimia and body dissatisfaction scales on the EDI‐2 Garner 1991).

Maternal bulimia was related to greater use of verbal pressure to eat (r = 0.47, P < 0.05). Restriction, physical prompts to eat, and incentives were not related to maternal bulimia.

Maternal drive for thinness was related to greater used of physical prompts to eat (r = 0.42, P < 0.05), and verbal pressure to eat (r = 0.36, P < 0.05), yet not restriction or incentives.

Maternal body dissatisfaction was positively related to use of restriction (r = 0.39, P < 0.05), and verbal pressure to eat (r = 0.57, P < 0.01). In contrast, maternal body dissatisfaction was not related to use of physical prompts or incentives for their child to eat.

Blissett et al. (2006)

n = 94 pairs of cohabitating parents (188 parents)

Mean parent age = 36.4 years

Mean child age = 37.7 months

Questionnaires

Cross‐sectional

To compare paternal and maternal child feeding practices for sons and daughters.

Perceived feeding responsibility, restriction, monitoring and pressure to eat subscales from the CFQ (Birch et al. 2001).

Bulimia, drive for thinness and body dissatisfaction scales from the EDI‐2 Garner 1991).

Maternal bulimia was positively related to her use of restriction of her daughter's intake (r = 0.34, P < 0.01). No other maternal variables were related to maternal child feeding practices among daughters.

No maternal variables were related to maternal child feeding practices among sons.

De Lauzon‐Guillain et al. (2009)

US and France

n = 219 parents (US 97; France 122)

Mean father age: US 36.4 years; France 37.8 years

Mean mother age not reported

Mean child age: US 5 years; France 5.5 years

Questionnaires

Cross‐sectional

To investigate and compare some of the possible motivators of parental child feeding practices in two samples; one from the US and one from France.

Nine domains from the CFPQ (Musher‐Eizenman & Holub 2007): monitoring, emotional regulation, reward, child control, teaching about nutrition, encouraging balance and variety, restriction for weight reasons, restriction for health reasons, and modelling healthful eating habits.

Parental restrained uncontrolled and emotional eating on the Dutch Eating Behaviour Questionnaire (Van Strien et al. 1986).

Parental restrained eating was related to greater use of monitoring (β = 0.3, P < 0.01), and restriction for weight purposes (β = 0.2, P < 0.001).

Parental uncontrolled eating was associated with greater use of restriction for health reasons (β = 0.3, P < 0.001), emotional regulation (β = 0.2, P < 0.001), and encouragement of balance and variety in diet (β = −0.1, P < 0.05).

Parental emotional eating was related to greater use of incentives (β = 0.2, P < 0.001). Monitoring, emotional regulation, child control, teaching about nutrition, encouraging balance and variety, restriction for weight reasons, restriction for health reasons, and modelling healthful eating habits were not related to parental emotional eating.

Francis et al. (2001)

USA

n = 197 mothers

Mean mother age = 35.4 years

Mean daughter age = 5.4 years

Questionnaires; objective measurement of weight and height

Cross‐sectional

To explore the role of child and maternal characteristics on maternal use of restriction of energy‐dense foods and pressure to eat when feeding their daughter.

This was achieved by examining structural equation models for maternal restriction and pressure to eat, which included the following variables: maternal weight concern and restraint, daughters’ adiposity, perceptions of daughters’ weight, concern for daughters’ weight, family income, maternal education, maternal depression and general parenting style.

Restriction and pressure to eat scales on the CFQ (Birch et al. 2001).

Weight Concern Scale (Killen et al. 1994).

Three‐Factor Eating Questionnaire's (Stunkard & Messick 1985) restraint scale.

Height and weight data was collected by trained staff and then BMI was calculated.

Centre for Epidemiologic Studies (Radloff 1977) depression scale.

Maternal weight concern and restraint had a positive relationship with restriction among non‐overweight mothers (β = 0.22, P < 0.05) and overweight mothers (β = 0.28, P < 05). Maternal depression was also related to greater restriction among non‐overweight mothers (β = 0.33, P < 05). No other variables were related to restriction among overweight and non‐overweight mothers

Maternal weight concern/restraint and maternal depression were not associated with pressure to eat among overweight mothers.

Haycraft & Blissett (2008a)

n = 214 parents (107 mothers)

Mean mother age = 35 years

Mean father age = 37 years

Mean child age = 41 months for girls; 42 months for boys

Questionnaires

Cross‐sectional

To investigate the role of parent and child gender in the relationship between parental controlling feeding practices and mental health.

Pressure to eat and restriction scales from the CFQ (Birch et al. 2001).

Drive for thinness, bulimia and body dissatisfaction scales in the EDI‐2 Garner 1991).

BSI's (Derogatis 1993) somatisation, obsession‐compulsion, interpersonal insensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism subscales as well as the subsequently calculated Global Severity Index (a measure of current and past level of symptomology, as determined by distress intensity and number of symptoms).

Maternal bulimia was associated positively with restriction of daughter's food intake (r = 0.32, P < 0.01). No other variables were related to maternal restriction of daughter's food intake.

Maternal use of pressure for her daughter to eat was correlated positively with maternal depression (r = 0.26, P < 0.05), hostility (r = 0.23, P < 0.05), psychoticism (r = 0.31, P < 0.01) and Global Severity Index scores (r = 0.27, P < 0.05). No other variables were related to maternal pressure for her daughter to eat.

Greater maternal interpersonal insensitivity (r = 0.27, P < 0.05) and Global Severity Index scores (r = 0.30, P < 0.05) were associated with pressure for her son to eat. No other variables were related to maternal pressure for her son to eat.

Maternal restriction of her son's food intake was correlated positively with maternal phobic anxiety (r = 0.28, P < 0.05). No other variables were related to maternal restriction of her son's food intake.

Haycraft & Blissett (2011)

n = 96 parents (48 mothers)

Mean mother age = 35 years

Mean father age = 37 years

Mean child age = 42 months

Living in West Midlands or Cambridge; UK

Questionnaires

Cross‐sectional

To investigate predictors of controlling feeding practices by parents of preschoolers.

The CFQ's (Birch et al. 2001) monitoring, pressure to eat and restriction scales.

Drive for thinness, bulimia and body dissatisfaction scales from the EDI‐2 Garner 1991).

The BSI's Global Severity Index (Derogatis 1993).

Maternal eating psychopathology and general psychopathology were not related to maternal monitoring or restriction.

Maternal use of pressure for her child to eat was related positively to maternal general psychopathology (r = 0.38, P < 0.01). Maternal eating psychopathology was not correlated with pressure to eat.

Hughes et al. (2008)

USA

n = 718 parents (92.7% mothers)

Mean parent age = 31.6 years

Mean child age = 4.4 years

43% African‐American; 29.1% Hispanic; 27.9% Caucasian

Questionnaires; objective collection of child and parent weight and height

Cross‐sectional

To investigate differences among parental affect and child temperament associated with parental feeding styles used by low‐income families.

Demandingness and responsiveness scales in the CFSQ (Hughes et al. 2005) to generate 4 parent feeding styles; authoritative, authoritarian, indulgent or uninvolved.

The trait versions of the positive and negative affect scales of the Positive and Negative Affect Schedule (Watson et al. 1988).

Negative parental affect was lower among parents with an indulgent feeding style (mean = 19.2) than parents with an authoritarian feeding style (mean = 21.1, P < 0.05).

Parents with an uninvolved feeding style tended to have lower positive affect (mean = 32.9) than parents with an authoritative feeding style (mean = 36.5, P < 0.05) or indulgent feeding style (mean = 36.0, P < 0.05).

Ystrom et al. (2012)

Norway

n = 14 122

Mean mother age: 33 years

Child age range: 6 months to 3 years

Questionnaires

Longitudinal (measurements taken at 6 months, 18 months and 3 years post‐partum).

To investigate the role of maternal negative affectivity, external parental locus of control and control‐orientated child feeding practices in child food intake.

The restriction and pressure to eat scales of the CFQ (Birch et al. 2001).

Negative affectivity was assessed using a combination of measures. These included anxiousness/depression scales on the short version of the Hopkins Symptom Checklist (Strand et al. 2003), anger subscale of the Differential Emotions Scale (Izard et al. 1993) and the short version of the Rosenberg Self‐Esteem Scale (Rosenberg 1989).

Using structural equation modelling, maternal negative affectivity was related positively to external parental locus of control (β = 0.55, P < 0.01), which in turn was related to pressure to eat (β = 0.29, P < 0.01) and restriction (β = 0.34, P < 0.01).

BMI, body mass index; BSI, Brief Symptom Inventory; CFPQ, Comprehensive Feeding Practices Questionnaire; CFQ, Child Feeding Questionnaire; EDI‐2, Eating Disorder Inventory‐2; FMCS, Family Mealtime Coding System.