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Objective: Many children with chronic musculoskeletal pain conditions experience stigma which can have negative downstream consequences. This study compares ratings of clinical pain (current pain intensity and pain interference), experimental pain (temporal summation, cold water tolerance, and cold pain intensity), and pain-related stigma among three groups of youth with rheumatic conditions. The relations among ratings of pain-related stigma and pain variables were explored., Methods: Eighty-eight youth aged 8-17 years with a diagnosis of juvenile idiopathic arthritis (JIA = 32), juvenile fibromyalgia (JFM = 31), or non-specific chronic pain (NSCP = 25) completed measures of clinical pain ratings (average 7-day pain intensity, day of assessment pain (DoA), and pain interference), experimental pain (cold pain tolerance, cold pain intensity, and temporal summation of mechanical pain), and pain-related stigma. Data analysis compared pain-related stigma and pain ratings across the three groups and examined the relations among pain-related stigma and pain ratings., Results: Youth with JFM reported higher ratings of clinical pain and pain-related stigma than their counterparts with NSCP or JIA. However, there were no differences in experimental pain. Pain-related stigma was associated with greater ratings of pain interference, particularly for those with JIA and NSCP. Pain-related stigma was also associated with greater average daily pain intensity but not DoA., Conclusion: Youth with medically unexplained pain report greater stigma and worse pain than their peers; thus, robust assessment of pain in this population is necessary. Future work should longitudinally explore the impact of pain-related stigma on pain outcomes and treatment responses., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Obesity is associated with executive function (EF) deficits across the lifespan. Higher body mass index (BMI), obesity severity, and poorer adherence and weight outcomes in obesity treatment have all been associated with EF deficits. Adult literature has begun to emphasize neuroinflammation in obesity as a possible pathway to later cognitive impairment in EF. However, pediatric obesity literature has yet to establish associations between peripheral inflammation and EF. Thus, the present study examined associations and variability in inflammation, EF, and adiposity in children with or at risk for obesity. Additionally, inflammation was examined as a mediator of the relationship between adiposity and EF., Methods: Children (N = 39) aged 8-12 years with BMI ≥ 50th percentile were recruited. The NIH Toolbox Cognitive Battery was used to assess performance-based EF. Peripheral inflammation was assessed in fasted sera. Dual-energy X-ray absorptiometry scans were conducted to assess body composition. Linear regression and Hayes' PROCESS Model 4 (Hayes, 2017) were used to evaluate associations between adiposity and inflammation, inflammation and EF, and whether adiposity effects EF through its effect on inflammation., Results: Positive associations were identified between adiposity and inflammation, and negative to null associations were identified between inflammation and EF. Medium indirect effects of adiposity on EF through inflammation were detected., Conclusion: Pilot evidence suggests greater adiposity is linked with greater inflammation, which in turn is associated with less EF in some domains. Directionality and causality cannot yet be established, but with replication, findings may inform efforts to target EF in pediatric obesity., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To examine the association between caregiver proxy report of executive function (EF) and dysregulated eating behavior in children with obesity., Methods: Participants were 195 youth with obesity aged 8-17 years, and their legal guardians. Youth height, weight, demographics, depressive symptoms, eating behaviors, and EF were assessed cross-sectionally during a medical visit. Analyses of covariance, adjusted for child age, gender, race/ethnicity, standardized BMI, depressive symptoms, and family income were used to examine differences in youth EF across caregiver and youth self-report of eating behaviors., Results: Youth EF differed significantly by caregiver report of eating behavior but not youth self-report. Post hoc analyses showed that youth with overeating or binge eating had poorer EF than youth without these eating behaviors., Conclusions: Executive dysfunction, as reported by caregivers, in youth with obesity may be associated with dysregulated eating behaviors predictive of poor long-term psychosocial and weight outcomes. Further consideration of EF-specific targets for assessment and intervention in youth with obesity may be warranted.

Objective: To examine the associations of peer victimization with internalizing symptoms, externalizing symptoms, social competence, and academic performance in a clinical sample of adolescents with severe obesity, and whether self-worth and social support affect these associations., Methods: Multisite cross-sectional data from 139 adolescents before weight loss surgery ( M age = 16.9; 79.9% female, 66.2% White; M Body Mass Index [BMI] = 51.5 kg/m 2 ) and 83 nonsurgical comparisons ( M age = 16.1; 81.9% female, 54.2% White; M BMI = 46.9 kg/m 2 ) were collected using self-reports with standardized measures., Results: As a group, participants did not report high levels of victimization. Self-worth mediated the effects of victimization on a majority of measures of adjustment, and further analyses provided evidence of the buffering effect of social support for some mediational models., Conclusions: Self-worth and social support are important targets for prevention and intervention for both victimization and poor adjustment in adolescent severe obesity., (© The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com)

Objective: Examine relations between depressive symptoms, ethnic identity, and health-related quality of life (HRQOL) in overweight or obese (OV/OB) children., Methods: A total of 166 OV/OB 8- to 17-year-olds (M = 12.94 years; 86.7% obese; 50.6% racial/ethnic minority) attending an outpatient pediatric obesity medical clinic participated. Children completed the Children's Depression Inventory-Short Form, Multigroup Ethnic Identity Measure (MEIM), and Pediatric Quality of Life Inventory., Results: Increased depressive symptoms significantly predicted reduced total, physical, and psychosocial HRQOL. For minority OV/OB youth only, MEIM Affirmation/Belonging moderated depressive symptoms and total HRQOL (effect = -2.59, t = -2.24, p = .027; R(2) overall model = 0.315) and depressive symptoms and psychosocial HRQOL (effect = -3.01, t = -2.47, p = .015; R(2) overall model = 0.331)., Conclusions: Depressive symptoms are negatively associated with HRQOL. In minority OV/OB youth, high ethnic identity may be protective when depressive symptoms are minimal. Ethnic identity and other cultural factors are important to consider in psychosocial treatments for pediatric obesity., (© The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: To examine disordered eating and associations with health-related quality of life (HRQOL) in rural overweight/obese (OW/OB) children., Methods: Cross-sectional analyses were conducted with 272 rural OW/OB children aged 8-12 years (M = 10.36; SD = 1.39). Child anthropometrics, demographics, disordered eating attitudes, unhealthy weight control behaviors (UWCBs), and HRQOL were measured. Relationships between these variables were analyzed using bootstrapped multiple linear regressions., Results: Clinically significant disordered eating attitudes were endorsed by 17% of the sample, and the majority endorsed UWCBs. Disordered eating attitudes and weight status were the most common predictors of HRQOL. Disordered eating attitudes and UWCBs were negatively related to emotional HRQOL but were unrelated to social, school, or physical HRQOL., Conclusions: Disordered eating is a serious and relevant problem in OW/OB children living in rural areas and may be indicative of impairments in emotional functioning. Early intervention may reduce the risk for eating disorders and associated negative sequelae., (© The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)