Temperament and emotional overeating: the mediating role of caregiver response to children's negative emotions

Emotional overeating (EOE), consuming excessive food to regulate negative emotions, is a significant concern from early childhood onward. It often involves high-calorie, energy-dense foods, increasing obesity risk. Given the global health concern of childhood obesity, identifying early precursors of obesogenic behaviors like EOE is crucial. While genetics play a role, relational and environmental factors, particularly caregiver feeding practices, significantly influence EOE. This study focuses on early childhood, a critical period for self-regulation and eating pattern development. The research question centers on the associations between infant temperament, caregiver responses to negative emotions, and subsequent EOE in preschool children, aiming to clarify the mechanisms linking early temperament to later EOE.

Food consumption is primarily driven by homeostatic motivations (hunger and satiety). However, hedonic motivations (eating for pleasure and emotion regulation) can override physiological signals. EOE is hypothesized as a learned response to regulate negative emotions through food consumption. Previous research links EOE to individual (child temperament), relational (caregiver feeding practices), and environmental factors. Child temperament, encompassing negative affectivity, orienting/regulation, and surgency, has been associated with EOE. Higher negative affectivity and lower self-regulation are linked to increased EOE, suggesting a greater need for emotion regulation. Surgency's relationship with EOE is less clear, but it could indicate higher food approach behaviors. Early caregiving practices, including feeding practices and broader emotional responses, have significant influence. Parental use of food for emotion regulation predicts increased sweet consumption under stress in young children. Caregiver warmth and emotional responsiveness are also crucial, with low responsiveness linked to increased EOE. A lack of research exists on how caregiver responses to negative emotions, outside of feeding practices, may mediate the relationship between early temperament and EOE in preschool children.

This study analyzed data from 358 children and their caregivers participating in the STRONG Kids 2 (SK2) longitudinal birth cohort study. Data were collected at three time points: 3 months (T1), 18 months (T2), and 36 months (T3). Caregivers completed questionnaires assessing child temperament (Infant Behavior Questionnaire-Revised Very Short Form [IBQR-VSF] at T1), caregiver response to negative emotions (Coping with Children's Negative Emotions Scale [CCNES] at T2), and child emotional overeating (Child Eating Behavior Questionnaire [CEBQ] at T3). Demographic data (child gender, race/ethnicity, parent education, household income) were also collected. Structural Equation Modeling (SEM) using the lavaan package in R was employed to test the hypothesized mediating role of caregiver responses. The model included three latent variables: supportive caregiver response, non-supportive caregiver response, and emotional overeating. Missing data were handled using Full Information Maximum Likelihood (FIML). Confirmatory factor analysis (CFA) was first conducted to assess the validity of the caregiver response constructs. Then, the SEM model assessed the direct and indirect effects of temperament (negative affectivity, orienting/regulation, surgency) on EOE, mediated by supportive and non-supportive caregiver responses, controlling for demographic variables. Bootstrapping (n=5,000) was used to assess the significance of indirect effects.

The CFA showed good fit for the modified model of caregiver responses. The SEM analysis revealed several key findings: 1) Infant temperamental surgency at T1 had a significant positive direct effect on EOE at T3. 2) Supportive caregiver responses at T2 significantly negatively predicted EOE at T3. 3) Non-supportive caregiver responses at T2 significantly positively predicted EOE at T3. 4) Supportive caregiver responses significantly mediated the relationship between infant orienting/regulation and EOE. Higher orienting/regulation predicted more supportive responses, which in turn were associated with less EOE. 5) Non-supportive caregiver responses did not significantly mediate the relationship between temperament and EOE. 6) Negative affectivity at T1 did not show a significant direct or indirect effect on EOE. The model demonstrated a good fit to the data (χ²(104) = 144.84, p < 0.005, CFI = 0.959, TLI = 0.945, RMSEA = 0.033, SRMR = 0.043).

The findings support the hypothesis that caregiver responses to children's negative emotions mediate the link between infant temperament and subsequent EOE. The indirect effect of orienting/regulation on EOE, mediated by supportive caregiver responses, suggests that caregivers' ability to respond supportively to a child's distress is particularly important for children with lower self-regulatory abilities. This finding highlights the transactional nature of the caregiver-child relationship. The direct effect of surgency on EOE suggests that this temperament dimension may have an independent influence on eating behaviors. The significant direct effect of non-supportive caregiver responses underscores the importance of addressing maladaptive caregiver behaviors. The lack of an effect for negative affectivity requires further investigation. The results point towards interventions focused on supporting caregivers in developing effective strategies for responding to their children's negative emotions.

This study highlights the crucial role of caregiver responses in the development of emotional overeating, particularly the mediating role of supportive responses to negative emotions. Infant temperament, specifically orienting/regulation and surgency, demonstrate distinct pathways influencing EOE. Future research should explore these pathways across development, investigate the specific aspects of temperament eliciting different caregiver responses, examine diverse samples, and use multiple data collection methods to reduce reliance on caregiver reports.

The study's reliance on caregiver reports may introduce common informant bias. The sample's predominantly White and well-educated demographic limits generalizability. The internal consistency of some temperament subscales was slightly below the ideal threshold. Future studies should address these limitations by including observational measures, diverse samples, and multiple informants.