Capturing complexity: a network approach to understanding child and parent causal attributions in childhood obesity

Abstract

Illness attributions affect psychological adjustment, while parental attributions are associated with treatment initiation, acceptability, engagement and outcome. Current knowledge of child and parent causal attributions in paediatric obesity is in its infancy. The purpose of this study was to investigate child and parental casual attributions in paediatric obesity using network analysis. A cross-sectional design was used employing the diagram network analytic method. 56 participants (30 children, 26 parents) generated individual causal attribution maps. Network theory was used in the analysis of causal effects and results visualised using open source network visualisation software. Separate aggregated maps were produced for children and parents. Child maps were analysed by eating style (emotional, external and restraint eating). Parent maps were analysed by reported child psychopathology (externalising and internalising). An individual map was reproduced to illustrate the value of network analysis as a clinical tool. Analysis by eating style and child psychopathology captured meaningful differences in causal understanding, illustrating the heterogeneous nature of this population. A ‘one-size-fits-all’ approach to the treatment of pediatric obesity is likely to be suboptimal given the diversity of this patient group. Child and parent attributional processes show potential as a treatment target and a mechanism to individually-tailor obesity treatment for children and parents. Further research is required to demonstrate a relationship between the treatment of attributions and client outcome in pediatric obesity.