Parent and Child Reports of Food Insecurity and Mental Health: Divergent Perspectives

Rachel Bernard; Rebecca Hammarlund; Mikki Bouquet; Taiwo Ojewole; Diane Kirby; Joseph Grizzaffi; Pamela McMahon

doi:10.31486/toj.18.0037

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Table 1. Comparison of Adults’ Perception of Children’s Behavior and Corresponding Child Self-Reported Survey Items

Item Type		Adult Survey Item		Child Survey Item
Food insecurity: adult self-report		Within the past 12 months:		N/A
	(a)	I worried whether our food would run out before we got money to buy more.
	(b)	the food we bought just didn’t last, and we didn’t have money to get more.
Food insecurity: adult report for child vs child self-report		Within the past 12 months, how often do you think the child:		Think about the past year. How many times did you:
	1	worried whether food would run out before the family got money to buy more?	1	get scared that your family would run out of food?
		N/A	2	run out of food at your house because of money?
	2	ate less food than they wanted in order to help make the food supply last?	3	eat a smaller meal than you wanted to help save food?
		Think about how the child is every day. How often do you think the child feels the following things?		Think about how you feel most days. How often do you feel each of these things?
Food-related concerns	3	Worry that he/she won’t get to eat a meal.	4	I worry that I won’t get to eat a meal.
	4	Can’t stop thinking about when he/she will eat.	5	I can’t stop thinking about when I will eat.
	5	Hides food so that he/she can eat it later.	6	I hide food so that I can eat it later.
Generalized anxiety symptoms	6	Worry that something bad will happen to him/her.	7	I worry that something bad will happen to me.
	7	Has stomach pains when he/she is upset.	8	When I am upset, my stomach hurts.
Obsessions and compulsions	8	Can’t get bad or silly thoughts out of his/her head.	9	I can’t get bad or silly thoughts out of my head.
	9	Has to do some things over and over again.	10	I have to do some things over and over again.
		Over the last 2 weeks, how often have you been bothered by the following problems?		N/A
Adult depression	10	I had little interest or pleasure in doing things.
	11	I felt down, depressed, or hopeless.
		Over the last two weeks, how often do you think the child has been bothered by the following problems?		Think about the past two weeks.
Child depression	12	The child had little interest or pleasure in doing things.	11	How often did you feel like nothing is fun?
	13	The child felt down, depressed, or hopeless.	12	How often did you feel sad or down?

N/A, not applicable

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Table 2. Demographic Characteristics of the Adult Sample

Variable	Value
Age, years, mean ± SD	37.4 ± 10.36
Number of adults in household, mean ± SD	1.24 ± 1.03
Number of children in household, mean ± SD	2.79 ± 1.30
Relationship to child
Mother	51 (88)
Grandmother	5 (9)
Father	1 (2)
Missing	1 (2)
Race
African American	44 (76)
Caucasian	8 (14)
Other	5 (9)
Missing	1 (2)
Education level
Master’s/doctoral degree	2 (3)
Bachelor’s degree	8 (14)
Some college	28 (48)
Other postsecondary training	3 (5)
High school diploma	17 (29)
Food assistance program
None	24 (41)
WIC, SNAP, or both	32 (55)
Food bank only	2 (3)
Annual household income
<$20,000	24 (41)
$20,000-$40,000	23 (40)
$40,001-$60,000	7 (12)
>$60,001	2 (3)
Missing	2 (3)

Data are presented as n (%) unless otherwise indicated.
Total percentages are subject to rounding error.
SNAP, Supplemental Nutrition Assistance Program; WIC, Women, Infants, and Children nutrition program.

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Table 3. Comparison of Adult and Child Self-Reports of Food Insecurity, Worry, and Conservation Variables

Survey Variable	Concordance/Nonconcordance	Overall, n (%)	WIC/SNAP Users, n (%)	WIC/SNAP Nonusers, n (%)
Adult self-reported food insecurity status vs child self-reported food insecurity status	Adult-child agreement	37 (64)	20 (63)	17 (65)
	Adult overestimate	14 (24)	9 (28)	5 (19)
	Adult underestimate	7 (12)	3 (9)	4 (15)
Adult report of child food worry vs child self-reported food worry^{^a}	Adult-child agreement	34 (60)	18 (56)	16 (64)
	Adult overestimate	8 (14)	3 (9)	5 (20)
	Adult underestimate	15 (26)	11 (34)	4 (16)
Adult report of child food conservation vs child self-reported food conservation^{^a}	Adult-child agreement	34 (60)	16 (50)	18 (72)
	Adult overestimate	5 (9)	5 (16)	0 (0)
	Adult underestimate	18 (32)	11 (34)	7 (28)

↵^a One data point is missing in the WIC/SNAP Nonusers group.
Total percentages are subject to rounding error.
SNAP, Supplemental Nutrition Assistance Program; WIC, Women, Infants, and Children nutrition program.

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Table 4. Comparison of Adult and Child Self-Reports of Food-Related Concerns and Symptoms of Depression, Anxiety, and Obsessive-Compulsive Disorder (OCD)

Survey Variable	Concordance/Nonconcordance	Overall, n (%)	WIC/SNAP Users, n (%)	WIC/SNAP Nonusers, n (%)
Food-related concerns^{^a}	Adult-child agreement	14 (25)	5 (16)	9 (36)
	Adult overestimate	15 (27)	11 (36)	4 (16)
	Adult underestimate	27 (48)	15 (48)	12 (48)
Depression symptoms	Adult-child agreement	24 (41)	12 (38)	12 (46)
	Adult overestimate	8 (14)	5 (16)	3 (12)
	Adult underestimate	26 (45)	15 (47)	11 (42)
Generalized anxiety symptoms^{^a}	Adult-child agreement	19 (34)	9 (29)	10 (40)
	Adult overestimate	4 (7)	3 (10)	1 (4)
	Adult underestimate	33 (59)	19 (61)	14 (56)
OCD symptoms	Adult-child agreement	15 (26)	6 (19)	9 (35)
	Adult overestimate	6 (10)	5 (16)	1 (4)
	Adult underestimate	37 (64)	21 (66)	16 (62)

↵^a Data points are missing; valid percentages are reported.
Total percentages are subject to rounding error.
SNAP, Supplemental Nutrition Assistance Program; WIC, Women, Infants, and Children nutrition program.

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Table 5. Comparison of Concerns and Symptoms in Children from Food Insecure vs Non–Food Insecure Homes

			Test Statistic
Survey Variable, mean score ± SD	Child-Reported Food Insecurity	Child-Reported Non–Food Insecurity	df	t	P Value
Food-related concerns	4.76 ± 1.57	4.11 ± 1.26	Not significant
Depression symptoms	3.86 ± 1.89	2.72 ± 1.03	43.4	−2.85	<0.01
Generalized anxiety symptoms	3.62 ± 1.01	2.79 ± 0.99	55	−3.14	<0.01
Obsessive-compulsive disorder symptoms	4.90 ± 1.57	3.41 ± 1.32	56	−3.89	<0.001