Dr Helen Coulthard

Job: Senior Lecturer

Faculty: Health and Life Sciences

School/department: School of Applied Social Sciences

Address: De Montfort, University, The Gateway, Leicester, LE1 9BH.

T: +44 (0)116 207 8828

E: hcoulthard@dmu.ac.uk

W: http://www.dmu.ac.uk/hls

 

Personal profile

A developmental psychologist who is primarily interested in the development of eating behaviour and psychopathology. Particular areas of interest include fruit and vegetable consumption, and food neophobia, throughout the lifespan.

Dr Coulthard's research centres on furthering understanding of the strategies that relate to increasing healthy food consumption, including exposure, modelling, restriction, pressure, as well as individual characteristics which contribute to pathology, such as anxiety and sensory processing.

She is also interested in the early predictors of problematic eating behaviour in later life.

Research group affiliations

Psychology

Publications and outputs 

  • The Role of Self-Disgust and Emotion Regulation within Recovering from an Eating Disorder: A Mixed Methods, Longitudinal Perspective
    The Role of Self-Disgust and Emotion Regulation within Recovering from an Eating Disorder: A Mixed Methods, Longitudinal Perspective Bell, Katie; Coulthard, Helen; Wildbur, Diane 1) Background There is a substantial body of literature supporting the view that disordered eating behaviour is broadly characterized by emotion dysregulation but little attention has been paid to the possible mediators that could explain this relationship. 2) Method Three hundred and fifteen female participants, with a self-reported diagnosis of anorexia nervosa (n=155), bulimia nervosa (n=97) or no previous history of an eating disorder (n=63) took part in a questionnaire based longitudinal study, using measures of eating disorder symptoms as the outcome variables and scores of self-disgust (SD) and difficulties in emotion regulation (DER) as the predictor variables. Out of this sample, twelve were also interviewed to learn more about their lived experiences of recovery and how SD may have impacted on this. 3) Results SD was significantly, positively associated with all sub types of difficulties in emotion regulation and disordered eating behaviour, as well measures of anxiety and depression. In line with this, SD also predicted eating disorder symptomology after controlling for anxiety, depression and emotional regulation difficulties. Key themes from the interviews are also discussed. 4) Discussion Difficulties in emotion regulation have already been established as a useful target for therapeutic intervention and therefore targeting and developing strategies to deal with SD explicitly may offer another strand of potential treatment for those with an eating disorder.
  • Using repeated visual exposure, rewards and modelling in a mobile application to increase vegetable acceptance in children
    Using repeated visual exposure, rewards and modelling in a mobile application to increase vegetable acceptance in children Farrow, C.; Belcher, E.; Coulthard, Helen; Thomas, J.M.; Lumsden, J.; Hakobyan, L.; Haycraft, E. Children are not consuming the recommended amounts of fruit and vegetables. Repeated visual exposure, modelling, and rewards have been shown to be effective at increasing vegetable acceptance in young children. The aim of this study was to assess the effectiveness of an evidence-based mobile application (Vegetable Maths Masters) which builds on these principles to increase children’s liking and acceptance of vegetables. Seventy-four children (37 male, 37 female) aged 3-6 years old were randomised to play with either the vegetable app or a similar control app that did not include any foods. Children played their allocated game for 10 minutes. Liking and acceptance of the vegetables used in Vegetable Maths Masters (carrot and sweetcorn) and other vegetables which were not used in the game (yellow pepper and tomato) were measured pre- and post-play in both groups. Parents provided data about their child’s food fussiness and previous exposure to the foods being used. Children who played with the Vegetable Maths Masters app consumed significantly more vegetables after playing with the app and reported significant increases in their liking of vegetables, relative to the control group. The effect of the Vegetable Maths Masters app on the change in consumption of vegetables was mediated by the change in liking of vegetables. These findings suggest that evidence-based mobile apps can provide an effective tool for increasing children’s liking and consumption of vegetables in the short-term. Further work is now required to establish whether these effects are maintained over time. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • “It's always on the safe list”: Investigating experiential accounts of picky eating in adults
    “It's always on the safe list”: Investigating experiential accounts of picky eating in adults Fox, G.; Coulthard, Helen; Williamson, I. R.; Wallis, D. J. Previous research into severely restricted eating for reasons which are not cultural, medical, due to a lack of food or due to concerns about body image has focused predominantly on “picky/fussy eating” in children. Despite evidence that picky eating does continue into adulthood and recognition in the new diagnostic category. Avoidant Restrictive Food Intake Disorder (ARFID) that problematically avoidant and restrictive patterns of eating affect people across the lifespan, relatively little is known about the challenges and consequences faced by older adolescents and adults. This research employs qualitative methods to explore the experience of living as an adult with picky eating behaviours. Semi-structured interviews were undertaken with thirteen adults who identify as picky eaters and eat a highly limited diet, as determined by a checklist food questionnaire. Data were analysed using interpretative phenomenological analysis (IPA). Two themes are presented in this paper: “Constructions of food” and “Motivators for and barriers to change”. These themes show the importance of how individuals perceive food, their diet and themselves, and implications for clinical practice and future research in light of these findings are considered. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • Music listening as a potential aid in reducing emotional eating: An exploratory study
    Music listening as a potential aid in reducing emotional eating: An exploratory study Van den Tol, Annemieke, J. M.; Coulthard, Helen; Hanser, W. E. Emotional Eating (EE) is understood as a maladaptive self-regulation strategy to satisfy emotional needs instead of hunger. Consequently, EE has been associated with negative health consequences. Enjoyment of food and music share similar neural activations in the brain and are both used by people for regulating affect. This suggests that music listening could potentially be a healthier alternative to EE. The present study was designed to investigate associations between EE, disordered mood, and music-related mood regulation. A total of 571 participants completed measures of EE, music listening strategies, and disordered mood. Associations between seven different music listening strategies and EE were examined, and also whether these regulation strategies were associated with depression, anxiety, and stress. Finally, we explored associations between music listening and EE in people with low and high (non-clinical) levels of disordered mood (depression, anxiety, and stress). The findings of this research indicated that music listening for discharge (releasing anger or sadness through music that expresses these same emotions) and EE were positively associated with one another. In addition, EE and the music listening strategies of entertainment, diversion or mental work were associated in people with low levels of disordered mood. When disordered mood was high, EE was higher, but was not associated with music listening strategies. These associations point towards the possibility of some music listening strategies being useful as healthier alternatives for EE. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • Multisensory evaluation and the neophobic food response
    Multisensory evaluation and the neophobic food response Farrow, C. V.; Coulthard, Helen Neophobia or the “fear of new foods” is a common developmental response that most children demonstrate at some point; however, there is also considerable variability between children in the expression of neophobic behaviors. The extent of sensory sensitivity that different children express is one factor that may predict the degree of food neophobia. In this chapter we review the role of sensory sensitivity in pediatric eating behavior and present evidence that has linked olfactory, visual, taste, and texture sensitivity to food refusal, food fussiness, and neophobia in children. We then evaluate the effectiveness of interventions that have been developed to tackle food fussiness and neophobia through using nontaste activities that allow multisensory exploration. We discuss the concept of a new decision-making model for neophobia and ideas for further research and interventions to reduce sensory related food refusal in children
  • Evaluation of a pilot sensory play intervention to increase fruit acceptance in preschool children
    Evaluation of a pilot sensory play intervention to increase fruit acceptance in preschool children Coulthard, Helen; Williamson, I. R.; Palfreyman, Zoe; Lyttle, Steven Recent research has found an association between dislike of messy play and higher levels of food neophobia in children. The aim of the present study was to pilot and assess a five week intervention with preschool children, to examine whether engagement in tactile sensory tasks leads to increased fruit acceptance. Interventions were carried out to examine whether weekly sessions of sensory play combined with fruit exposure, would increase acceptance and enjoyment of fruits to a greater extent than two non-sensory play conditions featuring fruit exposure or normal play activities alone. One hundred children aged 18 months to four years were recruited from ten playgroups in the Midlands area of the United Kingdom (UK) of which 83 completed the interventions. Participants were randomly assigned to one of four conditions: combined sensory play (fruit and non-food), non-food sensory play, fruit taste exposure, and control play. There were baseline differences in child fruit acceptance, so this was entered as a covariate into subsequent analyses. It was found that children in both the combined sensory play and non-food sensory play conditions enjoyed significantly more fruits at follow up than children in the control play condition, whilst children in the non-food sensory play group also enjoyed significantly more fruits than the fruit exposure group. These findings suggest that sensory play, with fruit and/or non-food substances, combined with exposure may be an effective strategy to increase tasting and fruit acceptance in children. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link
  • Self-disgust within eating disordered groups: Associations with anxiety, disgust sensitivity and sensory processing.
    Self-disgust within eating disordered groups: Associations with anxiety, disgust sensitivity and sensory processing. Bell, Katie; Coulthard, Helen; Wildbur, D. J. This study aimed to assess the relationship between self-disgust and sensory processing within eating psychopathology. Five hundred and ninety one women with a self-reported diagnosis of anorexia nervosa, bulimia nervosa or who had no previous history of an eating disorder completed a battery of on-line questionnaires measuring disgust, emotion and sensory variables. Those with an eating disorder reported significantly higher rates of self-disgust than those with no history of disordered eating. In groups of women with self-reported bulimia, self-disgust was associated with sensation avoidance and sensation seeking. Within the group with anorexia nervosa, self-disgust was associated with low registration and sensation seeking. This report is the first to examine the expression of the emotion self-disgust within eating psychopathology and examine associations of this factor with sensory processing. The emotion self-disgust needs to be further examined to understand its possible role in the onset and maintenance of disordered eating. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • Early maladaptive cognitive schema as predictors of acute phase post-stroke depression
    Early maladaptive cognitive schema as predictors of acute phase post-stroke depression Mitchell, H.; Coulthard, Helen; Stalias, M. Post-stroke depression is a leading cause of disability and the identification of risk factors is critical for rehabilitation and prevention initiatives. Early Maladaptive Cognitive Schema (EMS) have been implicated with depression with no known medical cause but not previously explored in post-stroke depression. The overall purpose of the study was to explore the role of EMS in post stroke depression. The Young Schema Questionnaire-Short Form (YSQ-SF) is used to assess EMS, and one objective was the validation of the YSQ-SF in a post-stroke sample. The validated questionnaire was subsequently used to identify EMS as covariates of post-stroke acute phase depression. Further, additional variables of health locus of control, social support and level of disability, among others, were also explored as covariates. The sample consisted of a total of 69 participants (M=64.97, SD=14.72 years old) who were recruited on average 25.10 days (SD=29.61) post-stroke. The theoretical structure of the YSQ-SF was successfully replicated in this post-stroke sample with 68 of the original 75 items having loadings greater than 0.40 and internal consistencies ranging between 0.62 and 0.89, and significant acute phase covariates with acute phase depression were the Failure to Achieve and the Vulnerability to Harm EMS. These findings show promising trends in the involvement of EMS in post-stroke psychopathology which warrants further investigation in this clinical group. (217 words) Summary Stroke is the third most common cause of disability worldwide (Mackay et al., 2004) and post-stroke depression is the most frequent neuropsychiatric disorder affecting acute stroke patients (Caeiro et al., 2006). Post-stroke depression is commonly diagnosed during the acute and subacute phase post-stroke with peak prevalence 3-6 months post-stroke (Newberg et al., 2006) and is associated with higher rates of morbidity, mortality and poor rehabilitation outcomes (Newberg et al., 2006; Whyte et al., 2006). Psychosocial factors associated with post-stroke depression include an external health locus of control (Thomas et al., 2006; Johnston et al., 1999), and lack of a social network and tangible support (Glymour et al., 2008; Huang et al., 2010; Salter et al., 2010). Demographic variables include gender and race, with women being at increased risk of depression post-stroke (Paolucci et al., 2005; Zhang et al., 2013) as well as white, non-Hispanic patients (Jia et al., 2010). Further, some medical/illness factors including lesion location (Allman, 1991; Caeiro et al., 2006), aphasia (Thomas et al., 2006), and level of impairment on activities of daily living (Hilari et al., 2010) increase risk for depression. Schemas are mental structures that are created through experience and guide our response to our environment (Tuddenham, 1966; Berlyne, 1957). Young, Klosko & Weishaar (2003) presented 15 Early Maladaptive Cognitive Schema (EMS), which fit into 5 higher order domains, and are said to be the core of psychopathology and the result of adverse childhood experience. The Young Schema Questionnaire Short Form (YSQ-SF) is a 75-item questionnaire used to assess EMS. The psychometric properties of the YSQ-SF have been assessed in undergraduate and various clinical samples and translated into multiple languages (Wellburn et al., 2000; Lachenal-Chevallet et al., 2006; Cui et al., 2011; Calvete et al., 2005). The YSQ-SF appears sound for research and clinical practice, however the psychometric properties have not previously been assessed in a post-stroke clinical sample. The main objectives of this research were to assess the factor structure of the YSQ-SF in a post-stroke population, and to incorporate EMS as potential risk factors in the acute phase post-stroke. Sixty-nine post-stroke patients with an average age of 64.97 years (SD=14.72) were recruited 25.10 days (SD= 29.61) post stroke. The BDI, YSQ-SF, Social Support Questionnaire, Barthel Index, and Multidimensional Health Locus of Control were administered and demographic variables of gender, location of stroke, marital status, ethnicity, living arrangements, level of education, occupation, and previous history of psychopathology were collected. Cross-sectional analyses included a factor analysis for the validation of the YSQ-SF, and a regression identifying covariates of depression. Due to the sample size and recommendations for a factor analysis, the factor structure was assessed using the higher order domain breakdown creating an acceptable item to participant ratio for each domain. Domain 1: Disconnection/Rejection 2.76:1, Domain 2: Impaired Autonomy 3.45:1, Domain 3: Impaired Limits 6.9:1, Domain 4: Other-Directedness 6.9:1, and Domain 5 Overvigilance 6.9:1. The results of the current study yielded a successful replication of the YSQ-SF, validating all 15 EMS with 68 out of the original 75 items. Factor loadings were greater than 0.40, and internal consistencies ranged between 0.62 and 0.89, with 10 of the 15 schema over the accepted 0.70 level. Overall, the factor structure and underlying construct of each EMS was not compromised in this sample and despite sample size limitations the current results are consistent with previous research of Welburn et al. (2002), Lachenal-Chevallet et al. (2006), and Cui et al. (2011) who replicated the theoretical structure with a range between 59 and 70 of the 75 items and between 13 and 15 of the original 15 schemas. Of all the variables collected only the EMS of Failure to Achieve and Vulnerability to Harm were significant in the regression model. As both variables increased, depression scores increased. The EMS of Failure to Achieve has been positively correlated with depression in previous studies and in Wegener et al. (2003) the greater the decrease in the Failure to Achieve EMS was associated with greater symptom reduction in patients with major depressive disorder. Overall, EMS have not previously been explored in a post-stroke population and the results show promising trends in the influence and involvement of EMS in post-stroke psychopathology. EMS warrant further investigation in this clinical group that is highly vulnerable to such influences mainly for rehabilitation and prevention purposes, such as the use of the YSQ-SF as a screening instrument and the use of Schema Therapy as a new potential treatment modality for post-stroke depression.
  • Non taste exposure techniques to increase fruit and vegetable acceptance in children:effects of task and stimulus type
    Non taste exposure techniques to increase fruit and vegetable acceptance in children:effects of task and stimulus type Coulthard, Helen; Ahmed, Shazia The strategies adopted to encourage children to taste fruits and vegetables (FV) tend to focus on immediate tasting. However there is some recent research which suggests that non-taste sensory tasks may encourage acceptance. The purpose of the current study was to compare the efficacy of different sensory tasks in encouraging novel food acceptance in school children. One hundred and two children aged between 4 and 8 years (53 males and 47 females) were recruited from schools in the Leicester region of the UK during September-December 2015. Children were randomly allocated to one of four conditions, each of which varied according to two factors; a stimuli factor (real FV vs photographs of FV) and a task factor (bingo game vs categorisation). Baseline stimuli preference ratings for featured FV and food neophobia were measured. After the task child consumption (grammes) of a novel fruit (pomegranate) and a novel vegetable (fresh soya beans) was measured. The use of real FV tasks led to increased consumption of both the fruit (+4.01 g, p < 0.001) and the vegetable (+3.42 g, p < 0.05). The conditions in which children played a game, compared to a sorting task, led to increased vegetable consumption (+2.47 g, p < 0.05). This is the first study to examine whether playing games with foods immediately before a tasting session will increase consumption. Rather than emphasising tasting alone, it is believed that more creative strategies should be adopted to make FV tasting exciting. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • The mediating effect of self-disgust on emotion regulation and eating disorder symptoms: A longitudinal perspective.
    The mediating effect of self-disgust on emotion regulation and eating disorder symptoms: A longitudinal perspective. Bell, Katie; Coulthard, Helen; Wildbur, D. 1) Background There is a substantial body of literature supporting the view that disordered eating behaviour is broadly characterized by emotion dysregulation but little attention has been paid to the possible mediators that could explain this relationship. 2) Method Two hundred and fifty eight female participants, with a self-reported diagnosis of anorexia nervosa (n=156), bulimia nervosa (n=34) or no previous history of an eating disorder (n=68) took part in a questionnaire based longitudinal study, using measures of eating disorder symptoms as the outcome variables and scores of self-disgust (SD) and emotional regulation as the predictor variables. 3)Results SD was significantly, positively associated with all sub types of difficulties in emotion regulation and disordered eating behaviour, as well measures of anxiety and depression. In line with this, SD also predicted eating disorder symptomology after controlling for anxiety, depression and emotional regulation difficulties. SD was found to mediate the relationship between depression, non-acceptance of emotion responses and difficulties in controlling behaviours when upset and disordered eating behaviour. The differences in change scores compared to base line measures were also examined. 4) Discussion Difficulties in emotion regulation have already been established as a useful target for therapeutic intervention and therefore targeting and developing strategies to deal with SD explicitly may offer another strand of potential treatment for those with an eating disorder.
 

Click here for a full listing of Helen Coulthard's publications and outputs.

Research interests/expertise

  • Feeding problems and eating behaviour in infants and children
  • Age of complementary feeding in infants
  • Baby food provision and later eating behaviour
  • Food neophobia
  • Fruit and vegetable consumption
  • Parental strategies, including exposure, modelling, control
  • Individual characteristics which influence consumption, including anxiety and sensory processing
  • Early predictors of later problematic behaviour, including neophobia, reduced fruit and vegetable consumption, emotional eating, external eating and restrained eating.

Areas of teaching

  • Infant development
  • Health psychology
  • Psychology of eating behaviour
  • Statistics and research methods.

Qualifications

  • BSc Psychology
  • PhD

Courses taught

Core areas in psychology

  • Infant Development
  • Psychology of Health and Food across the Lifespan.

Conference attendance

  • Feeding behaviour in Infancy and Childhood, March 2010, Institute of Child Health, London, ‘Sensory processing and eating behaviour’ , Invited speaker.
  • Postgraduate research conference, June 2010, Institut Paul Bocuse, Lyons, ‘Psychological determinants of food neophobia’, invited speaker.

Externally funded research grants information

Comparison of feeding behaviour in infants weaned early and late, Danone, research project, 01/10-08/11, CI, project based at University of Birmingham.

Professional esteem indicators

Journal reviewing activities

  • Appetite, 2011 to present, reviewer
  • British Journal of Health Psychology, 2009 to present, reviewer
  • Child Care Health & Development, 2011 to present, reviewer
  • Maternal Child Nutrition, 2009 to present, reviewer
  • Eating Behaviours, 2006 to present, reviewer
  • Public Health Nutrition, 2010 to present, reviewer.

Grant reviewing activities

  • National Institute Health Research (NIHR) Public Health Research programme, 2011- present, reviewer.

Case studies

Dr Coulthard's research is very relevant to the advice given to parents about the strategies that are most effective in promoting a healthy diet in children. She has frequently attended postnatal groups and children’s centres, and talked to mothers about eating behaviour in children.

In addition, her research has been published in the media, especially on local news programmes and radio programmes. In addition there has been coverage on websites for both parental advice and the national media. She recently contributed to the BBC website, ‘Scrubbing Up’ which showcases opinions from experts in their field.

Helen Coulthard

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