青少年身体羞耻及异常进食行为与进食障碍倾向的交叉滞后分析

Cross-lagged analysis of body shame, abnormal eating behavior and eating disorder tendency among adolescents

目的 了解青少年身体羞耻、异常进食行为与进食障碍倾向的纵向关系,为青少年进食问题干预提供参考。方法 于2020年9月开始对黑龙江省2所高中和2所高校共1 097名学生进行3次(T1、T2、T3)纵向追踪研究,每次间隔9个月。采用中文身体羞耻量表、中文版荷兰进食行为问卷和进食障碍筛查问卷进行测量,采用交叉滞后分析探讨青少年身体羞耻、异常进食行为与进食障碍倾向的关系。结果 青少年的身体羞耻、异常进食行为及进食障碍倾向均表现出上升趋势,但仅有异常进食行为的时间主效应有统计学意义(F=3.78,P<0.05,η2=0.18),性别主效应均有统计学意义(F值分别为18.06,30.48,25.09,P值均<0.01);身体羞耻、异常进食行为与进食障碍倾向之间均呈正相关(T1:r=0.34~0.58,T2:r=0.35~0.56,T3:r=0.33~0.53,P值均<0.01);身体羞耻能够跨时间预测异常进食行为(βT1-T2=0.13,βT2-T3=0.08),且在女生中预测作用更强(βT1-T2=0.16,βT2-T3=0.12),男生中仅在T1~T2之间有统计学意义(βT1-T2=0.09)(P值均<0.05);异常进食行为(βT1-T2=0.14,βT2-T3=0.15)与进食障碍倾向(βT1-T2=0.26,βT2-T3=0.24)存在跨时间互相预测作用(P值均<0.05);异常进食行为在身体羞耻预测进食障碍倾向之间存在着中介效应(βab=0.019,95%CI=0.006~0.047,P<0.05),在女生中中介效应更强(βab=0.029,95%CI=0.008~0.053,P<0.05)。结论 青少年身体羞耻正向预测异常进食行为,异常进食行为和进食障碍倾向能够互相影响,且身体羞耻能够通过作用于异常进食行为间接影响进食障碍倾向。

Objective To understand the longitudinal relationship between body shame, abnormal eating behavior and eating disorder tendency of adolescents, so as to provide reference for the intervention of eating problems among adolescents. Methods From September 2020, a total of 1 097 students from two high schools and two universities in Heilongjiang Province were investigated for three times(T1, T2 and T3) with an interval of 9 months. Adolescents completed the Chinese Body Shame Scale, the Chinese Version of Dutch Eating Behavior Questionnaire and the Sick, Control, One, Fat, Food(SCOFF) questionnaire. A cross-lag analysis was used to explore the relationship between body shame, abnormal eating behavior and eating disorder tendency. ResultsThe body shame, abnormal eating behavior and eating disorder tendency of adolescents showed an upward trend, but only the main effect of time on abnormal eating behavior was statistically significant(F=3.78, P<0.05, η~2=0.18), and the main effect of gender on three variables were statistically significant(F=18.06, 30.48, 25.09, P<0.01). There were significant and positive correlations between body shame, abnormal eating behavior and eating disorder tendency at three wave survey(T1:r=0.34-0.58, T2:r=0.35-0.56, T3:r=0.33-0.53, P<0.01). Body shame could predict abnormal eating behavior across time(βT1-T2=0.13, βT2-T3=0.08, P<0.05), and the predictive effect was stronger in female(βT1-T2=0.16, βT2-T3=0.12, P<0.05), only the effect between T1 and T2 was significant in male(βT1-T2=0.09, P<0.05). Abnormal eating behavior(βT1-T2=0.14, βT2-T3=0.15, P<0.01) and eating disorder tendency(βT1-T2=0.26, βT2-T3=0.24, P<0.01) had cross-time predictive effect. Abnormal eating behavior showed a mediating effect on the association between body shame and eating disorder tendency(βab=0.019, 95%CI=0.006-0.047, P<0.05), and the mediating effect was stronger in female(βab=0.029, 95%CI=0.008-0.053, P<0.05). Conclusion Adolescents’ body shame positively predicts abnormal eating behavior. Abnormal eating behavior and eating disorder tendency interact with each other, and body shame can indirectly affect eating disorder tendency through acting on abnormal eating behavior.