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

Abstract

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 tw-o 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.

Results The 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 (β _{T1– T2} = 0.13, β _{T2– T3} = 0.08, P<0.05), and the predictive effect was stronger in female (β _{T1– T2} = 0.16, β _{T2– T3} =0.12, P<0.05), only the effect between T1 and T2 was significant in male (β _{T1– T2} =0.09, P<0.05). Abnormal eating behavior (β _{T1– T2} = 0.14, β _{T2– T3} =0.15, P<0.01) and eating disorder tendency (β _{T1– T2} = 0.26, β _{T2– 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 (β _ab = 0.019, 95% CI = 0.006–0.047, P<0.05), and the mediating effect was stronger in female (β _ab = 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.

Abstract

【摘要】 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所髙中和2所髙校共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査问卷进行测量, 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, η ²=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(β _{T1– T2} =0.13, β _{T2– T3} =0.08), 且在女生 中预测作用更强(β _{T1– T2} = 0.16, β _{T2– T3} =0.12), 男生中仅在T1~T2之间有统计学意义(β _{T1– T2} =0.09) ( P值均<0.05); 异常进食 行为(β _{T1– T2} =0.14, β _{T2– T3} =0.15)与进食障碍倾向(β _{T1– T2} =0.26, β _{T2– 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(β _ab =0.019, 95% CI = 0.006 ~0.047, P<0.05), 在女生中中介效 应更强(β _ab =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。