Network analysis of anxiety, depression and perceived stress with eating behaviors in adolescents
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摘要:
目的 探索青少年焦虑、抑郁、感知压力与饮食行为的网络结构，为青少年饮食行为问题及负性情绪的有效预防和干预提供依据。 方法 基于“2021年中国居民心理与行为调查研究”数据库，纳入3 087名青少年。采用坂田饮食行为量表简版(EBS-SF)调查青少年饮食行为情况，采用患者健康问卷(PHQ-9)、广泛性焦虑障碍量表(GAD-7)、感知压力问卷(PSQ-3)评估青少年的抑郁、焦虑、感知压力。使用网络分析方法构建青少年饮食行为-负面情绪症状网络，评估各项目的中心性程度、桥梁强度以及稳定性和精准性。 结果 青少年饮食行为、抑郁、焦虑、压力感知总分分别为(17.41±4.53)(6.95±6.08)(4.86±5.03)(9.34±3.80)分；强度和预期影响最高的症状是“我购买食物的时候，购买的数量超过我的需要，我才满意”，节点强度与预期影响值为4.37；节点“抑郁”和“焦虑”连接最紧密(权重为0.87)。不同性别、居住地亚组的网络结构(M值分别为0.13，0.11)和网络连接强度(女性与男性：4.16，4.06，s=0.10；城镇与农村：4.08，4.07，s=0.01)的差异均无统计学意义(P值均>0.05)。 结论 可通过针对核心症状和桥梁症状的预防和干预，减少焦虑、抑郁、感知压力和饮食行为问题对青少年的负面影响。 Abstract:Objective To explore the network structure of eating behaviors with anxiety, depression and perceived stress in adolescents, so as to provide a basis for effective prevention and intervention of eating behavior problems and negative emotions in adolescents. Methods Based on the Psychology and Behavior Investigation of Chinese Residents (2021) database, the study was conducted among 3 087 adolescents. Sakata Eating Behavior Scale Short From(EBS-SF) was used to investigate their eating behaviors. The Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder Scale-7 Item(GAD-7), and Perceived Stress Questionnaire-3 Item (PSQ-3) were used to evaluate their depression, anxiety and perceived stress. Network analysis method was applied to construct a network of eating behaviors and negative emotional symptoms among adolescents, so as to evaluate the centrality, bridge strength, stability and accuracy of each item. Results The total scores of eating behaviors, depression, anxiety and stress perception in adolescents were 17.41±4.53, 6.95±6.08, 4.86±5.03, 9.34±3.80, respectively. The symptom with the highest intensity and expected impact was "I am only satisfied when I buy more food than I need", with a node intensity and expected impact value of 4.37. The nodes Depression and Anxiety were the most closely connected(weight=0.87). There were no statistically significant differences in the network structure(M=0.13, 0.11) and network connection strength(female and male: 4.16, 4.06, s=0.10;urban and rural areas: 4.08, 4.07, s=0.01) between different sexes and residents (P>0.05). Conclusion The negative impact of comorbidities such as anxiety, depression, perceived stress and eating behaviors among adolescents can be reduced through targeted prevention and intervention of core symptoms and bridging symptoms. -
Key words:
- Anxiety /
- Depression /
- Pressure /
- Food habits /
- Mental health /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。2) 何景波与张熠扬为共同第一作者 -
图 1 青少年饮食行为与焦虑、抑郁、感知压力的症状网络
注：EBS-SF1~SF7分别为EBS-SF的7个条目；边缘线越粗、颜色越深，表示相关性越强。
Figure 1. Symptom network of eating behavior with anxiety, depression and perceived stress in adolescents
图 2 青少年饮食行为与焦虑、抑郁、感知压力症状网络中心性特征
注：EBS-SF1~SF7分别为EBS-SF的7个条目。
Figure 2. Centrality characteristics of symptom network of eating behavior with anxiety, depression and perceived stress in adolescents
图 3 青少年饮食行为与焦虑、抑郁、感知压力桥接网络
注：EBS-SF1~SF7分别为EBS-SF的7个条目。
Figure 3. Bridge network of eating behavior with anxiety, depression and perceived stress in adolescents
表 1 不同组别青少年饮食行为得分比较(x±s)
Table 1. Comparison of eating behavior scores among different groups of adolescents(x±s)
组别 选项 人数 饮食行为 t/F值 P值 年龄/岁 ≤18 1 065 16.75±4.36 -6.01 ＜0.01 19~25 2 022 17.76±4.58 性别 男 1 303 17.43±4.74 0.15 0.88 女 1 784 17.39±4.38 常住地 城镇 2 158 17.37±4.59 -0.72 0.47 农村 929 17.50±4.40 文化程度 小学及以下 125 16.39±4.88 15.61 ＜0.01 初中及高中 856 16.80±4.31 大专及以上 2 106 17.71±4.57 家庭类型 单亲 158 16.99±4.60 2.99 0.01 隔代 36 17.33±4.70 核心 2 368 17.30±4.45 联合 62 18.61±5.03 其他形式 319 18.12±5.01 主干 144 17.50±4.32 民族 少数民族 204 17.51±4.14 0.35 0.73 汉族 2 883 17.40±4.56 焦虑 无 1 628 16.35±4.63 112.60 ＜0.01 轻度 972 17.76±3.82 中度 373 19.39±3.26 重度 114 22.99±5.57 抑郁 无 1 238 16.06±4.76 134.06 ＜0.01 轻度 1 112 17.31±3.78 中度 363 18.61±3.75 中重度及重度 374 21.00±4.24 感知压力 轻度 773 16.23±4.77 38.67 ＜0.01 中度 2 127 17.66±4.23 重度 187 19.35±5.61 BMI类别 体重过轻 748 16.42±4.62 42.82 ＜0.01 正常体重 1 894 17.35±4.45 超重 361 19.23±4.10 肥胖 84 19.67±4.22 兄弟姐妹数量/个 ≥3 185 17.41±4.47 0.22 0.88 0 1 120 17.46±4.77 1 1 437 17.34±4.45 2 345 17.50±4.12 家庭人均月收入/元 ≤3 000 1 075 17.45±4.21 1.28 0.28 3 001~6 000 1 103 17.36±4.50 6 001~9 000 452 17.11±4.82 >9 000 457 17.73±5.02 
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