青少年体象满意度与童年期不良经历的关联

左霞云; 张紫微; 廉启国; 余春艳; 涂晓雯; 房宇航; 楼超华

doi:10.16835/j.cnki.1000-9817.2023.03.014

青少年体象满意度与童年期不良经历的关联

doi: 10.16835/j.cnki.1000-9817.2023.03.014

1.
上海市生物医药技术研究院/国家卫生健康委员会计划生育药具重点实验室，200237
2.
苏州市吴中区卫生健康委员会

基金项目:

国家卫生健康委员会计划生育药具重点实验室科技创新导向项目 CX2017-05

世界卫生组织项目 ERC0003027

详细信息

作者简介:
左霞云(1980-)，女，江苏丹阳人，博士，副研究员，主要从事青少年健康行为方面工作

通讯作者:
楼超华，E-mail: louchaohua60@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.2
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出版历程
- 收稿日期: 2022-08-14
- 修回日期: 2022-11-27
- 刊出日期: 2023-03-25

Relationship between body image satisfaction and adverse childhood experiences in adolescents

1.
Key Lab of Reproduction Regulation of the National Health Commission, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai (200237), China

摘要

摘要: 目的研究青少年身体意象情况及与童年期不良经历(adverse childhood experiences, ACEs)间的关联，为有效应对青少年的体象问题提供依据。方法采用分层整群抽样的方法，对上海市3所初中六至八年级1 701名10~14岁学生进行计算机辅助的匿名问卷调查，问卷内容包括人口学特征、ACEs暴露、体象情况等。采用χ²检验和多因素Logistic回归分析青少年体象满意率和各种ACEs间的关联。结果 60.73%的青少年对自己的体象较为满意，男生的体象满意率(66.16%)高于女生(55.13%)，差异有统计学意义(χ²=21.70，P < 0.01)；79.19%的青少年至少经历过1种类型的ACE，分别有61.61%，65.14%和21.58%有过被虐待、忽视和家庭功能不良经历。多因素Logistic回归分析显示，女生中有过任一种ACE、虐待、忽视、家庭功能不良与体象满意率相关联(OR=0.33~0.57, P值均＜0.01)，男生中仅发现忽视、有过3或≥4种ACEs与体象满意率相关联(OR=0.54~0.64, P值均 < 0.05)；ACEs暴露对青少年体象评价的负面影响有累积效应。结论 ACEs与青少年的体象评价有关联，并呈现一定的累积效应，关联与累积效应存在性别差异，应注重在青少年(尤其是女生)中开展ACEs筛查和家庭养育环境建设。
- 体象 /
- 生活变动事件 /
- 精神卫生 /
- 回归分析 /
- 青少年
Abstract: Objective To explore the relationship between body image and adverse childhood experiences (ACEs) in adolescents. Methods A total of 1 701 adolescents in grade 6-8 in three middle schools in Shanghai were selected by stratified cluster sampling, and were investigated anonymously using computer assisted self-interview approach. Information including demographic characteristics, body image satisfaction, and ACEs were collected. The Chi-square test and multivariate Logistic regression were used to explore the relationship between adolescent body image satisfaction and types of ACEs. Results About 60.73% of the respondents were satisfied with their body image, with higher satisfaction among boys(66.16%) than among girls(55.13%)(χ²=21.70, P < 0.01). About 79.19% of the respondents had experienced at least one ACE, and respectively 61.61%, 65.14% and 21.58% of them had experienced abuse, neglect and family dysfunction. Multivariate Logistic regression analysis indicated that experiencing at least one ACE, abuse, neglect and family dysfunction were all related with low body image satisfaction among girls(OR=0.33-0.57, P < 0.01), while among boys neglect, having 3 or more than 4 ACEs were found to be associated with body image satisfaction (OR=0.54-0.64, P < 0.05). The cumulative effects of ACEs on adolescent body image were observed. Conclusion Different types of ACEs are associated with body image in adolescents, ACEs have cumulative effects on adolescent body image, which shows gender differences.Screen of ACEs and improvement of family nurturing environment should be highlighted among adolescents, especially among girls.
- Body image /
- Life change events /
- Mental health /
- Regression analysis /
- Adolescent
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表 1 不同组别青少年体象满意率比较

Table 1. Comparison of body image satisfaction among adolescents with different groups

组别	选项	人数	体象满意人数	χ²值	P值
性别	男	863	571(66.16)	21.70	< 0.01
	女	838	462(55.13)
年龄/岁	10~12	850	504(59.29)	1.46	0.23
	13~14	851	529(62.16)
是否独生子女	是	1 098	676(61.57)	0.91	0.34
	否	603	357(59.20)
是否上海户籍^*	是	1 350	836(61.93)	1.06	0.30
	否	213	124(58.22)
是否租房^*	是	312	170(54.49)	6.63	0.01
	否	1 366	852(62.37)
父母文化程度^*	初中及以下	206	123(59.71)	2.93	0.23
	高中/技校/中专	501	296(59.08)
	大学及以上	849	539(63.49)
自我感知体重^*	偏瘦	357	224(62.75)	52.24	< 0.01
	正好	533	384(72.05)
	偏胖	806	423(52.48)
自我感知身高^*	偏高	252	167(66.27)	25.56	< 0.01
	正好	732	481(65.71)
	偏矮	713	383(53.72)
注：()内数字为满意率/%；*表示该组数据有缺失值。

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表 2 不同ACEs暴露的青少年体象满意率比较

Table 2. Comparison of body image satisfaction among adolescents with different ACEs exposure

组别	选项	男生				女生				合计
组别	选项	人数	满意人数	χ²值	P值	人数	满意人数	χ²值	P值	人数	满意人数	χ²值	P值
有过任一种ACE	是	692	450(65.03)	2.01	0.16	655	326(49.77)	34.83	< 0.01	1 347	776(57.61)	26.40	< 0.01
	否	171	121(70.76)			183	136(74.32)			354	257(72.60)
虐待	是	546	350(64.10)	2.82	0.09	502	235(46.81)	35.02	< 0.01	1 048	585(55.82)	27.57	< 0.01
	否	317	221(69.72)			336	227(67.56)			653	448(68.61)
忽视	是	569	357(62.74)	8.74	< 0.01	539	255(47.31)	37.35	< 0.01	1 108	612(55.23)	40.23	< 0.01
	否	294	214(72.79)			299	207(69.23)			593	421(70.99)
家庭功能不良	是	187	114(60.96)	2.88	0.09	180	80(44.44)	10.58	< 0.01	367	194(52.86)	12.14	< 0.01
	否	676	457(67.60)			658	382(58.05)			1 334	839(62.89)
ACEs暴露种类	0	171	121(70.76)	25.32	< 0.01	183	136(74.32)	65.38	< 0.01	354	257(72.60)	80.17	< 0.01
累计	1	186	139(74.73)			157	95(60.51)			343	234(68.22)
	2	182	130(71.43)			174	103(59.20)			356	233(65.45)
	3	201	112(55.72)	198			86(43.43)	399			198(49.62)
	≥4	123	69(56.10)			126	42(33.33)			249	111(44.58)
注：()内数字为满意率/%。

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表 3 不同ACEs与青少年体象满意率的Logistic回归分析

Table 3. Logistic regression analysis on the correlation between ACEs and adolescent body image satisfaction

自变量	男生(n=863)			女生(n=838)			合计(n=1 701)
自变量	OR值(OR值95%CI)	Z值	P值	OR值(OR值95%CI)	Z值	P值	OR值(OR值95%CI)	Z值	P值
有过任一种ACE	0.81(0.52~1.26)	-0.91	0.36	0.33(0.22~0.51)	-5.03	< 0.01	0.50(0.37~0.68)	-4.45	< 0.01
虐待	0.84(0.59~1.19)	-0.94	0.35	0.39(0.28~0.54)	-5.49	< 0.01	0.56(0.44~0.72)	-4.69	< 0.01
忽视	0.64(0.45~0.92)	-2.39	0.02	0.42(0.30~0.60)	-4.86	< 0.01	0.52(0.40~0.66)	-5.21	< 0.01
家庭功能不良	0.72(0.48~1.06)	-1.64	0.10	0.57(0.39~0.83)	-2.88	< 0.01	0.64(0.49~0.84)	-3.19	< 0.01
ACEs暴露种类累计
1	1.29(0.75~2.24)	0.93	0.35	0.50(0.29~0.86)	-2.50	0.01	0.76(0.52~1.12)	-1.36	0.18
2	1.03(0.60~1.77)	0.14	0.89	0.52(0.31~0.86)	-2.51	0.01	0.70(0.48~1.01)	-1.86	0.06
3	0.57(0.34~0.94)	-2.16	0.03	0.25(0.15~0.41)	-5.33	< 0.01	0.36(0.25~0.52)	-5.55	< 0.01
≥4	0.54(0.30~0.96)	-2.07	0.04	0.16(0.09~0.29)	-6.27	< 0.01	0.28(0.19~0.42)	-6.10	< 0.01

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