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Article(id=1325502085244007290, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325501865651216714, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025103, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1730649600000, receivedDateStr=2024-11-04, revisedDate=1739721600000, revisedDateStr=2025-02-17, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953923760, onlineDateStr=2026-11-06, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953923760, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953923760, creator=13701087609, updateTime=1793953923760, updator=13701087609, issue=Issue{id=1325501865651216714, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='4', pageStart='457', pageEnd='572 578', issueExtLink='null', onlineDate='null', pubDate='1745510400000', pubDateStr='2025-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953871404, creator='13701087609', updateTime=1793953871404, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=563, endPage=568, ext={EN=ArticleExt(id=1325502085478888315, articleId=1325502085244007290, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=A cross-lagged study on body dissatisfaction, weight bias internalization, and eating disorders among junior high school students, columnId=1259565855189418448, journalTitle=Chinese Journal of School Health, columnName=Mental Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the dynamic association and gender difference among body dissatisfaction, weight bias internalization and eating disorders in junior high school students, so as to provide the reference for the rational implementation of relevant intervention activitites.

Methods

From June to December 2023, a cluster sampling method was used to select 698 students from a middle school in Fuzhou for three follow-up surveys for a period of 6 months (T1:June 2023, T2:September 2023, T3:December 2023). The Eating Disorders Inventory-Body Dissatisfaction (EDI-BD), the Chinese Version of the Weight Bias Internalization Scale for Mainland Chinese Children and Adolescents (C-WBIS), and the Chinese Version of the Eating Disorder Examination Questionnaire (C-EDE-QS) were used for investigation. Analysis of variance, t test, Pearson correlation analysis and cross-lagged analysis were used for statistical analysis.

Results

T1 there were statistically significant differences in body dissatisfaction scores among junior high school students of different grades and with or without left-behind experience (t=-3.25, 2.12, P < 0.05). There were statistically significant differences in weight bias internalization (t=-3.03, -2.43, 2.43) and eating disorders (t=-4.64, -2.04, 2.63) among junior high school students of different genders, grades and with or without left-behind experience (P < 0.05). Cross-lagged analysis showed that body dissatisfaction was a predictor of weight bias internalization (βT1-T2=0.22, βT2-T3=0.12) and eating disorders (βT1-T2=0.09, βT2-T3=0.17, P < 0.01). Eating disorders could predict body dissatisfaction (βT1-T2=0.15, βT2-T3=0.13) and weight bias internalization (βT1-T2=0.14, βT2-T3=0.23, P < 0.01). The mutual predictive effect of body dissatisfaction, weight bias internalization and eating disorders varied with gender. T2 weight bias internalization in girls had a predictive effect on T3 body dissatisfaction (β=0.11). T1 and T2 eating disorders in girls had a predictive effect on T2 and T3 weight bias internalization (βT1-T2=0.26, βT2-T3=0.21) (P < 0.01).

Conclusions

Body dissatisfaction, weight bias internalization, and eating disorders of the junior high school students are interconnected. And there is a certain two-way correlation and gender difference between body dissatisfaction, weight bias internalization and eating disorders in junior high school students.

, authors=Meng TIAN, Yiqing CAI, Qin JIANG*, authorsList=Meng TIAN, Yiqing CAI, Qin JIANG, authorCompany=null, correspAuthors=Qin JIANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325502087978693506, articleId=1325502085244007290, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=初中生身体不满体重偏见内化与饮食失调的交叉滞后研究, columnId=1259565858817491410, journalTitle=中国学校卫生, columnName=心理卫生, runingTitle=null, highlight=null, articleAbstract=
目的

探讨初中生身体不满、体重偏见内化和饮食失调之间的动态关联及性别差异，为合理开展相关干预活动提供参考。

方法

2023年6—12月，采用整群抽样方法在福州市某中学抽取698名初中学生进行为期6个月的3次追踪调查(T1：2023年6月，T2：2023年9月，T3：2023年12月)，采用进食障碍量表-身体不满意亚量表(EDI-BD)、中国儿童和青少年体重偏见内化量表(C-WBIS)、中文版饮食失调简短版问卷(C-EDE-QS)进行调查。采用方差分析、t检验、Pearson相关分析和交叉滞后分析进行统计分析。

结果

T1时不同年级和是否有留守经历初中生身体不满评分差异均有统计学意义(t值分别为-3.25，2.12)，不同性别、年级和是否有留守经历初中生的体重偏见内化与饮食失调评分比较，差异均有统计学意义(t值分别为-3.03，-2.43，2.43；-4.64，-2.04，2.63，P值均 < 0.05)。交叉滞后分析显示，身体不满是初中生体重偏见内化(βT1-T2=0.22，βT2-T3=0.12)和饮食失调(βT1-T2=0.09，βT2-T3=0.17)的预测因素，饮食失调可以预测身体不满(βT1-T2=0.15，βT2-T3=0.13)和体重偏见内化(βT1-T2=0.14，βT2-T3=0.23)，差异均有统计学意义(P值均 < 0.01)。身体不满、体重偏见内化和饮食失调三者的相互预测作用因性别而异，女生T2体重偏见内化对T3身体不满有预测作用(β=0.11)，女生T1、T2饮食失调对T2、T3体重偏见内化有预测作用(βT1-T2=0.26，βT2-T3=0.21)(P值均 < 0.01)。

结论

初中生身体不满、体重偏见内化与饮食失调之间相互影响，存在一定的双向关联和性别差异。

, authors=田梦, 蔡怡晴, 江琴*, authorsList=田梦, 蔡怡晴, 江琴, authorCompany=null, correspAuthors=江琴, authorNote=

田梦(1997-)，女，河南开封人，硕士，主要研究方向为心理健康教育

, correspAuthorsNote=
江琴，E-mail：
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J Health Psychol, 2020, 25(7): 922-930., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1325502088184214403, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, xref=null, ext=[AuthorCompanyExt(id=1325502088188408708, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, companyId=1325502088184214403, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Health, Fujian Medical University, Fuzhou (350122), Fujian Province, China), AuthorCompanyExt(id=1325502088196797317, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, companyId=1325502088184214403, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=福建医科大学健康学院，福州 350122)])], figs=[ArticleFig(id=1325502090000348066, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=EN, label=Fig.1, caption=Cross-lag analysis of body dissatisfaction, weight bias internalization and disordered eating among middle school students, figureFileSmall=wx2zO+bzNSz4P/xsULoVWw==, figureFileBig=jEViEQ7UbTvz7lMA8oE7hQ==, tableContent=null), ArticleFig(id=1325502091581600675, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=CN, label=图1, caption=初中生身体不满、体重偏见内化和饮食失调的交叉滞后分析, figureFileSmall=wx2zO+bzNSz4P/xsULoVWw==, figureFileBig=jEViEQ7UbTvz7lMA8oE7hQ==, tableContent=null), ArticleFig(id=1325502091778732964, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=EN, label=Fig.2, caption=Cross-lag analysis of body dissatisfaction, weight bias internalization and disordered eating in girls groups, figureFileSmall=ahHiRvdI5JhT80OKCEppLQ==, figureFileBig=1jyFDrU0GqIQwwXBwewATg==, tableContent=null), ArticleFig(id=1325502091871007653, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=CN, label=图2, caption=女生身体不满、体重偏见内化和饮食失调的交叉滞后分析, figureFileSmall=ahHiRvdI5JhT80OKCEppLQ==, figureFileBig=1jyFDrU0GqIQwwXBwewATg==, tableContent=null), ArticleFig(id=1325502091967476646, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=EN, label=Fig.3, caption=Cross-lag analysis of body dissatisfaction, weight bias internalization and disordered eating in boys groups, figureFileSmall=q7ZMmHgZL5Al6bEYYc/mWA==, figureFileBig=x7vm2kunYOnXQn8i3cp8BA==, tableContent=null), ArticleFig(id=1325502092114277287, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=CN, label=图3, caption=男生身体不满、体重偏见内化和饮食失调的交叉滞后分析, figureFileSmall=q7ZMmHgZL5Al6bEYYc/mWA==, figureFileBig=x7vm2kunYOnXQn8i3cp8BA==, tableContent=null), ArticleFig(id=1325502092185580456, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=EN, label=Tab.1, caption=

Comparative of scores of body dissatisfaction, weight bias internalization and disordered eating at T1 time point among middle school students with different demographic characteristics($\bar{x} \pm s$)

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人口学变量人数身体不满体重偏见内化饮食失调
$\bar{x} \pm s$t值 $\bar{x} \pm s$t值 $\bar{x} \pm s$t值
性别男36429.16±8.99-0.4016.49±8.60-3.03**3.29±4.44-4.64**
女33429.44±9.6118.64±10.035.04±5.38
年级初一33028.10±8.51-3.25**16.62±8.39-2.43*3.72±4.70-2.04*
初二36830.36±9.8318.33±10.114.49±5.21
留守经历是6531.62±9.222.12*20.20±9.602.43*5.80±5.422.63*
否63329.06±9.2717.25±9.313.96±4.91
), ArticleFig(id=1325502092340769705, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=CN, label=表1, caption=

不同人口学特征初中生T1时身体不满、体重偏见内化与饮食失调得分比较($\bar{x} \pm s$)

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学变量人数身体不满体重偏见内化饮食失调
$\bar{x} \pm s$t值 $\bar{x} \pm s$t值 $\bar{x} \pm s$t值
性别男36429.16±8.99-0.4016.49±8.60-3.03**3.29±4.44-4.64**
女33429.44±9.6118.64±10.035.04±5.38
年级初一33028.10±8.51-3.25**16.62±8.39-2.43*3.72±4.70-2.04*
初二36830.36±9.8318.33±10.114.49±5.21
留守经历是6531.62±9.222.12*20.20±9.602.43*5.80±5.422.63*
否63329.06±9.2717.25±9.313.96±4.91
), ArticleFig(id=1325502092416267178, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=EN, label=Tab.2, caption=

Correlation analysis among body dissatisfaction, weight bias internalization, and disordered eating among middle school students(r)

, figureFileSmall=null, figureFileBig=null, tableContent=
性别变量T1身
体不满		T2身
体不满		T3身
体不满		T1体重
偏见内化		T2体重
偏见内化		T3体重
偏见内化		T1饮
食失调		T2饮
食失调
总体T2身体不满0.73
(n=698)T3身体不满0.670.75
T1体重偏见内化0.550.470.48
T2体重偏见内化0.510.580.490.60
T3体重偏见内化0.490.530.600.570.69
T1饮食失调0.520.500.500.570.480.52
T2饮食失调0.460.520.490.480.550.560.74
T3饮食失调0.460.460.550.430.430.550.690.69
男生T2身体不满0.69
(n=364)T3身体不满0.650.73
T1体重偏见内化0.460.390.43
T2体重偏见内化0.440.520.410.52
T3体重偏见内化0.430.450.550.520.59
T1饮食失调0.440.400.460.490.320.39
T2饮食失调0.410.460.480.390.440.440.65
T3饮食失调0.410.400.520.350.330.440.590.61
女生T2身体不满0.76
(n=334)T3身体不满0.700.77
T1体重偏见内化0.640.540.52
T2体重偏见内化0.580.640.570.66
T3体重偏见内化0.550.590.630.610.77
T1饮食失调0.600.580.540.620.610.60
T2饮食失调0.510.560.500.530.640.640.79
T3饮食失调0.500.520.570.490.520.630.760.74
), ArticleFig(id=1325502092764394411, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502085244007290, language=CN, label=表2, caption=

初中生身体不满、体重偏见内化与饮食失调的相关分析(r值)

, figureFileSmall=null, figureFileBig=null, tableContent=
性别变量T1身
体不满		T2身
体不满		T3身
体不满		T1体重
偏见内化		T2体重
偏见内化		T3体重
偏见内化		T1饮
食失调		T2饮
食失调
总体T2身体不满0.73
(n=698)T3身体不满0.670.75
T1体重偏见内化0.550.470.48
T2体重偏见内化0.510.580.490.60
T3体重偏见内化0.490.530.600.570.69
T1饮食失调0.520.500.500.570.480.52
T2饮食失调0.460.520.490.480.550.560.74
T3饮食失调0.460.460.550.430.430.550.690.69
男生T2身体不满0.69
(n=364)T3身体不满0.650.73
T1体重偏见内化0.460.390.43
T2体重偏见内化0.440.520.410.52
T3体重偏见内化0.430.450.550.520.59
T1饮食失调0.440.400.460.490.320.39
T2饮食失调0.410.460.480.390.440.440.65
T3饮食失调0.410.400.520.350.330.440.590.61
女生T2身体不满0.76
(n=334)T3身体不满0.700.77
T1体重偏见内化0.640.540.52
T2体重偏见内化0.580.640.570.66
T3体重偏见内化0.550.590.630.610.77
T1饮食失调0.600.580.540.620.610.60
T2饮食失调0.510.560.500.530.640.640.79
T3饮食失调0.500.520.570.490.520.630.760.74
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Comparison of body dissatisfaction, weight bias internalization, and disordered eating at different time points among middle school students(n=698, $\bar{x} \pm s$)

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时间点身体不满体重偏见内化饮食失调
T129.29±9.2917.52±9.374.13±4.99
T228.87±9.8016.81±9.933.72±4.98
T328.05±9.6716.24±9.753.19±4.43
F值10.758.1122.70
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初中生不同时间点身体不满、体重偏见内化和饮食失调得分比较(n=698，$\bar{x} \pm s$)

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时间点身体不满体重偏见内化饮食失调
T129.29±9.2917.52±9.374.13±4.99
T228.87±9.8016.81±9.933.72±4.98
T328.05±9.6716.24±9.753.19±4.43
F值10.758.1122.70
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初中生身体不满体重偏见内化与饮食失调的交叉滞后研究
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田梦 , 蔡怡晴 , 江琴 *
中国学校卫生 | 心理卫生 2025,46(4): 563-568
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中国学校卫生 |心理卫生 2025 , 46 (4) : 563 -568
初中生身体不满体重偏见内化与饮食失调的交叉滞后研究
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田梦, 蔡怡晴, 江琴*
作者信息
  • 福建医科大学健康学院，福州 350122
通讯作者:
江琴，E-mail：
作者简介:

田梦(1997-)，女，河南开封人，硕士，主要研究方向为心理健康教育

A cross-lagged study on body dissatisfaction, weight bias internalization, and eating disorders among junior high school students
Meng TIAN, Yiqing CAI, Qin JIANG*
Affiliations
  • School of Health, Fujian Medical University, Fuzhou (350122), Fujian Province, China
出版时间: 2025-04-25 doi: 10.16835/j.cnki.1000-9817.2025103
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摘要
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目的

探讨初中生身体不满、体重偏见内化和饮食失调之间的动态关联及性别差异，为合理开展相关干预活动提供参考。

方法

2023年6—12月，采用整群抽样方法在福州市某中学抽取698名初中学生进行为期6个月的3次追踪调查(T1：2023年6月，T2：2023年9月，T3：2023年12月)，采用进食障碍量表-身体不满意亚量表(EDI-BD)、中国儿童和青少年体重偏见内化量表(C-WBIS)、中文版饮食失调简短版问卷(C-EDE-QS)进行调查。采用方差分析、t检验、Pearson相关分析和交叉滞后分析进行统计分析。

结果

T1时不同年级和是否有留守经历初中生身体不满评分差异均有统计学意义(t值分别为-3.25，2.12)，不同性别、年级和是否有留守经历初中生的体重偏见内化与饮食失调评分比较，差异均有统计学意义(t值分别为-3.03，-2.43，2.43；-4.64，-2.04，2.63，P值均 < 0.05)。交叉滞后分析显示，身体不满是初中生体重偏见内化(βT1-T2=0.22，βT2-T3=0.12)和饮食失调(βT1-T2=0.09，βT2-T3=0.17)的预测因素，饮食失调可以预测身体不满(βT1-T2=0.15，βT2-T3=0.13)和体重偏见内化(βT1-T2=0.14，βT2-T3=0.23)，差异均有统计学意义(P值均 < 0.01)。身体不满、体重偏见内化和饮食失调三者的相互预测作用因性别而异，女生T2体重偏见内化对T3身体不满有预测作用(β=0.11)，女生T1、T2饮食失调对T2、T3体重偏见内化有预测作用(βT1-T2=0.26，βT2-T3=0.21)(P值均 < 0.01)。

结论

初中生身体不满、体重偏见内化与饮食失调之间相互影响，存在一定的双向关联和性别差异。

偏见  /  体重  /  饮食习惯  /  精神卫生  /  交叉滞后分析  /  学生
Objective

To explore the dynamic association and gender difference among body dissatisfaction, weight bias internalization and eating disorders in junior high school students, so as to provide the reference for the rational implementation of relevant intervention activitites.

Methods

From June to December 2023, a cluster sampling method was used to select 698 students from a middle school in Fuzhou for three follow-up surveys for a period of 6 months (T1:June 2023, T2:September 2023, T3:December 2023). The Eating Disorders Inventory-Body Dissatisfaction (EDI-BD), the Chinese Version of the Weight Bias Internalization Scale for Mainland Chinese Children and Adolescents (C-WBIS), and the Chinese Version of the Eating Disorder Examination Questionnaire (C-EDE-QS) were used for investigation. Analysis of variance, t test, Pearson correlation analysis and cross-lagged analysis were used for statistical analysis.

Results

T1 there were statistically significant differences in body dissatisfaction scores among junior high school students of different grades and with or without left-behind experience (t=-3.25, 2.12, P < 0.05). There were statistically significant differences in weight bias internalization (t=-3.03, -2.43, 2.43) and eating disorders (t=-4.64, -2.04, 2.63) among junior high school students of different genders, grades and with or without left-behind experience (P < 0.05). Cross-lagged analysis showed that body dissatisfaction was a predictor of weight bias internalization (βT1-T2=0.22, βT2-T3=0.12) and eating disorders (βT1-T2=0.09, βT2-T3=0.17, P < 0.01). Eating disorders could predict body dissatisfaction (βT1-T2=0.15, βT2-T3=0.13) and weight bias internalization (βT1-T2=0.14, βT2-T3=0.23, P < 0.01). The mutual predictive effect of body dissatisfaction, weight bias internalization and eating disorders varied with gender. T2 weight bias internalization in girls had a predictive effect on T3 body dissatisfaction (β=0.11). T1 and T2 eating disorders in girls had a predictive effect on T2 and T3 weight bias internalization (βT1-T2=0.26, βT2-T3=0.21) (P < 0.01).

Conclusions

Body dissatisfaction, weight bias internalization, and eating disorders of the junior high school students are interconnected. And there is a certain two-way correlation and gender difference between body dissatisfaction, weight bias internalization and eating disorders in junior high school students.

Prejudice  /  Body weight  /  Food habits  /  Mental health  /  Gross-lagged analysis  /  Students
田梦, 蔡怡晴, 江琴. 初中生身体不满体重偏见内化与饮食失调的交叉滞后研究. 中国学校卫生, 2025 , 46 (4) : 563 -568 . DOI: 10.16835/j.cnki.1000-9817.2025103
Meng TIAN, Yiqing CAI, Qin JIANG. A cross-lagged study on body dissatisfaction, weight bias internalization, and eating disorders among junior high school students[J]. Chinese Journal of School Health, 2025 , 46 (4) : 563 -568 . DOI: 10.16835/j.cnki.1000-9817.2025103
正文
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身体不满意(body dissatisfaction, BD)是指对一个人的身体外貌的消极想法、感觉和感知[1]。青春期作为自我认知发展的关键阶段，往往伴随着不健康的、负面的、不准确的身体形象形成。研究表明，青春期女童的身体不满意率在57%~84%之间，男童则在49%~82%之间[2]。身体不满与体重耻辱经历，特别是体重偏见内化有关[3]。体重偏见内化(weight bias internalization, WBI)是指将来自外部的体重偏见和刻板印象应用于自己，从而导致负面情绪反应[4]。当个体对自己施加负面的体重刻板印象并因体重而自我贬低时，就会发生体重偏见内化[5]。早期研究表明，体重较重的中国青少年比体重较低的同龄人自我污名化程度更高[6]。较高的体重偏见内化与更严重的饮食失调病理存在并发关联[7-9]。饮食失调(disordered eating, DE)包括一系列与消极的心理和生理健康结果相关的不适应态度或认知和行为，是广泛的不规律或不健康饮食行为的总称[10]。在亚临床层面，饮食失调主要表现为节食和贪食[11]。关注身体形象和饮食失调的流行在青春期早期已经达到令人担忧的水平，高达50%的青春期前女孩对自己的身材或体重不满意，48%的女童报告不健康的体重控制行为，如禁食和使用食物替代品，14%的女童报告暴食失控[12]。饮食失调不仅有较高的流行率，而且往往是进食障碍的早期表现以及精神分裂的潜在原因之一[13]。本研究通过对福州市某中学学生进行为期6个月的追踪调查，探讨初中生的身体不满、体重偏见内化和饮食失调之间的动态关联及性别差异，报道如下。
1　对象与方法
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1.1　对象
于2023年6—12月，采用整群抽样方法在福州市某中学初一、初二各年级整群抽取8~9个班学生进行3次追踪调查，以班级为单位进行问卷测验，每次间隔3个月，第一阶段(T1)为2023年6月(学期末阶段)，共计887人完成调查；第二阶段(T2)为2023年9月(新学期开学阶段)，共计870人完成调查；第三阶段(T3)为2023年12月(学期末阶段)，共计867人完成调查。剔除规律性作答、作答不完整等无效问卷后，最终纳入有效数据的被试共698名。其中，男生364名，女生334名；平均年龄(12.56±0.50)岁。本研究项目已获得老师、学生本人及其监护人知情同意，并经过福建医科大学生物医学研究伦理审查委员会批准[批号：(2021)福医伦理审字第(89)号]。
1.2　方法
1.2.1　人口统计学信息
包括性别、年级、是否有留守经历等。
1.2.2　进食障碍量表-身体不满意亚量表(Eating Disorder Inventory-Body Dissatisfaction, EDI-BD)
采用张大荣等[14]在2004年修订的中文版。主要测量个体对腹部、臀部、腰围等身体部位的不满意程度，包含9个项目，采用Likert 6级计分法，从1(从不)~6(总是)进行评分。总分范围9~54分，分数越高，表示对身体的不满程度越高。在本研究中，该量表T1、T2和T3时的Cronbach α系数分别为0.85，0.88和0.89。
1.2.3　中国儿童和青少年体重偏见内化量表(Chinese version of the Weight Bias Internalization Scale for Mainland Chinese Children and Adolescents, C-WBIS)
采用由陈浩等[15]改编的量表，包含8个项目，采用Likert 7级计分法，从1(强烈不同意)~7(非常同意)进行评级。总分范围8~56分，总分越高表明WBI水平越高。本研究中，T1、T2和T3时的Cronbach α系数分别为0.92，0.94，0.94。
1.2.4　中文版饮食失调简短问卷(Chinese version of the Eating Disorder Examination Questionnaire, C-EDE-QS)
采用由何金波等[16]改编的中文版问卷，问卷包含12个项目，采用Likert 4级计分法，范围从0(0)~3(6~7 d)。总分范围0~36分，总分越高，表明在过去7 d内饮食失调的程度越高。本研究中，T1、T2和T3时的Cronbach α系数分别为0.83，0.86和0.86。
1.3　质量控制
经过专业培训的心理学硕士研究生以班级为单位进行匿名问卷调查，所有参与者均在知情同意的基础上自愿参与。要求学生在上课时间内完成问卷，时间约为10 min，期间若有任何疑问，均可随时向调查员提出。问卷调查使用统一的指导语，所有问卷在填写完毕后当场回收，每位参与者以学号作为唯一ID用于数据纵向匹配，剔除前后有明显逻辑错误的问卷。
1.4　统计学分析
采用SPSS 26.0、Mplus 8.0软件进行数据录入及统计分析。计数资料用频数或百分率描述，经正态性检验，计量资料符合正态分布的特征，采用($\bar{x} \pm s$)描述，并进一步进行Harman单因素检验、描述性统计、t检验、单因素方差分析、Pearson相关分析、重复测量方差分析和交叉滞后分析。总体初中生的交叉滞后分析，将性别、年级和是否有留守经历作为协变量，采用交叉滞后模型检验3次测量的身体不满、体重偏见内化和饮食失调的相互关系。检验水准α=0.05。
2　结果
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2.1　共同方法偏差检验
采用Harman单因子检验法对共同方法偏差进行检验，结果显示，3次调查数据得出的第1个因子方差解释率分别为33.50%，36.99%，37.86%，低于40%临界值，故本研究不存在严重的共同方法偏差。
2.2　初中生T1时身体不满、体重偏见内化、饮食失调差异性检验
女生体重偏见内化、饮食失调均高于男生，初二年级学生身体不满、体重偏见内化和饮食失调均高于初一年级，有留守经历学生身体不满、体重偏见内化和饮食失调均高于无留守经历学生(P值均 < 0.05)。见表1。
2.3　初中生身体不满、体重偏见内化与饮食失调的相关分析
Pearson相关分析结果显示，T1、T2、T3时间点初中生身体不满、体重偏见内化和饮食失调之间呈现出两两同时性和延时性的正相关关系(P值均 < 0.01)；其中各变量之间的相关系数在女生组中最大，其次是总体组，最后是男生组。见表2。
2.4　不同时间点初中生身体不满、体重偏见内化和饮食失调比较
采用单因素重复测量方差分析和事后检验比较3次测量水平，结果显示，T1与T2的身体不满水平高于T3；T1的体重偏见内化水平高于T3；T1的饮食失调水平高于T2，T2的饮食失调水平高于T3(P值均 < 0.05)。从T1到T3时间点，初中生身体不满、体重偏见内化和饮食失调得分均有下降趋势。见表3。
2.5　初中生身体不满、体重偏见内化与饮食失调的交叉滞后分析
进一步采用交叉滞后回归分析法探讨3个时间点初中生身体不满、体重偏见内化和饮食失调的相互关系，结合理论构成和修正系数的提示，得到了拟合度较好的模型。
总体初中生身体不满、体重偏见内化和饮食失调的交叉滞后分析交叉滞后模型[χ2=137.92，df=32，χ2/df=4.31，RMSEA(90%CI)=0.07(0.06，0.08)，CFI=0.98，TLI=0.95，SRMR=0.04]显示，在T1到T2阶段：初中生T1身体不满能够正向预测T2体重偏见内化和T2饮食失调；T1体重偏见内化不能正向预测T2身体不满和T2饮食失调；T1饮食失调能够正向预测T2身体不满和T2体重偏见内化。在T2到T3阶段：T2身体不满能够正向预测T3体重偏见内化和T3饮食失调；T2体重偏见内化不能预测T3身体不满和T3饮食失调；T2饮食失调能够正向预测T3身体不满和T3体重偏见内化。T1~T3饮食失调具有时间稳定性。见图1。
女生身体不满、体重偏见内化和饮食失调的交叉滞后分析交叉滞后模型[χ2=58.50，df=26，χ2/df=2.25，RMSEA(90%CI)=0.06(0.04，0.08)，CFI=0.99，TLI=0.97，SRMR=0.04]显示，T1到T2阶段：女生T1身体不满能够正向预测T2体重偏见内化，但不能预测T2饮食失调；T1饮食失调能够正向预测T2身体不满和T2体重偏见内化。T2到T3阶段：T2身体不满是T3体重偏见内化和T3饮食失调的正向预测因子；T2体重偏见内化能够正向预测T3身体不满，T2饮食失调是T3体重偏见内化的预测因子，但不能预测T3身体不满。T1~T3饮食失调具有时间稳定性。见图2。
男生身体不满、体重偏见内化和饮食失调的交叉滞后分析交叉滞后模型[χ2=78.49，df=24，χ2/df=3.27，RMSEA(90%CI)=0.08(0.06，0.10)，CFI=0.97，TLI=0.92，SRMR=0.05]显示，T1到T2阶段：男生T1身体不满能够正向预测T2体重偏见内化和T2饮食失调；T1饮食失调能够正向预测T2身体不满，但不能预测T2体重偏见内化。T2到T3阶段：T2身体不满能够正向预测T3饮食失调；T2饮食失调是T3身体不满的预测因子。T1~T3饮食失调具有时间稳定性。见图3。
3　讨论
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本研究在T1时间点的数据表明，初中生身体不满得分较高，且该现象在男女中均存在，与Dion等[2]研究一致。初中生正处于身体外貌和自我概念变化的阶段，容易夸大自身的不足。有证据表明，体重是青少年被嘲笑的最常见原因[17]，与肥胖相关的负面特征(如懒惰、缺乏意志力等)助长了肥胖污名背后的偏见[18-19]。超重/肥胖的青少年相比同龄人，遭受口头欺凌的可能性要高出32%，被网络欺凌的可能性要高出66%[20-21]。体重戏弄构成一种慢性压力源，对初中生的身体不满情绪产生影响。
本研究显示，初二年级学生身体不满、体重偏见内化和饮食失调得分均高于初一年级的同学，与以往的研究一致，即男、女生身体不满会随着年龄的增长而增加[2]。此外，有留守经历初中生身体不满、体重偏见内化和饮食失调得分均高于无留守经历者。可能归因于留守经历带来的多重心理压力，如孤独、焦虑、自卑等。已有研究表明，体重偏见内化与抑郁、焦虑、身体不满和饮食失调之间存在病理关联[22]，孤独感和情绪问题也会引起饮食紊乱[23]，而留守经历在一定程度上增加了青少年对自身外貌的偏见和饮食行为的失常。
交叉滞后分析表明，身体不满与饮食失调之间存在双向关联，即身体不满可以预测随后的饮食失调，饮食失调反过来也可以预测身体不满，值得注意的是，饮食失调具有时间稳定性，表明个体的不健康饮食行为在追踪期内呈现持续倾向。与现有研究结果一致，即身体不满可能是饮食病理最一致、最强大的风险和维持因素[24]。具有饮食失调行为的人也更容易产生对身体的不满[25]，即为迎合美容标准而采取的饮食限制和体重控制策略，可能会反过来加剧身体不满[2]。此外，身体不满和饮食失调可以预测体重偏见内化，与现有研究相符[4]。身体不满的三方影响模型[26]指出，青少年易受同伴、父母和媒体的影响，形成对理想体型的认知偏差，进而可能将体重偏见内化为自我观念。此外，出于心理调节机制，当个体因为身体形象或饮食问题感到不满、焦虑时，可能会将问题归因于外界普遍偏见(如以瘦为美)，作为不满和压力的“合理解释”，从而暂时逃避由身体不满和饮食失调带来的消极情绪。
性别差异在身体不满、体重偏见内化与饮食失调中较为显著。交叉滞后模型分析显示，女生身体不满和饮食失调能预测其后体重偏见内化的发生，体重偏见内化也能够预测身体不满的发生；而对于男生来说，身体不满可以预测后期体重偏见内化的发生，但体重偏见内化并不能预测身体不满，饮食失调也不能预测后期体重偏见内化。
前期研究普遍表明，体重偏见内化存在性别差异，女生较男生更易受影响[17]。出于当前社会文化对苗条的追求，女性通常面临更高的体重偏见风险[27]，有更多的自责经历并内化体重偏见[28]。相较于女生，社会通常期望男生具有强壮、肌肉发达的身体形象，而不是过分追求瘦身。本研究使用的身体不满量表主要针对“瘦”的社会理想，因此，男生体重偏见内化不直接引起身体不满。此外，男生中饮食失调与体重偏见的关系不如女生显著，可能与男生更倾向肌肉导向的饮食管理有关[29]，而相关研究常忽略此点[27]。饮食失调的评估多侧重于女生减肥行为，未充分考虑男生的饮食行为，如增加蛋白质摄入[27]。因此，样本和行为评估的不匹配可能导致结果无统计学意义。
综上所述，本研究进一步证实了初中生身体不满、体重偏见内化和饮食失调是相互作用、相互影响的。但仍存在一些局限性：首先，本研究样本仅为一所中学的初中生，缺乏其他不同群体的研究数据；其次，本研究通过纵向数据揭示变量关系的方向性，但缺乏实验设计以探讨变量间的因果关系；最后，本研究仅揭示性别、年级、是否留守儿童等人口学变量对主要变量的影响，尚有其他潜在因素未揭示。未来研究应纳入更多潜在变量，并考虑延长追踪周期及增加评估次数。

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2025年第46卷第4期
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doi: 10.16835/j.cnki.1000-9817.2025103
  • 接收时间：2024-11-04
  • 首发时间：2026-11-06
  • 出版时间：2025-04-25
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  • 收稿日期：2024-11-04
  • 修回日期：2025-02-17
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    福建医科大学健康学院，福州 350122

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