Department of Family Relations and Applied Nutrition, University of Guelph, ON, Canada.
J Sch Health. 2011 Sep;81(9):530-5. doi: 10.1111/j.1746-1561.2011.00623.x.
Early identification can greatly impact the trajectory of eating disorders, and school-based screening is 1 avenue for identifying those at risk. To be feasible in a school setting, a screening program must use a brief, valid screening tool. The aim of this study was to assess how well brief attitudinal and behavioral survey items identify adolescents at risk in a large sample of high school students from across the United States.
Data were drawn from the National Eating Disorder Screening Program, the first-ever national eating disorders screening initiative for US high schools. A 2-stage, clustered sampling method was used to randomly select a subset of student screening forms (n = 5740), which included the Eating Attitudes Test (EAT-26), behavioral questions assessing the frequency of vomiting and binge eating in the past 3 months, and an attitudinal item that assessed preoccupation with thinness.
Nearly 12% of females and 3% of males reported vomiting to control their weight and 17% of females and 10% of males reported binge eating 1 or more times per month. Approximately 24% of females and 8% of males report being preoccupied with being thinner. We found that the attitudinal measure yielded high sensitivity and specificity. Combined screening measures that used both the attitudinal and behavioral items yielded slightly higher sensitivity values than those found with the attitudinal measure alone.
High school administrators should include items that assess both preoccupation with thinness as well as behavioral items that deal with eating disorders on student health surveys.
早期识别可以极大地影响进食障碍的发展轨迹，而基于学校的筛查是识别高危人群的一种途径。为了在学校环境中可行，筛查计划必须使用简短、有效的筛查工具。本研究旨在评估在来自美国各地的大量高中生样本中，简短的态度和行为调查项目如何识别有风险的青少年。
数据来自全国饮食失调筛查计划，这是美国首个针对高中的全国性饮食失调筛查计划。采用两阶段、聚类抽样方法随机抽取部分学生筛查表格（n=5740），其中包括饮食态度测试（EAT-26）、过去 3 个月评估呕吐和暴食频率的行为问题以及评估对消瘦关注的态度项目。
近 12%的女性和 3%的男性报告为控制体重而呕吐，17%的女性和 10%的男性报告每月暴食 1 次或以上。大约 24%的女性和 8%的男性报告对更瘦的身材感到痴迷。我们发现态度测量具有较高的敏感性和特异性。同时使用态度和行为项目的综合筛查措施比单独使用态度测量的敏感性值略高。
高中管理人员应在学生健康调查中包括评估对消瘦关注的项目以及涉及饮食失调的行为项目。
