Patalay Praveetha, Sharpe Helen, Wolpert Miranda
Evidence Based Practice Unit, University College London and the Anna Freud Centre, London, UK.
J Child Psychol Psychiatry. 2015 Nov;56(11):1223-30. doi: 10.1111/jcpp.12415. Epub 2015 Apr 22.
Cross-sectional studies demonstrate that body dissatisfaction and internalising symptoms are correlated and are both overrepresented in girls compared to boys. However, it is not clear whether body dissatisfaction typically precedes internalising symptoms or vice versa. Existing literature provides theoretical and empirical support for both possibilities, but is limited in two ways: (a) no study has simultaneously tested the two temporal hypotheses within the same model, and (b) the studies focus almost exclusively on early adolescents resulting in little being known about development from preadolescence and across puberty.
This study used data from 5485 primary school students (49.1% girls, aged 8-9 years at baseline) and 5981 secondary school students (53.9% girls, aged 11-12 years at baseline). Self-reports of internalising symptoms and body dissatisfaction were collected over three consecutive years at 1-year intervals. Cross-lagged models were estimated in the two cohorts, for boys and girls separately, to examine the temporal associations between these two domains across the three measurement points.
In the younger cohort, internalising symptoms predicted body dissatisfaction 1-year later for both boys and girls, whereas there was no evidence for the reverse being true. In the older cohort, internalising symptoms predicted later body dissatisfaction for boys. However, in girls, body dissatisfaction predicted later internalising symptoms.
In preadolescents, internalising symptoms drive later body dissatisfaction regardless of gender, suggesting body dissatisfaction is a specific manifestation of a tendency towards negative affect. From age 11, girls develop a distinct risk profile whereby body dissatisfaction drives later internalising symptoms. Preventative interventions in this field would benefit from adopting a developmentally sensitive approach that takes into account gender differences in risk pathways.
横断面研究表明，身体不满与内化症状相关，且与男孩相比，女孩中这两者的比例都过高。然而，尚不清楚身体不满通常是先于内化症状出现，还是反之。现有文献为这两种可能性都提供了理论和实证支持，但存在两方面局限性：（a）没有研究在同一模型中同时检验这两种时间假设，（b）这些研究几乎完全集中在青少年早期，导致对青春期前和整个青春期的发展了解甚少。
本研究使用了5485名小学生（49.1%为女孩，基线年龄8 - 9岁）和5981名中学生（53.9%为女孩，基线年龄11 - 12岁）的数据。连续三年每年收集一次内化症状和身体不满的自我报告。分别在两个队列中对男孩和女孩估计交叉滞后模型，以检验这两个领域在三个测量点之间的时间关联。
在较年轻的队列中，内化症状在一年后预测男孩和女孩的身体不满，而没有证据表明反之亦然。在较年长的队列中，内化症状预测男孩后来的身体不满。然而，在女孩中，身体不满预测后来的内化症状。
在青春期前儿童中，无论性别，内化症状都会导致后来的身体不满，这表明身体不满是消极情绪倾向的一种具体表现。从11岁起，女孩呈现出一种独特的风险模式，即身体不满会导致后来的内化症状。该领域的预防性干预将受益于采用一种考虑到风险途径中性别差异的发展敏感方法。
