黑人群体中，体像不满与暴食障碍之间的关联存在性别和种族差异。
Gender and Ethnic Differences in the Association Between Body Image Dissatisfaction and Binge Eating Disorder among Blacks.
机构信息
Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 1415 Washington Heights, 2858 SPH I, Ann Arbor, MI, 48109-2029, USA.
Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA.
出版信息
J Racial Ethn Health Disparities. 2017 Aug;4(4):529-538. doi: 10.1007/s40615-016-0255-7. Epub 2016 Jun 28.
BACKGROUND
The research on binge eating has overwhelmingly focused on Whites. We aimed to study gender and ethnic differences in the association between body image dissatisfaction and binge eating in a nationally representative sample of Black adults in the USA.
METHODS
This cross-sectional study used data from the National Survey of American Life (NSAL), 2003-2004. Self-identified Caribbean Black (n = 1621) and African American (3570) adults aged 18 and older were enrolled. The independent variable was body dissatisfaction measured with two items. Using the World Health Organization Composite International Diagnostic Interview (WHO-CIDI), outcome was lifetime binge eating without hierarchy according to the DSM-IV criteria. Covariates included age, socioeconomic factors (i.e., education and marital status), and body mass index. Ethnicity and gender were focal moderators. Logistic regressions were used for data analysis.
RESULTS
Despite comparable prevalence of lifetime binge eating (5 vs 4 %, p > 0.05), African Americans reported higher body image dissatisfaction than Caribbean Blacks (36 vs 29 %, p > 0.05). In the pooled sample, body dissatisfaction was a strong predictor of lifetime binge eating disorders. There was a significant interaction (p = 0.039) between ethnicity and body image dissatisfaction on binge eating, suggesting a stronger association between body image dissatisfaction and lifetime binge eating for Caribbean Blacks (OR = 11.65, 95 % 6.89-19.72) than African Americans (OR = 6.72, 95 % CI 3.97-11.37). Gender did not interact with body image dissatisfaction on binge eating.
CONCLUSION
Ethnic variation in the link between body image dissatisfaction and binge eating may be due to within-race cultural differences in body image between African Americans and Caribbean Blacks. This may include different definitions, norms, and expectations regarding the body size. Findings suggest that ethnicity may bias relevance of body image dissatisfaction as a diagnostic criterion for binge eating disorders among diverse populations of Blacks.
背景
关于暴食症的研究绝大多数都集中在白人身上。我们的目的是在美国具有全国代表性的黑人成年人样本中，研究性别和族裔差异在身体意象不满与暴食症之间的关联。
方法
这项横断面研究使用了 2003-2004 年美国生活全国调查（NSAL）的数据。自我认定为加勒比裔黑人（n=1621）和非裔美国人（3570）的 18 岁及以上成年人参与了这项研究。自变量是使用世界卫生组织综合国际诊断访谈（WHO-CIDI）来衡量的两个项目的身体不满。根据 DSM-IV 标准，无层次的终生暴食症为因变量。协变量包括年龄、社会经济因素（即教育和婚姻状况）和体重指数。种族和性别是焦点调节因素。逻辑回归用于数据分析。
结果
尽管终生暴食症的流行率相似（5%与 4%，p>0.05），但非裔美国人报告的身体意象不满程度高于加勒比裔黑人（36%与 29%，p>0.05）。在汇总样本中，身体不满是终生暴食症的一个强有力的预测因素。身体不满与暴食症之间存在显著的交互作用（p=0.039），这表明身体不满与加勒比裔黑人的终生暴食症之间的关联更强（OR=11.65，95%CI 6.89-19.72），而非裔美国人（OR=6.72，95%CI 3.97-11.37）。性别与暴食症之间的身体不满没有相互作用。
结论
身体不满与暴食症之间的联系在族裔上的差异可能是由于非裔美国人和加勒比裔黑人之间的身体意象在种族内存在文化差异。这可能包括对身体大小的不同定义、规范和期望。研究结果表明，在不同族裔的黑人人群中，种族可能会影响身体不满作为暴食症诊断标准的相关性。
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