Calzo Jerel P, Horton Nicholas J, Sonneville Kendrin R, Swanson Sonja A, Crosby Ross D, Micali Nadia, Eddy Kamryn T, Field Alison E
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, and Harvard Medical School, Boston.
Amherst College, Amherst, MA.
J Am Acad Child Adolesc Psychiatry. 2016 Aug;55(8):693-700.e2. doi: 10.1016/j.jaac.2016.05.011. Epub 2016 May 27.
Research on the manifestations and health correlates of eating disorder symptoms among males is lacking. This study identified patterns of appearance concerns and eating disorder behaviors from adolescence through young adulthood and their health correlates.
Participants were 7,067 males from the prospective Growing Up Today Study. Surveys from 1999 to 2007 (spanning ages 13-26 years) provided repeated measures data on muscularity and leanness concerns, eating disorder behaviors (purging, overeating, binge eating, use of muscle-building products), and health correlates (obesity, non-marijuana drug use, binge drinking, and depressive symptoms).
Latent class analyses of observations at ages 13 to 15, 16 to 18, 19 to 22, and 23 to 26 years identified 1 large Asymptomatic class and 4 symptomatic patterns: Body Image Disturbance (high appearance concerns, low eating disorder behaviors; 1.0%-6.0% per age period); Binge Eating/Purging (binge eating and purging, use of muscle-building products, low appearance concerns; 0.1%-2.5%); Mostly Asymptomatic (low levels of muscularity concern, product use, and overeating; 3.5%-5.0%); and Muscularity Concerns (high muscularity concerns and use of products; 0.6%-1.0%). The Body Image Disturbance class was associated with high estimated prevalence of depressive symptoms. Males in the Binge Eating/Purging and Muscularity Concerns classes had high prevalence of binge drinking and drug use. Despite exhibiting modestly greater appearance concerns and eating disorder behaviors than the Asymptomatic class, being in the Mostly Asymptomatic class was prospectively associated with adverse health outcomes.
Results underscore the importance of measuring concerns about leanness, muscularity, and use of muscle-building products when assessing eating disorder presentations among males in research and clinical settings.
针对男性饮食失调症状的表现及其与健康的关联研究较为匮乏。本研究确定了从青春期到青年期出现的外表关注模式和饮食失调行为及其与健康的关联。
参与者为来自前瞻性“今日成长研究”的7067名男性。1999年至2007年(年龄跨度为13 - 26岁)的调查提供了关于肌肉发达程度和瘦度关注、饮食失调行为(催吐、暴饮暴食、过度进食、使用增肌产品)以及与健康关联(肥胖、非大麻类药物使用、酗酒和抑郁症状)的重复测量数据。
对13至15岁、16至18岁、19至22岁和23至26岁年龄段的观察结果进行潜在类别分析,确定了1个大的无症状类别和4种有症状模式:身体意象障碍(对外表高度关注,饮食失调行为较少;每个年龄段为1.0% - 6.0%);暴饮暴食/催吐(暴饮暴食和催吐、使用增肌产品、对外表关注较少;0.1% - 2.5%);基本无症状(对肌肉发达程度关注、产品使用和过度进食水平较低;3.5% - 5.0%);以及对肌肉发达程度的关注(对肌肉发达程度高度关注且使用产品;0.6% - 1.0%)。身体意象障碍类别与抑郁症状的估计患病率较高相关。暴饮暴食/催吐类别和对肌肉发达程度关注类别的男性酗酒和药物使用患病率较高。尽管与无症状类别相比,基本无症状类别表现出略多的外表关注和饮食失调行为,但该类别与不良健康结果存在前瞻性关联。
研究结果强调了在研究和临床环境中评估男性饮食失调表现时,测量对瘦度、肌肉发达程度和增肌产品使用的关注的重要性。