Zhang Yueyun, Liu Baozhong, Sun Long
Department of Sociology, School of Philosophy and Social Development, Shandong University, Jinan 250100, China.
Institute of Sociology, Chinese Academy of Social Sciences, Beijing 100732, China.
Healthcare (Basel). 2021 Sep 29;9(10):1299. doi: 10.3390/healthcare9101299.
Conflicting findings were reported about the associations between subjective body image (SBI), body mass index (BMI) and psychological symptoms in China and other countries in the world. In this study, we aim to explore the associations between SBI, BMI, and psychological symptoms based on a large-scale, national wide survey among Chinese adolescents.
The 2014-2015 China Education Panel Survey (CEPS) database, with 8134 middle school students (4137 boys and 3997 girls), was analyzed to explore the association between SBI, BMI and psychological symptoms. SBI was assessed by one question about the perception of own body shape with options "very thin", "slightly thin", "average", "weak heavy", and "very heavy". BMI was calculated by the self-reported body weight and height. Psychological symptoms were evaluated by 10 items involving both aspects of depression and anxiety.
The results indicated that both boys and girls who perceived weak or very heavy weight were positively associated with psychological symptoms ( < 0.05). For boys, perceiving very thin body image was also in higher risk of psychological symptoms ( < 0.05), after controlling social-demographic variables and BMI. Comparing with normal weight boys or girls, obese boys (β = -2.22, 95% CI -3.37-1.07) and overweight girls (β = -1.03, 95% CI -2.01-0.06) were in lower levels of psychological symptoms after controlling for SBI. Other factors associated with psychological symptoms were family economic status, academic performance, and self-rated health status.
A deviation from an "average" SBI was positively associated with psychological symptoms, which should be scanned when evaluating the Chinese adolescents' mental health. These findings provide epidemiological evidence for the association between SBI and psychological symptoms in non-western social contexts.
在中国和世界其他国家，关于主观身体意象（SBI）、体重指数（BMI）与心理症状之间的关联，有相互矛盾的研究结果报道。在本研究中，我们旨在基于一项针对中国青少年的大规模全国性调查，探讨SBI、BMI与心理症状之间的关联。
分析了2014 - 2015年中国教育追踪调查（CEPS）数据库，该数据库包含8134名中学生（4137名男生和3997名女生），以探讨SBI、BMI与心理症状之间的关联。SBI通过一个关于对自身身体形状感知的问题进行评估，选项包括“非常瘦”“有点瘦”“正常”“偏重”和“非常重”。BMI通过自我报告的体重和身高计算得出。心理症状通过涉及抑郁和焦虑两个方面的10个项目进行评估。
结果表明，认为自己体重偏重或非常重的男孩和女孩都与心理症状呈正相关（P < 0.05）。对于男孩，在控制了社会人口统计学变量和BMI后，认为自己身体非常瘦也有更高的心理症状风险（P < 0.05）。与正常体重的男孩或女孩相比，在控制了SBI后，肥胖男孩（β = -2.22，95%CI -3.37-1.07）和超重女孩（β = -1.03，95%CI -2.01-0.06）的心理症状水平较低。与心理症状相关的其他因素包括家庭经济状况、学业成绩和自评健康状况。
偏离“正常”的SBI与心理症状呈正相关，在评估中国青少年心理健康时应予以关注。这些发现为非西方社会背景下SBI与心理症状之间的关联提供了流行病学证据。
