Raney Julia H, Al-Shoaibi Abubakr A, Shao Iris Y, Ganson Kyle T, Testa Alexander, Jackson Dylan B, He Jinbo, Glidden David V, Nagata Jason M
Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA.
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
J Eat Disord. 2023 Aug 17;11(1):139. doi: 10.1186/s40337-023-00866-0.
Racial and ethnic discrimination are known stressors and are associated with negative psychological and physical health outcomes. Previous studies have found relationships between racial/ethnic discrimination and binge-eating disorder (BED), though they have mainly focused on adult populations. The aim of this study was to determine associations between racial/ethnic discrimination and BED in a large, national cohort study of early adolescents. We further sought to explore associations between the racial/ethnic discrimination perpetrator (students, teachers, or other adults) and BED.
We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (N = 11,075, 2018-2020). Logistic regression analyses examined associations between self-reported experiences of racial or ethnic discrimination and binge-eating behaviors and diagnosis, adjusting for potential confounders. Racial/ethnic discrimination measures were assessed based on the Perceived Discrimination Scale, which measures experiences of discrimination based on race/ethnicity and frequency of ethnic discrimination by teachers, adults outside of school, and students. Binge-eating behaviors and diagnosis were based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSAD-5).
In this racially diverse sample of adolescents (N = 11,075, age range 9-12 years), 4.7% of adolescents reported racial or ethnic discrimination and 1.1% met the criteria for BED. In the adjusted models, racial/ethnic discrimination was associated with 3 times higher odds of having BED (OR 3.31, CI 1.66-7.74). Further, experiences of ethnic discrimination by students and adults outside school were associated with significantly increased odds of BED diagnosis (OR 1.36, CI 1.10-1.68 and OR 1.42 CI 1.06-1.90, respectively)., Increased odds of binge eating behaviors were only significantly associated with ethnic discrimination perpetuated by students (OR 1.12, CI 1.02-1.23).
Children and adolescents who have experienced racial/ethnic discrimination, particularly when discrimination was perpetuated by other students, have higher odds of having binge-eating behaviors and diagnoses. Clinicians may consider screening for racial discrimination and providing anti-racist, trauma-informed care when evaluating and treating patients for BED.
种族和民族歧视是已知的压力源，与负面的心理和身体健康结果相关。以往的研究发现了种族/民族歧视与暴饮暴食症（BED）之间的关系，不过这些研究主要集中在成年人群体。本研究的目的是在一项针对青少年早期的大型全国性队列研究中，确定种族/民族歧视与BED之间的关联。我们还进一步探讨了种族/民族歧视的实施者（学生、教师或其他成年人）与BED之间的关联。
我们分析了青少年大脑认知发展研究（2018 - 2020年，N = 11,075）的横断面数据。逻辑回归分析检验了自我报告的种族或民族歧视经历与暴饮暴食行为及诊断之间的关联，并对潜在的混杂因素进行了调整。种族/民族歧视的测量基于感知歧视量表，该量表根据种族/民族以及教师、校外成年人和学生的种族歧视频率来衡量歧视经历。暴饮暴食行为和诊断基于儿童情感障碍和精神分裂症量表（KSAD - 5）。
在这个种族多样的青少年样本（N = 11,075，年龄范围9 - 12岁）中，4.7%的青少年报告了种族或民族歧视，1.1%符合BED的标准。在调整后的模型中，种族/民族歧视与患BED的几率高3倍相关（比值比3.31，置信区间1.66 - 7.74）。此外，学生和校外成年人的种族歧视经历与BED诊断几率的显著增加相关（分别为比值比1.36，置信区间1.10 - 1.68和比值比1.42，置信区间1.06 - 1.90）。暴饮暴食行为几率的增加仅与学生实施的种族歧视显著相关（比值比1.12，置信区间1.02 - 1.23）。
经历过种族/民族歧视的儿童和青少年，尤其是当歧视由其他学生实施时，出现暴饮暴食行为和诊断的几率更高。临床医生在评估和治疗患有BED的患者时，可考虑筛查种族歧视并提供反种族主义、创伤知情护理。
