Neumark-Sztainer D, Story M, Falkner N H, Beuhring T, Resnick M D
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.
Arch Pediatr Adolesc Med. 1998 Sep;152(9):871-8. doi: 10.1001/archpedi.152.9.871.
To compare prevalence rates of weight-control behaviors among adolescents with and without chronic illness and to explore the role of familial and other social factors on associations between disordered eating and chronic illness.
Survey conducted in public schools in Connecticut.
A representative statewide population-based sample of 9343 7th-, 9th-, and 11th-grade public school students, of whom 1021 reported a chronic illness.
Disordered eating (vomiting, diet pills, and laxatives), dieting, and exercise for weight control; chronic illness status; family structure, family communication, parental caring, parental monitoring, parental expectations, peer support, and sexual and physical abuse.
Adolescents with chronic illness were at greater risk for disordered eating than youth without chronic illness, after controlling for sociodemographic variables (girls: odds ratio, 1.59 [95% confidence interval, 1.19-2.14]; boys: odds ratio, 2.22 [95% confidence interval, 1.49-3.32]). Adolescents with chronic illness were less likely to come from 2-parent families; reported lower levels of family communication, parental caring, and parental expectations; and reported more sexual and physical abuse than youth without chronic illness. Male adolescents with chronic illness were more likely to report low peer support and low parental monitoring. Most of these familial-social factors were also associated with an increased prevalence of disordered eating. After familial-social factors were controlled for, however, associations between disordered eating and chronic illness remained statistically significant.
Adolescents with chronic illness are at greater risk for disordered eating behaviors than youth without chronic illness. Factors other than the familial-social factors assessed in this study may be contributing to this increased risk. In the clinical setting, youth with chronic illness need to be screened for disordered eating and familial and other social concerns.
比较患有和未患有慢性病的青少年体重控制行为的患病率，并探讨家庭及其他社会因素在饮食失调与慢性病之间关联中所起的作用。
在康涅狄格州的公立学校进行的调查。
从全州范围内具有代表性的以人群为基础的样本中选取了9343名7年级、9年级和11年级的公立学校学生，其中1021名报告患有慢性病。
饮食失调（呕吐、服用减肥药和泻药）、节食以及为控制体重而进行的锻炼；慢性病状况；家庭结构、家庭沟通、父母关爱、父母监督、父母期望、同伴支持以及性虐待和身体虐待。
在控制了社会人口统计学变量后，患有慢性病的青少年比未患慢性病的青少年出现饮食失调的风险更高（女孩：优势比为1.59[95%置信区间为1.19 - 2.14]；男孩：优势比为2.22[95%置信区间为1.49 - 3.32]）。患有慢性病的青少年来自双亲家庭的可能性较小；报告的家庭沟通、父母关爱和父母期望水平较低；并且比未患慢性病的青少年报告遭受更多的性虐待和身体虐待。患有慢性病的男性青少年更有可能报告同伴支持少和父母监督少。这些家庭社会因素中的大多数也与饮食失调患病率的增加有关。然而，在控制了家庭社会因素后，饮食失调与慢性病之间的关联在统计学上仍然显著。
患有慢性病的青少年比未患慢性病的青少年出现饮食失调行为的风险更高。本研究中评估的家庭社会因素以外的其他因素可能导致了这种风险增加。在临床环境中，需要对患有慢性病的青少年进行饮食失调以及家庭和其他社会问题的筛查。
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