Eating Disorders and Adolescent Body Image Among Boys and Sexual Minorities

描述（由申请人提供）：迄今为止，大多数关于饮食失调的研究都集中在女孩和妇女身上。然而，随着青少年超重和肥胖率达到流行病的程度，瘦和精瘦的压力可能会增加所有青少年参与无序节食和运动行为的风险。这样的行为不仅会增加患饮食失调的风险，还可能导致未来体重增加和并发精神病理（如抑郁症）。尽管越来越多的证据表明，男性和性少数群体（男同性恋/女同性恋、双性恋）的身体形象社会化过程可能不同于异性恋女性，性别表达和性取向可能影响对负面身体形象的认知和行为反应，但对男性和性少数群体（男同性恋/女同性恋、双性恋）的经历关注不够。这样的发现使得未来的研究有必要关注在饮食和运动紊乱中性别和性取向差异背后的过程。为了解决这些研究需求，本研究项目将集中在以下几个方面：(1)利用身体发育、身体形象社会化和饮食与运动行为的多波纵向数据来阐明异性恋和性少数群体男孩和女孩的身体形象社会化和饮食与运动障碍行为的发展。分析将检查饮食和运动紊乱途径的多样性，并调查性别、性取向以及两者之间的相互作用如何与这种发育变异性联系在一起。(2)阐明男孩负面身体形象社会化和饮食运动行为紊乱的形成因素。特别是，研究将集中在青春期的发展，性别表达（即性别一致性），以及理想肌肉的发展。(3)在性少数群体中确定饮食失调风险的独特和共同的纵向预测因素，特别关注性别、性别表达、身份披露水平（即外出）、身份相关困扰和性少数群体社区参与。研究结果将有助于澄清性取向是如何成为饮食和运动行为紊乱的风险因素和保护因素的。为了实现这些目标，这项研究将利用“今日成长研究”（Growing Up Today Study）的全国数据。“今日成长研究”是一项始于1996年的九波纵向队列研究，研究对象是16000多名年龄在9-14岁之间、现在25岁左右的年轻人。纵向统计方法的组合（例如，生长混合模型）将被用来检查在无序节食和运动发展的多样性。这项拟议中的研究将是第一批研究身体发育、身体形象社会化、以及在所有性取向的男性和女性中出现的无序节食和运动的影响的研究之一。研究结果将阐明健康风险和促进的关键机制，并为干预措施提供信息。

DESCRIPTION (provided by applicant): To date, most research on eating disorders has focused on girls and women. However, with youth overweight and obesity rates reaching epidemic proportions, pressure to be thin and lean has likely contributed to an increased risk for all youth to engage in disordered dieting and exercise behaviors. Such behaviors not only increase the risk for developing eating disorders, but may also contribute to future weight gain and the development of comorbid psychopathology (e.g., depression). Inadequate focus, however, has been devoted to the experiences of men and of sexual minorities (gay/lesbian, bisexual), in spite of emerging evidence that their body image socialization processes may differ from those of heterosexual women, and that gender expression and sexual orientation may impact cognitive and behavioral reactions to negative body image. Such findings necessitate future studies focused on the processes that underlie gender and sexual orientation differences in disturbed dieting and exercise. To address these research imperatives, the program of research will focus on the following aims: (1) Utilize multi-wave longitudinal data on physical development, body image socialization, and dieting and exercise behaviors to elucidate the development of heterosexual and sexual minority boys and girls' body image socialization and disordered dieting and exercise behaviors. Analyses will examine the diversity in pathways to disordered dieting and exercise, and investigate how gender, sexual orientation, and the interactions between the two are linked to such developmental variability. (2) Elucidate factors that contribute to the development of boys' negative body image socialization and disordered dieting and exercise behaviors. In particular, the research will focus on pubertal development, gender expression (i.e., gender conformity), and the development of the muscularity ideal. (3) Identify unique and shared longitudinal predictors of eating disorder risk among the sexual minority subgroups, paying particular attention to gender, gender expression, level of identity disclosure (i.e., outness), identity-related distress, and sexual minority community involvement. Findings will help clarify how sexual orientation serves as both a risk and protective factor for disordered dieting and exercise behaviors. To fulfill these aims the research will utilize national data from the Growing Up Today Study, a nine-wave longitudinal cohort study begun in 1996 of over 16,000 youth who were recruited when they were between the ages of 9-14 and who are now in their mid 20s. A combination of longitudinal statistical methods (e.g., growth mixture modeling) will be used to examine diversity in the development of disordered dieting and exercise. The proposed research will be among the first to examine the confluence of physical development, body image socialization, and the emergence of disordered dieting and exercise among males and females of all sexual orientations. Findings will clarify key mechanisms of health risk and promotion as well as inform interventions. PUBLIC HEALTH RELEVANCE: Eating disorders represent a tremendous cost to society, affecting productivity, physical health, social relationships, and well being. New research regarding gender and sexual orientation differences in the manifestation and prevalence of disturbed dieting and exercise suggest that boys and sexual minorities are understudied and underserved populations. Studying the unique risk and protective factors that create differential risk for boys and sexual minority subgroups has the potential to inform dieting and exercise disorder interventions for all youth.