Eating Disorders and Adolescent Body Image Among Boys and Sexual Minorities

描述(申请人提供)：到目前为止，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，随着年轻人超重和肥胖率达到流行病的比例，瘦和瘦的压力可能会增加所有年轻人从事无序饮食和锻炼行为的风险。这样的行为不仅增加了患进食障碍的风险，还可能导致未来体重增加和并发精神疾病(如抑郁症)的发展。然而，对男性和性少数群体(男/女同性恋、双性恋)的经历关注不足，尽管有新的证据表明，他们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会影响对负面身体形象的认知和行为反应。这些发现使未来的研究有必要集中在扰乱节食和锻炼的性别和性取向差异背后的过程。为了满足这些研究的需要，本研究计划将集中于以下目标：(1)利用身体发育、身体形象社会化以及节食和锻炼行为的多波纵向数据，阐明异性恋和性别少数民族男孩女孩身体形象社会化和无序饮食和锻炼行为的发展。分析将考察无序节食和锻炼途径的多样性，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联系在一起。(2)阐明影响男生负性身体形象社会化和饮食锻炼行为紊乱的因素。特别是，这项研究将侧重于青春期发展、性别表达(即性别一致性)和肌肉发达理想的发展。(3)在性少数群体中确定饮食障碍风险的独特和共同的纵向预测因素，特别注意性别、性别表达、身份暴露程度(即外露)、身份相关痛苦和性少数群体社区参与。研究结果将有助于厘清性取向如何成为无序节食和锻炼行为的风险和保护因素。为了实现这些目标，这项研究将利用Growth Up Today Study的全国数据，这是一项始于1996年的九波纵向队列研究，对象是超过1.6万名9-14岁到现在20多岁的年轻人。将使用纵向统计方法的组合(例如，生长混合模型)来检查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检查身体发育、身体形象社会化以及各种性取向的男性和女性之间出现无序饮食和运动的融合的研究之一。调查结果将澄清健康风险和促进健康的关键机制，并为干预措施提供信息。 与公共健康相关：饮食失调给社会带来了巨大的代价，影响了生产力、身体健康、社会关系和福祉。关于性别和性取向在饮食和锻炼障碍表现和流行方面的差异的新研究表明，男孩和性少数群体的研究和服务不足。研究对男孩和性少数群体造成不同风险的独特风险和保护因素，有可能为所有青年提供节食和运动障碍干预措施。

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.