健康与遗传心理学研究室知识库

进食障碍倾向在普通人群中大量存在，如果没有得到有效控制极易发展为进食障碍病理。家庭被认为是影响进食障碍倾向的三个主要社会压力来源之一，而家庭中与外表相关的言语沟通又是压力的主要表现形式。肥胖谈话特指在别人面前进行的关于自己的体重或身体的自我贬低的言论，因其存在的普遍性以 及对体像结果包括进食障碍症状的密切关联性，近年来备受研究人员的关注。目前国内尚缺乏关于家庭环境中的肥胖谈话对进食障碍倾向的影响的研究，本研究旨在探讨青少年家庭中，肥胖谈话对父母及子女的进食障碍倾向的影响程 度及机制，同时考察父母与子女间的相互影响关系，为进食障碍倾向的家庭预防及干预提供参考依据。

研究一以1049名中学生（女生574名；男生475名）为研究对象，目的是考察我国青少年家庭肥胖谈话及进食障碍倾向的存在情况，以及家庭肥胖谈话通过身体不满及负性情绪的中介作用对青少年进食障碍倾向的影响。研究采用问卷调查法，收集了中学生的家庭肥胖谈话、身体满意度、负性情绪水平以及进食障碍倾向的相关数据，运用 SPSS 统计软件进行了相关分析、差异检验及回归分析，别使用 PROCESS Model 4 及 Model 59 对身体不满及负性情绪在家庭肥胖谈话对进食障碍倾向的影响中的中介作用及性别的调节作用进行了检验。研究结果显示：（1）青少年的进食障碍倾向发生率高（26.41%）；（2）青少年家庭中普遍存在肥胖谈话现象（67.09%）；（3）在家庭环境中经历的肥胖谈话频率将正向影响青少年进食障碍倾向的发生（r=0.62, p<0.001)，青少年越频繁地暴露于家庭肥胖谈话中，越可能引发进食障碍倾向；（4）身体不满在家庭肥胖谈话对青少年进食障碍倾向的影响过程中起中介作用(间接效应=0.015, SE =0.002, 95% CI: 0.012, 0.018, 占总效应的25.86%)，家庭肥胖谈话将通过影响 青少年的身体满意水平，进而影响青少年的进食障碍倾向；（5）负性情绪是另一个中介变量(间接效应=0.003, SE =0.002, 95% CI: 0.009, 0.016, 占总效应的 5.17%)，家庭肥胖谈话将通过影响青少年的负性情绪，进而影响青少年的进食 障碍倾向；（6）家庭肥胖谈话通过身体不满的中介作用对女生进食障碍倾向的 影响大于男生。

研究二以 399 名高一学生父母（母亲291名；父亲108名）为研究对象，目的是考察父母家庭肥胖谈话及进食障碍倾向的存在情况，以及家庭肥胖谈话通过身体不满及负性情绪的中介作用对父母进食障碍倾向的影响。研究方法及过程与研究一相同。研究结果显示：（1）青少年父母也存在进食障碍倾向的问题，发生率为 14.79%；（2）青少年父母在家庭中普遍存在肥胖谈话现象（75.44%）；（3）家庭环境中经历的肥胖谈话频率将正向影响父母进食障碍倾 向的发生（r=0.48, p<0.001)，越频繁地暴露于家庭肥胖谈话中，越可能引发进食障碍倾向；（4）身体不满在家庭肥胖谈话对父母进食障碍倾向的影响过程中起中介作用(间接效应=0.005, SE= 0.002, 95% CI: 0.001, 0.009, 占总效应的 13.02%)，家庭肥胖谈话将通过影响父母的身体满意水平，进而影响父母的进食障碍倾向；（5）负性情绪在家庭肥胖谈话对父母进食障碍倾向的影响过程中中介作用不显著(间接效应=0.002, SE= 0.001, 95% CI: -0.001, 0.004)，即家庭肥胖谈话不会通过影响父母的负性情绪而对他们的进食障碍倾向产生影响；（6）家庭肥胖谈话对母亲进食障碍倾向的影响程度相较于对父亲的影响，没有显著差异。

研究三将研究一与研究二的样本数据进行匹配，共获得361 对父母与子女的配对样本作为研究对象，考察了家庭中父母与子女通过肥胖谈话互动，对彼此进食障碍倾向的影响。本研究运用 SPSS 27.0 统计软件进行了各变量的相关分析及差异检验，运用 AMOS 软件构建结构方程模型检验父母与子女间的交互影响效应。研究结果显示：（1）配对样本中，61.11%的女生报告父母存在肥胖谈话现象，高于男生报告的 35.58%，但父母报告的家庭肥胖谈话率没有因子女的性别而产生显著差异，71.72%的女生父母及 69.94%的男生父母报告自己在家中进行过肥胖谈话；（2）20%左右的父母对子女的体重认知有偏差，其中父母更担心女儿超重、而对儿子则更担心超轻；（3）在以自我肥胖谈话为预测变量，身体不满及负性情绪为中介变量的主客体互倚中介模型（APIMeM）中，父母与子女的主体效应均显著，客体效应均不显著，但父母的自我肥胖谈话与女生的自我肥胖谈话之间相互影响显著，子女的肥胖谈话与母亲的自我肥胖谈话之间相互影响显著。

综上所述，本研究发现家庭肥胖谈话与青少年及其父母的进食障碍倾向之间存在较为密切的联系，且身体不满与负性情绪在家庭肥胖谈话对进食障碍倾向的影响中起到重要的中介作用。此外，本研究还发现父母与子女在家庭中的 肥胖谈话除了直接影响各自的进食障碍倾向外，对女生和母亲而言，还会通过影响对方的肥胖谈话频率进而影响对方的进食障碍倾向。

Eating disorder tendencies are prevalent in the general population, and can easily result in eating disorders pathology without effectively controlled. Family is considered one of the three main sources of social culture pressures that affect eating disorder tendencies, while the appearance related communication within the family is the main manifestation of family pressure. Fat talk specifically refers to self- disparaging comments about one's own weight or body in front of others, which has attracted the attention of researchers in recent years due to its high prevalence and close associations with body image outcomes, including eating disorder tendencies. At present, there is limited researches to address the influence of family fat talk on eating disorder tendencies in China. Therefore, this study aims to explore the influence of family fat talk on the eating disorder tendencies of adolescent children and their parents, and also to examine the interactions between parents and children.

Study 1 examined the prevalence of family fat talk and eating disorder tendencies among 1,049 Chinese middle and high school students (574 girls and 475 boys), as well as the link between family fat talk and eating disorder tendencies with body dissatisfaction and negative affect as two mediators. Furthermore, the moderating role of gender in the mediation model was also examined. The participants completed self-reported measures of family fat talk, body dissatisfaction, negative affect and eating disorder tendencies. Result showed that: (1) The incidence of the eating disorder tendency was high among adolescents (26.41%). (2) Family fat talk was common in adolescents families (67.09%). (3) The frequency of family fat talk was positively correlated with eating disorder tendency (r=0.62, pindirect ef ect=0.015, SE=0.002, 95% CI: 0.012, 0.018, accounting for 25.86% of the total effect. (5) Negative affect was another mediator between family fat talk and eating disorder tendency, which also had a significant indirect effect, indirect ef ect=0.003, SE=0.001, 95% CI: 0.009, 0.016, accounting for 5.17% of the total effect; (5) Gender difference emerged in the path from family fat talk to eating disorder tendency through body dissatisfaction. Family fat talk, through the mediating role of body dissatisfaction, had a greater effect on girls eating disorder tendency than boys.

Study 2 examined the prevalence of family fat talk and eating disorder tendencies among 399 parents (291 mothers and 108 fathers), as well as the link between family fat talk and eating disorder tendencies with the mediator of body dissatisfaction and negative affect. Furthermore, the moderating role of gender in the mediation model was also examined. The participants completed self-reported measures of family fat talk, body dissatisfaction, negative affect and eating disorder tendency. Result showed that: (1) The incidence of the eating disorder tendency was high among middle-aged parents of adolescents (14.79%). (2) Family fat talk was common in middle-aged parents of adolescents (75.44%). (3) The frequency of family fat talk was positively correlated with eating disorder tendency (r=0.48, pindirect ef ect= 0.005, SE=0.002, 95% CI: 0.001, 0.009, accounting for 13.02% of the total effect. (5) Negative affect didn’t have a significant indirect effect between family fat talk and eating disorder tendency, indirect ef ect= 0.003, SE=0.001, 95% CI: -0.001, 0.004;. (5) There was no gender difference in the mediation model.

Study 3 investigated how eating disorder tendencies were related to the dyadic dynamics of family fat talk in parent-offspring relationship. Total 361 dyad data come from the paired samples of Study 1 and Study 2. The APIMeM model was established using AMOS to examine the interaction between parents and adolescents. Results showed that: (1) 61.11% girls reported fat talk from their parents, higher than 35.58% reported by boys. However, there was no significant difference in the fat talk frequency reported by parents due to the gender of their children, 71.72% of girls parents and 69.94% of boys parents reported having fat talk at home. (2) More than 20% parents had a bias in their children’s weight perception. (3) In the Actor-partner interdependence model extended to mediation (APIMeM), the actor effects were significant for both adolescents and their parents, while the partner effects were not significant. But there was a significant mutual influence between parental self fat talk frequency and girls' self fat talk frequency, and a significant mutual influence between mothers’self fat talk frequency and their children’s self fat talk frequency. In summary, this study found that family fat talk had close associations with eating disorder tendencies in adolescents and their parents, with body dissatisfaction and negative affect playing a mediating role in this process.

In addition, it was found that adolescent girls and their parents would affect the frequency of fat talk with each other. That is to say, more parental fat talk would be related with more girls’ fat talk which might result in more eating disorder tendencies with girls. Similarly, mothers and their children would affect the frequency of fat talk with each other. More children fat talk would be related with more mothers’ fat talk, which might result in more eating disorder tendencies with mothers.