外貌導向社群媒體意識與飲食失序之關係：以臺灣新北市高中生為例—心理困擾與自尊的中介角色

Abstract

背景 青少年時期為身心快速發展與自我認同形成的重要階段，個體對外貌、體型與他人評價較為敏感。隨著社群媒體普及，青少年在日常生活中經常接觸照片、影像等與外貌相關內容，也可能透過社群媒體進行自我呈現與社會比較。飲食失序雖未必達到臨床飲食障礙之診斷標準，但其所涉及之過度節食、暴食、體重控制與對飲食或身體形象過度關注等行為，仍可能對青少年身心健康造成負面影響。過去國內已有部分針對國中生飲食失序之研究，然而高中生族群及社群媒體外貌意識相關研究仍相對有限，因此本研究欲進一步探討外貌導向社群媒體意識與高中生飲食失序之關係。

目的 本研究旨在瞭解外貌導向社群媒體意識與高中生飲食失序之關係，並探討心理困擾與自尊是否為此關係之中介因子，以進一步理解外貌導向社群媒體意識可能透過何種心理機轉與飲食失序產生關聯。

方法 本研究採橫斷式問卷調查設計，以新北市某公立完全中學高中部學生為研究對象。研究資料由班級導師協助發放電子問卷資訊，學生於完成法定代理人同意程序後，依本人意願自行填答。共有957名學生納入研究招募範圍，最終共有786名學生參與研究，研究參與率為82.13%。問卷系統共產生791筆填答紀錄，經排除5筆重複填答紀錄後，最終納入786筆有效資料進行分析。研究工具包括外貌導向社群媒體意識量表、簡式健康量表、Rosenberg自尊量表及飲食態度量表。資料分析方法包括描述性統計、探索性因素分析、信度分析、相關分析、階層迴歸分析及平行中介分析。

結果 本研究發現外貌導向社群媒體意識與高中生飲食失序呈顯著正向關聯，表示越關注社群媒體中自身外貌呈現與他人評價的學生，其飲食失序傾向越高。在控制體位、家庭型態、性別、運動天數、父母教育程度及社群媒體使用時間後，外貌導向社群媒體意識仍與飲食失序呈顯著迴歸關聯。在中介效果分析上，本研究發現外貌導向社群媒體意識較高者，其心理困擾程度較高，並與較高的飲食失序傾向相關；同時，外貌導向社群媒體意識較高者，其自尊程度較低，亦與較高的飲食失序傾向相關。整體而言，心理困擾與自尊皆呈現顯著特定間接效果；納入兩項中介變項後，外貌導向社群媒體意識與飲食失序之直接效果仍達顯著。

結論 本研究指出，外貌導向社群媒體意識與高中生飲食失序具有重要關聯。當高中生越重視自己在社群媒體中的外貌呈現、照片觀看與他人評價時，其飲食失序傾向可能較高。另一方面，外貌導向社群媒體意識也可能經由較高的心理困擾與較低的自尊，間接與飲食失序產生關聯。由於本研究採橫斷式設計，研究結果應解讀為變項之間的關聯、迴歸關聯與間接效果，而非因果關係。未來若能在高中健康教育與輔導工作中納入社群媒體素養、身體意象教育、情緒調節與自尊促進等內容，將有助於飲食失序風險之早期辨識與預防。

Background Adolescence is a critical stage of physical and psychological development and identity formation, during which individuals become more sensitive to appearance, body shape, and others’ evaluations. With the widespread use of social media, adolescents are frequently exposed to appearance-related content and may engage in self-presentation and social comparison through photos, videos, and online feedback. Although disordered eating does not necessarily meet the diagnostic criteria for clinical eating disorders, excessive dieting, binge eating, weight-control behaviors, and excessive concerns about eating or body image may negatively affect adolescents’ physical and mental health. Previous studies in Taiwan have examined disordered eating among junior high school students; however, research focusing on high school students and appearance-related social media consciousness remains limited.

Objectives This study aimed to examine the relationship between appearance-related social media consciousness and disordered eating among high school students, and to investigate whether psychological distress and self-esteem mediate this relationship.

Methods This study adopted a cross-sectional survey design and recruited students from the senior high school division of a public secondary school in New Taipei City, Taiwan. Students voluntarily completed an electronic questionnaire after completing the legal guardian consent process. A total of 957 students were included in the recruitment pool, of whom 786 participated in the study, yielding a participation rate of 82.13%. The online survey system generated 791 response records. After five duplicate records were excluded, data from 786 participants were included in the final analysis. Data were analyzed using descriptive statistics, exploratory factor analysis, reliability analysis, correlation analysis, hierarchical regression analysis, and parallel mediation analysis.

Results The findings showed that appearance-related social media consciousness was significantly and positively associated with disordered eating among high school students. Specifically, students who were more concerned about their appearance presentation and others’ evaluations on social media tended to report higher levels of disordered eating. After controlling for body weight status, family structure, gender, exercise frequency, parental educational level, and time spent on social media, appearance-related social media consciousness remained significantly associated with disordered eating in the regression model. In the mediation analysis, higher appearance-related social media consciousness was associated with greater psychological distress, which was in turn associated with higher levels of disordered eating. At the same time, higher appearance-related social media consciousness was associated with lower self-esteem, which was also associated with higher levels of disordered eating. Overall, psychological distress and self-esteem both showed significant specific indirect effects. The direct effect of appearance-related social media consciousness on disordered eating remained significant after both mediators were included.

Conclusion This study indicates that appearance-related social media consciousness is meaningfully associated with disordered eating among high school students. When high school students place greater importance on their appearance presentation, how they look in photos, and others’ evaluations on social media, they may report higher levels of disordered eating. In addition, appearance-related social media consciousness may be indirectly associated with disordered eating through higher psychological distress and lower self-esteem. Since this study adopted a cross-sectional design, the findings should be interpreted as associations, regression-based relationships, and indirect effects rather than causal relationships. Future health education and counseling practices in high schools may incorporate social media literacy, body image education, emotion regulation, and self-esteem enhancement to support the early identification and prevention of disordered eating risks.