台灣舞蹈資優班和非舞蹈班高中生的兩階段飲食障礙症調查

Abstract

目的：進行本研究的目的，是想用兩種篩選問卷及兩階段方法，調查台灣地區舞蹈資優班高中生和非舞蹈班高中生飲食障礙症的盛行率和心理社會相關因子，以及比較兩種問卷篩選飲食障礙症的能力。方法：此研究的對象有兩組，一為舞蹈資優班的高中女生(12個學校分布於全台灣)(n=655)，二為同校同年級的非舞蹈班女同學依一比二的比例選出為比較組(n=1251)。第一階段施測是請學生在課堂上完成自填問卷的填寫，包括兩份篩選問卷(飲食態度問卷Eating Attitude Test, EAT和暴食問卷表Chinese version of Bulimic Investigatory Test, Ediburgh BITE)，一個身體形象問卷 (身體形態問卷Body Shape Questionnaire,BSQ)，和一個簡式症狀量表(精神病理問卷Brief Symptom Rating Scale, BSRS)，以及其基本資料等。第二階段的研究對象為任一篩選條件為陽性的個案和約10%兩個篩選條件均為陰性的個案，由兩位精神科醫師分別以結構性面談SCID建立飲食障礙症診斷，以及請病人填寫一份家庭關懷量表(Family APGAR)。結果：舞蹈班的每一種飲食障礙症盛行率均比非舞蹈班為高。厭食症均比西方國家低。暴食症均比厭食症為高，且非舞蹈班生的暴食症和西方國家的暴食症盛行率相當。根據ROC曲線下面積，暴食問卷表比飲食態度問卷更能正確鑑別出飲食障礙症。兩班學生飲食障礙症的共同社會心理因子是高體型關切度和家庭關係不佳。除此之外，非舞蹈班生的飲食障礙症與父母教育低程度有關，而合併體重過重、情緒障礙，和親戚有減重行為是舞蹈班生得飲食障礙症的相關因子。 結論：飲食障礙症較盛行於體重相關的次族群 (如舞蹈學生)，但是其診斷的分佈和一般族群或西方國家的舞蹈學生不同。暴食症的盛行率較厭食症高，和西方國家的暴食症盛行率相近。暴食問卷表有良好的信度和效度，是進行社區篩選飲食障礙症的一個有效工具。

Aims: To investigate the prevalence and psychosocial correlates of eating disorders (EDs) among Taiwanese population, and to evaluate relative performance of the EAT and the BITE as a screening tool for EDs. Methods: The study subjects consisted of all female high school students who were enrolled in the gifted dance class in the whole nation and non-dance female students randomly chosen from the same school. Students were asked to complete self-report questionnaires, including two screening instruments (EAT-26 and BITE), and two other questionnaires (BSQ and BSRS), as well as demographic details at phase-one survey. Phase-two participants consisted of all the screen positives for either one criteria or an approximate 10 % random sample from the screen negatives for both criteria. Every phase-two participant was interviewed with SCID to establish ED diagnoses in the past one year, and was asked to complete the Family APGAR scale. Results: The prevalence of individual ED was higher in the dance class students than that in the non-dance class students. The prevalence of bulimia nervosa was comparable to that of Western countries, in contrast to the low prevalence of anorexia nervosa among Taiwanese young girls. Under such context, the BITE had better accuracy than the EAT in detecting cases with EDs. Higher concern in body shape and lower family support were common psychosocial correlates of EDs for both groups of students. While lower parental education was associated with a higher risk of developing EDs for the non-dance class students, distinctive features were associated with EDs for the dance students, i.e., those who are overweight, have emotional disturbance, and have relatives with weight reduction practices. Conclusion: The EDs were more prevalent in weight-concern subpopulation. Bulimia nervosa was more prevalent than anorexia nervosa, and was in a similar rate to that of Western countries. The BITE was a valid screening tool for detecting cases of EDs in the community samples.