Data_Sheet_1_Exploring the associations between behavioral health risk factors, abnormal eating attitudes and socio-demographic factors among Chinese youth: Survey of 7,984 vocational high school students in Hunan in 2020.PDF

BackgroundThis study investigated the associations between behavioral health risk factors (anxiety, depression, stress, insomnia, drinking, smoking) and abnormal eating attitudes among Chinese vocational high school students (CVHSS). Potential moderating relationships were also explored with relevant socio-demographic factors of the student's age, sex, rural or urban community, household income, family type and educational level of the father and mother.
MethodsA total of 7,984 students from three vocational high schools in Hunan, China completed a questionnaire about their socio-demographic characteristics, alcohol use, smoking, and symptoms of depression, anxiety, stress (21-item version of the Depression Anxiety Stress Scale), insomnia (8-item Athens Insomnia Scale), and abnormal eating attitudes (19-item Chinese version of Eating Attitudes Test).
ResultsThe prevalence rates for behavioral health problems among these students ranged widely depending on the risk factor: 42.5% insomnia, 41.3% anxiety, 26.2% depression, 14.4% stress, 13.7% drinking, and 8.3% smoking. Additionally, 61.7% of students were at-risk for at least one of these six behavioral health disorders. Abnormal eating attitudes were associated with depression (r = 0.422), anxiety (r = 0.490), stress (r = 0.490), and insomnia (r = 0.375), with all of these relationships being significant (p < 0.01) and large size statistical effects. However, other analyzes found that none of the socio-demographic background factors had meaningful associations with the behavioral health risk factors (0 of 28 tests) and very few background factors were associated with the abnormal eating attitude measures (only 3 of 35 tests). Females had higher levels than males on dieting and bulimia but not on the other two eating attitude components.
ConclusionsThis study determined that behavioral health risk factors (sleep problems and anxiety in particular) were common among high school students in China and that mental health and sleep disorder risks also tended to co-occur in some students with abnormal eating attitudes. Therefore, prevention and early identification programs for behavioral risk factors are needed for this population. It is important to pay more attention to students with abnormal eating attitude-related symptoms, who may have also underlying mental health problems and need further evaluation.

研究背景 本研究旨在探讨中国职业高中学生（Chinese Vocational High School Students, CVHSS）的行为健康风险因素（焦虑、抑郁、压力、失眠、饮酒、吸烟）与异常进食态度之间的关联，并探究学生年龄、性别、城乡社区、家庭收入、家庭类型及父母受教育程度等相关社会人口学因素的潜在调节效应。
研究方法 本研究共纳入中国湖南省3所职业高中的7984名学生，采用问卷收集其社会人口学特征、饮酒与吸烟行为，以及抑郁、焦虑、压力症状（采用21项版抑郁焦虑压力量表（21-item Depression Anxiety Stress Scale））、失眠症状（采用8项版雅典失眠量表（8-item Athens Insomnia Scale））和异常进食态度（采用19项中文版进食态度测试量表（19-item Chinese version of Eating Attitudes Test））的相关数据。
研究结果 本研究群体中各类行为健康问题的检出率差异显著：失眠检出率为42.5%，焦虑为41.3%，抑郁为26.2%，压力为14.4%，饮酒为13.7%，吸烟为8.3%。另有61.7%的学生至少存在上述6类行为健康问题中的1类。异常进食态度与抑郁（r=0.422）、焦虑（r=0.490）、压力（r=0.490）及失眠（r=0.375）均呈显著正相关（p<0.01），且相关效应量较大。进一步分析显示，28项社会人口学特征与行为健康风险因素均无有意义的统计学关联；在35项与异常进食态度相关的检验中，仅3项存在有意义的关联。女性学生在节食与贪食维度上的得分显著高于男性，但在其余两项进食态度维度上无显著性别差异。
研究结论 本研究证实，中国职业高中学生群体中行为健康风险因素（尤以睡眠问题与焦虑症状为甚）普遍高发，且部分存在异常进食态度的学生同时合并心理健康与睡眠障碍风险。因此，该群体亟需开展针对行为健康风险因素的预防与早期识别项目。需重点关注伴随异常进食态度相关症状的学生，这类群体可能存在潜在的心理健康问题，需进一步评估。