Chain mediating effect of negative evaluation fear and self-esteem between body image and social appearance anxiety in adolescent idiopathic scoliosis
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摘要:
目的 探讨青少年特发性脊柱侧弯患者身体意象、社交外表焦虑、负面评价恐惧和自尊之间的关系,并验证负面评价恐惧和自尊在身体意象和社交外表焦虑间的链式中介效应,以期为干预青少年特发性脊柱侧弯患者社交外表焦虑提供理论方法和依据。 方法 采用一般资料调查问卷、身体图像干扰问卷-脊柱侧弯版本、自尊量表、简明负面评价恐惧量表、社交外表焦虑量表对2019年9月—2022年5月于中国科学技术大学附属第一医院南区脊柱外科住院的101例青少年特发性脊柱侧弯患者进行问卷调查。 结果 不同年龄、体重、治疗方式青少年特发性脊柱侧弯患者的身体意象水平差异有统计学意义;身体意象可正向预测负面恐惧(r=0.302,P<0.001),身体意象(r=-0.348,P<0.01)、负面评价恐惧(r=-0.349,P<0.01)均可负向预测自尊,身体意象(r=0.422,P<0.001)、负面评价恐惧(r=0.766,P<0.001)均可正向预测社交外表焦虑,自尊可负向预测社交外表焦虑(r=-0.483,P<0.01)。负面评价恐惧和自尊在身体意象和社交外表焦虑中起部分中介效应,中介效应比为62.96%。 结论 青少年特发性脊柱侧弯患者的年龄、体重及治疗方式对身体意象水平有一定的预测作用,负面评价恐惧和自尊在青少年特发性脊柱侧弯患者身体意象和社交外表焦虑中的链式中介作用成立。医护人员进行心理护理时应协助患者树立对身体的正确认知,提高患者的自尊水平,降低负面评价恐惧,进而减缓社交外表焦虑的发生和进展。 Abstract:Objective This study aims to investigate the relationship between self-esteem and negative evaluation fear between body image and social appearance anxiety in adolescent idiopathic scoliosis patients, as well as the chain mediating effects among these variables. Methods This study investigated a sample of 101 hospitalized adolescent idiopathic scoliosis patients, who were admitted from September 2019 to May 2022. Data were collected using a general data questionnaire, the scoliosis version of the body image interference questionnaire, the self-esteem scale, the concise fear of negative evaluation scale, and the social appearance anxiety scale. Results The level of body image level in adolescent idiopathic scoliosis patients showed significant statistical differences based on age, weight, and treatment methods. Fear of negative evaluation was positively predicted by body image (r=0.302, P<0.001). While body image (r=-0.348, P<0.001) and fear of negative evaluation (r=-0.349, P<0.001) had negative predictive effects on self-esteem. Additionally, body image (r=0.422, P<0.001) and fear of negative evaluation (r=0.766, P<0.001) had positive predictive effects on social appearance anxiety, while self-esteem negatively predicted social appearance anxiety (r=-0.483, P<0.01). Both fear of negative evaluation and self-esteem demonstrated valid indirect effects. Fear of negative evaluation and self-esteem partially mediated the relationship between body image and social appearance anxiety, with a mediating effect ratio of 62.96%. Conclusion The age, weight, and treatment methods of adolescent idiopathic scoliosis patients have predictive effects on body image, while fear of negative evaluation and self-esteem act as chain mediator in the relationship between body image and social appearance anxiety in these patients. When providing psychological care, healthcare professionals should assist patients in developing a healthy body perception, enhancing their self-esteem, and reducing fear of negative evaluation, thereby mitigating the onset and progression of social appearance anxiety. -
表 1 AIS患者的一般资料与身体意象得分比较
Table 1. Comparison of general information and body image scores of AIS patients
项目 例(%) 身体意象得分(x±s, 分) 统计量 P值 性别 1.980a 0.060 男 44(43.6) 17.98±7.18 女 57(56.4) 15.51±5.35 年龄(岁) 1.830b 0.029 10~11 37(36.6) 15.19±6.00 12~15 45(44.6) 16.93±5.51 16~18 19(18.8) 18.47±8.14 身高(cm) 1.253b 0.234 <150 10(5.9) 16.40±5.78 150~<160 22(27.7) 15.23±6.87 160~<170 42(41.6) 16.90±6.06 ≥170 27(15.8) 17.26±6.56 体重(kg) 9.836b 0.001 <40 18(17.8) 19.44±6.63 40~<60 65(64.4) 14.69±5.19 ≥60 18(17.8) 20.56±7.02 确诊年限(年) 0.974b 0.503 <1 24(23.8) 16.29±5.85 1~<3 36(35.6) 16.97±6.72 3~<5 20(19.8) 16.25±5.95 ≥5 21(20.8) 16.57±6.79 治疗方式 2.795b 0.001 手术治疗 81(80.2) 15.93±5.95 支具治疗 14(13.9) 22.64±5.65 未治疗 6(5.9) 11.33±1.37 家庭住址 0.884a 0.379 城市 33(32.7) 16.97±6.61 农村 68(67.3) 15.79±5.63 家庭月收入(元) 1.646b 0.059 ≤3 000 30(29.7) 19.23±6.96 3 000~<8 000 61(60.4) 15.49±5.62 ≥8 000 10(0.9) 15.30±6.43 注:a为t值,b为F值。 表 2 身体意象、自尊、负面评价恐惧与社交外表焦虑的相关分析(r值)
Table 2. Analysis of the relationships among body image, self-esteem, fear of negative evaluation, and social appearance anxiety (r value)
变量 身体意象 自尊 负面评价恐惧 社交外表焦虑 身体意象 1 自尊 -0.348a 1 负面评价恐惧 0.302a -0.349a 1 社交外表焦虑 0.422a -0.483a 0.766a 1 注:aP<0.01。 -
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