• 沒有找到結果。

第五章 討論與結論

第五節 結語與建議

綜合本研究之線性迴歸及邏輯式迴歸分析研究結果發現,迴歸全模式 分析四組的體重狀態當中,體重正常且較不滿意自己的外表者比滿意自己 外表者與憂鬱傾向、自尊、久坐行為、減重行為有關,而體重過重/肥胖且 不滿意自己的外表者比體重正常且滿意自己外表者與自尊、久坐行為、減 重行為有關。

然而,依本研究的結果可知,單看身體質量指數(Body Mass Index, BMI) 對於社會心理因素(包括憂鬱傾向、自尊)及健康相關行為(包括睡眠時數、

睡眠品質、吃早餐行為、久坐行為、減重行為)的相關不大,需利用身體質 量指數(Body Mass Index, BMI)再加上是否滿意自己的外表後,對於社會心 理因素及健康相關行為等相關較大,未來的相關研究除了考慮學生本身的 身體質量指數(Body Mass Index, BMI)之外,還需進一步加入對於自己身體 的滿意度,才能正確的得知青少年的社會心理因素情形及得到更健康的相 關行為。

研究結果可應用於未來學校規劃青少年體重與社會心理因素及健康 相關行為之相關預防介入計畫;建議未來相關研究除了考慮學生身體質量 指數(Body Mass Index, BMI)之外,還需更加探討學生對於自己的身體意象 (body image)認知,以瞭解體重知覺(weight perception)對於社會心理因素及 健康相關行為之影響。

感謝(Acknowledgement)

本論文感謝臺北市政府衛生局 95 年度研究發展獎勵計畫(題目:

北市市立高中學生肥胖與血脂肪、血壓及憂鬱情形的關係)的支持,

特別感謝台北市立聯合醫院 吳振龍副院長、仁愛院區 吳維峰主任、

和平院區 洪嘉蔚醫師的指導與協助。

參考文獻(Reference)

Affenito, S. G., D. R. Thompson, et al. (2005). "Breakfast consumption by African-American and white adolescent girls correlates positively with

calcium and fiber intake and negatively with body mass index." Journal of the American Dietetic Association 105(6): 938-45.

Agras, W. S., L. D. Hammer, et al. (2004). "Risk factors for childhood overweight: a prospective study from birth to 9.5 years.[see comment][erratum appears in J Pediatr. 2004 Sep;145(3):424]." Journal of Pediatrics 145(1): 20-5.

Barton, B. A., A. L. Eldridge, et al. (2005). "The relationship of breakfast and cereal consumption to nutrient intake and body mass index: the National Heart, Lung, and Blood Institute Growth and Health Study." Journal of the American

Dietetic Association 105(9): 1383-9.

Beebe, D. W., D. Lewin, et al. (2007). "Sleep in overweight adolescents: shorter sleep, poorer sleep quality, sleepiness, and sleep-disordered breathing." Journal of Pediatric Psychology 32(1): 69-79.

Berkey, C. S., H. R. H. Rockett, et al. (2003). "Longitudinal study of skipping breakfast and weight change in adolescents." International Journal of Obesity

& Related Metabolic Disorders: Journal of the International Association for the Study of Obesity 27(10): 1258-66.

Birmaher, B., N. D. Ryan, et al. (1996). "Childhood and adolescent depression: a review of the past 10 years. Part I.[see comment]." Journal of the American Academy of Child & Adolescent Psychiatry 35(11): 1427-39.

Booth, M. L., M. Wake, et al. (2001). "The epidemiology of overweight and obesity among Australian children and adolescents, 1995-97." Australian & New Zealand Journal of Public Health 25(2): 162-9.

Boutelle, K., D. Neumark-Sztainer, et al. (2002). "Weight control behaviors among obese, overweight, and nonoverweight adolescents." Journal of Pediatric Psychology 27(6): 531-40.

Bruch, H. (1981). "Developmental considerations of anorexia nervosa and obesity."

Canadian journal of psychiatry 26: 212-217.

Carskadon, M. A., K. Harvey, et al. (1980). "Pubertal changes in daytime sleepiness."

Sleep 2(453-460).

Castelli, D. M., C. H. Hillman, et al. (2007). "Physical fitness and academic

achievement in third- and fifth-grade students." Journal of Sport & Exercise Psychology 29(2): 239-52.

Chabrol, H., A. Montovany, et al. (2002). "[Study of the CES-D on a sample of 1,953 adolescent students]." Encephale 28(5 Pt 1): 429-32.

Crow, S., M. E. Eisenberg, et al. (2006). "Psychosocial and behavioral correlates of dieting among overweight and non-overweight adolescents." Journal of Adolescent Health 38(5): 569-74.

Dietz, W. H. (1998). "Health consequences of obesity in youth: childhood predictors of adult disease." Pediatrics 101(3 Pt 2): 518-25.

Eisenmann, J. C., P. Ekkekakis, et al. (2006). "Sleep duration and overweight among Australian children and adolescents." Acta Paediatrica 95(8): 956-63.

Epstein, L. H., J. N. Roemmich, et al. (2008). "A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children.[see comment]." Archives of Pediatrics & Adolescent Medicine 162(3): 239-45.

Erermis, S., N. Cetin, et al. (2004). "Is obesity a risk factor for psychopathology among adolescents?" Pediatrics International 46(3): 296-301.

Erickson, S. J., T. N. Robinson, et al. (2000). "Are overweight children unhappy?:

Body mass index, depressive symptoms, and overweight concerns in elementary school children.[see comment]." Archives of Pediatrics &

Adolescent Medicine 154(9): 931-5.

French, S. A., M. Story, et al. (1995). "Self-esteem and obesity in children and adolescents: a literature review." Obesity Research 3(5): 479-90.

Garrison, C. Z., C. L. Addy, et al. (1991). "The CES-D as a screen for depression and other psychiatric disorders in adolescents." Journal of the American Academy of Child & Adolescent Psychiatry 30(4): 636-41.

Goodman, E. and R. C. Whitaker (2002). "A prospective study of the role of depression in the development and persistence of adolescent obesity."

Pediatrics 110(3): 497-504.

Gortmaker, S. L., A. Must, et al. (1996). "Television viewing as a cause of increasing obesity among children in the United States, 1986-1990." Archives of

Pediatrics & Adolescent Medicine 150(4): 356-62.

Gowaed, P. (1992). "Body Image and Eating Awareness: A Guide to Developing

Groups for Adult Women." Victorian Health Foundation: 13.

Guinn, B., T. Semper, et al. (1997). "Body image preception in femaile

Mexican-American adolescents." Journal of School Health 67(112-115).

Gupta, N. K., W. H. Mueller, et al. (2002). "Is obesity associated with poor sleep quality in adolescents?" American Journal of Human Biology 14(6): 762-8.

Gutierrez-Saldana, P., N. Camacho-Calderon, et al. (2007). "[Self-esteem, family function, and school achievement of adolescents]." Atencion Primaria 39(11):

597-601.

Hancox, R. J., B. J. Milne, et al. (2004). "Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study.[see comment]." Lancet 364(9430): 257-62.

Hatcher, J. (2007). "The state of measurement of self-esteem of African American women." Journal of Transcultural Nursing 18(3): 224-32.

Hauser, S. T., S. I. Powers, et al. (1991). "Adolescents and their families paths of 76 ego development." New York: Macmillan.

Herva, A., J. Laitinen, et al. (2006). "Obesity and depression: results from the

longitudinal Northern Finland 1966 Birth Cohort Study." International Journal of Obesity 30(3): 520-7.

Heywood, S. and M. P. McCabe (2006). "Negative affect as a mediator between body dissatisfaction and extreme weight loss and muscle gain behaviors." Journal of Health Psychology 11(6): 833-44.

Hu, F. B., T. Y. Li, et al. (2003). "Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women.[see comment]." JAMA 289(14): 1785-91.

Huon, G. F. (1994). "Dieting, binge eating, and some of their correlates among secondary school girls. ." The International journal of eating disorders 15:

159-164.

Huurre, T., H. Junkkari, et al. (2006). "Long-term Psychosocial effects of parental divorce A follow-up study from adolescnce to adulthood." European Archives of psychiatry and clinical neuroscience Mar.(26): Epub ahead of print.

Israel, A. C. and M. Y. Ivanova (2002). "Global and dimensional self-esteem in pre-adolescent and early adolescent children who are overweight: age and gender differences." The International journal of eating disorders 31(424-429).

Janssen, I., P. T. Katzmarzyk, et al. (2004). "Overweight and obesity in Canadian

adolescents and their associations with dietary habits and physical activity patterns." Journal of Adolescent Health 35(5): 360-7.

Janssen, I., P. T. Katzmarzyk, et al. (2005). "Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns." Obesity Reviews 6(2): 123-32.

Jebb, S. A., K. L. Rennie, et al. (2004). "Prevalence of overweight and obesity among young people in Great Britain." Public Health Nutrition 7(3): 461-5.

Kendly, K. S., M. C. Neale, et al. (1992). "A population-based twin study of major depression in women: The impact of varying definitions of illness." Archives of General Psychiatry 49: 257-266.

Keski-Rahkonen, A., J. Kaprio, et al. (2003). "Breakfast skipping and

health-compromising behaviors in adolescents and adults." European Journal of Clinical Nutrition 57(7): 842-53.

Kilpatrick, M., C. Ohannessian, et al. (1999). "Adolescent weight management and perceptions: an analysis of the National Longitudinal Study of Adolescent Health." Journal of School Health 69(4): 148-52.

Klein-Platat, C., A. Wagner, et al. (2003). "Prevalence and sociodemographic determinants of overweight in young French adolescents."

Diabetes/Metabolism Research Reviews 19(2): 153-8.

Kostanski, M., A. Fisher, et al. (2004). "Current conceptualisation of body image dissatifactions: have we got it wrong?" Journal of child psychology and psychiatry 45: 1317-1325.

Kristjansdottir, G. and R. Vilhjalmsson (2001). "Sociodemographic differences in patterns of sedentary and physically active behavior in older children and adolescents." Acta Paediatrica 90(4): 429-35.

Kuriyan, R., S. Bhat, et al. (2007). "Television viewing and sleep are associated with overweight among urban and semi-urban South Indian children." Nutrition Journal 6: 25.

Lacar, E. S., X. Soto, et al. (2000). "Adolescent obesity in a low-income Mexican American district in South Texas." Archives of Pediatrics & Adolescent Medicine 154(8): 837-40.

Lee, K., H. Sohn, et al. (2004). "Weight and BMI over 6 years in Korean children:

relationships to body image and weight loss efforts." Obesity Research 12(12):

1959-66.

Marttunen, M. J., H. M. Aro, et al. (1991). "Mental disorders in adolescent suicide.

DSM-III-R axes I and II diagnoses in suicides among 13- to 19-year-olds in Finland." Archives of General Psychiatry 48(9): 834-9.

McCabe, M. P. and L. A. Ricciardelli (2003). "Body image and strategies to lose weight and increase muscle among boys and girls." Health Psychology 22(1):

39-46.

McCabe, M. P. and L. A. Ricciardelli (2003). "Sociocultural influences on body image and body changes among adolescent boys and girls." Journal of Social

Psychology 143(1): 5-26.

McCabe, M. P. and L. A. Ricciardelli (2004). "Body image dissatisfaction among males across the lifespan: a review of past literature." Journal of

Psychosomatic Research 56(6): 675-85.

McCabe, M. P. and L. A. Ricciardelli (2005). "A prospective study of pressures from parents, peers, and the media on extreme weight change behaviors among adolescent boys and girls." Behaviour Research & Therapy 43(5): 653-68.

Miller, C. T. and K. T. Downey (1999). "A Meta-Analysis of Heavyweight and Self-Esteem." Personality and Social Psychology Review 3(1): 68-84.

National Eating Disorders Association. (2002). Body image Handout. Seattle, WA:

National Eating Disorders Association.

Needham, B. L. and R. Crosnoe (2005). "Overweight status and depressive symptoms during adolescence." Journal of Adolescent Health 36(1): 48-55.

Nicklas, T. A., W. Bao, et al. (1993). "Breakfast consumption affects adequacy of total daily intake in children." Journal of the American Dietetic Association 93(8):

886-91.

Nicklas, T. A., C. Reger, et al. (2000). "Breakfast consumption with and without vitamin-mineral supplement use favorably impacts daily nutrient intake of ninth-grade students." Journal of Adolescent Health 27(5): 314-21.

Niemeier, H. M., H. A. Raynor, et al. (2006). "Fast food consumption and breakfast skipping: predictors of weight gain from adolescence to adulthood in a nationally representative sample." Journal of Adolescent Health 39(6): 842-9.

Ogden, C. L., M. D. Carroll, et al. (2006). "Prevalence of overweight and obesity in the United States, 1999-2004." JAMA 295(13): 1549-55.

Ohring, R., J. A. Gaber, et al. (2002). "Girls' recurrent and concurrent body

dissatisfaction: correlates and consequences over 8 years." The International

journal of eating disorders 31: 404-415.

Ozaki, R., Q. Qiao, et al. (2007). "Overweight, family history of diabetes and attending schools of lower academic grading are independent predictors for metabolic syndrome in Hong Kong Chinese adolescents." Archives of Disease in Childhood 92(3): 224-8.

Ozmen, D., E. Ozmen, et al. (2007). "The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents." BMC Public Health 7(147): 80.

Paxton, S. J., E. H. Wertheim, et al. (1991). "Body image satisfaction, dieting beliefs, and weight loss behaviors in adolescent girls and boys " Journal of Youth and Adolescence 20(3): 361-379.

Peden, A. R., D. B. Reed, et al. (2005). "Depressive symptoms in adolescents living in rural America." Journal of Rural Health 21(4): 310-6.

Pesa, J. A. (1999). "Psychosocial Factors Associated With Dieting Bhaviors Among Female Adolescents." Journal of Adolescent Health 69(5): 196-201.

Pesa, J. A., T. R. Syre, et al. (2000). "Psychosocial differences associated with body weight among female adolescents: the importance of body image." Journal of Adolescent Health 26(5): 330-7.

Pine, D. S., R. B. Goldstein, et al. (2001). "The association between childhood depression and adulthood body mass index." Pediatrics 107(5): 1049-56.

Radloff, L. S. (1977). "A Self-Report Depression Scale for Research in the General Population " Applied Psychological Measurement 1( 385): 385-401.

Rampersaud, G. C., M. A. Pereira, et al. (2005). "Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents." Journal of the American Dietetic Association 105(5): 743-60; quiz 761-2.

Reinherz, H. Z., G. Stewart-Berghauer, et al. (1989). "The relationship of early risk and current mediators to depressive symptomatology in adolescence." Journal of the American Academy of Child & Adolescent Psychiatry 5: 653-685.

Roberts, R. E., P. M. Lewinsohn, et al. (1991). "Screening for adolescent depression: a comparison of depression scales." Journal of the American Academy of Child

& Adolescent Psychiatry 30(1): 58-66.

Rosenberg, M. (1965). "Society and the adolescent self-image." Princeton, NJ:

Princeton University Press.

Ross, C. E. (1994). "Overweight and depression." Journal of health and social

behavior 35(63-79).

Sekine, M., T. Yamagami, et al. (2002). "Parental obesity, lifestyle factors and obesity in preschool children: results of the Toyama Birth Cohort study." Journal of Epidemiology 12(1): 33-9.

Serdula, M. K., D. Ivery, et al. (1993). "Do obese children become obese adults? A review of the literature." Preventive Medicine 22(2): 167-77.

Siega-Riz, A. M., B. M. Popkin, et al. (1998). "Trends in breakfast consumption for children in the United States from 1965-1991." American Journal of Clinical Nutrition 67(4): 748S-756S.

Sjoberg, R. L., K. W. Nilsson, et al. (2005). "Obesity, shame, and depression in school-aged children: a population-based study." Pediatrics 116(3): e389-92.

Spencer, E. A., P. N. Appleby, et al. (2002). "Validity of self-reported height and weight in 4808 EPIC-Oxford participants." Public health nutrition 5: 561-565.

Spiegel, K., R. Leproult, et al. (2004). "Leptin levels are dependent on sleep duration:

relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin." Journal of Clinical Endocrinology & Metabolism 89(11):

5762-71.

Spiegel, K., R. Leproult, et al. (1999). "Impact of sleep debt on metablic and endocrine function." Lancet 354: 1435-1439.

Stice, E., C. Hayward, et al. (2000). "Body-image and eating disturances predict onset of depression among female adolescnets: a longitudinal study." Journal of abnormal psychology 199(438-444).

Strauss, R. S. (2000). "Childhood obesity and self-esteem." Pediatrics 105(1): e15.

Sugimori, H., K. Yoshida, et al. (2004). "Analysis of factors that influence body mass index from ages 3 to 6 years: A study based on the Toyama cohort study."

Pediatrics International 46(3): 302-10.

Sund, A. M., B. Larsson, et al. (2003). "Psychosocial correlates of depressive symptoms among 12-14-year-old Norwegian adolescents." Journal of Child Psychology & Psychiatry & Allied Disciplines 44(4): 588-97.

Swallen, K. C., E. N. Reither, et al. (2005). "Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health." Pediatrics 115(2): 340-7.

te Velde, S. J., I. De Bourdeaudhuij, et al. (2007). "Patterns in sedentary and exercise behaviors and associations with overweight in 9-14-year-old boys and girls--a

cross-sectional study." BMC Public Health 7: 16.

Terman, L. and A. Hocking (1913). "The sleep of school children: its distribution according to age, and its relation to physical and mental efficiency." Journal of education & psychology 4: 138-147.

Thombs, B. D., M. Hudson, et al. (2008). "Reliability and validity of the center for epidemiologic studies depression scale in patients with systemic sclerosis."

Arthritis & Rheumatism 59(3): 438-43.

Thrane, L. E., L. B. Whitbeck, et al. (2004). "Comparing three measures of depressive symptoms among American Indian adolescents." American Indian & Alaska Native Mental Health Research (Online) 11(3): 20-42.

Timlin, M. T., M. A. Pereira, et al. (2008). "Breakfast eating and weight change in a 5-year prospective analysis of adolescents: Project EAT (Eating Among Teens)." Pediatrics 121(3): e638-45.

Van Der Horst, K., M. J. C. A. Paw, et al. (2007). "A brief review on correlates of physical activity and sedentariness in youth." Medicine & Science in Sports &

Exercise 39(8): 1241-50.

Vincent, M. and M. McCabe (2000). "Gender Differences Among Adolescents in Family, and Peer Influences on Body Dissatisfaction, Weight Loss, and Binge Eating Behaviors." Journal of Youth and Adolescence 2: 205-220.

Viner, R. M. and T. J. Cole (2006). "Who changes body mass between adolescence and adulthood? Factors predicting change in BMI between 16 year and 30 years in the 1970 British Birth Cohort." International Journal of Obesity 30(9):

1368-74.

Viner, R. M., M. M. Haines, et al. (2006). "Body mass, weight control behaviours, weight perception and emotional well being in a multiethnic sample of early adolescents." International Journal of Obesity 30(10): 1514-21.

von Kries, R., A. M. Toschke, et al. (2002). "Reduced risk for overweight and obesity in 5- and 6-y-old children by duration of sleep--a cross-sectional study."

International Journal of Obesity & Related Metabolic Disorders: Journal of the International Association for the Study of Obesity 26(5): 710-6.

Waaddegaard, m. (2002). "Dieting and Desire for Weight Loss Among Adolescents in Denmark: A Questionnaire Survey." European Journal of Disorders Review 10:

329-346.

Wardle, J., S. Williamson, et al. (2006). "Depression in adolescent obesity: cultural

moderators of the association between obesity and depressive symptoms."

International Journal of Obesity 30(4): 634-43.

Well, J. C. K. (2000). "Netural selection and sex differences in morbidity and mortality in early life." Journal of theoretical biology 202(65-76).

Wichstrom, L. (1995). "Social, psychological and physical correlates of eating problems: A study of the general adolescents population in Norway. ."

Psychological medicine 25: 567-579.

Wolfson, A. R. and M. A. Carskadon (1998). "Sleep schedules and daytime functioning in adolescents." Child Development 69(4): 875-87.

Zullig, K., V. A. Ubbes, et al. (2006). "Self-reported weight perceptions, dieting behavior, and breakfast eating among high school adolescents." Journal of School Health 76(3): 87-92.

尤怡人 (2005). "兒童知覺父母婚姻關係預測其憂鬱情緒及其調節變項之探討 "

國立嘉義大學家庭教育研究所碩士論文,未出版。.

尤嫣嫣 (2002). "大學生體型及其身體意象相關因素之研究―以中原大學新生為 例." 台灣師範大學衛生教育研究所博士論文,未出版,台北市。.

文星蘭 (2004). "高中職學生身體意象與減重意圖之研究." 立台北護理學院醫護 教育研究所碩士論文,未出版,台北市。.

王元玲 (2003). "兒童肥胖與自尊關係及影響檢重成效相關因素之探討." 中原大 學心理學系碩士論文,未出版,桃園縣。.

王麗瓊 (2001). "國中生身體意象之相關因素分析研究." 台灣師範大學衛生教育 研究所碩士論文,未出版,台北市。.

伍連女, 黃. (1999). "台北市高職學生身體意象與運動行為之研究." 學校衛生 35:

1-31.

李幸玲 (2004). "高雄市高職學生自尊、身體意象及性行為之研究." 中國文化大 學生活應用科學研究所碩士論文,未出版,台北市。.

李復惠(1987)。 (1987). "某大學學生對死亡及瀕死態度之研究." 國立台灣師範大 學衛生教育研究所碩士論文,未出版,台北市。.

林宜親 (2000). "青少年體型意識與節制飲食行為之研究." 國立師範大學家政教 育學系研究所碩士論文,未出版,台北市。.

侯堂盛 and 林晉榮 (2006). "兒童與青少年肥胖對生活品質影響之探討." 嘉大

體育健康休閒期刊 5: 10-18.

洪嘉謙 (2001). "大專女生性別角色與身體形象關係之研究." 靜宜大學青少年兒 童福利學系研究所碩士論文,未出版,台北市。.

范麗娟 (2004). "重視身體意象之社會建構對服務肥胖少年之實務意涵." 學校衛

范麗娟 (2004). "重視身體意象之社會建構對服務肥胖少年之實務意涵." 學校衛