Body image flexibility has shown robust negative associations with body dissatisfaction. However, research in this area is confined to cross-sectional studies on adults in Western cultural contexts. Responding to these gaps and the unique cultural nuances and increasing prevalence estimates of body dissatisfaction in China, we examined the bi-directional nature of body image flexibility and body fat and muscularity dissatisfaction in Chinese adolescent boys and girls (N = 1381, 57.3 % girls) at two points over 18 months (Wave [W] 1=baseline, W2=18 months later). We also explored sex differences in longitudinal models. In boys, higher W1 body image flexibility was associated with lower W2 body fat dissatisfaction, and higher W1 body fat dissatisfaction was associated with lower W2 body image flexibility. Null prospective associations between body image flexibility and muscularity dissatisfaction were identified in boys. In girls, higher W1 body fat and muscularity body dissatisfaction were associated with lower W2 body image flexibility. Higher W1 body image flexibility was associated with lower W2 body fat and muscularity dissatisfaction in girls. We found no significant sex differences in the models. Findings advance a multicultural understanding of the temporal and bi-directional links between body image flexibility and body fat and muscularity dissatisfaction in Chinese adolescents.

OBJECTIVES:Previous research suggests potential moderating roles of dispositional mindfulness and body image flexibility in the association between body dissatisfaction and disordered eating. However, relevant research is mainly conducted on adult women from Western countries, and limited evidence exists for adolescent samples, especially from non-Western contexts (e.g., China). Thus, this study aimed to examine the moderating roles of dispositional mindfulness and body image flexibility in the relationship between body dissatisfaction and disordered eating in Chinese adolescents. METHOD:We recruited 545 Chinese adolescents (53.9% boys, aged 12-16 years) who completed measures of body dissatisfaction, dispositional mindfulness, body image flexibility, and disordered eating. Moderation analyses were examined with PROCESS macro on SPSS. RESULTS:In separate models, both higher dispositional mindfulness and body image flexibility weakened relationships between body dissatisfaction and disordered eating. However, when both dispositional mindfulness and body image flexibility were entered into the same moderation model, only body image flexibility showed a significant moderating effect. DISCUSSION:Both dispositional mindfulness and body image flexibility may weaken the association between body dissatisfaction and disordered eating in adolescents. However, body image flexibility might have a stronger effect than dispositional mindfulness. These findings suggest that interventions aimed at reducing body dissatisfaction to prevent disordered eating in adolescents may pay more attention to adolescents' body image flexibility.

OBJECTIVE:The present longitudinal study examined sex-specific, symptom-level relationships among emotion regulation (ER), interpersonal problems (IP), and eating disorder (ED) psychopathology in a large sample of Chinese adolescents. METHOD:Data were from a project with four waves of data collection (N = 1540; 710 boys and 830 girls) at 6-month intervals over 18 months. Questionnaires assessed ED psychopathology, ER, and IP at each wave of data collection. Longitudinal network analyses were conducted separately for boys and girls. Sex differences in the network structures were also examined. RESULTS:The results revealed pronounced heterogeneity in the presentation of ED psychopathology, ER, and IP across Chinese adolescent boys and girls longitudinally and intra-individually. For example, weight/shape preoccupation in ED psychopathology and awareness in ER emerged as important nodes in the temporal network for boys. However, weight/shape preoccupation and dissatisfaction in ED psychopathology were identified as the most important nodes in the temporal network for girls. Regarding bridge strength, awareness in ER emerged as the node with the highest connectivity in the temporal network for boys. At the same time, weight/shape dissatisfaction in ED psychopathology was the node with the highest connectivity for girls. DISCUSSION:The current study extended network theory to better understand the longitudinal interplay among ER, IP, and ED psychopathology in Chinese adolescents and their sex differences in the importance of symptoms. Such insights may pave the way for developing targeted prevention and treatment strategies for adolescent boys and girls in China.

This study, which is a longitudinal extension of previous cross-sectional studies in Chinese and American college students and general adults (Dixit, He, Whited, Ellis, & Zickgraf, 2023; He, Chen, Wu, Niu, & Fan, 2020; Xu et al., 2024), used latent profile and latent transition analyses to investigate negative emotional eating patterns and the stability of these patterns in 1462 Chinese adolescents (41% boys, aged 11-17 years) at baseline and 18 months later. We also explored baseline demographic predictors of negative emotional eating patterns and the associations between these patterns and outcome variables measured 18 months later. Negative emotional eating was measured with the Adult Eating Behavior Questionnaire (emotional undereating and emotional overeating subscales). Latent profile analysis (LPA) replicated the four patterns of negative emotional eating in each wave of assessment: low emotional eating (Low-EE), emotional overeating (EOE), emotional undereating (EUE), and emotional over- and under-eating (EOE-EUE). Latent transition analysis (LTA) showed that the EE patterns had transition probabilities of <55% remaining in the same class across 18 months. Furthermore, relative to adolescents in the stable Low-EE group, adolescents in all other stable or unstable emotional eating groups in LTA were linked to higher eating disorder psychopathology and psychological distress measured 18 months later. Thus, emotional eating, regardless of type (i.e., EOE, EUE, and EOE-EUE) and stability (i.e., stable or unstable), may be a viable research and treatment target in improving adolescents' eating behaviors and mental health.

Functionality appreciation, as an important aspect of positive image, is associated with fewer body image disturbances, fewer disordered eating behaviors, and improved psychological well-being. However, it has been under-researched in Asian countries. The current work aimed to examine the psychometric properties of the Functionality Appreciation Scale (FAS) among four Chinese samples of different ages, and further examine measurement invariance and differences of the FAS across gender and age groups. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to examine the factorial structure of the FAS among four Chinese samples of different ages, including middle school adolescents (n = 894, Mage = 12.17 years), high school adolescents (n = 1347, Mage = 15.07 years), young adults (n = 473, Mage = 21.95 years), and older adults (n = 313, Mage = 67.90 years). The measurement invariance of the FAS across gender and age was examined. Internal consistency reliability and construct validity were evaluated. The FAS had a unidimensional structure and was invariant across gender and age groups. The FAS presented sound psychometric properties in all age groups by gender, with good internal consistency reliability [e.g., high Cronbach’s α values (.91 .97)] and good construct validity (e.g., significant associations with body appreciation, body dissatisfaction, and disordered eating). Moreover, group comparisons showed minimal gender differences in functionality appreciation. However, significant age differences were found in functionality appreciation, with older ages generally associated with higher functionality appreciation. Overall, findings suggest that the FAS is a sound instrument to be used in the Chinese context. Furthermore, functionality appreciation was found to be higher in older adults than adolescents or young adults, suggesting the potential important role of aging in functionality appreciation. Functionality appreciation, as a positive body image component emphasizing the appreciation on one’s body for what it can do, is associated with fewer body image disturbances, fewer disordered eating behaviors, and improved psychological well-being. The Functionality Appreciation Scale (FAS) measures functionality appreciation and has been widely validated in a number of different populations. However, the psychometric properties of the FAS have not been systematically examined in the Chinese context, especially for adolescents and older adults. Results indicated that the psychometric properties of the FAS were sound and could be equally used to assess functionality appreciation in Chinese adolescents, young adults, and older adults.

A longitudinal approach with Latent Growth Curve Modeling (LGCM) was adopted to explore the trajectories of appetitive traits corresponding to BMI in Chinese adolescents. Within a large sample of adolescents (N = 2566, 45.9% boys) aged from 11 to 17 years (M = 13.80, SD = 1.56) at the baseline survey, our results indicated that appetitive traits of emotional overeating, food fussiness, and hunger increased significantly over time while enjoyment of food decreased over time. Slowness in eating and satiety responsiveness significantly increased in girls, while emotional undereating significantly decreased in boys. Moreover, the growth parameters of emotional undereating and satiety responsiveness were significantly and negatively related to BMI in girls. Our findings evidence that certain appetitive traits could change over time in adolescence and these changes relate to weight status. Gender differences are suggested in the design of future intervention and treatment of overweight/ obesity in Chinese adolescents.

This study aimed to explore the relationship between trait emotional intelligence and disordered eating by proposing and testing the mediating roles of body dissatisfaction and body image inflexibility. A total of 500 Chinese adults (48.8 % women) completed questionnaires for assessing trait emotional intelligence, body dissatisfaction, body image inflexibility, and disordered eating. Correlation analyses were conducted to evaluate the relationships between the study variables. Mediation analysis was performed to examine the mediating roles of body dissatisfaction and body image inflexibility in the relationship between trait emotional intelligence and disordered eating. Multi-group analysis was further conducted to assess the invariance of the mediation model across men and women. Correlation analyses revealed significant bivariate relationships among the four study variables. In both men and women, the relationship between trait emotional intelligence and disordered eating was fully mediated by body dissatisfaction and body image inflexibility. Multi-group invariance analysis showed that this mediation model was invariant across men and women. The findings shed light on the potential mechanisms in the relationship between trait emotional intelligence and disordered eating. In developing in-terventions for reducing disordered eating, the findings of the current study may be considered to improve intervention effectiveness.

The Clinical Impairment Assessment (CIA) is the most widely used instrument for assessing psychosocial impairment related to eating disorders (EDs). The CIA was translated into Chinese based on standard procedures. The psychometric properties of the Chinese CIA (C-CIA) were assessed among four adolescent and adult samples [i.e., 792 junior high school students (47.0% boys; Mage = 13.09 years), 1324 senior high school students (44.2% boys; Mage = 16.06 years), 812 undergraduate students (36.3% boys; Mage = 18.88 years), and 406 male adults from a general population (Mage = 28.53 years)]. The three-factor structure of the CIA was replicated. Excellent internal consistencies of the C-CIA were revealed, alpha = 0.93-0.98. The C-CIA showed moderate and good testretest reliability in a six-month interval for junior high school students (ICC = 0.69) and senior high school students (ICC = 0.76), respectively. The C-CIA had good test-retest reliability in a two-week interval for undergraduate students (ICC = 0.78) and general adult men (ICC = 0.81). Our results supported good construct validity, known-group validity of the C-CIA, and measurement invariance across sex and age. These findings suggest that the C-CIA can be a useful tool assessing psychosocial impairment related to EDs for Chinese adolescents, young adults, and adult men.

OBJECTIVEThis study examined the bidirectional relationships between sleep quality, loss of control (LOC) eating, and night eating in Chinese adolescents using longitudinal data over an 18-month study period.METHODFour-waves of data measurement (Waves 1-4), at 6-month intervals, were conducted with 2566 adolescents aged 11-17 years at baseline. A set of questionnaires were used to assess night eating, LOC eating, and sleep quality at each wave of data collection. Cross-lagged models were applied to analyze the bidirectional relationships between night eating, LOC eating, and sleep quality.RESULTSResults indicated that higher night eating scores consistently predicted poorer sleep quality and higher LOC eating scores at Waves 1, 2, and 3. Furthermore, poorer sleep quality predicted higher night eating scores at Wave 1 and Wave 3, and higher LOC eating scores predicted higher night eating scores at Wave 1 and Wave 2.DISCUSSIONThese findings highlight that night eating, LOC eating, and sleep quality were interrelated across time in Chinese adolescents. Improving sleep quality and reducing LOC eating might be promising in the prevention of night eating in adolescents. Similarly, reducing night eating might be promising in improving sleep quality and reducing LOC eating in adolescents.PUBLIC SIGNIFICANCEThis study explored the bidirectional relationship between night eating, LOC eating, and sleep quality in Chinese adolescents using cross-lagged models. Findings indicate bidirectional relationships between these variables and highlight the potential utility in incorporating sleep, LOC eating, and night eating interventions in eating pathology prevention designs for adolescents.

The aim of this study was to provide preliminary psychometric evidence for the Chinese version of the Inflexible Eating Questionnaire (C-IEQ) among a large sample of Chinese adolescents. For testing the psychometric properties of the C-IEQ, a total of 2241 (Mage = 13.91 years; 46.4% boys) adolescents from mainland China responded to the survey. Confirmatory factor analysis (CFA) was used to examine the factor structure of the C-IEQ. Measurement invariance by gender was examined by both multi-group CFA and differential item functioning (DIF). Convergent validity of the C-IEQ was assessed via examining the correlations between the C-IEQ scores and theoretically related constructs (e.g., orthorexia nervosa symptomatology, eating disorder symptomatology, and body image inflexibility). The unidimensional structure with correlated errors of the C-IEQ showed good model fit (χ2 = 1674.05, df = 44, p < 0.001; CFI = 0.93; TLI = 0.91; RMSEA = 0.13; SRMR = 0.06). The C-IEQ had an adequate internal consistency (α = 0.89) and demonstrated strong measurement invariance across genders. Moreover, the scores of the C-IEQ showed significant correlations with theoretically correlated constructs: orthorexia nervosa symptomatology (girls; r = 0.53 p < 0.001, boys; r = 0.45 p < 0.001), eating disorder symptomatology (girls; r = 0.32 p < 0.001, boys; r = 0.25 p < 0.001) body image inflexibility (girls; r = 0.41 p < 0.001, boys; r = 0.36 p < 0.001), suggesting good convergent validity of the C-IEQ. The C-IEQ showed good psychometric properties in a sample of Chinese adolescents and can be used in future studies to assess eating-specific psychological inflexibility among Chinese adolescents. Level V, cross-sectional descriptive study.

This paper aimed to explore the association between the patterns of perceived parenting styles and adolescents’ night eating syndrome symptoms and correlates, including sleep quality, weight status, loss of control over eating, and psychological distress. A sample of 455 Chinese adolescents (54.5% females, aged 12–15 years) were included in the current study. Latent Profile Analysis (LPA) was adopted to examine the patterns of perceived parenting styles. The three-step approach was used to explore the differences in night eating syndrome symptoms and correlates between different profiles. A four-profile solution was found to fit the data best, and the four profiles were labeled as positive parenting, negative parenting, highly engaged parenting, and lowly engaged parenting. Subsequent analyses showed that adolescents across profiles exhibited significant differences in night eating syndrome symptoms and correlates. Specifically, adolescents in the positive parenting profile generally had the lowest scores in night eating and its correlates, while those in the negative parenting group reported the highest scores in night eating and its correlates. Using a person-centered approach (i.e., LPA), the present study identified four distinct patterns of perceived parenting styles in a sample of Chinese adolescents, with night eating and related symptomatology differing across each profile. Future interventions targeting night eating among adolescents may consider the potential influence from the patterns of perceived parenting styles to have a better intervention outcome. Level V, cross-sectional descriptive study

There is ample evidence suggesting that negative emotional eating is closely related to disordered eating behaviors. However, most previous studies on the topic focused only on emotional over-eating, but neglected emotional under-eating. Moreover, previous studies also mainly used variable-oriented methods by reducing negative emotional eating to a single dimension, which limits our understanding of individual differences in negative emotional eating. In this study, we used a person-oriented approach, latent class analysis (LCA), to examine the negative emotional eating patterns and to characterize these patterns in a sample of 1,068 Chinese young adults (52.6% females, aged 17-24 years). Negative emotional eating was measured by the Emotional Over-Eating and Emotional Under-Eating subscales of the Adult Eating Behavior Questionnaire. Four patterns, namely, "non-emotional eating" (38.9%), "emotional over- and under-eating" (15.4%), "emotional over-eating" (14.7%), and "emotional under-eating" (31.0%), were identified. Sex and BMI were found to be statistically significant predictors for negative emotional eating patterns. The identified four patterns showed significant differences in eating disorder symptoms and psychological distress. Particularly, participants in emotional over- and under-eating exhibited the highest level of eating disorder symptoms and psychological distress. Overall, this study identified four distinct negative emotional eating patterns, among which, the emotional over- and under-eating was the most problematic. Future studies regarding negative emotional eating and its impact on mental health may benefit from focusing not only on individuals with emotional over-eating, but also on those showing a mixed pattern of negative emotional eating.

The negative effect of mother-daughter relationship on female's eating behaviors has been widely reported; however, few studies examined how other family members-child relationships might be related to children's eating behaviors, especially for male children. The purpose of this study was to investigate whether child abuse by family members (parents and others) was related to overeating (four levels of eating disorder symptoms) among Chinese adolescents. A cross-sectional survey was conducted with a school-based sample of 4346 middle school students in China, and the participants completed self-report measures for child abuse, overeating, and demographic variables. Bivariate correlation analyses and ordinal logistic regression analyses (adjusting for potential confounding variables) were performed to estimate the association between childhood abuse by different family members and overeating. Boys and girls who reported higher levels of child abuse perpetrated by their father, mother, and other family members showed higher levels of overeating. These three sources (father, mother, other members) of family member abuse were differentially associated with overeating between boys and girls. After adjusting for potential confounding variables, boys who experienced child abuse by fathers (OR = 1.51, 95% CI: 1.14-1.98) and by other family members (OR = 1.78, 95% CI: 1.00-2.71) were more likely to have overeating. However, for girls, experiences of child abuse by fathers (OR = 1.74, 95% CI: 1.31-2.31) and by mothers (OR = 1.38, 95% CI: 1.03-1.83) were significant predictors for overeating. The results not only replicated previous findings that child abuse could contribute to overeating, but also extended previous findings by showing that the sources of family abuse could influence overeating differently for boys and girls.

PURPOSE:Even though many studies have investigated the relationship between body dissatisfaction and eating disorder symptoms, the relationship is still far from being clear, especially about what factors that could potentially mediate such relationship. This study aimed to examine the direct pathway in the relationship between body dissatisfaction and eating disorder symptoms, and possible mediation pathways between the two via regulatory emotional self-efficacy and depression symptoms.METHODS:A sample of 654 adolescents from central China completed questionnaires for a set of study variables. Modeling analysis was conducted that examined the direct pathway between body dissatisfaction and eating disorder symptoms, and the mediating roles of regulatory emotional self-efficacy and depression symptoms between these two constructs. Multi-group modeling analysis was conducted to assess model invariance across gender and age groups.RESULTS:The results showed that, in addition to the direct pathway between body dissatisfaction and eating disturbances, regulatory emotional self-efficacy and depression symptoms partially mediated the relationship between these two constructs. Results of multi-group invariance analysis showed that the mediation model was consistent across gender and age groups.DISCUSSION:These results indicated that management of regulatory emotional self-efficacy and appropriate intervention for depression could potentially buffer against the negative impact of body dissatisfaction on eating disorder symptoms. Finally, some potential clinical implications are discussed, and possible preventions for eating disorder symptoms are suggested.LEVEL OF EVIDENCE:V, Cross-sectional descriptive study.

Purpose: Previous studies suggested that parenting styles, dispositional mindfulness and self-compassion were associated with body image. However, these constructs have not been examined together in any study; consequently, the relationship pattern of these constructs is largely unknown, especially about how some of these constructs are related to one positive aspect of body image (e.g., body appreciation). The present study examined the association between adolescents' perceived parenting styles and body appreciation and explored whether such association was mediated by mindfulness and self-compassion. Method: A sample of 455 middle school students (203 males, 248 females; aged from 12 to 15 years old) participated in the current study. They completed a battery of questionnaires assessing parenting styles, dispositional mindfulness, self-compassion, and body appreciation. Path analysis was used to test the proposed mediating model. Results: The results revealed that parenting styles were significantly related to body appreciation, and the relationships between parenting styles of overprotection and emotional warmth and body appreciation could be partially mediated by self-compassion, but not by dispositional mindfulness. Discussion: The results suggest that parenting styles and self-compassion might be important contributing factors for body appreciation among Chinese adolescents; however, future studies are warranted to further examine the causal effects of parenting styles, dispositional mindfulness, and self-compassion on adolescents' body appreciation. Y

The current study examined the roles of weight-related teasing in the relationship between body weight (body mass index, BMI) and body dissatisfaction in boys and girls. Participants were 711 adolescents recruited from secondary schools in China. They completed self-report questionnaires designed to assess weight-related teasing and body dissatisfaction. Participants’ BMIs were derived from their measured weights and heights. Weight-related teasing was found to play two roles in the relationship between body weight and body dissatisfaction. Specifically, weight-related teasing mediated the path from BMI to body dissatisfaction partially in girls and fully in boys. Weight-related teasing had a moderating effect on the relationship between BMI and body dissatisfaction in girls; this moderating effect was not significant in boys. Adolescents with higher BMIs tend to have higher levels of body dissatisfaction, and this association may be mediated and moderated by weight-related teasing. Interventions targeting body dissatisfaction among overweight and obese adolescents could be attentive to weight-related teasing.

The ability of self-compassion and Confucian coping to predict anxiety and depression were examined in impoverished Chinese undergraduate students. Three hundred and thirty impoverished undergraduates completed measures of self-compassion, Confucian coping, depression, and anxiety. Results showed that higher self-compassion predicted lower depression and anxiety in impoverished undergraduates. Higher pro-setback thinking and responsibility thinking of Confucian coping were related with lower depression and anxiety. Higher fate thinking of Confucian coping was related with higher depression and anxiety. The predictive ability for depression and anxiety of self-compassion combined with fate thinking was better than self-compassion alone. Intervention to enhance self-compassion and reduce fate thinking may be beneficial to mental health in impoverished undergraduates.

The aim of this study was to test whether the association between belief in a just world (BJW) and Internet altruistic behavior (IAB) was mediated by gratitude and self-esteem in a sample of Chinese undergraduates. A total of 238 participants (aged from 18 to 25) completed a paper-and-pencil questionnaire which assessed their BJW, self-esteem, gratitude, and Internet altruistic behavior. Mplus 7.0 was used to conduct structural equation modeling to estimate direct and indirect effects. Path analysis showed that self-esteem and gratitude partially mediated the relationship between BJW and IAB. The final model also revealed a significant path from BJW thorough self-esteem and gratitude to IAB. Limitations and implications for research and practical application of the present study were discussed.