“飲食態度量表－26題版”(EAT-26)本土最佳切點之探討－以台南市兩所高中為例

Exploration of the Optimal Cut-off Point of the EAT-26 for Taiwanese Adolescence Population-An Example of Two Senior High Schools

10.30074/FJMH.200812_21(4).0003

陳宇平(Yu-Ping Chen)；陳信昭(Shin-Jaw Chen)；蔡政潔(Cheng-Chieh Tsai)

飲食異常 ； 飲食態度量表－26題 ； 切點 ； 鑑別效度 ； eating disorder ； EAT-26 ； cut-off point ； discriminant validity

中華心理衛生學刊

21卷4期（2008 / 12 / 01）

379 - 405

繁體中文

研究目的：本研究目的在探討「飲食態度量表－26題」(EAT-26)在台灣社區使用的最佳切點為何。研究方法：研究過程採兩階段研究設計，先於台南市選取高中男、女校各一所，以「EAT-26」進行第一階段之大規模施測，共得有效問卷2966份，再根據得分以分層隨機抽樣之方式，兩校各抽取120位、共240位學生接受第二階段之診斷性晤談，以尋找此問卷在本土最具鑑別性之切點。研究結果：研究結果發現：與其他切點分數相較，當「EAT-26」總分21分時，「ROC」曲線下面積(AUC)值為0.81，呈現最佳之敏感度、特異度與鑑別效度。研究結論：顯示「EAT-26」在本土使用時，篩選社區飲食異常高危險群之切點分數以21分、稍高於國外之20分為宜。本文最後討論研究之限制、建議與未來研究方向。

Purpose: The purpose of this study was to identify the best cut-off point of ”EAT-26” used in a local community. Methods: One girl and one boy senior high schools in Tainan city were purposively selected and, then, ”EAT-26” was applied to screen 2966 students in both schools. Using stratified random sampling method, 120 students were chosen from each school, a total of 240 students. Researchers interviewed with 240 students to decide whether they meet the diagnostic criteria of any eating disorder, then compared the results between the clinical diagnoses and the ”EAT-26” scores of all study samples to find the best cut-off point in Taiwan. Results: There were two major findings: firstly, using psychiatrist's clinical diagnosis as the golden standard, the areas under ”ROC” curve (ACU) of ”EAT-26” equals to 0.81, which shows a good discriminant validity. Conclusions: The best cut-off point of ”EAT-26” used in this local community is 21. Finally, the suggestions and limitations of the study are also addressed.

1. Al-Subaie, A.,Al-Shammari, S.,Bamgboye, E.,Al-sabhan, K.,Al-shehri, S.,Azzah, R. B(1996).Validity of the Arabic version of the eating attitudes test.International Journal of Eating Disorder,20(3),321-324.
2. American Psychiatric Association APA編著、孔繁鐘、孔繁錦譯(1994)。精神疾病診斷準則手冊。台北:合記。
3. Andrist, L. C.(2003).Media images, body dissatisfaction, and disordered eating in adolescent women.American Journal of Maternal Child Nursing,28(2),119-123.
4. Caradas, A. A.,Lambert, E. V.,Charlton, K. E.(2001).An ethnic comparison of eating attitudes and associated body image concerns in adolescent South African schoolgirls.Journal of Human Nutrition & Dietetics,14,111-120.
5. Davis, C.(1999).The prevalence of high-level exercise of eating disorders: Etiological implications.Year Book of Psychiatry and Applied Mental Health,6,283.
6. Domholdt, E.(2000).Physical Therapy Research: Principles and Applications.Philadelphia:W. B. Saunders Company.
7. Fairburn, C. G.,Welch, S. L.,Doll, H. A.,Davies, B. A.,O`Connor, M. E.(1997).Risk factors for bulimia nervosa: A community-based case-control study.Archives of General Psychiatry,54(6),509-517.
8. Fisher, M.,Golden, N. H.,Katzman, D. K.,Kreipe, R.E.,Rees, J.,Schebendach, J.,Sigman, A.,Hoberman, A.(1995).Eating disorders in adolescents: A background paper.Journal of Adolescents Health,16,420-437.
9. Fombonne, E.(1995).Anorexia nervosa: No evidence of an increase.Br Journal Psychiatry,166,462-471.
10. Garfinkel, P. E.,Newman, A.(2001).The Eating Attitudes Test: Twenty-five years later.Eating and Weight Disorders,6,1-24.
11. Garner, D. M.,Garfinkel, P. E.(1979).The eating attitudes test: an index of the symptoms of anorexia nervosa.Psychological Medicine,9,273-279.
12. Garner, D. M.,Olmstead, M. P.(1983).Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia.International Journal of Eating Disorders,2,15-34.
13. Helewa, A.,Walker, J. M.,A. Helewa,J. M. Walker (Eds.)(2000).Critical Evaluation of Research in Physical Rehabilitation: Toward Evidence-Based Practice.Philadelphia:W. B. Saunders Company.
14. Hewitt, P. L.,Coren, S.,Steel, G. D.(2001).Death from anorexia nervosa: Age span and sex differences.Aging & Mental Health,5(1),41-46.
15. Joiner, G. W.,Kashubeck, S.(1996).Acculturation, body image, self-esteem, and eating disorder symptomatology in adolescent Mexican American Women.Psychology of Women Quarterly,20(3),419-435.
16. Jones, J. M.,Bennett, S.,Olmsted, M. P.,Lawson, M. L.,Rodin, G.(2001).Disordered eating attitudes and behaviors in teenaged girl: A school-based study.Canadian Medical Association journal,165(5),547-552.
17. Kielsas, E.,Bjornstrom, C.,Gotestam, K. G.(2004).Prevalence of eating disorders in female and male adolescents(14-15 years).Eating Behaviors,5,13-25.
18. Kirk, G.,Singh, K.,Getz, H.(2001).Risk of eating disorders among female college athletes and nonathletes.Journal of College Counseling,4,122-132.
19. Kohn, M.,Golden, N. H.(2001).Eating disorders in children and adolescents: Epidemiology, diagnosis and treatment.Pediatric Drugs,3(2),91-99.
20. Latzer,Y.,Tzischinsky, O.(2005).Eating attitudes in a diverse sample of Israeli adolescent females: a comparison study.Journal of Adolescence,28,317-323.
21. Lee, A. M.,Lee, S.(1996).Disordered eating and its psychological correlates among Chinese adolescent females in Hong Kong.International Journal of Eating Disorders,20,177-183.
22. Lucas, A. R.,Beard, C. M.,O`Fallon, W. M.,Kurland, L. T.(1991).Fifty-year trend in the incidence of anorexia nervosa in Rochester Minnesota: A population-based study.American Journal of Psychiatry,148,917-922.
23. Lynch, W. C.,Everingham, A.,Dubitzky, J.,Hartman, M.,Kasser, T.(2001).Does binge eating play a role in the self-regulation of moods?.Integrative Physiological & Behavioral Science,35(4),298-313.
24. Mann, A. H.,Wakeling, A.,Wood, K.,Monck, E.,Dobbs, R.,Szmukler, G.(1983).Screening for abnormal eating attitudes and psychiatric morbidity in an unselected population of 15-year-old schoolgirls.Psychological Medicine,13,573-580.
25. Nasser, M.(1986).The validity of the Eating Attitude Test in a non-Western population. Acta.Psychiatrica Scandinavica,73,109-110.
26. Nunes, M. A.,Camey, S.,Olinto, M. T. A.,Mari, J. J.(2005).The validity and 4-year test-retest reliability of the Brazilian version of the Eating Attitudes Test-26.Brazilian Journal of Medical and Biological Research,38,1655-1662.
27. O`Dea, J.(2002).Can body image education programs be harmful to adolescent females?.The Journal of Treatment & Prevention,10(1),1-13.
28. Patton, G. C.,Selzer, R.,Coffey, C.,Carlin, J. B.,Wolfe, R.(1999).Onset of adolescent eating disorders: Population based cohort study over 3 years.British Medical Journal,318,765-768.
29. Prouty, A. M.,Protinsky, H. O.,Canady, D.(2002).College women: Eating behaviors and help-seeking preferences.Adolescence,37(146),353-363.
30. Sullivan, P. F.,Bulik, C. M.,Fear, J. L.,Pickering, A.(1998).Outcome of anorexia nervosa: a case–control study.American Journal of Psychiatry,155,939-946.
31. Theander, S.,G. Szmukler,C. Dare,J. Treasure (Eds.)(1995).Handbook of Eating Disorders: Theory, Treatment and Research.London:Wiley.
32. Thomas, C. L.,James, A. C.,Bachmann, M. O.(2002).Eating attitude in English secondary school students: Influences of ethnicity, gender, mood, and social class.International Journal of Eating Disorders,31(1),92-96.
33. Thompson, S. H.,Digsby, S.(2004).A preliminary survey of dieting, body dissatisfaction, and eating problems among high school cheerleaders.Journal of School Health,74,85-90.
34. Williams, P.,Hand, D.,Tarnopolsky, A.(1982).The problem of screening for uncommon disorders-A comment on the Eating Attitudes Test.Psychological Medicine,12,431-434.
35. 古琪雯(2003)。國立台灣師範大學衛生教育研究所碩士論文（未出版）。
36. 宋筧珍(2005)。中山醫學大學營養學研究所碩士論文（未出版）。
37. 李靜慧(1998)。國立台灣師範大學家政教育研究所碩士論文（未出版）。
38. 李麗晶、鄭溫暖、葉海山、高瑾蓉(2001)。大專男性運動員的飲食異常及其相關因素之探討。北體學報，9，37-44。
39. 林旭龍(1995)。大專院校女生減肥意識、體型誤認有關之健康科學研究。國立臺北護理學院學報，2，131-157。
40. 林宜親、林薇(2000)。青少年體型意識與節制飲食行為之研究。中華衛誌，19(1)，33-41。
41. 洪建德、鄭淑慧(1992)。臺北地區女學生的身體形象和飲食行為。中華衛誌，11(4)，316-326。
42. 唐妍蕙(2004)。國立成功大學公共衛生研究所碩士論文（未出版）。
43. 張育甄(2003)。中山醫學大學營養科學研究所（未出版）。
44. 張淑珍(1987)。國立陽明大學公共衛生研究所碩士論文（未出版）。
45. 陳玉欣(1999)。國立臺灣大學公共衛生學院流行病學研究所碩士論文（未出版）。
46. 陳宇平(2005)。彰化師範大學輔導與諮商研究所博士論文（未出版）。
47. 陳冠宇、林亮吟、陳喬琪、胡維恆(2000)。某高中職學生的暴食症盛行率。台灣精神醫學，14(4)，279-289。
48. 陳映燦、曾美智、李宇宙、李明濱(2000)。厭食症之追蹤研究：臨床病程與結果。台灣精神醫學，14(1)，51-62。
49. 童安真(2005)。中山醫學大學營養學研究所碩士論文（未出版）。
50. 楊浩然(2003)。國立臺灣大學公共衛生學院流行病學研究所碩士論文（未出版）。
51. 董棋芬(2005)。中山醫學大學營養學研究所碩士論文（未出版）。
52. 蕭芳惠(1995)。國立台灣師範大學家政教育研究所碩士論文（未出版）。
53. 蕭芳惠、林薇(1998)。臺北市高中女生的體型意識及飲食異常傾向之研究。衛生教育學報，11，107-127。
54. 賴靖薇(2002)。國立陽明大學社區護理研究所碩士論文（未出版）。
55. 謝佳容、蔡素玲、陳冠宇、熊秉荃(2003)。台北市某二所大學護理系女學生暴食症之探討。慈濟醫學，15(5)，327-335。

1. 陳宇平(2021)。「兒童版飲食態度量表-26題」應用於本土國小高年級兒童之切點探究。台灣公共衛生雜誌，40(4)，441-452。
2. 陳宇平(2021)。心理師、輔導教師與同儕領導介入在女高中生飲食異常預防方案之應用。教育心理學報，52(3)，519-543。
3. 黃珮嘉、游一龍、曾美智、陳秋盈、郭素娥、郭柏秀、張秦松、李國鼎、吳筱瑩、吳至行(2014)。某醫學中心體重管理門診肥胖患者之飲食異常行為及相關影響因子。臺灣家庭醫學雜誌，24(1)，21-34。
4. 簡莉盈、連婉如、徐菊容、李靜芳(2010)。台灣北部某技術學院大一男性體型意識及相關行為研究。健康促進與衛生教育學報，33，1-20。
5. 楊慧貞、馮祥勇、李詠青(2015)。大專學生食育初探—食物知識與飲食行為之關聯性研究。聯大學報，12(1)，117-133。
6. 游勝翔,王治凱(2018)。台灣大學生之偏差飲食行為及其預測因子探討。臨床心理學刊，12(1/2)，53-74。