Validation of sociocultural attitudes towards appearance questionnaire and its associations with body-related outcomes and eating disorders among Chinese adolescents

Houyi Huang; Zhongting Liu; Haoran Xiong; Fabian Herold; Jin Kuang; Erle Chen; Alyx Taylor; Albert Yeung; Jing Sun; Md M Hossain; Arthur Kramer; Tianyou Guo; Liye Zou

doi:10.3389/fpsyt.2023.1088769

Validation of sociocultural attitudes towards appearance questionnaire and its associations with body-related outcomes and eating disorders among Chinese adolescents

Front Psychiatry. 2023 Mar 13:14:1088769. doi: 10.3389/fpsyt.2023.1088769. eCollection 2023.

Authors

Houyi Huang¹, Zhongting Liu¹, Haoran Xiong¹, Fabian Herold², Jin Kuang¹, Erle Chen³, Alyx Taylor⁴, Albert Yeung^{5

6}, Jing Sun⁷, Md M Hossain^{8

9}, Arthur Kramer^{10

11}, Tianyou Guo¹, Liye Zou^{1

2}

Affiliations

¹ Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, China.
² Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.
³ Shenzhen College of International Education, Shenzhen, China.
⁴ AECC University College, School of Rehabilitation, Sport and Psychology, Bournemouth, United Kingdom.
⁵ Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
⁶ Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States.
⁷ School of Medicine and Dentistry and Menzies Health Institute Queensland, Griffith University, Birtinya, QLD, Australia.
⁸ Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, Houston, TX, United States.
⁹ Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, United States.
¹⁰ Center for Cognitive & Brain Health, Northeastern University, Boston, MA, United States.
¹¹ Beckman Institute, University of Illinois, Champaign, IL, United States.

Abstract

Introduction: The Sociocultural Attitudes Towards Appearance Questionnaire-4 Revised (SATAQ-4R) has been widely used in Western countries to link body appearance that is related to eating disorders and body dissatisfaction being commonly reported by adolescents. However, a comprehensive psychometric validation of the SATAQ-4R in Chinese adolescent samples is still lacking. To this end, the aim of the current study was to validate the gender-appropriate SATAQ-4R in a sample of Chinese adolescents, following by an investigation of its associations with body-related outcomes and eating disorder symptoms.

Methods: Two gender-specific studies were conducted to examine the psychometric properties of the SATAQ-4R-Female and SATAQ-4R-Male respectively among adolescent girls (Study1, N=344, with 73 participants at retest) and boys (Study2, N=335, with 64 participants at retest). Confirmatory factor analysis was employed to examine the factor structure and their test-retest reliability, the internal consistency and convergent validity were subsequently examined.

Results: For the SATAQ-4R-Females, the seven-factor model has a reasonable fit, with Chi-square =1112.769 (p < 0.001), CFI = 0.91, RMSEA = 0.071, SRMR = 0.067. For the SATAR-4R-Males, an acceptable seven-factor model with Chi-square = 982.92 (p<0.001), CFI = 0.91, RMSEA = 0.08, SRMR= 0.06 was observed. With respect to test-retest reliability, the internal consistency for 7 subscales was rated as good (Cronbach's alpha =0.74 to 0.95) among female adolescents, likewise the internal consistency of the seven subscales was also rated as good (Cronbach's alpha =0.70 to 0.96) among male participants. Good convergent validity was observed, reflected by associations of the subscales of the gender-specific SATAQ-4R with muscularity-related attitude, body image-acceptance, body appearance, perceived stress level, symptoms of eating disorder and self-esteem.

Discussion: For women and men, the original 7-factor structure was validated among Chinese adolescents, internal reliability coefficients for the seven subscale scores were good and test-retest reliability was acceptable. Our results also confirmed the convergent validity of the two different gender-appropriate scales.

Keywords: Chinese adolescents; body dissatisfaction; eating disorders; sociocultural attitudes towards appearance questionnaire-4R; validation.