Ansiedade social devido à aparência física e preocupação com a alimentação saudável de praticantes de exercício físico
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2022-12-06
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Universidade Estadual Paulista (Unesp)
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Resumo: Objetivos: O presente estudo foi desenvolvido com os seguintes objetivos: (i) realizar a adaptação transcultural da versão em inglês da Social Appearance Anxiety Scale (SAAS) para a língua portuguesa do Brasil; (ii) estimar e avaliar as propriedades psicométricas da SAAS e da Teruel Orthorexia Scale (TOS) para uma amostra de adultos brasileiros praticantes de exercício físico; (iii) verificar a influência de diferentes características amostrais nos construtos avaliados pela SAAS (ansiedade social com a aparência) e pela TOS (ortorexia nervosa–ON; ortorexia saudável–OS); (iv) analisar as propriedades psicométricas de diferentes modelos fatoriais disponíveis na literatura para o ORTO-15 quando aplicado na amostra de estudo. Métodos: Trata-se de um estudo observacional do tipo transversal no qual participaram indivíduos adultos fisicamente ativos. A versão em português da SAAS foi construída a partir de protocolo consolidado internacionalmente. As propriedades psicométricas da SAAS, da TOS e também da Social Physique Anxiety Scale (SPAS) e do ORTO-15 foram estimadas para a amostra de estudo. A validade e a confiabilidade dos dados obtidos a partir de cada instrumento utilizado no presente estudo foram investigadas a partir de análise fatorial confirmatória. Os índices de ajustamento selecionados foram Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Standardized Root Mean Square Residual (SRMR) e Root Mean Square Error of Approximation (RMSEA). A modelagem de equações estruturais foi utilizada para testar a relação entre variáveis latentes e manifestas de interesse conforme objetivo de cada estudo desenvolvido. Para tanto, trajetórias hipotéticas (β) foram estimadas e avaliadas com o auxílio do teste z. O nível de significância adotado foi de 5% para as análises. Resultados: A versão em português da SAAS foi adequadamente compreendida pelos participantes do estudo. O modelo fatorial original dos instrumentos SAAS, SPAS e TOS apresentou ajuste satisfatório/aceitável, tanto para homens (SAAS: CFI=0,97; TLI=0,97; SRMR=0,04 / SPAS: CFI=0,98; TLI=0,98; SRMR=0,04 / TOS: CFI=0,92; TLI=0,91; RMSEA=0,10; SRMR=0,12), quanto para mulheres (SAAS: CFI=0,97; TLI=0,97; SRMR=0,04 / SPAS: CFI=0,98; TLI=0,98; SRMR=0,04 / TOS: CFI=0,95; TLI=0,94; RMSEA=0,10; SRMR=0,10). O modelo fatorial original do ORTO-15 não apresentou ajustamento adequado para as amostras de estudo (homens: CFI=0,70; TLI=0,64; RMSEA=0,12; SRMR=0,10 / mulheres: CFI=0,84; TLI=0,80; RMSEA=0,10; SRMR=0,08), o que também foi observado para os demais modelos testados. Os coeficientes de confiabilidade encontrados foram adequados para os instrumentos, exceto para os modelos do ORTO-15. Com relação aos modelos estruturais testados sobre a influência de características amostrais na ansiedade social com a aparência, observou-se que, tanto para homens quanto para mulheres, uma menor idade, índice de massa corporal (IMC) mais elevado, já ter sido diagnosticado com transtorno alimentar (TA) e autopercepção de mudança corporal após o início da pandemia de COVID-19 foram preditores significativos (p<0,05) de maior ansiedade. Apenas para as mulheres, maior renda e ter iniciado a prática de exercícios físicos mais recentemente foram significativos para maior ansiedade social com a aparência. Já nos modelos sobre a influência de características da amostra na preocupação com alimentação saudável, observou-se que para os homens, o tipo de mudança alimentar percebida como melhor durante a COVID-19 e avaliar como melhor a qualidade da própria alimentação influenciou maior OS. O diagnóstico de TA influenciou maior ON. A prática de dieta e menor satisfação com o tipo de mudança alimentar percebida devido a pandemia, influenciou maior OS e ON. Para as mulheres, maior idade e menor IMC influenciaram maior OS. Quanto menor a satisfação com o tipo de mudança alimentar devido a pandemia, maior foi ON. Autorrelato de diagnóstico de TA, prática de dieta para alterar o corpo e maior mudança alimentar por conta da pandemia influenciaram maior OS e ON. A autoclassificação da qualidade da alimentação como melhor influenciou maior OS e a pior autoclassificação da qualidade da própria alimentação influenciou maior ON. Conclusões: A versão em português da SAAS foi apresentada e essa pode contribuir com futuras avaliações sobre ansiedade social com a aparência em adultos brasileiros. Os dados obtidos a partir da SAAS e da TOS foram válidos e confiáveis, enquanto que os diferentes modelos fatoriais do ORTO-15 não ajustaram para as amostras de estudo indicando cautela quando ao uso desse instrumento. Diferentes características clínicas, sociais e demográficas influenciaram significativamente, tanto na ansiedade social com a aparência, quanto na preocupação com a alimentação saudável dos indivíduos. Tais informações podem auxiliar na elaboração de estratégias de prevenção e intervenção no âmbito da saúde física e psicossocial.
Aims: The present study has the following aims: (i) to perform the cross-cultural adaptation of the English version of the Social Appearance Anxiety Scale (SAAS) into Brazilian Portuguese; (ii) to estimate and evaluate the psychometric properties of the SAAS and the Teruel Orthorexia Scale (TOS) for a sample of Brazilian adults who practice physical exercise; (iii) to verify the influence of different sample characteristics on the constructs assessed by SAAS (social anxiety with appearance) and TOS (orthorexia nervosa–ON; healthy orthorexia– HO); (iv) to analyze the psychometric properties of different factor models available in the literature for the ORTO-15 when applied to the study sample. Methods: This is a cross-sectional observational study in which physically active adults participated. The Portuguese version of SAAS was developed from an internationally consolidated protocol. The psychometric properties of the SAAS, of the TOS, of the Social Physique Anxiety Scale (SPAS), and of the ORTO-15 were estimated for the study sample. The validity and reliability of the data obtained from each instrument used in the present study were investigated using confirmatory factor analysis. The fit indices selected were Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Standardized Root Mean Square Residual (SRMR), and Root Mean Square Error of Approximation (RMSEA). Structural equation modeling was used to test the relationship between latent and manifest variables of interest according to the aim of each study developed. The hypothetical paths (β) were estimated and evaluated using z test. The significance level adopted was 5% for all analyses. Results: The study participants adequately understood the Portuguese version of the SAAS. The original factorial model of the SAAS, SPAS, and TOS showed a satisfactory/acceptable fit for men (SAAS: CFI=0.97, TLI=0.97, SRMR=0.04 / SPAS: CFI=0.98, TLI =0.98, SRMR=0.04 / TOS: CFI=0.92, TLI=0.91, RMSEA=0.10, SRMR=0.12), and women (SAAS: CFI=0.97, TLI=0.97, SRMR=0.04 / SPAS: CFI=0.98, TLI=0.98, SRMR=0.04 / TOS: CFI=0.95, TLI=0.94, RMSEA=0.10, SRMR=0.10). The original ORTO-15 factorial model did not show a good fit for the study samples (men: CFI=0.70, TLI=0.64, RMSEA=0.12, SRMR=0.10 / women: CFI=0.84, TLI=0.80, RMSEA=0.10, SRMR=0.08), which was also observed for the other models tested. The reliability coefficients found were adequate for all instruments, except for the ORTO-15 models. Regarding the structural models tested on the influence of sample characteristics on social anxiety with appearance, it was observed that, for both men and women, a younger age, a higher body mass index (BMI), already been diagnosed with eating disorder (ED) and self-perception of body change after the onset of the COVID-19 pandemic were significant predictors (p<0.05) of greater anxiety. The higher income and recent start on physical exercise were significant for greater social anxiety with women's appearance. In the models on the influence of sample characteristics on the concern with healthy eating, it was observed that for men, the type of dietary change perceived as better during COVID-19 and the better evaluation of the quality of their own food had a significant influence on HO. The diagnosis of ED influenced higher ON. The practice of diet and lower satisfaction with the type of food change perceived due to the pandemic, influenced higher HO and ON. For women, older age and lower BMI influenced higher HO. The lower the satisfaction with the type of food change due to the pandemic, the higher the ON. Self-reported diagnosis of ED, diet practice to change the body and greater dietary change due to the pandemic influenced greater HO and ON. The self classification of food quality as better influenced higher HO, and a worse self classification of the quality of the food itself influenced higher ON. Conclusions: The Portuguese version of the SAAS was presented and this may contribute to future assessments of social anxiety with appearance of Brazilian adults. The data obtained from the SAAS and the TOS were valid and reliable, while the different factorial models of the ORTO-15 did not fit for the study samples, indicating caution when using this instrument. Different clinical, social and demographic characteristics significantly influenced social anxiety with appearance and concern about healthy eating. Such information can help elaborate prevention and intervention strategies in physical and psychosocial health.
Aims: The present study has the following aims: (i) to perform the cross-cultural adaptation of the English version of the Social Appearance Anxiety Scale (SAAS) into Brazilian Portuguese; (ii) to estimate and evaluate the psychometric properties of the SAAS and the Teruel Orthorexia Scale (TOS) for a sample of Brazilian adults who practice physical exercise; (iii) to verify the influence of different sample characteristics on the constructs assessed by SAAS (social anxiety with appearance) and TOS (orthorexia nervosa–ON; healthy orthorexia– HO); (iv) to analyze the psychometric properties of different factor models available in the literature for the ORTO-15 when applied to the study sample. Methods: This is a cross-sectional observational study in which physically active adults participated. The Portuguese version of SAAS was developed from an internationally consolidated protocol. The psychometric properties of the SAAS, of the TOS, of the Social Physique Anxiety Scale (SPAS), and of the ORTO-15 were estimated for the study sample. The validity and reliability of the data obtained from each instrument used in the present study were investigated using confirmatory factor analysis. The fit indices selected were Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Standardized Root Mean Square Residual (SRMR), and Root Mean Square Error of Approximation (RMSEA). Structural equation modeling was used to test the relationship between latent and manifest variables of interest according to the aim of each study developed. The hypothetical paths (β) were estimated and evaluated using z test. The significance level adopted was 5% for all analyses. Results: The study participants adequately understood the Portuguese version of the SAAS. The original factorial model of the SAAS, SPAS, and TOS showed a satisfactory/acceptable fit for men (SAAS: CFI=0.97, TLI=0.97, SRMR=0.04 / SPAS: CFI=0.98, TLI =0.98, SRMR=0.04 / TOS: CFI=0.92, TLI=0.91, RMSEA=0.10, SRMR=0.12), and women (SAAS: CFI=0.97, TLI=0.97, SRMR=0.04 / SPAS: CFI=0.98, TLI=0.98, SRMR=0.04 / TOS: CFI=0.95, TLI=0.94, RMSEA=0.10, SRMR=0.10). The original ORTO-15 factorial model did not show a good fit for the study samples (men: CFI=0.70, TLI=0.64, RMSEA=0.12, SRMR=0.10 / women: CFI=0.84, TLI=0.80, RMSEA=0.10, SRMR=0.08), which was also observed for the other models tested. The reliability coefficients found were adequate for all instruments, except for the ORTO-15 models. Regarding the structural models tested on the influence of sample characteristics on social anxiety with appearance, it was observed that, for both men and women, a younger age, a higher body mass index (BMI), already been diagnosed with eating disorder (ED) and self-perception of body change after the onset of the COVID-19 pandemic were significant predictors (p<0.05) of greater anxiety. The higher income and recent start on physical exercise were significant for greater social anxiety with women's appearance. In the models on the influence of sample characteristics on the concern with healthy eating, it was observed that for men, the type of dietary change perceived as better during COVID-19 and the better evaluation of the quality of their own food had a significant influence on HO. The diagnosis of ED influenced higher ON. The practice of diet and lower satisfaction with the type of food change perceived due to the pandemic, influenced higher HO and ON. For women, older age and lower BMI influenced higher HO. The lower the satisfaction with the type of food change due to the pandemic, the higher the ON. Self-reported diagnosis of ED, diet practice to change the body and greater dietary change due to the pandemic influenced greater HO and ON. The self classification of food quality as better influenced higher HO, and a worse self classification of the quality of the food itself influenced higher ON. Conclusions: The Portuguese version of the SAAS was presented and this may contribute to future assessments of social anxiety with appearance of Brazilian adults. The data obtained from the SAAS and the TOS were valid and reliable, while the different factorial models of the ORTO-15 did not fit for the study samples, indicating caution when using this instrument. Different clinical, social and demographic characteristics significantly influenced social anxiety with appearance and concern about healthy eating. Such information can help elaborate prevention and intervention strategies in physical and psychosocial health.
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Alimentação saudável, Ansiedade, Aparência física, Validade e Confiabilidade, Psicometria, Covid-19