Association between body dissatisfaction and bullying in children of socioeconomically vulnerable areas

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parameters at admission and patient comorbidities with mortality.</li><li class="elsevierStyleListItem" id="lsti0015">•Characterization of severe community-acquired pneumonia patients admitted to ICU.</li></ul>" ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444866417300405?idApp=UINPBA00004N" "url" => "/24448664/0000000200000006/v1_201711081124/S2444866417300405/v1_201711081124/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2444866417300028" "issn" => "24448664" "doi" => "10.1016/j.pbj.2017.05.002" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "87" "copyright" => "PBJ-Associação Porto Biomedical/Porto Biomedical Society" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Porto Biomed J. 2017;2:254-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 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id="lis0005"><li class="elsevierStyleListItem" id="lsti0025">•This paper identifies a set of constraints experienced by FC in the caregiver role.</li><li class="elsevierStyleListItem" id="lsti0030">•This paper identifies difficulties experienced by FC.</li><li class="elsevierStyleListItem" id="lsti0020">•Urgent care nurses should address the FC constraints and difficulties.</li></ul>" ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444866417300028?idApp=UINPBA00004N" "url" => "/24448664/0000000200000006/v1_201711081124/S2444866417300028/v1_201711081124/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Association between body dissatisfaction and bullying in children of socioeconomically vulnerable areas" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "260" "paginaFinal" => "264" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Marcela Almeida Zequinão, Pâmella de Medeiros, Helena Rafaela Vieira do Rosário, Andreia Pelegrini, Luis Lopes, Beatriz Pereira, Fernando Luiz Cardoso" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Marcela Almeida" "apellidos" => "Zequinão" "email" => array:1 [ 0 => "marcelazequinao@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Pâmella" "apellidos" => "de Medeiros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Helena Rafaela Vieira do" "apellidos" => "Rosário" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Andreia" "apellidos" => "Pelegrini" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Luis" "apellidos" => "Lopes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "Beatriz" "apellidos" => "Pereira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 6 => array:3 [ "nombre" => "Fernando Luiz" "apellidos" => "Cardoso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "University of Western Santa Catarina, Joaçaba, SC, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Santa Catarina State University – UDESC, Florianópolis, SC, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "University of Minho, Braga CP: 4710-057, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "IntroductionPrevious studies about body image indicate that body dissatisfaction has been increasingly recurrent during childhood<a class="elsevierStyleCrossRefs" href="#bib0165">1,2</a> and adolescence.<a class="elsevierStyleCrossRefs" href="#bib0175">3,4</a> Likewise, body dissatisfaction has been increasingly recurrent during childhood and adolescence. It is known that at this stage, girls and boys are more dependent on peer acceptance and approval. Thus, supportive relationships with friends can provide protection against feelings of dissatisfaction with the body,<a class="elsevierStyleCrossRef" href="#bib0185">5</a> while a low acceptance may predict greater dissatisfaction with body image and behaviors that are harmful to health.<a class="elsevierStyleCrossRefs" href="#bib0190">6,7</a>Evidence indicates that children and adolescents dissatisfied with their body image end up becoming more psychologically vulnerable and even though they do not have any physical differences, they are more easily victims of school bullying.<a class="elsevierStyleCrossRefs" href="#bib0200">8,9</a> Although there are innumerable reasons for which children and adolescents become victims of bullying, several studies point out that one of the most frequent reason is the deviation of the ideal appearance, in which bodies differ from socially imposed norms.<a class="elsevierStyleCrossRefs" href="#bib0205">9–11</a> In addition, it is also noted that body weight is reported by students as the main cause of school bullying, being more frequent than sexual orientation and ethnicity.<a class="elsevierStyleCrossRefs" href="#bib0220">12,13</a>On the other hand, body dissatisfaction seems to have a contrary sense in relation to the role of bully. Studies have pointed out that children and adolescents who take on this role in school bullying tend to be more satisfied with body Image,<a class="elsevierStyleCrossRef" href="#bib0230">14</a> besides having higher self-esteem,<a class="elsevierStyleCrossRef" href="#bib0190">6</a> and being classified by colleagues as being the physically strongest.<a class="elsevierStyleCrossRef" href="#bib0235">15</a> Thus, knowing that body image can be influenced not only by physiological but also psychological, social and environmental factors,<a class="elsevierStyleCrossRef" href="#bib0240">16</a> it is believed that the relationship between these variables deserves to be better discussed in the literature, especially with children and adolescents from different contexts such as those living in socioeconomically vulnerable areas.It is known that school violence can have greater impact in unfavorable social contexts. In Brazil, several metropolises present children and adolescents who live in this context. Thus, there are places characterized by higher levels of social inequality and access to services of lower quality and whose inhabitants are in a situation of social vulnerability, that definition corresponds “to the condition of not having or not being able to use material and immaterial assets which would allow the individual or social group to deal with the situation of poverty”.<a class="elsevierStyleCrossRef" href="#bib0245">17</a>The vulnerability experienced in these areas is complex and multifaceted, going beyond health, social life, educational contexts, symbolic organizations, ethnic issues, labor camps, and public policies in general, with regard to living conditions and social supports.<a class="elsevierStyleCrossRef" href="#bib0250">18</a> When combined with the low socioeconomic conditions, it provides great tension among the young, which hampers the processes of social integration, and can foment violent attitudes, such as the involvement in bullying.<a class="elsevierStyleCrossRef" href="#bib0255">19</a>Until now, little is known about how body image behaves and what its relation with school bullying, in children and adolescents living in socioeconomically vulnerable areas, in which there is a negative result of the relationship between availability of material resources and access to social, economic and cultural structures and opportunities. Therefore, the present study aims to analyze the associations between body image dissatisfaction with weight status and the roles assumed in school bullying among children and adolescents living in a socioeconomically vulnerable area.MethodParticipants and methods of recruitmentTwo public schools located in socioeconomically vulnerable areas were intentionally selected according to the indication of the municipality's Education Department. After the selection, all students from 3rd to 7th grade were invited to participate in the study. The only exclusion criteria adopted in the recruitment of participants was the presence of some type of intellectual disability that compromised the understanding of the instruments, as indicated by the Special Education Service of the schools.Based on the number of children and adolescents participating in the social project that serves children and adolescents in situations of social vulnerability in the metropolitan region of Florianópolis, a sample size was calculated assuming an alpha of 0.05 and power of 50%. According to the sample calculation the minimum expected was a sample with 316 participants. As dropouts are common during the course of the studies, the final sample of 409 children and adolescents was considered.Participated in the study a total of 409 students, 207 (50.61%) boys and 202 (49.39%) girls, aged between 8 and 16 years old, with an average age of 11.14 (SD=1.6) years in boys and 10, 9 (SD=1.8) years in girls. Participants were Caucasian 290 (70.9%), Black 103 (25.2%) and Brown 16 (3.9%). Regarding weight status, 168 (49.4%) were underweight, 153 (45%) with normal weight and 19 (5.6%) were overweight or obese. For the purpose of this study and attending to the low number (n=19) of overweight or obese children and adolescents, this category was further grouped with normal weight.Ethical considerationsThis research is part of a broad project approved by the Ethics Committee for Human Beings Research at the (blind) (process 5439/2011).Prior to the data collection, parents, children and adolescents received detailed information about the research. Only those students who expressed their willingness to cooperate with the investigation participated and presented a consent term signed by the parents. After delivery of signed consent terms, all participants were individually present at the two stages of data collection. In the first stage, the participants answered both questionnaires, self-reported their participation in bullying, and described their perceived and desired body image, while the second step consisted in the measurement of body mass and height.InstrumentsBody image was self-assessed through the Body Silhouettes Scale proposed by Stunkard, Sorensen and Schulsinger<a class="elsevierStyleCrossRef" href="#bib0260">20</a> which is composed of a set of human figures numbered from 1 to 9, representing a continuum from the thinness (silhouette 1) to severe obesity (silhouette 9). The figures were presented to the students on a single sheet, and then they answered the following questions: (1) Which silhouette best represents your current physical appearance (real silhouette)? (2) Which silhouette would you like to have (Ideal Silhouette)? Satisfaction with body image was identified by the discrepancy between the value corresponding to the actual silhouette and the value indicated as the ideal silhouette (real silhouette–ideal silhouette). Students who presented values equal to zero were classified as “Satisfied” with body image, and those who presented values different from zero were considered “Dissatisfied”. When this difference was positive the individual was considered dissatisfied for being overweight, and when negative, dissatisfied for thinness. Regarding internal reliability, the Stunkard Body Silhouettes Scale presented a moderate internal consistency level, with a Cronbach alpha of 0.600.Body mass and height were measured by persons previously trained and following the procedures described by Ross and Marffell-Jones.<a class="elsevierStyleCrossRef" href="#bib0265">21</a> At the time of the evaluation the children were in light clothing and barefoot. To measure the body mass, a digital scale with graduation of 0.1kg was used, and for height a stadiometer with a resolution of 0.1cm, the children were with the head in the Frankfort plane, arms along the body and united feet. Weight status was assessed by body mass index (BMI=body mass (kg)/height (m)2). The BMI classification was performed according to the cut-off points established by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0270">22</a> for the Brazilian population, stratifying the participants into three categories: underweight, normal weight and overweight.To describe the possible roles of participation in bullying were used two questions in the Olweus Questionnaire.<a class="elsevierStyleCrossRef" href="#bib0275">23</a> The first question asked how many times, in the last 3 months of school, the participant had been a victim of school bullying, while the second asked how many times the participant had been a bully. With the information obtained through those who responded that they were victims and bully three or more times, a “bully-victim” variable was created, classifying them in four categories of participation in bullying: “non participant”, “victim”, “bully” and “bully-victim”. The Olweus Questionnaire presented a good level of internal consistency, with a Cronbach alpha equal to 0.750.Statistical analysisInitially an exploratory analysis of the data was performed, in order to summarize the information obtained in the study. The nominal variables were described in terms of absolute frequency and percentage, and the quantitative variables were described by mean and standard deviation. The Mann–Whitney U test was used to verify the difference between the means, while the chi-square test was used to verify the possible associations between the categorical variables. The association between body image and the others independents variables was analyzed using binary logistic regression. Two models were tested, one simple and the other adjusted for all the variables that presented a p<0.20.<a class="elsevierStyleCrossRef" href="#bib0280">24</a> In all analyzes, the significance level of 5% was adopted using the SPSS statistical program, version 20.0.ResultsAccording to the results of the crude analysis, an association between dissatisfaction with thinness and sex, participation role in school bullying, and weight status, even after adjustment for confounders was observed. The underweight participants, the bully-victim and the boys presented, respectively, 5.22 (CI95%=3.07–8.86), 3.67 (CI95%=1.15–11.72) and 2.18 (CI95%=1.31–3.65) odds to be dissatisfied with thinness (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Regarding the dissatisfaction with the excess, in the crude analysis, was observed an association with sex, age, and weight status. In the adjusted analysis, there were negative associations between the outcome and the participants aged 11–12 and 13–16 years (OR=0.30, CI95%=0.17–0.53 and OR=0.39; CI95%=0.20–0.76) and the students underweight (OR=0.17, CI95%=0.10–0.29), indicating that these groups had a less odds to be dissatisfied with the excess (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>DiscussionIn the present study, the factors associated with dissatification about thinness were sex, role of participation in bullying and weight status, while dissatisfaction about excess was negatively associated with age and weight status.The high number of participants with underweight and low overweight prevalence was a peculiar characteristic of these participants living in socioeconomically vulnerable areas. According to the last statistics in the 2008–2009 Household Budgets Survey, by the Brazilian Institute of Geography and Statistics (IBGE) and the Ministry of Health, 33.5% of children between 5 and 9 years old were overweight, 14.3% were obese, and among adolescents aged 10–19 years, 20.5% were overweight and only 3.4% were underweight. Also, according to data produced by IBGE, income is directly linked to overweight: three times more among boys with higher income than those with lower income, 34.5% against 11.5%. While for girls the difference was 24% versus 14.2%. Therefore, it is believed that the data found about underweight are related to the characteristics of the participants of this study that living in socioeconomically vulnerable areas, alerting to a possible problem of child malnutrition in these communities.Weight status was associated to the outcome, proving to be an important variable in the attempt to better understand the levels of dissatisfaction with body image. Other studies also found an association between these variables, however the most studies indicating that overweight schoolchildren are more likely to be dissatisfied with body image when compared to normal or underweight schoolchildren.<a class="elsevierStyleCrossRefs" href="#bib0285">25,26</a> On the other hand, there are many children are underweight, and who also more likely to have an impaired body perception, but in relation a greater dissatisfaction with thinness.<a class="elsevierStyleCrossRef" href="#bib0295">27</a> This may explain in part why underweight was positively associated with thinness dissatisfaction and negatively associated with overweight dissatisfaction (protective effect).Another finding of this study concerns the association between dissatisfaction with body image and participation in school bullying. Some studies found that body dissatisfaction, independently of their weight status, is associated with behaviors of involvement in bullying, and therefore belonging to a group of risk.<a class="elsevierStyleCrossRefs" href="#bib0200">8,9</a> In the current research, as in the studies of Reulbach et al.,<a class="elsevierStyleCrossRef" href="#bib0200">8</a> the greatest association between the roles of participation in bullying was related to the perception of thinness. Although the literature highlights this body dissatisfaction as mainly associated with victimization in school,<a class="elsevierStyleCrossRef" href="#bib0200">8</a> our data showed that the participants who declared themselves bully-victims had almost four times as much odds of being dissatisfied with the thinness when compared to those who did not participate in this phenomenon.<a class="elsevierStyleCrossRefs" href="#bib0200">8,9</a> It should be noted that in these cases, the same child or adolescent assumes both roles in different situations.<a class="elsevierStyleCrossRef" href="#bib0300">28</a> Approximately 10% of students have double involvement, sometimes as bully, sometimes as victims,<a class="elsevierStyleCrossRef" href="#bib0305">29</a> and this is the group with the highest risk factors, with higher levels of involvement in violent behaviors outside of school, reports of depression and physical and psychological symptoms.<a class="elsevierStyleCrossRef" href="#bib0230">14</a> Even if these data are not able to state whether the involvement in bullying caused a greater dissatisfaction with the body, or if this feeling preceded and facilitated participation in the phenomenon, what is known is that these children and adolescents need special attention, because the double involvement has a multiplicative negative effect. Adding the lack of social support, the risk factors increased by the area in which they live and a high dissatisfaction with the body, these can have disastrous effects on the development of these young people.Although other studies have not found associations between body image satisfaction and age,<a class="elsevierStyleCrossRefs" href="#bib0290">26,30,31</a> in the present study, it was verified that the age group was associated with excess dissatisfaction. It is believed that body image dissatisfaction tends to increase in adolescents due to puberty, mainly due to the increase in BMI.<a class="elsevierStyleCrossRef" href="#bib0320">32</a> In the current study, older schoolchildren (11–12 and 13–16 years old) were less likely to be dissatisfied about the excess. There is a tendency for dissatisfaction with body image to be reaching children more precociously. These results may be one more specific characteristic of this group of participants of high-risk social vulnerability and demonstrate that this negative feeling about the body has social characteristics, going beyond the changes related to sexual maturation and that deserve greater attention on by the school and professionals related to the health of children and adolescents.This study presents several strengths. First, the analysis of a differentiated group of participants, who lives in socioeconomically vulnerable conditions, showing another perspective for the dissatisfaction of these children and adolescents. Second, the high number of underweight children and adolescents was also a peculiar characteristic of this group of participants, enriching the theme about body dissatisfaction that is frequently investigated only in groups of overweight and obese participants. Finally, the associations of thinness dissatisfaction with the role of bully-victims is a new and relevant topic for researchers in school bullying, which may contribute to a better understanding of this role associated to many risk factors.The limitations of this study include the following items: (i) the questionnaires used in the study, particularly the measurement of body image and the roles of participation in bullying, although used in large scale in Brazil and in the world, are still needing validity for the Brazilian population; (ii) the social vulnerability condition of the participants was not directly evaluated, relying only on the criteria adopted by the social program in which they participated. Nevertheless, we do not have data supporting that the program has participants belonging to other social classes; (iii) we used a cross-sectional approach, which do not enable us to establish causal relations; (iv) we did not a representative sample, and generalization of the results have to be precautious. However, the results obtained in this study already offer relevant information, mainly because it indicates peculiar characteristics of this group that presents major associated risk factors, which can help in the implementation of intervention programs with the purpose of preventing or intervening in the occurrence of cases of malnutrition, early body dissatisfaction and involvement in school bullying; (v) data were not collected with a control group of students that did not living in socioeconomically vulnerable areas, which limited the interpretation of the results. We recommend that further studies address these limitations so that they contribute to further insight to clarify the associations between body satisfaction, weight status and bullying. Thus, it will be possible to obtain more precise data that can support efforts to prevent and address these problems in schools.This study allowed relevant findings regarding both weight status and bullying in relation to body satisfaction. There was a high number of underweight participants in this socioeconomically vulnerable group. In addition, it can be stated that body dissatisfaction in children and adolescents of high social vulnerability presented associations with weight status and bullying in some aspects, such as sex, role of participation in bullying and weight status for thinness dissatisfaction, while age and weight status were negatively associated with dissatisfaction with excess. The main contribution of this study is attributed to the capacity to use a positive body image as a tool to prevent and combat bullying. Probably, improving the body satisfaction of underweight children, they may feel able to deal with violent behavior in schools.Conflicts of interestThe authors declare that there are no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres936421" "titulo" => "Highlights" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:3 [ "identificador" => "xres936422" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Aim" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] 2 => array:2 [ "identificador" => "xpalclavsec910511" "titulo" => "Keywords" ] 3 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 4 => array:3 [ "identificador" => "sec0010" "titulo" => "Method" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Participants and methods of recruitment" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Ethical considerations" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Instruments" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 5 => array:2 [ "identificador" => "sec0035" "titulo" => "Results" ] 6 => array:2 [ "identificador" => "sec0040" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 8 => array:2 [ "identificador" => "xack316217" "titulo" => "Acknowledgement" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-02-07" "fechaAceptado" => "2017-04-26" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec910511" "palabras" => array:3 [ 0 => "Body dissatisfaction" 1 => "Bullying" 2 => "Social vulnerability" ] ] ] ] "tieneResumen" => true "highlights" => array:2 [ "titulo" => "Highlights" "resumen" => "<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">•The association between body image, body composition and school bullying was evaluated.</li><li class="elsevierStyleListItem" id="lsti0010">•409 children with 11.14 years in high social vulnerability in Brazil participated.</li><li class="elsevierStyleListItem" id="lsti0020">•Victim–aggressor bullying participants are dissatisfied with thinness.</li><li class="elsevierStyleListItem" id="lsti0025">•Girls aged 8–10 years and with high fat % have dissatisfaction with excess.</li><li class="elsevierStyleListItem" id="lsti0030">•Body dissatisfaction showed associations with body composition and bullying.</li></ul>" ] "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "AimTo analyze the association between dissatisfaction with body image and weight status and the roles assumed in school bullying in children and adolescents living in a socioeconomically vulnerable area. Method409 children and adolescents with average age of 11 years, from Florianópolis, Brazil, participated in this study. The body image was self-assessed through the Body Silhouettes Scale, the weight state through the body mass index (BMI) and the roles of participation in bullying through the Olweus Questionnaire. ResultsIt was verified a significant association between “dissatisfaction with thinness” and (i) weight status, (ii) sex and (iii) roles of participation in bullying. In addition, low weight, boys and bully-victims presented a greater odds of body dissatisfaction due to thinness. The variable “dissatisfaction with excess” was negatively associated with age and weight status. Participants aged 11–12 years and 13 and 16 years, as well as children and adolescents with low weight, had lower odds of having excessive dissatisfaction. ConclusionThe associations found in this study are important tools for developing interventions to avoid or minimize the effects of early body dissatisfaction and consequently violence at school, especially in children with increased determinants such as those living in socioeconomically vulnerable areas." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Aim" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "OR: odds ratio; CI95%: confidence interval of 95%." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR (CI95%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR<a class="elsevierStyleCrossRef" href="#tblfn0005">**</a> (CI95%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.98 (1.25–3.13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.18(1.31–3.65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.736 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8–10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">11–12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.192 (0.72–1.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">13–16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.22 (0.66–2.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Roles in bullying \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.094 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.062 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Non-participant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Victim \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.88 (0.47–1.66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.86 (0.43–1.72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bully \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.66 (0.27–1.61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.52 (0.20–1.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bully-victim \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.27 (1.14–9.33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.67 (1.15–11.72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight status \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">≤0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal weight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Underweight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.85 (2.95–7.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.22 (3.07–8.86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1582958.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "**" "nota" => "OR adjusted by the variables that presented p<0.20 in the crude model." ] ] ] "descripcion" => array:1 [ "en" => "Dissatisfaction with thinness and sex, age, roles in bullying and weight status." ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "OR: odds ratio; CI95%: confidence interval of 95%." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR (RI95%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR<a class="elsevierStyleCrossRef" href="#tblfn0010">**</a> (CI95%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.039 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.550 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.59 (1.02–2.47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.61 (0.99–2.61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8–10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">11–12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.40 (0.25–0.67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.30 (0.17–0.53) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">13–16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.67 (0.37–1.21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.39 (0.20–0.76) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Roles in bullying \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.248 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Non-participant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Victim \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.35 (0.74–2.46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bully \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.51 (0.69–3.33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bully-victim \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.40 (0.11–1.45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight status \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal weight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Underweight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.22 (0.14–0.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.168 (0.10–0.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1582959.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "**" "nota" => "OR adjusted by the variables that presented p<0.20 in the crude model." ] ] ] "descripcion" => array:1 [ "en" => "Dissatisfaction with excess and sex, age, roles in bullying and weight status." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0165" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Disordered eating among preadolescent boys and girls: the relationship with child and maternal variables" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. 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Marcela Almeida Zequinãoa,

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marcelazequinao@gmail.com

Corresponding author.

, Pâmella de Medeirosb, Helena Rafaela Vieira do Rosárioc, Andreia Pelegrinib, Luis Lopesc, Beatriz Pereirac, Fernando Luiz Cardosob

a University of Western Santa Catarina, Joaçaba, SC, Brazil

b Santa Catarina State University – UDESC, Florianópolis, SC, Brazil

c University of Minho, Braga CP: 4710-057, Portugal

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="par0035" class="elsevierStylePara elsevierViewall">Previous studies about body image indicate that body dissatisfaction has been increasingly recurrent during childhood<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1&#44;2</span></a> and adolescence&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">3&#44;4</span></a> Likewise&#44; body dissatisfaction has been increasingly recurrent during childhood and adolescence&#46; It is known that at this stage&#44; girls and boys are more dependent on peer acceptance and approval&#46; Thus&#44; supportive relationships with friends can provide protection against feelings of dissatisfaction with the body&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">5</span></a> while a low acceptance may predict greater dissatisfaction with body image and behaviors that are harmful to health&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Evidence indicates that children and adolescents dissatisfied with their body image end up becoming more psychologically vulnerable and even though they do not have any physical differences&#44; they are more easily victims of school bullying&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8&#44;9</span></a> Although there are innumerable reasons for which children and adolescents become victims of bullying&#44; several studies point out that one of the most frequent reason is the deviation of the ideal appearance&#44; in which bodies differ from socially imposed norms&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">9&#8211;11</span></a> In addition&#44; it is also noted that body weight is reported by students as the main cause of school bullying&#44; being more frequent than sexual orientation and ethnicity&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">12&#44;13</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">On the other hand&#44; body dissatisfaction seems to have a contrary sense in relation to the role of bully&#46; Studies have pointed out that children and adolescents who take on this role in school bullying tend to be more satisfied with body Image&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">14</span></a> besides having higher self-esteem&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">6</span></a> and being classified by colleagues as being the physically strongest&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a> Thus&#44; knowing that body image can be influenced not only by physiological but also psychological&#44; social and environmental factors&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">16</span></a> it is believed that the relationship between these variables deserves to be better discussed in the literature&#44; especially with children and adolescents from different contexts such as those living in socioeconomically vulnerable areas&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">It is known that school violence can have greater impact in unfavorable social contexts&#46; In Brazil&#44; several metropolises present children and adolescents who live in this context&#46; Thus&#44; there are places characterized by higher levels of social inequality and access to services of lower quality and whose inhabitants are in a situation of social vulnerability&#44; that definition corresponds &#8220;to the condition of not having or not being able to use material and immaterial assets which would allow the individual or social group to deal with the situation of poverty&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">17</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The vulnerability experienced in these areas is complex and multifaceted&#44; going beyond health&#44; social life&#44; educational contexts&#44; symbolic organizations&#44; ethnic issues&#44; labor camps&#44; and public policies in general&#44; with regard to living conditions and social supports&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a> When combined with the low socioeconomic conditions&#44; it provides great tension among the young&#44; which hampers the processes of social integration&#44; and can foment violent attitudes&#44; such as the involvement in bullying&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Until now&#44; little is known about how body image behaves and what its relation with school bullying&#44; in children and adolescents living in socioeconomically vulnerable areas&#44; in which there is a negative result of the relationship between availability of material resources and access to social&#44; economic and cultural structures and opportunities&#46; Therefore&#44; the present study aims to analyze the associations between body image dissatisfaction with weight status and the roles assumed in school bullying among children and adolescents living in a socioeconomically vulnerable area&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Method</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Participants and methods of recruitment</span><p id="par0065" class="elsevierStylePara elsevierViewall">Two public schools located in socioeconomically vulnerable areas were intentionally selected according to the indication of the municipality&#39;s Education Department&#46; After the selection&#44; all students from 3rd to 7th grade were invited to participate in the study&#46; The only exclusion criteria adopted in the recruitment of participants was the presence of some type of intellectual disability that compromised the understanding of the instruments&#44; as indicated by the Special Education Service of the schools&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Based on the number of children and adolescents participating in the social project that serves children and adolescents in situations of social vulnerability in the metropolitan region of Florian&#243;polis&#44; a sample size was calculated assuming an alpha of 0&#46;05 and power of 50&#37;&#46; According to the sample calculation the minimum expected was a sample with 316 participants&#46; As dropouts are common during the course of the studies&#44; the final sample of 409 children and adolescents was considered&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Participated in the study a total of 409 students&#44; 207 &#40;50&#46;61&#37;&#41; boys and 202 &#40;49&#46;39&#37;&#41; girls&#44; aged between 8 and 16 years old&#44; with an average age of 11&#46;14 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;6&#41; years in boys and 10&#44; 9 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;8&#41; years in girls&#46; Participants were Caucasian 290 &#40;70&#46;9&#37;&#41;&#44; Black 103 &#40;25&#46;2&#37;&#41; and Brown 16 &#40;3&#46;9&#37;&#41;&#46; Regarding weight status&#44; 168 &#40;49&#46;4&#37;&#41; were underweight&#44; 153 &#40;45&#37;&#41; with normal weight and 19 &#40;5&#46;6&#37;&#41; were overweight or obese&#46; For the purpose of this study and attending to the low number &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41; of overweight or obese children and adolescents&#44; this category was further grouped with normal weight&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Ethical considerations</span><p id="par0080" class="elsevierStylePara elsevierViewall">This research is part of a broad project approved by the Ethics Committee for Human Beings Research at the &#40;blind&#41; &#40;process 5439&#47;2011&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Prior to the data collection&#44; parents&#44; children and adolescents received detailed information about the research&#46; Only those students who expressed their willingness to cooperate with the investigation participated and presented a consent term signed by the parents&#46; After delivery of signed consent terms&#44; all participants were individually present at the two stages of data collection&#46; In the first stage&#44; the participants answered both questionnaires&#44; self-reported their participation in bullying&#44; and described their perceived and desired body image&#44; while the second step consisted in the measurement of body mass and height&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Instruments</span><p id="par0090" class="elsevierStylePara elsevierViewall">Body image was self-assessed through the Body Silhouettes Scale proposed by Stunkard&#44; Sorensen and Schulsinger<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a> which is composed of a set of human figures numbered from 1 to 9&#44; representing a continuum from the thinness &#40;silhouette 1&#41; to severe obesity &#40;silhouette 9&#41;&#46; The figures were presented to the students on a single sheet&#44; and then they answered the following questions&#58; &#40;1&#41; Which silhouette best represents your current physical appearance &#40;real silhouette&#41;&#63; &#40;2&#41; Which silhouette would you like to have &#40;Ideal Silhouette&#41;&#63; Satisfaction with body image was identified by the discrepancy between the value corresponding to the actual silhouette and the value indicated as the ideal silhouette &#40;real silhouette&#8211;ideal silhouette&#41;&#46; Students who presented values equal to zero were classified as &#8220;Satisfied&#8221; with body image&#44; and those who presented values different from zero were considered &#8220;Dissatisfied&#8221;&#46; When this difference was positive the individual was considered dissatisfied for being overweight&#44; and when negative&#44; dissatisfied for thinness&#46; Regarding internal reliability&#44; the Stunkard Body Silhouettes Scale presented a moderate internal consistency level&#44; with a Cronbach alpha of 0&#46;600&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Body mass and height were measured by persons previously trained and following the procedures described by Ross and Marffell-Jones&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">21</span></a> At the time of the evaluation the children were in light clothing and barefoot&#46; To measure the body mass&#44; a digital scale with graduation of 0&#46;1<span class="elsevierStyleHsp" style=""></span>kg was used&#44; and for height a stadiometer with a resolution of 0&#46;1<span class="elsevierStyleHsp" style=""></span>cm&#44; the children were with the head in the Frankfort plane&#44; arms along the body and united feet&#46; Weight status was assessed by body mass index &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>body mass &#40;kg&#41;&#47;height &#40;m&#41;<span class="elsevierStyleSup">2</span>&#41;&#46; The BMI classification was performed according to the cut-off points established by Conde and Monteiro<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a> for the Brazilian population&#44; stratifying the participants into three categories&#58; underweight&#44; normal weight and overweight&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">To describe the possible roles of participation in bullying were used two questions in the Olweus Questionnaire&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a> The first question asked how many times&#44; in the last 3 months of school&#44; the participant had been a victim of school bullying&#44; while the second asked how many times the participant had been a bully&#46; With the information obtained through those who responded that they were victims and bully three or more times&#44; a &#8220;bully-victim&#8221; variable was created&#44; classifying them in four categories of participation in bullying&#58; &#8220;non participant&#8221;&#44; &#8220;victim&#8221;&#44; &#8220;bully&#8221; and &#8220;bully-victim&#8221;&#46; The Olweus Questionnaire presented a good level of internal consistency&#44; with a Cronbach alpha equal to 0&#46;750&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Statistical analysis</span><p id="par0105" class="elsevierStylePara elsevierViewall">Initially an exploratory analysis of the data was performed&#44; in order to summarize the information obtained in the study&#46; The nominal variables were described in terms of absolute frequency and percentage&#44; and the quantitative variables were described by mean and standard deviation&#46; The Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test was used to verify the difference between the means&#44; while the chi-square test was used to verify the possible associations between the categorical variables&#46; The association between body image and the others independents variables was analyzed using binary logistic regression&#46; Two models were tested&#44; one simple and the other adjusted for all the variables that presented a <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;20&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">24</span></a> In all analyzes&#44; the significance level of 5&#37; was adopted using the SPSS statistical program&#44; version 20&#46;0&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Results</span><p id="par0110" class="elsevierStylePara elsevierViewall">According to the results of the crude analysis&#44; an association between dissatisfaction with thinness and sex&#44; participation role in school bullying&#44; and weight status&#44; even after adjustment for confounders was observed&#46; The underweight participants&#44; the bully-victim and the boys presented&#44; respectively&#44; 5&#46;22 &#40;CI95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;07&#8211;8&#46;86&#41;&#44; 3&#46;67 &#40;CI95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;15&#8211;11&#46;72&#41; and 2&#46;18 &#40;CI95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;31&#8211;3&#46;65&#41; odds to be dissatisfied with thinness &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Regarding the dissatisfaction with the excess&#44; in the crude analysis&#44; was observed an association with sex&#44; age&#44; and weight status&#46; In the adjusted analysis&#44; there were negative associations between the outcome and the participants aged 11&#8211;12 and 13&#8211;16 years &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;30&#44; CI95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;17&#8211;0&#46;53 and OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;39&#59; CI95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;20&#8211;0&#46;76&#41; and the students underweight &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;17&#44; CI95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;10&#8211;0&#46;29&#41;&#44; indicating that these groups had a less <span class="elsevierStyleItalic">odds</span> to be dissatisfied with the excess &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">In the present study&#44; the factors associated with dissatification about thinness were sex&#44; role of participation in bullying and weight status&#44; while dissatisfaction about excess was negatively associated with age and weight status&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The high number of participants with underweight and low overweight prevalence was a peculiar characteristic of these participants living in socioeconomically vulnerable areas&#46; According to the last statistics in the 2008&#8211;2009 Household Budgets Survey&#44; by the Brazilian Institute of Geography and Statistics &#40;IBGE&#41; and the Ministry of Health&#44; 33&#46;5&#37; of children between 5 and 9 years old were overweight&#44; 14&#46;3&#37; were obese&#44; and among adolescents aged 10&#8211;19 years&#44; 20&#46;5&#37; were overweight and only 3&#46;4&#37; were underweight&#46; Also&#44; according to data produced by IBGE&#44; income is directly linked to overweight&#58; three times more among boys with higher income than those with lower income&#44; 34&#46;5&#37; against 11&#46;5&#37;&#46; While for girls the difference was 24&#37; versus 14&#46;2&#37;&#46; Therefore&#44; it is believed that the data found about underweight are related to the characteristics of the participants of this study that living in socioeconomically vulnerable areas&#44; alerting to a possible problem of child malnutrition in these communities&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Weight status was associated to the outcome&#44; proving to be an important variable in the attempt to better understand the levels of dissatisfaction with body image&#46; Other studies also found an association between these variables&#44; however the most studies indicating that overweight schoolchildren are more likely to be dissatisfied with body image when compared to normal or underweight schoolchildren&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">25&#44;26</span></a> On the other hand&#44; there are many children are underweight&#44; and who also more likely to have an impaired body perception&#44; but in relation a greater dissatisfaction with thinness&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">27</span></a> This may explain in part why underweight was positively associated with thinness dissatisfaction and negatively associated with overweight dissatisfaction &#40;protective effect&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Another finding of this study concerns the association between dissatisfaction with body image and participation in school bullying&#46; Some studies found that body dissatisfaction&#44; independently of their weight status&#44; is associated with behaviors of involvement in bullying&#44; and therefore belonging to a group of risk&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8&#44;9</span></a> In the current research&#44; as in the studies of Reulbach et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">8</span></a> the greatest association between the roles of participation in bullying was related to the perception of thinness&#46; Although the literature highlights this body dissatisfaction as mainly associated with victimization in school&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">8</span></a> our data showed that the participants who declared themselves bully-victims had almost four times as much odds of being dissatisfied with the thinness when compared to those who did not participate in this phenomenon&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8&#44;9</span></a> It should be noted that in these cases&#44; the same child or adolescent assumes both roles in different situations&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a> Approximately 10&#37; of students have double involvement&#44; sometimes as bully&#44; sometimes as victims&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a> and this is the group with the highest risk factors&#44; with higher levels of involvement in violent behaviors outside of school&#44; reports of depression and physical and psychological symptoms&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">14</span></a> Even if these data are not able to state whether the involvement in bullying caused a greater dissatisfaction with the body&#44; or if this feeling preceded and facilitated participation in the phenomenon&#44; what is known is that these children and adolescents need special attention&#44; because the double involvement has a multiplicative negative effect&#46; Adding the lack of social support&#44; the risk factors increased by the area in which they live and a high dissatisfaction with the body&#44; these can have disastrous effects on the development of these young people&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Although other studies have not found associations between body image satisfaction and age&#44;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">26&#44;30&#44;31</span></a> in the present study&#44; it was verified that the age group was associated with excess dissatisfaction&#46; It is believed that body image dissatisfaction tends to increase in adolescents due to puberty&#44; mainly due to the increase in BMI&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a> In the current study&#44; older schoolchildren &#40;11&#8211;12 and 13&#8211;16 years old&#41; were less likely to be dissatisfied about the excess&#46; There is a tendency for dissatisfaction with body image to be reaching children more precociously&#46; These results may be one more specific characteristic of this group of participants of high-risk social vulnerability and demonstrate that this negative feeling about the body has social characteristics&#44; going beyond the changes related to sexual maturation and that deserve greater attention on by the school and professionals related to the health of children and adolescents&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">This study presents several strengths&#46; First&#44; the analysis of a differentiated group of participants&#44; who lives in socioeconomically vulnerable conditions&#44; showing another perspective for the dissatisfaction of these children and adolescents&#46; Second&#44; the high number of underweight children and adolescents was also a peculiar characteristic of this group of participants&#44; enriching the theme about body dissatisfaction that is frequently investigated only in groups of overweight and obese participants&#46; Finally&#44; the associations of thinness dissatisfaction with the role of bully-victims is a new and relevant topic for researchers in school bullying&#44; which may contribute to a better understanding of this role associated to many risk factors&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The limitations of this study include the following items&#58; &#40;i&#41; the questionnaires used in the study&#44; particularly the measurement of body image and the roles of participation in bullying&#44; although used in large scale in Brazil and in the world&#44; are still needing validity for the Brazilian population&#59; &#40;ii&#41; the social vulnerability condition of the participants was not directly evaluated&#44; relying only on the criteria adopted by the social program in which they participated&#46; Nevertheless&#44; we do not have data supporting that the program has participants belonging to other social classes&#59; &#40;iii&#41; we used a cross-sectional approach&#44; which do not enable us to establish causal relations&#59; &#40;iv&#41; we did not a representative sample&#44; and generalization of the results have to be precautious&#46; However&#44; the results obtained in this study already offer relevant information&#44; mainly because it indicates peculiar characteristics of this group that presents major associated risk factors&#44; which can help in the implementation of intervention programs with the purpose of preventing or intervening in the occurrence of cases of malnutrition&#44; early body dissatisfaction and involvement in school bullying&#59; &#40;v&#41; data were not collected with a control group of students that did not living in socioeconomically vulnerable areas&#44; which limited the interpretation of the results&#46; We recommend that further studies address these limitations so that they contribute to further insight to clarify the associations between body satisfaction&#44; weight status and bullying&#46; Thus&#44; it will be possible to obtain more precise data that can support efforts to prevent and address these problems in schools&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">This study allowed relevant findings regarding both weight status and bullying in relation to body satisfaction&#46; There was a high number of underweight participants in this socioeconomically vulnerable group&#46; In addition&#44; it can be stated that body dissatisfaction in children and adolescents of high social vulnerability presented associations with weight status and bullying in some aspects&#44; such as sex&#44; role of participation in bullying and weight status for thinness dissatisfaction&#44; while age and weight status were negatively associated with dissatisfaction with excess&#46; The main contribution of this study is attributed to the capacity to use a positive body image as a tool to prevent and combat bullying&#46; Probably&#44; improving the body satisfaction of underweight children&#44; they may feel able to deal with violent behavior in schools&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest&#46;</p></span></span>"
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    "highlights" => array:2 [
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      "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0005" class="elsevierStylePara elsevierViewall">The association between body image&#44; body composition and school bullying was evaluated&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0010" class="elsevierStylePara elsevierViewall">409 children with 11&#46;14 years in high social vulnerability in Brazil participated&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8226;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Victim&#8211;aggressor bullying participants are dissatisfied with thinness&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8226;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Girls aged 8&#8211;10 years and with high fat &#37; have dissatisfaction with excess&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8226;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Body dissatisfaction showed associations with body composition and bullying&#46;</p></li></ul></p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Aim</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To analyze the association between dissatisfaction with body image and weight status and the roles assumed in school bullying in children and adolescents living in a socioeconomically vulnerable area&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">409 children and adolescents with average age of 11 years&#44; from Florian&#243;polis&#44; Brazil&#44; participated in this study&#46; The body image was self-assessed through the Body Silhouettes Scale&#44; the weight state through the body mass index &#40;BMI&#41; and the roles of participation in bullying through the Olweus Questionnaire&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">It was verified a significant association between &#8220;dissatisfaction with thinness&#8221; and &#40;i&#41; weight status&#44; &#40;ii&#41; sex and &#40;iii&#41; roles of participation in bullying&#46; In addition&#44; low weight&#44; boys and bully-victims presented a greater odds of body dissatisfaction due to thinness&#46; The variable &#8220;dissatisfaction with excess&#8221; was negatively associated with age and weight status&#46; Participants aged 11&#8211;12 years and 13 and 16 years&#44; as well as children and adolescents with low weight&#44; had lower odds of having excessive dissatisfaction&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The associations found in this study are important tools for developing interventions to avoid or minimize the effects of early body dissatisfaction and consequently violence at school&#44; especially in children with increased determinants such as those living in socioeconomically vulnerable areas&#46;</p></span>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;&#42;</span></a> &#40;CI95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gender</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;98 &#40;1&#46;25&#8211;3&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;18&#40;1&#46;31&#8211;3&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age group</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;736&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>8&#8211;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>11&#8211;12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>13&#8211;16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Roles in bullying</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;094&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Victim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;88 &#40;0&#46;47&#8211;1&#46;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;86 &#40;0&#46;43&#8211;1&#46;72&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bully&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;66 &#40;0&#46;27&#8211;1&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;52 &#40;0&#46;20&#8211;1&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bully-victim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;27 &#40;1&#46;14&#8211;9&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;67 &#40;1&#46;15&#8211;11&#46;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Weight status</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                        0 => array:2 [
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                          "autores" => array:4 [
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                            3 => "P&#46;P&#46; Machado"
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                        0 => array:2 [
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                          "autores" => array:5 [
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                            3 => "G&#46;K&#46; Nativg"
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                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2702.2010.03693.x"
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                        "tituloSerie" => "J Clin Nurs"
                        "fecha" => "2011"
                        "volumen" => "20"
                        "paginaInicial" => "3048"
                        "paginaFinal" => "3056"
                        "link" => array:1 [
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                      "titulo" => "Factors associated with body image dissatisfaction among adolescents in public schools students in Salvador&#44; Brazil"
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Article information

ISSN: 24448664
Original language: English

DOI:10.1016/j.pbj.2017.04.010

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Year/Month	Html	Pdf	Total

2024 October	22	3	25
2024 September	49	3	52
2024 August	54	6	60
2024 July	95	5	100
2024 June	36	3	39
2024 May	28	6	34
2024 April	38	18	56
2024 March	36	5	41
2024 February	19	8	27
2024 January	24	6	30
2023 December	23	9	32
2023 November	52	6	58
2023 October	60	5	65
2023 September	40	6	46
2023 August	32	7	39
2023 July	38	9	47
2023 June	40	4	44
2023 May	54	4	58
2023 April	41	1	42
2023 March	59	3	62
2023 February	31	4	35
2023 January	31	9	40
2022 December	59	6	65
2022 November	67	15	82
2022 October	51	17	68
2022 September	21	10	31
2022 August	31	12	43
2022 July	25	13	38
2022 June	26	13	39
2022 May	35	15	50
2022 April	36	18	54
2022 March	42	12	54
2022 February	29	10	39
2022 January	50	10	60
2021 December	42	16	58
2021 November	35	16	51
2021 October	41	19	60
2021 September	34	16	50
2021 August	18	10	28
2021 July	18	12	30
2021 June	33	9	42
2021 May	23	9	32
2021 April	91	8	99
2021 March	61	16	77
2021 February	27	17	44
2021 January	24	7	31
2020 December	20	8	28
2020 November	21	2	23
2020 October	26	5	31
2020 September	30	11	41
2020 August	35	17	52
2020 July	27	12	39
2020 June	32	12	44
2020 May	26	10	36
2020 April	35	8	43
2020 March	81	7	88
2020 February	132	7	139
2020 January	24	11	35
2019 December	40	7	47
2019 November	21	4	25
2019 October	37	8	45
2019 September	19	11	30
2019 August	25	4	29
2019 July	26	13	39
2019 June	42	34	76
2019 May	70	45	115
2019 April	71	21	92
2019 March	55	4	59
2019 February	54	6	60
2019 January	49	5	54
2018 December	59	5	64
2018 November	73	5	78
2018 October	149	11	160
2018 September	39	3	42
2018 August	92	24	116
2018 July	97	17	114
2018 June	102	18	120
2018 May	121	19	140
2018 April	129	26	155
2018 March	89	33	122
2018 February	62	29	91
2018 January	26	19	45
2017 December	24	21	45
2017 November	21	22	43
2017 October	3	10	13
2017 September	1	18	19
2017 August	0	13	13
2017 July	1	16	17
2017 June	2	15	17
2017 May	0	1	1

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