What is and what is not positive body image? Conceptual foundations and construct definition

Extending the use of the Body Appreciation Scale -2 in older adults: A Portuguese validation study

Body appreciation is a key characteristic, and the most common operationalization, of positive body image. Positive body image is often measured using the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a), which has demonstrated good psychometric properties in adult samples. The purpose of this study is to extend the validation of the BAS-2 to late adulthood facilitating future research with this population. A total of 202 male and female participants (aged 65-91 years) completed the Portuguese version of the BAS-2, along with other body image-related instruments and measures of self-esteem and intuitive eating. Confirmatory factor analysis supported the one-factor model and demonstrated sex invariance. There were no significant sex differences in BAS-2 scores. The BAS-2 had satisfactory convergent, discriminant, and incremental validity. Internal consistency and test-retest stability estimates were adequate. The BAS-2 will likely meet the needs of researchers interested in exploring body appreciation among elderly people.

Body Appreciation in Lesbian, Bisexual, and Queer Women: Examining a Model of Social Support, Resilience, and Self-Esteem

Purpose: There is increasing research on positive body image, but no studies to date have examined these constructs in lesbian, bisexual, and queer (LBQ) women. However, LBQ women are at increased risk for mental health concerns and disordered eating, and there is evidence that body appreciation might be both adaptive and protective. This study examined factors that could uniquely relate to body appreciation in LBQ women. Method: Women identifying as LBQ (N=150) completed demographics and measures of social support, resilience, self-esteem, and body appreciation. We tested a hypothesized mediational model of social support leading indirectly to body appreciation through resilience and self-esteem, controlling for body mass index. Results: All direct effects, except social support to body appreciation (p=0.696), were significant (ps=0.017-0.001), reflecting a full multiple mediation. As hypothesized, the effect of social support on body appreciation was indirect (p=0.011), through resilience and self-esteem. Conclusion: This is the first study to investigate factors that might facilitate positive body image in LBQ women. Although preliminary, results suggest social support, resilience, and self-esteem might be important targets of body image interventions with LBQ women.

The Utility of a Positive Body Image Among Community-Dwelling Older Adults Who Perceive Death to Be Near and Fear It

Physical changes are an inevitable part of the aging process. However, research has demonstrated inconclusive findings with regard to body image among older adults. This study attempts to clarify the utility of body image among this age-group, by adopting the framework of terror management theory. It is suggested that a positive body image may moderate the connection between two types of death concerns and psychological distress: subjective nearness-to-death and death anxiety. A convenience sample of 386 community-dwelling older adults, aged 60-97, filled scales measuring subjective nearness-to-death, positive body image, psychological distress, and death anxiety. A significant negative association was found between a positive body image and distress. Moreover, positive body image moderated the connection between distress and both subjective nearness-to-death and death anxiety. Thus, holding a positive image of the body seems to be an important resource for older adults when death is perceived to be near.

Body Esteem among Korean Adolescent Boys and Girls

Establishing a positive body image is a critical factor for adolescents’ physical and mental health as it leads to sustainable individual growth and development throughout their lives. Therefore, possible personality traits need to be examined for their capability as protective factors for a healthy body image. The current study examined how one internal personality trait (self-concept clarity) and three external factors (tripartite influence from media, parents, and peers) are associated with adolescents’ internalization of the thin-body ideal and body esteem in a sample of Korean adolescents (N = 1127). Self-concept clarity was identified as a powerful factor that is positively related with body esteem. The results showed that greater self-concept clarity, lower tripartite influences and thin body internalization were related to greater body esteem. Gender differences were found in the relationships between body esteem and the predictor variables. The implications of the findings and future research directions are discussed.

Online interpersonal sexual objectification experiences and Chinese adolescent girls' intuitive eating: The role of broad conceptualization of beauty and body appreciation

Interpersonal sexual objectification experiences are pervasive in online communication contexts, and their influence on positive eating behaviors should not be ignored. Broad conceptualization of beauty refers to how widely women and girls define female beauty in terms of both internal and external characteristics, and body appreciation refers to loving, respecting, and holding a positive attitude toward the body. This study examined the association between online interpersonal sexual objectification (OISO) experiences and intuitive eating, as well as the mediating role of broad conceptualization of beauty and body appreciation. Participants were 1152 Chinese adolescent girls aged 11 to 15 years who completed a questionnaire survey measuring OISO experiences, broad conceptualization of beauty, body appreciation, and intuitive eating. The results showed a negative association of OISO experiences with broad conceptualization of beauty and intuitive eating. Mediation analysis using structural equation modeling showed a negative association of OISO experiences with intuitive eating through broad conceptualization of beauty and body appreciation. These results suggest that programs aiming to improve healthy eating behaviors could direct adolescent girls to criticize the appearance-focused mindset in online interaction and encourage them to focus on body functionality, such as health, creative endeavors, and communication with others.

The Role of BMI Group on the Impact of Weight Bias Versus Body Positivity Terminology on Behavioral Intentions and Beliefs: An Experimental Study

This experimental study investigated the role of BMI on the impact of weight bias vs body positivity terminology on behavioral intentions and beliefs about obesity. Participants (n = 332) were randomly allocated to two conditions to receive a vignette depicting an image of a person with obesity using either weight bias (n = 164) or body positivity (n = 168) terminology. Participants were divided into three groups based upon their BMI category (normal weight n = 173; overweight n = 92; obese n = 64). They then completed measures of behavioral intentions, obesity illness beliefs, and fat phobia. Although there were several differences in beliefs by BMI group, the results showed no differences between weight bias or body positivity terminology on any measures. There were, however, significant BMI group by condition interactions for beliefs about obesity relating to personal control and treatment control. Post hoc tests showed that weight bias resulted in reduced personal control in the obese BMI group compared to other participants. Weight bias also resulted in higher personal control over obesity in normal weight individuals compared to body positivity. People with obesity reported higher treatment control when exposed to weight bias compared to overweight participants, whereas normal weight participants reported greater treatment control when exposed to body positivity compared to both other groups. To conclude, the impact of weight bias and body positivity information is not universal and varies according to the BMI of the audience and the outcome being measured; whereas people of normal weight may benefit from weight bias there is no evidence that obese people benefit from body positivity. Implications for the prevention and treatment of obesity are discussed.

Examining positive body image, sport confidence, flow state, and subjective performance among student athletes and non-athletes

The primary purpose of the present study was to examine differences in positive body image, specifically body appreciation and functionality appreciation, between student athletes and non-athletes. A secondary purpose was to examine the relationships between positive body image and other sport-related variables. Seventy-nine National Collegiate Athletic Association (NCAA) Division I student athletes (M_age = 19.79, SD = 1.13) and 175 non-athletes (M_age = 19.38, SD = 1.81) completed measures of body appreciation and functionality appreciation. The athletes further completed measures of sport confidence, flow state, and subjective sport performance. Student athletes reported higher levels of both facets of positive body image. Significant relationships were also found between positive body image and the sport-related variables. The present results contribute novel findings to the positive body image literature and potential implications for coaches to encourage a culture that focuses less on body appearance and more on cultivating positive body image.

Regional Differences in Body Image Perception Among Young African American Women Living in the United States

The current study examined regional differences in body image perceptions and body mass index (BMI) among young African American women. Three hundred forty-one African American women, 18 to 40 years old, living in three regions of the United States were recruited. Pulver's Figure Rating scale was used to identify body image perceptions. Weight and height were measured for BMI calculation. Analysis of covariance was used to examine body image perception differences. The sample mean age was 27.8 years and mean BMI was 30.3 kg/m². Participants' body image perceptions were significantly smaller among participants living in the Northeast compared to the Southeast (mean difference = -0.65, 95% confidence interval [CI] [-1.18, -0.11], p = 0.018) and Midwest (mean difference = -0.64, 95% CI [-1.16, -0.12], p = 0.015). No significant differences in BMI were found among regions (F(8,318) = 1.17, p = 0.314). Clinical implications of these findings are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 57(3), 25-31.].

The Body Appreciation Scale-2: Item interpretation and sensitivity to priming

The Body Appreciation Scale-2 (BAS-2) is a widely-used measure of positive body image. Items are worded ambiguously to allow reference to any aspect of the body during measure completion. We examined (a) how BAS-2 items are interpreted and whether this interpretation is influenced by the content of measures administered prior to it, (b) whether measures administered prior to the BAS-2 alter its scores or (c) the correlation between BAS-2 scores and scores on a measure of body dissatisfaction, (d) how BAS-2 item interpretation relates to total scores, and (e) whether BAS-2 scores are associated with investment in appearance for aesthetic purposes. Canadian female undergraduates (N = 392) completed one of four priming questionnaires, followed by the BAS-2, and then indicated how they interpreted each BAS-2 item. Most items were interpreted in terms of appearance, with the primes having no impact on item interpretation, scores, or the magnitude of the correlation with body dissatisfaction. BAS-2 scores were highest among women interpreting a moderate number of items in terms of appearance and negatively correlated with investment for aesthetic purposes. Thus, the BAS-2 is not vulnerable to priming, but among young Western women, items are likely to be interpreted in terms of appearance.

A randomized experimental evaluation of a yoga-based body image intervention

Recent literature argues that body image interventions need to become more embodied. This paper evaluates a brief yoga-based body image intervention which incorporates themes specifically tailored to focus on positive body image. Young women (M_age = 20.21, SD_age = 2.15) were randomly allocated to a four-session yoga intervention (n = 22) or a control condition (n = 22). Compared to controls, participants in the yoga condition reported significant increases in body appreciation, body connectedness, body satisfaction, and positive mood at posttest and at 4-week follow-up. There were no significant changes in negative mood or body surveillance. These findings add to existing evidence that yoga can improve women's body image and positive mood. In addition, they suggest that a strong thematic focus on positive body image can achieve benefits at relatively low yoga doses. These findings are important as intervention length impacts the potential for dissemination.

Factor structure and psychometric properties of a Bahasa Malaysia (Malay) translation of the Body Appreciation Scale-2 (BAS-2)

The 10-item Body Appreciation Scale-2 (BAS-2) is a widely-used measure of a facet of positive body image. Here, we examined the psychometric properties of a Bahasa Malaysia (Malay) translation of the BAS-2 in a community sample of Malaysian Malay and Chinese adults (N = 781). Participants completed the Malay BAS-2 alongside demographic items and measures of subjective happiness, life satisfaction, actual-ideal weight discrepancy (women only), drive for muscularity (men only), and internalisation of appearance ideals. Exploratory factor analyses with a Malay subsample indicated that BAS-2 scores reduced to a single dimension with all 10 items in women and men, although the factor structure was similar but not identical across sex. Confirmatory factor analysis indicated that the one-dimensional factor structure had adequate fit following modifications. BAS-2 scores were partially scalar invariant across sex (with no significant sex differences) and ethnicity (Malay participants had significantly higher body appreciation than Chinese participants), as well as had adequate internal consistency. Evidence of construct and incremental validity was also provided through associations with additional measures and the prediction of subjective happiness over-and-above other variables, respectively. The availability of the Malay BAS-2 should help advance research on the body appreciation construct in Malay-speaking populations.

Women's Use of Social Media: What Is the Evidence About Their Impact on Weight Management and Body Image?

PURPOSE OF THE REVIEW

This review aims to summarize recent research on the effects of social media-delivered weight management interventions on weight loss and the impact of social media use on body image concerns in women and adolescent girls.

RECENT FINDINGS

Evidence supports the feasibility, but not the efficacy, of studies using single-component social media-delivered weight management interventions (i.e., including no other modes of intervention delivery) in women. Studies conducted in adolescent girls and women suggest that the impact of social media on body image outcomes is mostly detrimental, but is dependent on the context (e.g., exposure to idealized social media appearance images), peers' feedback, and constructs, such as appearance comparison tendency. More research is needed to conclude on the efficacy of social media-delivered interventions on both weight and body image outcomes and to understand how and when exposure to social media could promote effective weight management and also advocate positive body image in women.

Religion and spirituality: Pathways to positive body image

Positive body image is a multidimensional construct referring to love, respect, and acceptance of one's body, including aspects inconsistent with sociocultural ideals. The aim of the present study was to investigate potential pathways leading from religion and spirituality to positive body image. Participants were 345 women who completed questionnaire measures of engagement with formal religion, spirituality, gratitude, self-objectification, and positive body image. Both engagement with formal religion and spirituality were found to be positively associated with positive body image. Further, mediation analyses showed that the relationship between spirituality and positive body image was mediated by gratitude and reduced self-objectification. It was concluded that a broader spiritual consciousness may assist women to develop a loving, appreciative, and respectful relationship with their bodies. In addition, gratitude and a de-emphasis on external appearance provide useful goals and potential intervention points for promoting positive body image.

From negative to positive body image: Men's and women's journeys from early adolescence to emerging adulthood

This study examined the developmental journeys of individuals who have overcome negative body image in early adolescence and developed positive body image on their way to emerging adulthood. Interviews were conducted with 15 women and 16 men (aged 26-27) recruited from a large longitudinal sample. Results demonstrated different patterns of positive body image development, but most participants had overcome their negative body image by age 18. Factors contributing to their negative body image in early adolescence included negative peer influence and discontent with life in general. Turning points included finding a new social context, experiencing agency and empowerment, and using cognitive strategies to improve body image. Characteristics of the participants' current positive body image coincided with established features of positive body image; novel findings were that the women were more likely to think of positive body image as needing constant work to maintain and were also more likely to have a feminist identity, whereas the men were more likely to try to improve their body shape and perceive their body as resembling the ideal. In conclusion, body image interventions need to target not only matters related to physical appearance but also adolescents' general sense of belonging, agency, and empowerment.

Sustained hypervigilance for one's own body in women with weight and shape concerns: Competition effects in early visual processing investigated by steady-state visual evoked potentials (SSVEP)

This study aimed to analyze the covert attentional time course in early body processing areas in women with high body concerns. Therefore, we assessed the effect of pictures of one's own body and other bodies as distractions from a demanding dot detection task in 24 women with low and 20 women with high body concerns. Participants were instructed to attend to flickering dots eliciting steady-state visual evoked potentials (SSVEP) measured by EEG. Both groups showed a sustained SSVEP amplitude reduction, which was more pronounced for average-weight or thin bodies than for overweight bodies. For women with high body concerns, SSVEP amplitudes decreased more in the case of pictures of their own body. The results indicate covert vigilance and maintenance patterns for body stimuli, especially for bodies representing the thin ideal. Moreover, women with high body concerns attend more to information about their own body, which might maintain body dissatisfaction.

Predictors of outcome in cognitive behavioural therapy for eating disorders: An exploratory study

OBJECTIVE

Early decrease in symptoms is a consistent predictor of good treatment outcome across all eating disorders. The current study explored the predictive value of novel early change variables in a transdiagnostic, non-underweight sample receiving 10-session cognitive behavioural therapy.

METHOD

Participants who reported bingeing and/or purging in the week preceding baseline assessment (N = 62) were included in analyses. Early change variables were calculated for novel (body image flexibility, body image avoidance, body checking, and fear of compassion) and established predictors (behavioural symptoms and therapeutic alliance). Outcomes were global eating disorder psychopathology and clinical impairment at posttreatment and three-month follow-up. Intent-to-treat analyses were conducted using linear regression, adjusting for baseline values of the relevant outcome and early change in behavioural symptoms.

RESULTS

Early improvement in body image flexibility was the most consistent predictor of good outcome. Early change in body image avoidance and the fear of expressing and receiving compassion to/from others were significant predictors in some analyses.

DISCUSSION

Novel early change variables were significant predictors of eating disorder outcomes in this exploratory study. Model testing is required to understand the exact mechanisms by which these variables impact on outcomes, and whether there is potential benefit of modifying existing protocols.

ANZCTR TRIAL NUMBER

ACTRN12615001098527.

Male Nursing Students' Social Appearance Anxiety and Their Coping Attitudes

This study aimed at examining social appearance anxiety levels of male nursing students and their coping attitudes and identifying the relationship between them. A cross-sectional research approach was adopted in a study population of 180; the sample comprised 129 students. Data were collected using a socio-demographic information form, the Social Appearance Anxiety Scale (SAAS), and the Assessment of Coping Attitudes Inventory (COPE). The average age of students was 20.54 ± 1.49 years. The male students' average score obtained from the SAAS measure was 32.64 ± 13.07, while that of the COPE Inventory was 138.11 ± 14.47. Significant correlations were detected between students' SAAS scores and COPE scale scores. There were negative relationships between social anxiety scores and COPE subscales of positive reinterpretation and growth ( p < .05), use of instrumental social support ( p < .05), active coping ( p ≤ .01), and planning ( p ≤ .01). In contrast, there were positive relationships between social anxiety scores and COPE subscales of mental disengagement ( p ≤ .01), denial ( p ≤ .01), behavioral disengagement ( p ≤ .01), restraint ( p ≤ .01), use of emotional social support ( p < .05), substance use ( p ≤ .01), and acceptance ( p < .05). The conclusion was that male students who do not perceive themselves as having an ideal body image face high social appearance anxiety. There is a prejudice that social appearance anxiety has negative effects on these students' self-confidence. In this context, this research revealed concrete results about how male nursing students have battled the prejudices that they have faced throughout their student life.

Relationship Quality and Perceived Partner's Body Appreciation Is Related to Women's Own Body Appreciation and Sexual Functioning

Research on body appreciation is limited, especially when examining its relationship to sexual functioning. The aim of this study was to explore the relationship between body appreciation and sexual functioning, while measuring perceived partner's body appreciation and general relationship quality. A sample of 244 women aged 18 to 30 completed measures of sexual functioning, relationship quality, and body image online. General relationship quality and perceived partner's appreciation of one's body predicted levels of sexual functioning. Levels of body appreciation did not predict sexual functioning over and above general relationship quality and perceived partner's appreciation of one's body. This study is the first to demonstrate the significance of general relationship quality and perceived partner's body appreciation in relation to levels of body appreciation and sexual functioning. The findings highlight the importance of understanding body appreciation and its role in buffering the harmful impacts of viewing idealized images within the media.

Body image and attitude to one's body in adolescent: family and sociocultural factors (based on foreign researches)

The article provides an overview of foreign studies published between 2014 and 2019 on the problem of body image and attitudes of adolescents to their bodies. The influence of social environment, social networks and family on the formation of body image and satisfaction with it is analyzed. The emphasis is on the studies that consider child-parent relations, parents' attitudes and behaviors towards adolescents, their own attitudes towards their parents and their own attitudes to their own bodies as the main factors convey their behaviors to children. It is shown that the attitude to the body can be a predictor of eating disorders, overweight, depressive symptoms, dysmorphia. The analysis of the presented studies leads to understanding of the necessity in awareness-raising work with the sociocultural and family environment of adolescents, primarily with their parents

Evaluating the impact of a brief yoga intervention on preadolescents' body image and mood

Yoga is an embodying activity that promotes body awareness, body connection, body responsiveness, and appreciation of body functionality, and it therefore may be a beneficial school-based intervention for children's body image. The present study examined the impact of a 4-week yoga intervention on pre-adolescent girls' and boys' body image (body appreciation, body esteem, and body surveillance) and mood (positive and negative affect) 1-week post-intervention and at 6-week follow-up. British children (N = 344; 54.4% female) aged 9-11 years were recruited from four schools, two of which were randomly assigned to the yoga intervention and two to a physical education control condition. Overall, girls reported greater body image concern and negative mood than boys. Unexpectedly, both groups reported increased body appreciation, body esteem, and positive mood, and decreased body surveillance and negative affect from baseline to post-intervention and/or follow-up. Both girls and boys in the yoga intervention evaluated the sessions very favourably; the majority desired to participate in more lessons. Potential explanations for these findings are discussed.

Body pride and physical activity: Differential associations between fitness- and appearance-related pride in young adult Canadians

Body-related pride has been associated with health behaviors such as physical activity; however, researchers have overlooked distinctions between different domains of pride (appearance/fitness) and the two facets of pride (authentic/hubristic). The objective of the present research was to examine relationships between fitness- and appearance-related authentic and hubristic pride and physical activity. In Study 1, participants (N = 115) completed measures of fitness-related pride and participation in moderate-to-vigorous physical activity (MVPA). Both authentic and hubristic pride were positively associated with MVPA. In Study 2, participants (N = 173) completed measures of appearance-related pride and MVPA. Neither facet of pride predicted engagement in MVPA. In Study 3, participants (N = 401) completed measures of both fitness-related pride and appearance-related pride as well as MVPA. Authentic and hubristic fitness-related pride were associated with MVPA, while appearance-related hubristic pride was negatively associated with MVPA. Results support the adaptive nature of pride in motivating engagement in health behaviors when it is experienced around the body's functionality rather than appearance.

Examining the unique contribution of body appreciation to heterosexual women's sexual agency

Although numerous studies demonstrate links between negative body image and sexual well-being, recent research has emphasized studying the positive aspects of these constructs. The current study built upon this prior research by examining the association between body appreciation and sexual agency among a US community sample of 355 heterosexual women aged 18-40. This study also examined whether body appreciation is uniquely associated with sexual agency above and beyond levels of self-objectification. Regression analyses demonstrated that women who reported greater body appreciation also reported greater condom use self-efficacy, sexual satisfaction, sexual assertiveness, and feelings of entitlement to sexual pleasure, and lower levels of body self-consciousness during intimacy. These findings remained consistent even when self-objectification was entered into the model as a covariate. Results highlight the importance of studying how body appreciation may promote women's sexual agency.

A systematic review of the roles of body image flexibility as correlate, moderator, mediator, and in intervention science (2011-2018)

The emergence of body image flexibility into the positive body image nomenclature has innovatively expanded the conceptualization of how individuals may adaptively respond to body image threats. Given the notable growth of interest in researching this construct over nearly the past decade, the present analysis provides a systematic and critical review of evidence examining the roles of body image flexibility as correlate, mediator, moderator, and in intervention research. Results indicated that body image flexibility tended to demonstrate a pattern of relationships with correlates in directions predicted by its conceptualization and showed promise in functioning as both effect modifier and as an explanatory variable in the associations evaluated. Multiple studies demonstrated susceptibility to change following intervention. Although the current state of the literature is bound by notable limitations, the results of this review point to pertinent future steps in advancing the theory and application of body image flexibility scholarship.

Body appreciation in British men: Correlates and variation across sexual orientation

Investigations of positive body image among men and across various social identities are lacking, and could contribute to a more complete understanding of the construct, including how positive body image can be improved. This study addressed this gap by investigating correlates of body appreciation - a key facet of positive body image - in men, and testing whether levels of body appreciation vary across sexual orientation. Data from a British community sample of 439 men (M_age = 39.13) showed that body appreciation inversely correlated with conformity to masculine norms and upward appearance-based social comparisons, and positively correlated with physical activity. Body appreciation was lower among sexual minority compared to heterosexual men, and athletic appearance-ideal internalisation and upward appearance-based social comparisons mediated this relationship. Replicating prior research among men, body appreciation positively correlated with body satisfaction, and inversely correlated with perceived appearance pressures from media and eating pathology. These findings have implications for interventions addressing body image among men.

Yoga and body image: How do young adults practicing yoga describe its impact on their body image?

This study explored the perceived impact of yoga on body image. Young adults (n= 34 female, 12 male; M_age = 30.6 [SD = 1.6]) practicing yoga were interviewed and data were analyzed for emerging themes across weight status. In general, participants discussed the positive impact of yoga on their body image, but some described both a positive and negative impact. Yoga was perceived as having a positive impact on body image via perceived physical changes, gratitude for one's body, a sense of accomplishment within one's yoga practice, self-confidence, and witnessing different types of bodies practicing yoga. Yoga was perceived to have a negative impact on body image via comparative critique (e.g., upward comparisons with others) and inner critique (e.g., negative self-talk). Themes were generally similar across weight status; exceptions were that participants at higher weight status were more likely than those at lower weight status to discuss accomplishment within one's yoga practice as a positive impact on body image and comparative critique as a negative impact on body image. Yoga studios and instructors can take steps to further enhance the positive impact of yoga and to provide environments that are inclusive of participants with diverse body shapes and sizes.

Understandings and experiences of visible difference and romantic relationships: A qualitative exploration

The association between disfigurement ('visible difference') and romantic relationships has received relatively little consideration in the research literature. This qualitative research, conducted in the United Kingdom, explored participants' accounts of their visible difference and romantic life. Semi-structured interviews were conducted with 22 participants who had a variety of visible differences. Inductive thematic analysis demonstrated that participants understood their difference as having a pervasive and enduring impact. These encompassed challenges that must be negotiated in the formation of romantic relationships, including feeling unattractive to others and feeling personally devalued. Relevant physical and sexual sequelae were comprised of anxieties regarding informing partners of a difference, impacted sexual activity, and concerns about heritability. Finally, the potential for partner support and acceptance to positively impact romantic relationships was recognised. This research highlighted the need to extend our understanding of visible difference and intimate relationships and to develop effective interventions to ameliorate appearance-related concern.

A Cross-Sectional Multicenter Study of Multidimensional Body Image in Adolescents and Adults with Gender Dysphoria Before and After Transition-Related Medical Interventions

Persistent feelings of gender dysphoria (GD) are accompanied by distress and body dissatisfaction in most clinically referred adolescents and adults. Transition-related medical interventions (e.g., puberty suppression, hormones, or surgery) may alleviate body dissatisfaction. The aim of the present cross-sectional study was to compare multidimensional body image across clinically referred adolescents and adults undergoing different transition-related medical interventions. Two clinical samples of adolescents (n = 82) and adults (n = 120) referred to specialized departments of four different transgender health services in Germany participated in the study. In total, 202 individuals from the female-to-male (FtM individuals) and male-to-female (MtF individuals) spectrum aged 14-74 years were included at different stages of their transition. Four scales assessing multidimensional aspects of body image (measured by the Body Image Assessment Questionnaire, FBeK) were compared across three groups: sample, gender, and medical interventions (while controlling for age and treatment duration). The results indicated less favorable body image scores compared with the norm in both adolescents and adults with GD. Individuals who had undergone transition-related medical interventions presented a significantly better body image on two of the four scales. Differences according to gender and age were also present. These findings suggest that medical interventions, especially gender-affirming hormones and surgery, are generally beneficial to the body image in individuals with GD. However, not all of the less favorable outcomes in multidimensional body image were positively influenced by the treatment conditions and may thus benefit from additional integrative counseling before and during transition.

The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years

OBJECTIVE

The aim of this study was to examine the relative importance of dissatisfaction, overvaluation, and preoccupation with body weight and shape in predicting increases in disordered eating behaviors and depressive symptoms from adolescence through to early adulthood.

METHOD

The study involved 1,830 participants (60% female) who completed the Project EAT survey during adolescence (mean age = 14.90 years, SD = 1.65 years) and again, 15 years later, in early adulthood. Participants provided assessments of dissatisfaction, overvaluation and preoccupation with weight and shape, as well as disordered eating and depressive symptoms at both time points.

RESULTS

The three aspects of body image had distinct patterns of association with the outcomes both concurrently and longitudinally. Dissatisfaction predicted depressive symptoms as well as a wide range of disordered eating outcomes, including dieting, unhealthy weight control behaviors (UWCBs), and binge eating, particularly in female participants. Preoccupation was associated with all of these disordered eating behaviors (but not with depressive symptoms) and was notably the strongest predictor of dieting and UWCBs in female participants. Overvaluation was associated with both disordered eating and depressive symptoms, although typically was a less potent predictor of difficulties than the other aspects of body image.

DISCUSSION

Dissatisfaction, overvaluation, and preoccupation are related but make distinct contributions to clinically significant outcomes. Models of eating disorders should move beyond focusing exclusively on dissatisfaction or overvaluation toward a broader conceptualisation of body image. Findings from this study particularly suggest the importance of considering preoccupation with weight and shape.

Factor structure and psychometric properties of the Body Appreciation Scale-2 among adolescents and young adults in Danish, Portuguese, and Swedish

In recent years, the study of body image shifted from focusing on the negative aspects to a more extensive view of body image. The present study seeks to validate a measure of positive body image, the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a) in Denmark, Portugal, and Sweden. Participants (N = 1012) were adolescents and young adults aged from 12 to 19. Confirmatory factor analyses confirmed the one-dimensional factor structure of the scale. Multi-group confirmatory factor analyses indicated that the scale was invariant across sex and country. Further results showed that BAS-2 was positively correlated with self-esteem, psychological well-being, and intuitive eating. It was negatively correlated with BMI among boys and girls in Portugal but not in Denmark and Sweden. Additionally, boys had higher body appreciation than girls. Results indicated that the BAS-2 has good psychometric properties in the three languages.

"Who does this body belong to?" The development and psychometric evaluation of the Body Experience during Pregnancy Scale

Women's experiences of their bodies during pregnancy may reflect their reactions to concrete physical changes as well as self-representations during the transition to motherhood. However, adequate measures of the body experience during pregnancy are lacking. This study aims to evaluate the psychometric properties of a new measure, the Body Experience during Pregnancy Scale (BEPS). In Study 1, the BEPS was administered to 423 pregnant women. In Study 2, 373 pregnant women completed the BEPS, as well as questionnaires assessing body shame, disrupted body boundaries, and well-being. Three BEPS subscales emerged from Study 1: body agency, body estrangement, and body visibility. In Study 2, a confirmatory factor analysis replicated the scale's structure. The factors were significantly correlated with measures of body shame, disrupted body boundaries, and well-being. The results of the present analyses suggest that the BEPS has good psychometric properties, making it useful in future research.

Selfie posting and self-esteem among young adult women: A mediation model of positive feedback and body satisfaction

This study examined whether selfie-posting was positively associated with women’s self-esteem and whether this association was mediated by positive feedback and body satisfaction. A sample of 442 Chinese young adult women completed questionnaires on selfie-posting, positive feedback, body satisfaction, and self-esteem. Results indicated that selfie-posting was significantly and positively related to women’s self-esteem. In addition, positive feedback mediated the relation between selfie-posting and women’s self-esteem. Furthermore, the association between selfie-posting and self-esteem was sequentially mediated through positive feedback and body satisfaction. Findings from this study provide new insights into the relation between selfie-posting and self-esteem.

Brazilian Version of the Body Appreciation Scale (BAS) for Young Adolescents

The present study developed a Brazilian adaptation of the BAS for young adolescents, testing its factor structure by the Confirmatory Factor Analysis (CFA), concurrent and criterion validity, and its internal consistency. Participants were 347 adolescents (171 male and 176 female, aged between 10 and 13 years old). Three psychologists experts in psychological evaluation and three teachers of Portuguese of elementary school also participated for the adaptation stage of the items in order to be properly understood by the sample age group. There were few changes from the version culturally adapted for the Brazilian adult population. Cronbach's alpha coefficients were satisfactory for the general population and both sexes (.804; female =.851; male =.752). The one-factor model of the BAS was confirmed by the confirmatory factor analysis with good indicators for the measurements of adjustment to the model, χ2 = 77.9; GFI = 0.967; NFI = 0.940, CFI = 0.979; TLI = 0.968; RMSEA;.038). The convergent validity analyzes revealed significant correlations between BAS scores and BMI (r = -.230; p < .001) and between the first and body image satisfaction (r = .309; p < .001). The BAS version for Brazilian young adolescents had adequate levels of validity and reliability, keeping the one-dimensional structure which indicates its use in Brazilian adolescent's samples.

Psychometric evaluation and sex invariance of the Spanish version of the Body and Appearance Self-Conscious Emotions Scale

This study examined the psychometric properties of a Spanish translation of the Body and Appearance Self-Conscious Emotions Scale (BASES; Castonguay et al., 2014) in a sample of university Spanish students. A total of 815 participants enrolled in two public universities located in Almería and Elche, Spain, completed the BASES along with measures of social physique anxiety and positive/negative affect. Exploratory and confirmatory factor analyses showed that one item failed to load clearly on the hypothesized factor (guilt). Once it was removed, results supported the hypothesized four-factor structure. Evidence of invariance of the four-factor structure across sex was obtained. Scores on the BASES showed adequate internal consistency and acceptable convergent validity. Compared to men, women reported significantly higher body and appearance-related guilt and shame, and significant lower authentic and hubristic pride. Preliminary evidence supporting the validity and reliability of the Spanish translation of the BASES is provided.

Development and exploration of the gratitude model of body appreciation in women

Although researchers and clinicians recognize the importance of positive body image for women's well-being, development of theoretical frameworks for understanding positive body image has not kept pace with research documenting its many benefits. The present study proposed and tested a comprehensive model linking gratitude, contingent self-worth, social comparison, body appreciation, and intuitive eating. Path analysis indicated that this model fit the data for a sample of college and online community women (N = 263). Gratitude was indirectly linked to body appreciation via lower investment in self-worth based on appearance and others' approval, and via lower engagement in eating and body comparison. Gratitude had a strong direct effect on body appreciation, and body appreciation accounted for a large portion (88%) of gratitude's relationship with intuitive eating. These results provide strong preliminary support for the model, revealing that gratitude, which can be improved via intervention, plays a key role in body appreciation.

Appearance Dissatisfaction, Body Appreciation, and Sexual Health in Women Across Adulthood

Risk and protective factors are equally important to the promotion of sexual health. Yet, in body image and sexuality research, most of the focus has been placed on the deleterious effects of appearance dissatisfaction and body mass index (BMI) at the expense of more adaptive dimensions. Furthermore, although age can affect appearance and sexual function, little is known regarding the experience of older women. Therefore, this study was aimed at comparing how positive body image (operationalized as body appreciation) and negative body image (operationalized as appearance dissatisfaction) each contribute to indicators of sexual health when controlling for BMI in a sample of age-varied women. Cross-sectional data were collected online from 215 heterosexual women aged 18-88 years. Results showed that body appreciation was a unique predictor of sexual function, satisfaction, and distress, above and beyond the effect of BMI and appearance dissatisfaction. Body appreciation was not found to fluctuate with age. Further, body appreciation moderated the relationship between age and sexual satisfaction, but not sexual distress. Post hoc analyses showed that high body appreciation may serve as a buffer against age-related changes in sexual satisfaction only in women with clinically significant sexual function difficulties. Increasing body appreciation may be a promising clinical intervention in the treatment of sexual problems in older adult women.

The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students

BACKGROUND

Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating.

METHODS AND DESIGN

Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students' benefits and satisfaction with the programme.

DISCUSSION

The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services.

TRIAL REGISTRATION

The study was registered and released at ClinicalTrials.gov 21th August 2016 with the Clinical Trial.gov ID: PRSNCT02901457 . In addition, the study is approved by the Regional Committee for Medical and Health Research Ethics.

This girl can #jointhemovement: Effectiveness of physical functionality-focused campaigns for women's body satisfaction and exercise intent

We tested the effectiveness of exposure to two functionality-focused media campaigns, This Girl Can and #jointhemovement, in improving state appearance and physical functionality satisfaction, exercise intent, and protecting against exposure to idealised imagery. Across two studies, 339 (M_age=24.94, SD=4.98) and 256 (M_age=26.46, SD=5.50) women viewed the campaign or control video, followed by images of models who were posed or physically active, or images of landscapes. State satisfaction and exercise intent was measured at pre-test, post-video, post-images, and 1-week follow-up. Social comparison was measured at post-images. Viewing either campaign produced higher appearance satisfaction and exercise intentions than the control video. Effects weren't maintained after viewing idealised imagery or 1 week later. Further, the campaigns did not decrease social comparisons when viewing idealised imagery. Results can inform agencies about campaign effectiveness and suggest that women benefit from campaigns that feature non-idealised depictions of women exercising.

Exposure to natural environments, and photographs of natural environments, promotes more positive body image

Five studies were conducted to understand the impact of nature exposure on body image. In three studies using different designs and outcome measures, British university students were exposed to photographs of natural or built environments. Results indicated that exposure to images of natural, but not built, environments resulted in improved state body image. In Study 4, British community participants went on a walk in a natural or built environment, with results indicating that the walk in a natural environment resulted in significantly higher state body appreciation, whereas the walk in a built environment resulted in significantly lower scores. In Study 5, British participants were recruited as they were entering a designed green space on their own volition. Results indicated that spending time in the green space led to improved state body appreciation. These results indicate that exposure to isomorphic or in-situ natural environments has positive effects on state body image.

Associations Between Body Appreciation and Comfort Communicating About Sex: A Brief Report

Communicating about sex with potential or current sex partners can lead to many positive outcomes, including fewer unplanned pregnancies and sexually transmitted infections. Although body image is related to many sexual health behaviors, the association between positive body image and comfort communicating about sex is underexplored. The purpose of the current study is to better understand this relationship among a sample of 399 18- to 25-year-old college women. Results suggest that positive body image, measured by body appreciation, is related to greater comfort communicating about sex with a current sex partner, even after accounting for body mass index (BMI).

The effect of functionality-focused and appearance-focused images of models of mixed body sizes on women's state-oriented body appreciation

Research demonstrates that exposure to appearance-focused images of models depicting societal standards of beauty negatively affect women's state-oriented body dissatisfaction. The purpose of this research was to extend this experimental research to women's state-oriented body appreciation. The 374 women participants were randomly assigned to view images that were either depicting a model who was representative or not representative of the thin ideal (body size), while this model was in either an appearance-focused pose or a function-oriented pose (pose type). State body appreciation increased significantly after viewing images depicting models who did not conform to societal standards of thinness (p<0.001). Exposure to the control condition images, which were images of natural environments, also produced increases in state body appreciation (p=0.049). These findings provide insight into the construct of state body appreciation and offer implications for future positive body image research.

Yoga and body image: Findings from a large population-based study of young adults

This study explored the potential for yoga to promote body satisfaction in a general population of young adults. The sample included 1664 participants (M age: 31.1, SD=1.6years) in Project EAT, a 15-year longitudinal study. Data from the third and fourth waves (EAT-III and EAT-IV), collected five years apart, were utilized. Practicing yoga (≥30min/week) was reported by 16.2% of young adults. After adjusting for EAT-III body satisfaction and body mass index, yoga practitioners had higher concurrent body satisfaction at EAT-IV than those not practicing yoga (difference: 1.5 units [95% CI: 0.1-2.8], p=.03). Among participants within the lowest quartile of prior (EAT-III) body satisfaction, there was preliminary evidence that body satisfaction at EAT-IV was higher among yoga practitioners than in other young adults. Findings suggest that yoga may be associated with improved body satisfaction, particularly among young adults with low prior body satisfaction.

[Body image and low back pain]

BACKGROUND

Many factors seem to be causal for non-specific low back pain and are sometimes controversially discussed. Some years ago the concept of subjective body image attracted attention but due to the inconsistent use of terms and concepts it is difficult to classify publications in the literature. Studies confirmed a difference between the body images of patients with low back pain and healthy controls so that an inclusion of body image concepts could be relevant for causation and therapy.

OBJECTIVE

This article presents an overview of the current state of research on the association between body image and low back pain and with respect to the allocation of body image in psychosocial concepts of low back pain.

MATERIAL AND METHODS

Relevant studies on body image and low back pain were reviewed and are discussed with respect to the different use of terms and concepts of body image. Moreover, an approach for integration of the body image into current psychosocial concepts and therapy of low back pain is presented. Finally, it is discussed whether consideration of the body image could be of value in the therapy of low back pain.

RESULTS

Studies have shown that low back pain patients have a more negative body image compared to healthy controls. There is a lack of studies on clinical evidence for the application and effectiveness of interventions that influence the body image in low back pain.

CONCLUSION

Further studies are necessary which include body image concepts as a possible psychosocial risk factor, in particular studies on the mechanism of body image procedures.

The effectiveness of self-compassion and self-esteem writing tasks in reducing body image concerns

This study investigated whether single-session self-compassion and self-esteem writing tasks ameliorate the body image concerns evoked by a negative body image induction. Ninety-six female university students aged 17-25 years (M_age=19.45, SD=1.84) were randomly assigned to one of three writing treatment groups: self-compassion, self-esteem, or control. After reading a negative body image scenario, participants completed scales measuring state body appreciation, body satisfaction, and appearance anxiety. They then undertook the assigned writing task, and completed the three measures again, both immediately post-treatment and at 2-week follow-up. The self-compassion writing group showed higher post-treatment body appreciation than the self-esteem and control groups, and higher body appreciation than the control group at follow-up. At post-treatment and follow-up, self-compassion and self-esteem writing showed higher body satisfaction than the control. The groups did not differ on appearance anxiety. Writing-based interventions, especially those that enhance self-compassion, may help alleviate certain body image concerns.

How do you define body image? Exploring conceptual gaps in understandings of body image at an exercise facility

The definition of body image has evolved within research; however, less is known about the layperson's understanding of the construct. This study explored how members and student trainees of an exercise facility (designed for older adults, people with physical disability, and those with cardiac complications) defined body image. Nineteen participants completed a one-on-one interview, and seven of those participants took part in six additional focus group meetings. The following main themes were found: stereotypical assumptions about body image (e.g., it is solely a person's weight or merely a woman's issue), body image continua for positive and negative body image, degree of complexity of body image dimensions, broad considerations of body image (e.g., it is self-esteem), and limited knowledge about body image. These findings suggest a need for knowledge translation between researchers and the general public which informs future body image program design.

Positive appearance and functionality reflections can improve body satisfaction but do not protect against idealised media exposure

We tested the effectiveness of a positive appearance or functionality reflective writing task on women's body satisfaction and whether these writing task reflections offered any protective advantage when exposed to idealised imagery. Young adult women (N=230; M_age=23years) wrote about positive elements of either their appearance or their body's functionality, and then were exposed to images of scenery, or thin and attractive models presented in posed or active form. Direction and amount of social comparison were also examined. Women reported immediate gains in both appearance and physical functionality satisfaction regardless of reflection type. However, neither reflection was protective against decreased satisfaction after exposure to idealised images. Greater upward comparison on either appearance or physical functionality domains was related to poorer outcomes. Our reflection task has potential to shift body focus but future research could examine multiple sessions and reflections on a broader range of self-relevant domains.

Factor structure and psychometric properties of a Romanian translation of the Body Appreciation Scale-2

We examined the psychometric properties of a Romanian translation of the 10-item Body Appreciation Scale-2 (BAS-2). A total of 453 university students from Romania completed the BAS-2, along with measures of disordered eating, self-esteem, satisfaction with life, and subjective happiness. In addition, a separate sample of university students (N=109) completed only the BAS-2 at two time-points three weeks apart. Principal-axis factor analysis indicated that BAS-2 scores had a one-dimensional factor structure in both women and men. Confirmatory factor analysis indicated that this factor structure had adequate fit, but invariance across sex was not supported. Further analyses indicated that BAS-2 scores evidenced internal consistency, convergent validity, and test-retest reliability in both women and men. These results suggest that BAS-2 scores reduce to one dimension in Romanian adults, but the lack of sex invariance may indicate that the same latent construct is not being measured in women and men.

Perceptual body image and the relationship with weight control across the adult lifespan by sex in Koreans

Background

This study aimed to investigate perceptual body image and the relationship between perceived body image (PBI) and weight control differentiated according to obesity categories across the adult lifespan by sex among Koreans.

Methods

We analyzed data on 10 198 adults aged 25 or older from the Korean National Health and Nutrition Examination Survey of a nationally representative sample of non-institutionalized Koreans.

Results

Significant discordance between PBI and body mass index (BMI) or waist circumference (WC) was found in all age groups in both sexes, and the discordance for obesity grew more severe with age. Linear associations between PBI and BMI or WC were found in normal weight and obese groups in all age groups in both sexes, with relatively greater BMI or WC differences for PBI found in obese men aged ≤64 or ≤44, respectively, and obese women of all ages or aged ≥75, respectively, compared to normal weight. Obese women aged ≥65 (BMI) or ≥75 (WC) and obese men in the 45-54 and 65-74 age groups (BMI and WC) had significant association between PBI and weight control.

Conclusions

Interventions regarding accurate body size perception should be prioritized for obese women aged ≥65 or ≥75 and for obese men aged 45-54 and 65-74.