Sociocultural factors in the development of bulimia nervosa in a blind woman: a case report

Self-Esteem and Coping Styles in Polish Youths with and Without Visual Impairments

Introduction:

The aim of this study was to compare self-esteem and coping styles in youths with and without visual impairments (i.e., blindness or low vision) and to explore relationships between self-esteem and coping styles.

Methods:

The participants were students of secondary schools in Poland: 50 with visual impairments (23 females) and 50 typically sighted (21 females). Self-esteem and coping styles were measured with the following questionnaires: Multidimensional Self-Esteem Inventory, by O’Brien and Epstein, in Polish adaptation by Fecenec and Coping Inventory for Stressful Situations, by Endler and Parker, in Polish adaptation by Strelau, Jaworowska, Wrześniewski, and Szczepaniak.

Results:

There were no group differences in global self-esteem nor in the majority of self-esteem domains excepting moral self-approval, in which the group with visual impairments scored higher than did their sighted peers. Females with visual impairments reported lower self-esteem related to body appearance than control females and males with visual impairments. There were no group differences in coping styles. Moral self-approval and self-esteem in the domain of body functioning served as predictors of an avoidance coping style.

Discussion:

Self-esteem seems to be influenced by both gender and visual impairment. The absence of differences in global self-esteem between groups with and without visual disabilities may be a result of access to rehabilitation, professional support, and education in the group with visual impairment. Body appearance seems to be a particularly important aspect of self-esteem for females with visual impairments, who scored lower than the other groups.

Implications for practitioners:

The results show the need to provide specialized psychological support to females with visual impairments aimed at developing positive body image. Further studies on factors influencing self-esteem and coping styles among youths with visual impairments could enable practitioners to better understand how to support them in coping with everyday stress.

Implicações da Cegueira Congênita na Imagem Corporal: Uma Revisão Integrativa

RESUMO Este estudo objetiva investigar, por meio de uma revisão integrativa, as principais implicações da cegueira congênita na imagem corporal. Um processo de buscas de artigos, sem limite de data de publicação, com os descritores “congenital blindness” e “congenitally blind”, nas bases SCOPUS, PsycINFO, Web of Science e PubMed, foi utilizado. Dentre as 3.612 publicações identificadas, 20 foram analisadas. Discutiu-se as implicações da cegueira em cinco áreas distintas: transtorno alimentar, representação do self, insatisfação corporal, experiência corporal e representação neural de autoconceito. Concluiu-se ser fundamental valorizar um complexo conjunto de fatores psicossociais no desenvolvimento da pessoa com cegueira congênita, que poderia impactar de modo positivo ou negativo a formação da imagem corporal.

Low Energy Availability, Menstrual Dysfunction, and Low Bone Mineral Density in Individuals with a Disability: Implications for the Para Athlete Population

Low energy availability, functional hypothalamic amenorrhea, and low bone mineral density are three interrelated conditions described in athletic women. Although described as the female athlete triad (Triad), males experience similar health concerns. The literature suggests that individuals with a disability may experience altered physiology related to these three conditions when compared with the able-bodied population. The goal of this review is to describe the unique implications of low energy availability, low bone mineral density, and, in females, menstrual dysfunction in individuals with a disability and their potential impact on the para athlete population. A literature review was performed linking search terms related to the three conditions with six disability categories that are most represented in para sport. Few articles were found that directly pertained to athletes, therefore, the review additionally characterizes literature found in a non-athlete population. Review of the available literature in athletes suggests that both male and female athletes with spinal cord injury demonstrate risk factors for low energy availability. Bone mineral density may also show improvements for wheelchair athletes or athletes with hemiplegic cerebral palsy when compared with a disabled non-athlete population. However, the prevalence of the three conditions and implications on the health of para athletes is largely unknown and represents a key gap in the sports medicine literature. As participation in para sport continues to increase, further research is needed to understand the impact of these three interrelated health concerns for athletes with a disability, accompanied by educational initiatives targeting athletes, coaches, and health professionals.

Eating Attitudes of Women Living With a Vision Impairment

Internalization of cultural standards of attractiveness and subscription to gender-based discourses are significant predictors of disordered eating attitudes in fully sighted women. Yet, whether these variables predict the disordered eating attitudes of women who are legally blind is underexplored. In the current study, we examined how internalization of White European cultural standards of attractiveness and subscription to gender-based discourses (body surveillance and self-silencing) and body shame predicted the disordered eating attitudes of 80, primarily White, heterosexual, Australian women who are legally blind. Participants completed an online survey comprising existing validated measures of all variables. A path analysis was performed using the Hayes PROCESS approach. As predicted, in women living with vision impairment, body surveillance, self-silencing, and shame fully mediated the relation between internalization of cultural standards of attractiveness and disordered eating attitudes. Results showed that in much the same way as sighted women, women living with vision impairment are susceptible to internalizing harmful messages related to socio-cultural standards of attractiveness. We provide further support for including subscription to gender-based discourses in research on women’s body-image disturbances. Data will be available for other researchers from the author via email. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index

Development and validation of the self-acceptance scale for persons with early blindness: the SAS-EB

Investigations of self-acceptance are critical to understanding the development and maintenance of psychological health. However, valid and reliable instruments for measuring self-acceptance in persons with early blindness have yet to be developed. The current research describes three studies designed to develop and validate the Self-acceptance Scale for Persons with Early Blindness (SAS-EB). In Study 1, we developed the initial item pool. Thirty-three items were generated, based on data from specialized literature and from 2 focus groups. Items were organized in a three-factor structure, theoretically predicted for SAS-EB - (1) body acceptance, (2) self-protection from social stigmas, and (3) feeling and believing in one's capacities. In Study 2, information obtained from a panel of 9 experts and 22 persons with early blindness representing the target population was used to refine the initial item pool, generating a new pool of 27 items. In Study 3, 318 persons with early blindness (141 women and 177 men), between 18 and 60 years of age (M = 37.74 years, SD = 12.37) answered the new pool of 27 items. After the elimination of 9 items using confirmatory factor analysis, we confirmed the theoretical three-factor structure of the SAS-EB. Study 3 also provided support for the scale's internal consistency and construct validity. Finally, the psychometric properties of the SAS-EB, its utility, and its limitations are discussed along with considerations for future research.

Body image among eating disorder patients with disabilities: a review of published case studies

While individual cases of eating disorder (ED) patients with disabilities have been reported, there has been little synthesis of their experiences of body image and thin idealization. This study reviews 19 published clinical reports of ED patients with sensory, mobility-related, or intellectual disabilities and evaluates the extent to which their experiences align with or challenge current conceptions of body image in ED. ED patients with visual impairment reported a profound disturbance of body image, perceived intersubjectively and through tactile sensations. Reducing dependence in mobility was an important motivation to control body size for ED patients with mobility-related disabilities. ED as a way of coping with and compensating for the psychosocial consequences of disability was a recurrent theme for patients across a range of disabilities. These experiential accounts of ED patients with disabilities broaden current understandings of body image to include touch and kinaesthetic awareness, intersubjective dynamics, and perceptions of normalcy.