People who overvalue appearance selectively attend to descriptors of the attractiveness ideal: Findings from an emotional Stroop task

The correlates of appearance focused self-concept: personality traits, self-concept, sociocultural, and early life experience factors

BACKGROUND

Theory and research indicate that an appearance focused self-concept (i.e., placing overriding importance on physical appearance for self-definition and self-worth) plays a role in the etiology and maintenance of disordered eating and eating disorders. Although the consequences of an appearance focused self-concept are palpable, less is known about its correlates. Accordingly, we examined a range of factors that may characterize appearance focused people, including personality traits (perfectionism, impulsivity, sensation-seeking, hopelessness, and anxiety sensitivity), self-concept (global self-esteem and self-concept clarity), sociocultural (thin-ideal, muscular-ideal, general attractiveness internalizations, and perceived pressure to be thin), and early life experiences (adverse childhood experiences, attachment styles) factors.

METHODS

Female undergraduate university students (N = 568; Mage = 19.58, SDage = 4.24) completed a questionnaire battery that included the Beliefs About Appearance Scale, Depressive Experiences Questionnaire-Self-Criticism-6 Scale, Frost-Multidimensional Perfectionism Scale, the Revised Almost Perfect Scale, Substance Use Risk Profile Scale, Self-Concept Clarity Scale, Rosenberg Self-Esteem Scale, Sociocultural Attitudes Towards Appearance Questionnaire-4 Scale, Adverse Childhood Experiences Questionnaire, Experiences in Close Relationships Scale Short Form, and the Dietary Restraint subscale of the Eating Disorders Examination Questionnaire.

RESULTS

Multiple regression analyses were conducted for each set of factors separately and together. For personality traits, perfectionism, impulsivity, and anxiety sensitivity were uniquely associated with appearance focused self-concept. For self-concept, global self-esteem and self-concept clarity were uniquely associated with appearance focused self-concept. For sociocultural, general attractiveness internalization, thin-ideal internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept. For early life experiences, attachment anxiety and avoidance were uniquely associated with appearance focused self-concept. In the combined analysis, the various factors explained 54% of the variance in appearance focused self-concept. Impulsivity, global self-esteem, general attractiveness internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept.

CONCLUSIONS

Results for global self-esteem were consistent with prior research. Findings for evaluative concerns perfectionism were inconsistent with prior research. We discuss future research directions to examine the link between evaluative concerns perfectionism and appearance focused self-concept. We also discuss how sociocultural factors (general attractiveness internalization and perceived pressure to be thin) and impulsivity may help cultivate an appearance focused self-concept, advancing knowledge on the characteristics of appearance-focused people.

Connecting a health-focused self-concept with orthorexia nervosa symptoms via fear of losing control over eating unhealthy food and disgust for unhealthy food

PURPOSE

Orthorexia nervosa (ON) involves a maladaptive preoccupation with healthy eating through strict dietary rules that negatively affect physical and mental health. Recent evidence suggests that ON symptoms may stem, in part, from having a health-focused self-concept (i.e., overvaluing the importance of health for self-definition and self-worth). Herein, fear of losing control over eating unhealthy foods and disgust for unhealthy foods were examined as potential mediators of the association between health-focused self-concept and ON symptoms.

METHODS

The parallel mediation model was tested using a community sample of people who believe they are currently following a healthy eating diet plan and/or believe they are leading a healthy eating lifestyle (N = 442). Participants were recruited from Amazon's Mechanical Turk and completed a questionnaire battery that included the Health-Focused Self-Concept Scale, questionnaires assessing fear of losing control over eating unhealthy food and disgust with unhealthy food, and the Orthorexia Nervosa Inventory.

RESULTS

As expected, a health-focused self-concept was indirectly and positively associated with ON symptoms via fear and disgust.

CONCLUSION

The findings conceptually replicate and extend prior research on anorexia nervosa supporting the transdiagnostic utility of a focused self-concept, fear of losing control, and disgust across eating disorders.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

A p-curve analysis of the emotional Stroop effect among women with eating disorders

OBJECTIVE

A recent meta-review of attentional bias research in eating disorders suggests that meta-analyses and systematic reviews include many low-quality and underpowered studies (Stott et al., 2021). As such, we examined whether published research examining the link between attentional bias, using the emotional Stroop task, and eating disorders among women with eating disorders has evidential value (ruling out selective reporting of a statistically significant effect) using a p-curve analysis. A p-curve analysis plots statisticall significant p-values onto a curve from .01 to .05 to examine its distribution. We hypothesized that the p-curve would be flat, indicating no true effect.

METHOD

The hypothesis, database search strategy, and data analytic approach were pre-registered. The inclusion criteria were reports that compared control and eating disorder groups, reported inferential statistics, and that used body shape/weight or general threat target words.

RESULTS

Fifty published reports were included in the p-curve analyses. Unexpectedly, the half and full p-curves were significantly right-skewed, indicating evidential value. However, the results were not robust to the exclusion of the seven lowest p-values and on average, reports were underpowered. There were also 18 reports with null results (they had a p-value greater than .05), which precluded their inclusion in the p-curve analyses.

DISCUSSION

The findings suggest that most of the evidence from research examining attentional biases using the emotional Stroop task among women with an eating disorder or with elevated eating disorder symptoms is underpowered and so should be interpreted with considerable caution.

PUBLIC SIGNIFICANCE

Concerns have been raised about the low quality of research examining attentional biases among women with eating disorders using the emotional Stroop task. In the current research, we observed that the evidential value of primary research reporting differences between women with and without eating disorders was equivocal and had low statistical power. These results can guide researchers towards conducting more rigorous research on attentional biases among people with eating disorders.

The association of perfectionism, health-focused self-concept, and erroneous beliefs with orthorexia nervosa symptoms: A moderated mediation model

OBJECTIVE

Orthorexia nervosa (ON) is a putative eating disorder linked to perfectionism among people who eat healthily (or who want to eat healthily). However, little is known about the process by which perfectionism fosters ON symptoms. Like the Transdiagnostic Cognitive-Behavioral Theory of Eating Disorders, we hypothesized that perfectionism among people who eat healthily (or who want to eat healthily) fosters ON symptoms indirectly by cultivating a health-focused self-concept (i.e., placing overriding importance on health for self-definition and self-worth). We also hypothesized that a health-focused self-concept would be associated with ON symptoms among people who have erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies.

METHOD

To test this moderated mediation model, a sample of people following a healthy eating diet plan and/or who believe they are leading a healthy eating lifestyle (N = 456) were recruited from Amazon's Mechanical Turk and completed measures that assessed perfectionism, health-focused self-concept, ON symptoms, and erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies. They also completed a measure of appearance-focused self-concept.

RESULTS

Health-focused and appearance-focused self-concepts were empirically distinct. As expected, perfectionism was indirectly and positively associated with ON symptoms via a health-focused self-concept. Importantly, the indirect association was only observed among participants high, but not low, in erroneous beliefs.

DISCUSSION

The findings support the role of perfectionism in ON. The findings also advance knowledge by identifying a health-focused self-concept and erroneous beliefs as potential factors in the etiology and maintenance of ON.

Perfectionism predicts disordered eating and gambling via focused self-concept among those high in erroneous beliefs about their disordered behavior

BACKGROUND AND AIMS

Perfectionism, a focused self-concept, and erroneous beliefs have been implicated in the development and maintenance of various disordered behaviors. However, researchers have yet to examine how these factors combine to explain different disordered behaviors. Herein, we addressed this gap and hypothesized a moderated-mediation model whereby perfectionism fosters the development of disordered behaviors through a focused self-concept. Critically, the effect of a focused self-concept on disordered behaviors is specific to people with erroneous beliefs about their disordered behaviors. The model was tested in the contexts of disordered gambling and disordered eating, particularly dietary restraint.

METHOD

In Study 1, participants were community members who gamble (N = 259). In Study 2, participants were university women (N = 219). In both studies, participants completed self-report measures of all constructs that are both reliable and valid.

RESULTS

In Study 1, as expected, there was a positive association between perfectionism and disordered gambling, which was mediated by financially focused self-concept. This mediation was only observed among participants who scored high on illusion of control and belief in luck. Likewise, in Study 2, there was a positive association between perfectionism and dietary restraint, which was mediated by appearance focused self-concept. The mediation effect was only observed among participants who believed that maladaptive dietary restraint behaviors were safe and efficacious.

DISCUSSION AND CONCLUSIONS

The findings support the transdiagnostic utility of our model, which may help explain an array of disordered behaviors, including other addictive behaviors as well as behaviors that involve rigid adherence to rules and control.

Attentional bias in eating disorders: A meta-review

OBJECTIVE

This meta-review summarizes and synthesizes the most reliable findings regarding attentional bias in eating disorders across paradigms and stimulus types and considers implications for theory and future research.

METHOD

Four databases were systematically searched, along with reference lists of included reviews, yielding 15 systematic reviews (four of which were also meta-analyses). The quality of each review was appraised using the AMSTAR-2.

RESULTS

Key findings from systematic reviews are summarized, organized by paradigm and stimulus type.

DISCUSSION

The authors synthesize evidence from the highest-quality studies. There is evidence for attentional avoidance and vigilance in eating disorders depending on stimulus properties (low vs. high-calorie food; high-body mass vs. low-body mass index photos of others) and attentional avoidance of food stimuli in those with anorexia nervosa. Sad mood induction may generate attentional bias for food in those with binge-eating disorder. There may also be attentional bias to general threat in eating disorder samples. This meta-review concludes that most systematic reviews in this field are low in quality and summarizes the main areas that could be improved upon in future reviews. Implications of this study's findings for theory and intervention research are also discussed.