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Rekkers ME, Aardenburg L, Scheffers M, van Elburg AA, van Busschbach JT. Shifting the Focus: A Pilot Study on the Effects of Positive Body Exposure on Body Satisfaction, Body Attitude, Eating Pathology and Depressive Symptoms in Female Patients with Eating Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11794. [PMID: 36142068 PMCID: PMC9517204 DOI: 10.3390/ijerph191811794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
One of the most commonly used techniques for the treatment of body image problems in eating disorders (ED) is body exposure (BE). However, evidence of its effectiveness in clinical populations is scarce. In the Positive Body Experience (PBE) protocol, the focus of positive BE is on aesthetic, functional and tactile aspects of the body. The current study evaluates the outcomes of positive BE with regard to changes in attitudinal body image and eating pathology, as well as the factors that influence these changes, in a sample of 84 adult female patients with different EDs who did not receive any other treatment for their EDs during the period in which BE treatment occurred. The results show significant positive changes in attitudinal body image, ED behaviors and depressive symptoms, with depressive symptoms at baseline mediating the changes in attitudinal body image. This study indicates that the PBE protocol is a suitable intervention for reducing negative attitudinal body image in anorexia and bulimia nervosa patients, as well as those with binge eating disorder. Furthermore, the results suggest that positive non-weight-related and functional body satisfaction are strong catalysts for change and that depressive symptoms play an important role in the ability to change. Additional RCTs are needed to gain more insight into the effects of PBE.
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Affiliation(s)
- Marlies E. Rekkers
- Faculty of Social Sciences, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
| | - Lisanne Aardenburg
- GGZ inGeest, Mental Health Institute, Laan van de Helende Meesters 433, 1186 DL Amstelveen, The Netherlands
| | - Mia Scheffers
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
| | - Annemarie A. van Elburg
- Faculty of Social Sciences, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
- Rintveld, Centre for Eating Disorders, Altrecht Mental Health Institute, 3705 WE Zeist, The Netherlands
| | - Jooske T. van Busschbach
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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Petrovics P, Nagy A, Sandor B, Palfi A, Szekeres Z, Toth K, Szabados E. Examination of Self-Esteem, Body Image, Eating Attitudes and Cardiorespiratory Performance in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413172. [PMID: 34948781 PMCID: PMC8701836 DOI: 10.3390/ijerph182413172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 11/24/2022]
Abstract
Self-esteem, body image and eating attitudes are important characteristics regarding adolescent mental health. In our present work, we aimed to investigate these psychological items in adolescent boys and girls examining gender differences and correlations with the BMI-for-age and cardiorespiratory performance. 374 students (209 girls with an average age of 16.4 ± 1.08 years, and 165 boys with an average age of 16.5 ± 1.03 years) underwent investigation using the Rosenberg self-esteem scale, EAT-26 and BAT questionnaires. The BMI-for-age was calculated with BMI growth charts and the cardiorespiratory performance was measured with the 20 m shuttle run test. Our results showed that adolescent girls scored lower self-esteem and higher values for BAT and each scale of eating behaviors, such as uncontrolled eating, cognitive restraints and emotional eating compared to boys despite the fact, that obesity and overweight were more common among boys. No significant correlation was found between BMI and psychological test results in either boys or girls, however, subjective body shape and gender predicted self-esteem and BAT scores and the cognitive restraints in the eating attitudes. Uncontrolled and emotional eating were primarily influenced by gender, in which BMI played only a weaker role. Cardiorespiratory performance was positively associated with self-esteem and body image among boys, and it had a negative correlation regarding BMI in both genders.
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Affiliation(s)
- Peter Petrovics
- Institute of Physical Education and Sport Sciences, Faculty of Sciences, University of Pecs, H-7624 Pecs, Hungary;
| | - Alexandra Nagy
- State Hospital for Cardiology, H-8230 Balatonfüred, Hungary;
| | - Barbara Sandor
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Anita Palfi
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Zsolt Szekeres
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
| | - Kalman Toth
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, H-7624 Pecs, Hungary;
| | - Eszter Szabados
- Division of Preventive Cardiology and Rehabilitation, 1st Department of Medicine, Medical School, University of Pecs, H-7623 Pecs, Hungary; (B.S.); (A.P.); (Z.S.)
- Correspondence:
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Godoy-Izquierdo D, Díaz I. Inhabiting the Body(ies) in Female Soccer Players: The Protective Role of Positive Body Image. Front Psychol 2021; 12:718836. [PMID: 34630229 PMCID: PMC8497972 DOI: 10.3389/fpsyg.2021.718836] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
In a social and sports world dominated by weight-centred beliefs and highly exigent and gendered athletic and beauty body standards, the vulnerability for eating pathology, i.e., disordered eating and eating disorders (EDs), is elevated among women athletes. The aim of this study was to explore body image facets and ED risk among female athletes in masculinised sports such as soccer. Forty-five federated amateur female soccer players from Spain participated in this study, voluntarily complying with an extensive evaluation protocol on attitudes towards body and appearance and eating practises. The participants overall reported self-representations of their bodies that corresponded to their reality as athletes, but their body ideals were also more demanding in terms of low fat and muscularity, in association with the functionality of their body and the physical demands of their athletic activity. Despite having a fairly high positive body image and body satisfaction, they also expressed negative attitudes towards their bodies. Around 2 out of 10 players were at risk of suffering from an ED. Players with negative attitudes towards their bodies had an odd 12 times likely to develop an ED compared to those with lower self-devaluation, after adjusting for BMI and body perceptions (OR = 12.3, p < 0.01). On the contrary, players who appreciate their bodies and hold a positive body image had an odd 83% lower to suffer from eating pathology, after adjusting for BMI and body satisfaction (OR = 0.17, p < 0.05). Our findings support the healthy and protective role of positive body image in sports contexts. Body attitudes should be addressed in preventive and therapeutic efforts for reducing the prevalence of EDs in women's sports, within both a "negative" and a "positive" paradigm of body image.
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Affiliation(s)
- Débora Godoy-Izquierdo
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain.,Women's and Gender Studies Research Institute, University of Granada, Granada, Spain
| | - Isabel Díaz
- Gimbernat-Cantabria Research Unit (Servicio Universitario de Investigación Gimbernat-Cantabria), University School Gimbernat-Cantabria, University of Cantabria, Torrelavega, Spain
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Kling J, Kwakkenbos L, Diedrichs PC, Rumsey N, Frisén A, Brandão MP, Silva AG, Dooley B, Rodgers RF, Fitzgerald A. Systematic review of body image measures. Body Image 2019; 30:170-211. [PMID: 31394462 DOI: 10.1016/j.bodyim.2019.06.006] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 01/09/2023]
Abstract
This systematic review synthesizes and critically appraises measurement properties of influential body image measures. Eight measures that met the definition of an assessment of body image (i.e., an individual's cognitive or affective evaluation of their body or appearance with a positive or negative valence), and scored high on systematic expert priority ranking, were included. These measures were: the Body Appreciation Scale (original BAS and BAS-2), the Body Esteem Scale for Adolescents and Adults, the Body Shape Questionnaire, the Centre for Appearance Research Valence Scale, the Drive for Muscularity Scale, two subscales of the Eating Disorders Examination Questionnaire, one subscale of the Eating Disorder Inventory 3, and two subscales of the Multidimensional Body Relations Questionnaire. Articles assessing these scales' psychometric properties (N = 136) were evaluated for their methodological quality using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist, and a best evidence synthesis was performed. The results supported the majority of measures in terms of reliability and validity; however, suitability varied across populations, and some measurement properties were insufficiently evaluated. The measures are discussed in detail, including recommendations for their future use in research and clinical practice.
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Affiliation(s)
- Johanna Kling
- Department of Psychology, University of Gothenburg, Box 500, 405 30 Gothenburg, Sweden.
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Postbus 9104, 6500, Nijmegen, the Netherlands.
| | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS161QY, UK.
| | - Nichola Rumsey
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS161QY, UK.
| | - Ann Frisén
- Department of Psychology, University of Gothenburg, Box 500, 405 30 Gothenburg, Sweden.
| | - Maria Piedade Brandão
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Cintesis, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Cintesis, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
| | - Barbara Dooley
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.
| | - Amanda Fitzgerald
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland.
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Scheffers M, van Duijn MAJ, Bosscher RJ, Wiersma D, Schoevers RA, van Busschbach JT. Psychometric properties of the Dresden Body Image Questionnaire: A multiple-group confirmatory factor analysis across sex and age in a Dutch non-clinical sample. PLoS One 2017; 12:e0181908. [PMID: 28746387 PMCID: PMC5528876 DOI: 10.1371/journal.pone.0181908] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 07/10/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Body image has implications for psychosocial functioning and quality of life and its disturbance is reported in a broad range of psychiatric disorders. In view of the lack of instruments in Dutch measuring body image as a broad concept, we set out to make an instrument available that reflects the multidimensional character of this construct by including more dimensions than physical appearance. The Dresden Körperbildfragebogen (DBIQ, Dresden Body Image Questionnaire) particularly served this purpose. The DBIQ consists of 35 items and five subscales: body acceptance, sexual fulfillment, physical contact, vitality, and self-aggrandizement. The main objective of the present study was to evaluate the psychometric properties of the Dutch translation of the Dresden Body Image Questionnaire (DBIQ-NL) in a non-clinical sample. METHODS The psychometric properties of the DBIQ-NL were examined in a non-clinical sample of 988 respondents aged between 18 and 65. We investigated the subscales' internal consistency and test-retest reliability. In order to establish construct validity we evaluated the association with a related construct, body cathexis, and with indices of self-esteem and psychological wellbeing. The factor structure of the DBIQ-NL was examined via confirmatory factor analysis (CFA). The equivalence of the measurement model across sex and age was evaluated by multiplegroup confirmatory factor analyses. RESULTS Confirmatory factor analyses showed a structure in accordance with the original scale, where model fit was improved significantly by moving one item to another subscale. Multiple group confirmatory factor analysis across sex and age demonstrated partial strong invariance. Internal consistency was good with little overlap between the subscales. Temporal reliability and construct validity were satisfactory. CONCLUSION Results indicate that the DBIQ-NL is a reliable and valid instrument for non-clinical subjects. This provides a sound basis for further investigation of the DBIQ-NL in a clinical sample.
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Affiliation(s)
- Mia Scheffers
- Windesheim University of Applied Sciences, School of Human Movement and Education, Zwolle, The Netherlands
- * E-mail:
| | | | - Ruud J. Bosscher
- Windesheim University of Applied Sciences, School of Human Movement and Education, Zwolle, The Netherlands
| | - Durk Wiersma
- University of Groningen, University Medical Center, Rob Giel Research Centre, Groningen, The Netherlands
| | - Robert A. Schoevers
- University of Groningen, University Medical Center, Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Jooske T. van Busschbach
- Windesheim University of Applied Sciences, School of Human Movement and Education, Zwolle, The Netherlands
- University of Groningen, University Medical Center, Rob Giel Research Centre, Groningen, The Netherlands
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Wyssen A, Bryjova J, Meyer AH, Munsch S. A model of disturbed eating behavior in men: The role of body dissatisfaction, emotion dysregulation and cognitive distortions. Psychiatry Res 2016; 246:9-15. [PMID: 27639817 DOI: 10.1016/j.psychres.2016.09.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 09/07/2016] [Accepted: 09/08/2016] [Indexed: 10/21/2022]
Abstract
Comprehensive models, targeting the development of eating disorders (EDs) in males, often employ a sociocultural perspective and empathize the importance of body dissatisfaction (BD). To further illuminate psychological factors contributing to the development of ED pathology, we propose a mediator model of disturbed eating and compensatory behavior (DECB) for men. This model suggests that emotion dysregulation and the susceptibility to body-related cognitive distortions (thought-shape fusion, TSF) mediate the relationship between BD and DECB. Based on data from a cross-sectional online-survey we tested our model in a non-clinical community sample of young men (N=123, 18-37 years). We found a significant positive association between BD and DECB, accounting for participant's body mass index (BMI), age and depressive symptoms. While TSF partially mediated the relationship between BD and DECB, we did not detect a corresponding effect for emotion dysregulation. Based on our findings, we concluded that TSF, which describes specific distorted cognitions with respect to one's own body triggered by fattening/ forbidden food, contributes to the pathological eating- and body-related behavior in men who are dissatisfied with their body. We suggest that TSF should be included in etiological models as a relevant aspect of cognitive information processing with emotional and behavioral consequences.
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Affiliation(s)
- Andrea Wyssen
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue de Faucigny 2, 1700 Fribourg, Switzerland.
| | - Jana Bryjova
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue de Faucigny 2, 1700 Fribourg, Switzerland.
| | - Andrea Hans Meyer
- Institute of Psychology, Department of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 62A, 4055 Basel, Switzerland.
| | - Simone Munsch
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue de Faucigny 2, 1700 Fribourg, Switzerland.
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Probst M, Majeweski M, Albertsen M, Catalan-Matamoros D, Danielsen M, De Herdt A, Duskova Zakova H, Fabricius S, Joern C, Kjölstad G, Patovirta M, Philip-Rafferty S, Tyyskä E, Vancampfort D. Physiotherapy for patients with anorexia nervosa. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/21662630.2013.798562] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Geerdens C, Vanderlinden J, Pieters G, De Herdt A, Probst M. Missing data in long-term follow-up of patients with eating disorders using the body attitude test. EUROPEAN EATING DISORDERS REVIEW 2012; 21:224-9. [PMID: 23055244 DOI: 10.1002/erv.2205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Incompleteness of data is a major problem within clinical follow-up studies. The aim of present study was to compare different statistical models in the management of follow-up data in patients with eating disorders using the Body Attitude Test. METHOD A prospective longitudinal investigation with repeated evaluations over fixed time intervals was conducted among 807 female patients with eating disorders using the Body Attitude Test as a dependent-variable. Three types of missing data mechanisms were explored: missing completely at random, missing at random and missing not at random. RESULTS Multivariate analysis showed that the missing completely at random type of missing data mechanism is less reliable than the missing at random or missing not at random mechanisms. Five years after admission, the body experience of eating disorder patients is less deviant. Compared with normative data, 37% of the eating disorder patients still had a more negative body experience 5 years after admission. DISCUSSION There is no single correct method for dealing with missing data. Therefore, it is recommended that multiple methods be used under different assumptions of absenteeism.
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Affiliation(s)
- Candida Geerdens
- Interuniversity for Biostatistics and statistical Bioinformatics, Universiteit Hasselt, Belgium
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Czeglédi E, Urbán R, Csizmadia P. Measuring body image: Psychometric properties and construct validity of the Hungarian version of Body Attitude Test. ACTA ACUST UNITED AC 2010. [DOI: 10.1556/mpszle.65.2010.3.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A Testi Attitűdök Tesztje (BAT) hazánkban is széles körben alkalmazott mérőeszköz, tudomásunk szerint azonban mindeddig nem történt meg a kérdőív magyar változatának nagyobb mintán végzett, széles körű pszichometriai elemzése. Vizsgálatunk ezt tűzte ki célul. Keresztmetszeti, kérdőíves kutatásunk résztvevői normális súlyú egyetemi hallgatónők, valamint egy munkahelyi életmód-változtató program női résztvevői voltak. Az adatgyűjtés során az alábbi mérőeszközöket használtuk: Testi Attitűdök Tesztje, Emberalakrajzok Tesztje, Rosenberg Önértékelési skála, Vonásszorongás skála. A konfirmatív faktorelemzés eredményei szerint a BAT belső struktúrája elfogadhatóan illeszkedik a vizsgált mintákon aProbst, Vandereyckenés munkatársai (1995) által evészavarban szenvedő nőkön azonosított faktorstruktúrához. A mérőeszköz megbízhatóságának mutatói (belső megbízhatóság, teszt-reteszt reliabilitás) kiválónak bizonyultak. A kérdőív konstruktum validitása is alátámasztást nyert. A kritérium validitást alátámasztják a testtömeg-indexszel és a saját alak méretének szubjektív megítélésével való pozitív korrelációk. A konvergens validitást pedig alátámasztja, hogy a kérdőív és alskálái egyaránt pozitív irányú kapcsolatot mutatnak a testképpel való elégedetlenség egy további mutatójával (nevezetesen az alakra vonatkozó én-énideál diszkrepanciával), valamint a vonásszorongással. A kedvezőtlen testi attitűdök és élmények emellett negatív irányú kapcsolatot mutatnak az önértékeléssel.
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Affiliation(s)
- Edit Czeglédi
- 1 ELTE PPK Pszichológiai Intézet, Személyiség- és Egészségpszichológiai Tanszék
| | - Róbert Urbán
- 1 ELTE PPK Pszichológiai Intézet, Személyiség- és Egészségpszichológiai Tanszék
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