Obsessive–Compulsive Symptoms and Body Checking in Women and Men

Body checking and avoidance among dancers

Dancers are at heightened risk for eating disorders (EDs) and have job and training demands that obscure ED assessment and likely impede treatment. Two behavioral manifestations of ED psychopathology that may present uniquely in a dance environment are body checking and body avoidance. The current study sought to provide a foundational understanding of the phenomenology of body checking and avoidance among dancers by assessing the reliability (i.e., internal consistency) of existing body checking and avoidance measures and the relationships, or convergent validity, between measures of body checking and avoidance and measures of related constructs. Eighty professional and pre-professional (i.e., conservatory level) dancers (78.8 % female) from seven dance genres completed self-report measures of body checking and avoidance, ED pathology, clinical perfectionism, depression, and anxiety. Across the dancer sample, body checking and avoidance measures demonstrated adequate internal consistency. More frequent body checking and body avoidance was strongly related to higher levels of ED pathology. There were moderate to strong correlations between body checking and body avoidance and clinical perfectionism, depression, and anxiety such that higher body checking and body avoidance was related to higher clinical perfectionism, depression, and anxiety. Exploratory analyses found no significant differences between ballet dancers and dancers of other dance genres; professional dancers scored in the normative range on measures of body checking and body avoidance. Dancers' qualitative descriptions of body checking and avoidance revealed behaviors not included in existing questionnaires, such as unique mirror use behaviors, technology-assisted body checking, and the checking and avoidance of body parts relevant to the dance-specific body ideal. Results support the inclusion of body checking and avoidance interventions in ED treatments for dancers (particularly pre-professional dancers) and emphasize the need for dancer-specific ED assessment methods.

A longitudinal examination of body-checking behaviors and eating disorder pathology in a community sample of adolescent males and females

OBJECTIVE

Related to the cognitive-behavioral theory of eating disorders, body checking has gained increasing recognition as both a maintaining factor for eating disorders and an important target for treatment. However, it is unclear whether body-checking behaviors contribute to the development of disordered eating, or if these behaviors develop as a response to experiencing eating disorder thoughts and behaviors. This study aims to examine the relationships between body-checking behaviors and eating disordered thoughts and behaviors in adolescent females and males in the community over time.

METHODS

Participants included 238 adolescents (n = 104 males, n = 134 females, M_age = 16.5 years) recruited from high schools in British Columbia, Canada, who completed the Eating Disorder Examination Questionnaire and Body Checking Questionnaire at baseline (T1) and again approximately 4 months later (T2).

RESULTS

After controlling for baseline levels of eating pathology and body mass index (BMI), body checking at T1 predicted increases in eating pathology for both males and females. In contrast, after controlling for baseline levels of body checking and BMI, eating pathology at T1 did not predict changes in body checking for females, but it did for males. Findings suggest that, among adolescents, engaging in body-checking behaviors may increase risk for disordered eating.

DISCUSSION

If supported by further research, targeting body-checking behaviors in prevention programs may be warranted.

Gender Differences in Affective and Evaluative Responses to Experimentally Induced Body Checking of Positively and Negatively Valenced Body Parts

Body checking (BC) is defined as behavior aimed at gaining information on body shape, size, or weight. Besides its occurrence as a transdiagnostic symptom in eating disorders (EDs), BC is widespread in non-clinical populations. It is associated with body dissatisfaction and the development of body image disturbances and ED. Males and females differ in terms of body dissatisfaction and associated BC strategies. However, the question of a gender-related intensity of negative affect and state body satisfaction as reactions to BC remains open. Therefore, the present experimental study aimed to examine gender differences in affective and evaluative responses to BC. We tested n = 60 women and n = 60 men in a crossover design, implementing two experimental conditions and one control condition. In the negative body checking condition (NBC), participants received standardized instructions to check negatively valenced body parts. In the positive body checking condition (PBC), by contrast, participants were asked to check positively valenced body parts. The control condition (CBC) consisted of playing a computer game. Before and after checking of one’s own body, participants rated negative body-related affect, i.e., guilt, shame, and disgust, and state body satisfaction. The results indicate that both NBC and PBC led to an increase in negative affect for men and women. Eating pathology predicted negative affect after checking in NBC for both genders. Men reported a significantly higher state body satisfaction in all conditions, whereas only women showed decreased body satisfaction in NBC. These findings suggest that BC of any body part (i.e., positively or negatively valenced) leads to increased negative affect for both genders. Eating pathology significantly influences the affective responses to BC for both genders. Changes in state body satisfaction, however, only occur in females. An explanation might be that men generally report higher body satisfaction, resulting in a more stable body image. Females and males with pathological eating behavior seem to be more vulnerable to changes in negative affect. As negative affect is equally increased after NBC and PBC for both genders, BC might play a central role in the maintenance of body image disturbances in males and females.

Affect and worry during a checking episode: A comparison of individuals with symptoms of obsessive-compulsive disorder, anorexia nervosa, bulimia nervosa, body dysmorphic disorder, illness anxiety disorder, and panic disorder

Checking behavior (CB) occurs in a variety of disorders such as obsessive-compulsive (OCD), body dysmorphic (BDD), illness anxiety (IA), and panic disorder (PD), as well as anorexia (AN) and bulimia nervosa (BN). Etiological models of these disorders - with the exception of those for PD - postulate that CB mainly occurs in situations characterized by negative affect and serves to regulate it. We aimed to test these assumptions: N = 386 individuals with a self-reported diagnosis of one of the disorders rated their affect at baseline, directly before a remembered CB episode, during, immediately afterwards, and 15 and 60 minutes afterwards, and rated their endorsement of different functions of CB. The results show that transdiagnostically negative affect is significantly higher before CB compared to baseline, and is significantly reduced from before CB to all post-CB assessments. Reduction of negative affect and Attainment of certainty were the sole functions predicting the affective course during CB, and most prominently reported transdiagnostically. Assumptions of the etiological models were confirmed, suggesting that exposure and ritual prevention should be examined across disorders. As attainment of certainty seems to be predictive for the course of CB, this might be targeted in cognitive interventions.

Dimensions of control and their relation to disordered eating behaviours and obsessive-compulsive symptoms

BACKGROUND

Issues of personal control have been proposed to play a central role in the aetiology and maintenance of eating disorders. Empirical evidence supporting this relationship is inconsistent, partly due to the multiplicity of constructs used to define "control". This study compares six commonly used measures of control with the aim of determining which operationalisation of control is most centrally relevant to eating pathology. Given the high level of comorbidity between eating disorders and obsessive-compulsive disorder and the potentially common risk/maintenance factors for the two disorders, we also examine the relationship between control and obsessive-compulsive symptomatology.

METHODS

Female community participants (N = 175) completed self-report measures of control, eating disorder pathology and obsessive-compulsive symptoms.

RESULTS

Multivariate analyses of variance indicated significant differences between individuals with high vs. low levels of psychopathology on most of the measures of control. Using regression analyses, we found that a sense of ineffectiveness and fear of losing self-control were the only significant independent predictors of eating pathology, and fear of losing self-control was the most significant predictor of obsessive-compulsive symptoms.

CONCLUSIONS

This study highlights the importance of issues of control, particularly feelings of ineffectiveness and fear of losing self-control, in eating disorder symptoms. Furthermore, our findings suggest that there may be a similar underlying fear of losing self-control among individuals who engage in disordered eating and obsessive-compulsive behaviours. Thus, ineffectiveness and fear of losing self-control are two dimensions that are important to consider in maintenance and treatment models of disordered eating behaviours.

An initial psychometric evaluation and exploratory cross-sectional study of the body checking questionnaire among Brazilian women

Body checking is considered an expression of an excessive preoccupation with appearance. The first aim of this study was to evaluate the psychometric properties of a Brazilian Portuguese version of the Body Checking Questionnaire (BCQ). Additionally, we wanted to examine the questionnaire’s associations with body avoidance behaviour, body mass index, dietary habits, and the intensity, frequency, and length of physical exercise. Finally, we also examined the differences between the total BCQ score and the individual BCQ factor scores. Differences between active and sedentary persons and between non-dieters and those on weight-loss diets were also analyzed. For the psychometric study, 546 female public university students from four different courses were surveyed. Two minor samples of university students and eating disorders women were also recruited. In the second part of the study, 403 women were recruited from weight-loss programs, gyms, and a university. All participants were verbally invited to participate in the research and voluntarily took part. Confirmatory factor analysis showed a good fit to the original model of the Brazilian BCQ that retained all 23 items. Satisfactory evidence of construct validity and internal consistency were also generated through analysis of factor loadings, t-values, Cronbach’s alpha, and construct reliability tests. The results also showed associations among body checking and body avoidance, body satisfaction, social anxiety, body mass index, and the frequency and intensity of physical exercise. Significant differences were found between non-dieters and weight-loss dieters for all BCQ factors and the total BCQ score. For physically active and sedentary persons, a significant difference was only observed for idiosyncratic checking behaviour. In conclusion, the BCQ appears to be a valid and reliable scale for Brazilian research, and the associations and differences found in this study suggest that women at gyms and especially in weight-loss programs should be targeted for future body checking studies.

A naturalistic examination of body checking and dietary restriction in women with anorexia nervosa

Body checking has been conceptualized as a behavioral manifestation of the core overvaluation of eating, shape, and weight concerns underlying eating disorder psychopathology. Cognitive-behavioral theories suggest that body checking behaviors may function to maintain dietary restriction. The current study examined the association between body checking frequency and dietary restriction among women with anorexia nervosa (AN) in the natural environment. Women (N = 118) with full or partial AN completed baseline clinical interviews and a two-week ecological momentary assessment protocol, during which they reported on body checking behaviors (i.e., checking whether one's thighs touch; checking joints/bones for fat) and dietary restriction (i.e., 8 waking hours without eating; consuming less than 1200 calories per day). Average daily body checking frequency was positively associated with baseline eating disorder symptoms and body mass index. Daily body checking frequency was associated with both forms of dietary restriction on the same day, as well as the following day. Results support the theorized association between body checking and overvaluation of shape and weight, and suggest that targeting such behaviors in treatment may have utility in reducing dietary restriction.