Does body shame mediate the relationship between parental bonding, self-esteem, maladaptive perfectionism, body mass index and eating disorders? A structural equation model

The Relationship and Effects of Self-Esteem and Body Shape on Eating Disorder Behavior: A Cross-Sectional Survey of Chinese University Students

BACKGROUND

Eating disorders (EDs) have become a global public health concern among adolescents and young adults. However, Chinese university students exhibit a high prevalence of eating disorders. This study aims to investigate the effects of self-esteem (SE) and body shape (BS) on ED behaviors among Chinese university students.

METHODS

Using random sampling, 946 Chinese university students (aged 18 to 24, M = 19.94, SD = 1.04) participated in a survey comprising the Sick, Control, One, Fat, and Food Questionnaire (SCOFF-Q), the Body Shape Questionnaire (BS-Q), and the Rosenberg Self-Esteem Scale (RS-S) to assess their eating disorder or non-eating disorder (NED) behavior.

RESULTS

There was a significant positive correlation between body shape and eating disorder behaviors (r = 0.19, p < 0.01), while there was a significant negative correlation between self-esteem and eating disorder behaviors (r = -0.14, p = 0.001 < 0.01). Gender was a moderating factor in the relationship between body shape and eating disorder behaviors (t = 3.14, p = 0.002 < 0.01), while parents' marital status was a moderating factor in the relationship between self-esteem and eating disorder behavior (t = 2.72, p = 0.007 < 0.01). Body shape (z = 6.47, p = 0.001 < 0.01), self-esteem (z = -2.81, p = 0.005 < 0.05), and gender (z = 3.06, p = 0.002 < 0.01) significantly influenced eating disorder behavior among Chinese university students aged 18-24 years.

CONCLUSIONS

There was a direct effect between body shape and self-esteem and eating disorder behaviors among Chinese university students aged 18-24 years. Alarmingly, female university students are becoming susceptible to external influences on self-esteem and body shape, leading to eating disorder behaviors at an increasingly younger age in China.

A meta-analysis of disordered eating and its association with self-criticism and self-compassion

OBJECTIVE

Future treatments for eating disorders (ED) need to be enhanced by targeting maintaining mechanisms. Literature suggests self-criticism and self-critical perfectionism act as key mechanisms exacerbating ED, and self-compassion protects against self-criticism. This meta-analysis examines associations between self-criticism and self-critical perfectionism on disordered eating (DE), and reviews how self-compassion and self-criticism relate to each other with respect to DE.

METHOD

Searches across three databases yielded 135 studies across 42,952 participants. Heterogeneity, publication bias, and quality assessments were analyzed. Moderation analyses between self-criticism measures, self-compassion measures, between clinical and nonclinical samples, and between cross-sectional and experimental studies were also conducted.

RESULTS

Random-effects models showed a medium positive link between self-criticism and DE (r = .37), and 10 subgroups pertaining to various measures of self-criticism utilized in literature showed small to large positive links with DE (r = .20-.52). Preliminary evidence also suggests negative relationships between self-compassion and DE (r = -.40 to -.43) and negative relationships between self-compassion and self-criticism (r = -.04 to -.88).

DISCUSSION

Greater levels of self-criticism is linked with greater levels of DE and reduced levels of self-compassion, suggesting a need to tackle self-criticism and nurture self-compassion in standard treatments for ED. Understanding these interactions better in conjunction with dismantling intervention studies can help develop more effective and efficient interventions targeting self-criticism and self-compassion for people with DE.

PUBLIC SIGNIFICANCE STATEMENT

Higher levels of self-criticism are linked with higher levels of DE and lower self-compassion. Self-compassion interventions could be more effective and efficient in reducing ED symptoms if self-criticism is tackled early in such treatments.

The role of mothers' involvement in their daughters' self-esteem and dieting behaviors

This study presents an initial effort to develop disordered eating pathology (DEP) prevention program with an emphasis on maternal involvement. Disordered eating pathology representing a range of behaviors and attitudes, from negative body image to full-blown eating disorder. It appears mainly in adolescent females and related to psychological and familial factors, including maternal modeling of thinness. A sample of 118 Israeli girls (11-12) was divided into three groups: participants in the program in parallel with their mothers, participants without their mothers, and control. Participants completed self-report questionnaires. Groups were tested three times: pre-intervention, post-intervention, and follow-up. For those girls who participated in parallel with their mothers, higher self-esteem was associated with fewer pathological diet behaviors. Findings deepen understanding of the risk factors involved in the development of DEP. The main study contribution is the important role mothers play in preventing DEP among their daughters.

Self-Objectification and its Biological, Psychological and Social Predictors: A Cross-Cultural Study in Four European Countries and Iran

Although scholars started investigating self-objectification more than twenty years ago, only a few studies focused on men and even fewer have taken into account the cross-cultural dimension. Our study focused on the antecedents of self-objectification paying attention to the role of biological and sociodemographic variables (gender, BMI), psychological characteristics (self-esteem, perfectionism) together with social and cultural factors (internalization of media standards, influence of family and friends). Self-objectification was operationalized as Body Shame and Body Surveillance. A self-reported questionnaire was administered to 2165 adults living in four European countries (UK, Italy, Poland and Romania) and Iran. Ten regression models were performed (2 per country) to analyse the correlates of self-objectification. Overall, self-objectification emerged as a process affected by factors entrenched in psychological, biological, social and cultural domains, partially different for Body Shame and Body Surveillance. Findings showed the key role of self-esteem as a protective factor against Body Shame across countries. On the other hand, the internalization of media standards emerged as risk factor for both Body Shame and Body Surveillance in the five countries. Taken together, these results underline the complexity of self-objectification and the need to deepen research on this topic among non-Western countries.

Dyadic Predictors of Child Body Shame in a Polish and Italian Sample

The present study aimed at assessing the predictors (related to the functioning of a parent-child dyad) of child body shame. Therefore, in the main analysis we examined relationships among child body shame, child perfectionism, child body dissatisfaction, parent body shame, parent perfectionism, and parent body dissatisfaction. In our main hypothesis we assumed that higher levels of the abovementioned parent functioning-related variables would be associated with higher child body shame after accounting for the effects of the foregoing child functioning-related variables. The analysis finally included complete data from 420 participants, i.e., a 115 Polish and 95 Italian parent-child dyad. Participants completed: (a) child: the Objectified Body Consciousness Scale for Youth, the Child-Adolescent Perfectionism Scale, the Children's Body Image Scale/the Figure Rating Scale; (b) parent: the Objectified Body Consciousness Scale, the Frost Multidimensional Perfectionism Scale, and the Contour Drawing Rating Scale. The results of a correlational analysis show that in both the Polish and Italian samples, the higher the level of child body shame, the higher the level of the following variables: child perfectionism, child body dissatisfaction, parent perfectionism, and parent body dissatisfaction. Interestingly, the only insignificant relationship in both samples is the association between body shame in both members of the child-parent dyad. Moreover, all steps of the regressions were significant in both Polish and Italian samples. It turned out that only in the Italian sample were all predictors significantly associated with a child's body shame (in the Polish sample there was no significant association between child's body shame and parent's perfectionism). To sum up, the above studies show the importance of considering the functioning of the parent-child dyad in understanding child body shame. These findings suggest that parents' attitudes toward their bodies and their beliefs about an ideal self should be taken into account when planning interventions to improve children's and adolescents' attitudes toward their bodies. This is so because it is possible for children to internalize their parents' beliefs about how to look and how critical one should be of themselves, which can result in strong body shame when they are not perfect enough against the internalized ideal. Therefore, it is also necessary to make parents aware that children's attitude toward their body is often a reflection of parents' attitude toward the body.

Eating Disorders and Sexual Satisfaction: The Mediating Role of Body Image Self-consciousness during Physical Intimacy and Dissociation

Women with eating disorders experience difficulties related to sexual activity, yet little is known about the indirect association between eating disorders and sexual satisfaction. This study examined the indirect association between eating disorders and sexual satisfaction using body image self-consciousness during physical intimacy and dissociation as mediators. Online questionnaires were answered by 985 Israeli women. Of them, 98 were identified as likely to have eating disorders (study group). A matching control group (n = 98) was selected from the remaining respondents. Participants in the study group had significantly higher body image self-consciousness and dissociation than the matched controls, as well as significantly lower sexual satisfaction. The research model revealed that body image self-consciousness during physical intimacy mediates the link between eating disorders and sexual satisfaction, while dissociation does not. Women with eating disorders have higher levels of self-consciousness about their body during sexual activity, which may distract them from their own sexual needs and desires and those of their partners, and this, in turn, is associated with sexual dissatisfaction. Findings highlight the need for improved evidenced-based assessment and management of the sexual satisfaction of women with eating disorders.Abbreviations: ED: eating disorders; AN: anorexia nervosa; BN: bulimia nervosa; BED: binge eating disorder.

Risk factors for binge eating severity among adolescent girls and boys. A structural equation modeling approach

OBJECTIVE

Parental bonding, low self-esteem, emotion dysregulation, and eating style are correlated with each other and are associated with binge eating among adolescents. However, no studies have yet examined all these variables simultaneously. In the current study, the independent and combined influences of such constructs on binge eating were tested with structural equation modeling.

METHOD

A sample of 973 students aged between 12 and 16 (M = 14.17, SD = 1.25) years was screened by means of self-report measures assessing parental bonding, self-esteem, emotion dysregulation, eating styles and binge eating severity.

RESULTS

Self-esteem (β = -0.205) and eating styles (emotional β = 0.313, external β = 0.133, and restrained β = 0.178) had a direct effect on binge eating severity. The model (χ²₍₂₂₎ = 57.679; RMSEA = 0.041; CFI = 0.987; TLI = 0.949; SRMR = 0.024) revealed that the paths from both maternal and paternal care and maternal overprotection to binge eating were mediated through low self-esteem, emotion dysregulation and each eating style, explaining 35% of the variance.

DISCUSSION

Findings provide support for a comprehensive theoretical-based model of risk factors for binge eating and suggest the possible mechanisms through which the quality of early parental relationships contribute to developing dysfunctional eating patterns. Treatment and prevention efforts should improve self-esteem and emphasize emotion regulation capabilities.

Shame and eating disorders symptoms: A meta-analysis

OBJECTIVE

Numerous empirical studies and theoretical models posit that shame is a common experience among individuals across the eating disorder spectrum. In this study we aim to investigate the association between shame and eating disorders symptoms using a meta-analytical approach.

METHOD

In this meta-analysis, we synthesized findings from 195 studies to examine the proposed association between shame and eating disorders symptoms. We looked at the associations with both general eating disorders symptoms and with specific eating disorders symptoms (i.e., anorexic, bulimic, and binge-eating symptoms). Moderation analyses testing for the effect of type of shame, type of eating symptoms, clinical status, quality of the study, age, and gender were conducted.

RESULTS

Shame was significantly associated with a medium to large effect size with all types of eating disorders symptoms (rs between .40 and .52). Body shame (r = .55) and shame around eating (r = .59) were more strongly related with eating disorders pathology. Type of eating disorders symptoms did not moderate the relationship between shame and disturbed eating.

DISCUSSION

Overall, the magnitude of the effect size of the association between shame and eating disorders symptoms is a medium to large one. Body shame and shame around eating seem to be the types of shame most closely tied with eating disorders symptoms, suggesting that directly targeting them in interventions might be highly beneficial. Findings highlight current gaps in the literature (e.g., mostly correlational studies, low quality studies) with implications for future research.

Focus on the Beauty of Body: The Mediation Role of Body Appreciation Between Perfectionism and Body-Related Shame and Body-Related Guilt

Objectives: According to traditional views, perfectionists are prone to experience shame and guilt. As a relative part of negative body image, body appreciation reflects an appreciation attitude toward physical characteristics, functionality, and health, accepting and appreciating all parts and functions of the body, predicting body-related shame and guilt. Methods: Therefore, body appreciation was examined for its potential mediating role in the relationship between two dimensions of perfectionism (e.g., healthy perfectionism and unhealthy perfectionism) and body-related shame and body-related guilt among 514 females. Results: The results highlight that body appreciation partially mediated the relationship between perfectionism and body-related shame and body-related guilt. Implications for enhancing body appreciation among females between experiencing healthy or unhealthy perfectionism and body-related shame and body-related guilt feelings are discussed. Conclusions: These findings underscore the importance of considering body appreciation in addressing perfectionism dimensions and body-related shame and body-related guilt. Research and clinical implications are also addressed.

Early Warning Method for Public Health Emergency Under Artificial Neural Network in the Context of Deep Learning

The purpose is to minimize the substantial losses caused by public health emergencies to people’s health and daily life and the national economy. The tuberculosis data from June 2017 to 2019 in a city are collected. The Structural Equation Model (SEM) is constructed to determine the relationship between hidden and explicit variables by determining the relevant indicators and parameter estimation. The prediction model based on Artificial Neural Network (ANN) and Convolutional Neural Network (CNN) is constructed. The method’s effectiveness is verified by comparing the prediction model’s loss value and accuracy in training and testing. Meanwhile, 50 pieces of actual cases are tested, and the warning level is determined according to the T-value. The results show that comparing and analyzing ANN, CNN, and the hybrid network of ANN and CNN, the hybrid network’s accuracy (95.1%) is higher than the other two algorithms, 89.1 and 90.1%. Also, the hybrid network has sound prediction effects and accuracy when predicting actual cases. Therefore, the early warning method based on ANN in deep learning has better performance in public health emergencies’ early warning, which is significant for improving early warning capabilities.

Non-Suicidal Self-Injury Among Italian Adolescents: The Role of Parental Rejection, Self-Concept, Anger Expression, and Body Investment

Objective

Parental rejection, poor self-concept, anger expression, and negative body investment have often been associated with non-suicidal self-injury (NSSI). However, research has investigated each factor separately. To address this shortcoming, the main aim of the study was to integrate these factors and test a hierarchical regression to examine the impact of each factor above and beyond the others.

Method

A cross-sectional sample of 481 Italian high school students aged 13-19 (M_age=15.48; SD=1.46) were screened by self-report measures that assess parental rejection, self-concept, anger expression, body emotional investment, and NSSI. A semi-structured interview was administered in order to assess the characteristics of self-injurious behaviors.

Results

After the interview, twenty-three (4.8%) students reported having engaged in NSSI (Mage =12.63; SD=1.58). Neither gender nor age differences were found. The hierarchical regression revealed the NSSI was associated with the inward expression of anger (ORs=1.1–1.7) and the negative body investment (ORs=.037–.281).

Conclusions

These findings point out that the expression of anger inwardly and the emotional investment in the body may be salient factors to consider in understanding the occurrence of NSSI among adolescents. The clinical relevance of these findings was discussed.