The relationships among social comparisons, body surveillance, and body dissatisfaction in the natural environment

Integrating social media, body shame and psychological distress within the Elaborated Sociocultural Model

The Elaborated Sociocultural Model proposes exposure to sociocultural appearance pressures increases women's internalisation of the thin ideal, their engagement in social comparison and body surveillance, and subsequent body dissatisfaction and disturbances in eating (Fitzsimmons-Craft et al., 2011). Although this model has received some empirical support, it is limited in that it does not currently account for social media as a contemporary source of appearance pressure, nor include additional known outcomes of thin ideal internalisation (i.e., body shame, psychological distress). The current study tested the integration of these variables within the Elaborated Sociocultural Model. Using structural equation modelling with latent variables, the extended model provided acceptable to good fit to the data in a sample of 271 female participants. A latent variable representing sociocultural appearance pressures originating from social media, traditional media, family and peers was found to significantly predict thin ideal internalisation and body image concerns. Furthermore, both social comparison and body surveillance emerged as indirect mediators of the relationship between thin ideal internalisation and body image concerns, which in turn, increased report of restrained eating and psychological distress. Aligning with previous research, this extended model offers a useful and comprehensive framework for investigating women's body image.

Comorbidity between body dissatisfaction and nicotine vaping among young adults in college: a daily diary study

Objective: The purpose of this study was to elucidate comorbidity between body dissatisfaction and nicotine vaping. Participants: Participants were 121 college students (M age = 20.51 years; 75.0% female; 75.2% White) who participated in a 14-day daily diary study. Methods: Logistic regression was used to test links between baseline trait body dissatisfaction and vaping frequency across 14 days. Multilevel logistic regression was used to test within-person, daily links between body dissatisfaction and nicotine vaping. Results: Each additional unit of trait body dissatisfaction increased the odds of frequent vaping by 33% (95% CI [1.00, 1.77]) and daily vaping by 54% (95% CI [1.10, 2.15]). Within-person, daily associations between body dissatisfaction and vaping were nonsignificant. Conclusions: Body dissatisfaction may increase college students' risk for engaging in frequent nicotine vaping. However, daily changes in body dissatisfaction may not predict same- or next-day vaping. College students with body dissatisfaction may benefit from nicotine interventions.

Food insecurity and body dissatisfaction in a sample of Canadian adults

Food insecurity may predict poorer body image, which is associated with increased risk of mental health problems. However, minimal attention has been given to the food insecurity-body image link and to factors that may influence this link, such as assigned sex; importantly, females are more likely to experience both food insecurity and body dissatisfaction. The present study used data from the 2017 to 2018 Canadian Community Health Survey (N = 32,017) to investigate the effects of food insecurity and sex on body satisfaction via generalized ordered logistic regression. Results indicated: (1) Food insecurity predicted lower odds of body satisfaction, (2) Males were more likely than females to be satisfied with their bodies, and (3) Food insecurity no longer predicted body satisfaction following the inclusion of sex. Findings suggest the association between food insecurity and body satisfaction may largely be driven by the link between food insecurity and sex. Further investigation is warranted.

Transgender body image: Weight dissatisfaction, objectification & identity - Complex interplay explored via matched group

In the context of body image and mental health, transgender individuals face distinctive challenges stemming from the complexities of their gender identity journey, societal expectations, and body norms. However, the existing line of research on this topic remains limited. This study explores the complex relationship in transgender individuals between body objectification, body weight dissatisfaction, and eating concerns. A sample of 154 individuals (77 transgenders paired with 77 cisgenders) was recruited via LGBTQ+ groups' mailing lists. Participants completed various questionnaires assessing body image, eating psychopathology, depression, and body objectification. Propensity score matching was performed with different variables: age, current BMI, years of education, current self-identified gender, and sexual orientation. The results revealed that transgender individuals experienced higher levels of body objectification, body weight dissatisfaction, and eating concerns compared to their cisgender counterparts. Additionally, age emerged as a protective factor, as older transgender individuals demonstrated improved body acceptance and self-esteem. Logistic regression analyzes indicated that bulimic behaviors, depressive symptoms, and appearance control beliefs were specific factors significantly associated with being transgender. Our findings highlight the unique challenges faced by transgender individuals in navigating their gender identity and body image, underscoring the importance of targeted interventions and support systems.

Evidence-Based Assessments for Transdiagnostic Eating Disorder Symptoms: Guidelines for Current Use and Future Directions

Eating disorders are severe and often chronic mental illnesses that are associated with high impairment and mortality rates. Recent estimates suggest that eating disorder prevalence rates are on the rise, indicating an increased need for accurate assessment and detection. The current review provides an overview of transdiagnostic eating disorder assessments, including interview, self-report, health and primary care screeners, and technology-based and objective assessments. We focused on assessments that are transdiagnostic in nature and exhibit high impact in the field. We provide recommendations for how these assessments should be used in research and clinical settings. We also discuss considerations that are crucial for assessment, including the use of a categorical versus dimensional diagnostic framework, assessment of eating disorders in related fields (i.e., anxiety and depression), and measurement-based care for eating disorders. Finally, we provide suggestions for future research, including the need for more research on short transdiagnostic screeners for use in health care settings, standardized assessments for ecological momentary assessment, development of state-based assessment of eating disorder symptoms, and consideration of assessment across multiple timescales.

Stimulating appearance comparison dynamics and their effects on psychological dysfunctions: The moderating role of self-compassion

In recent decades, attitudes towards appearance comparison, and self-disapproval have rapidly increased, and these are attitudes strongly associated with psychological disorders. The present study aims to investigate the underlying patterns of depression, appearance-based stress, dietary constraints, and social and celebrity appearance comparison among young adults. It also examines the role of self-compassion in moderating the relationship between psychological dysfunctions and appearance comparison as well as the criteria and influences contributing to appearance comparison. Data on BMI, the measures of depression, appearance-based stress, eating restraints, appearance comparison, self-compassion, and predictors of peers and celebrity appearance comparison were collected from 434 college students (Age: Mean = 22; SD = 2.36; Male = Female = 217) in Sialkot, Pakistan. The data was analyzed by using the Hierarchical Regression Model. The results revealed that respondents who compared their appearances to peers and celebrities had increased depression and appearance-based stress while eating constraints didn't affect the appearance-based comparison, stress, and depression. Moreover, self-compassion significantly moderated the relationship between depression, appearance-based stress, and appearance comparison whereas an insignificant moderation effect is observed between eating restraints and self-compassion. Despite psychological distresses such as depression, appearance-based stress, and eating restraints, appearance comparisons are connected to appearance-based victimization, media appearance pressure, social-cultural appearance pressure, appearance conversation, and self-consciousness.

The whole is more than the sum of its parts: A qualitative investigation of body-dissatisfied college women's experiences of relational body image

Research on relational body image suggests that women's body image changes across their important relationships, with women most at risk for maladaptive body image reporting the most extreme changes. To enrich our understanding of relational body image beyond that offered by prior psychologically-based quantitative research, the present study integrated critical-feminist approaches. Eighteen female-identified university students participated in a one-on-one semi-structured interview. Each participant first completed ratings of her body image across seven important relationships, which the interviewer used to create a graph depicting her relational body image. The interviewer shared the graph with the participant to prompt reflection on her subjective experiences of relational body image and asked her a series of questions. Reflexive thematic analysis, informed by a critical-realist framework, was used to identify themes. One overarching theme, "The Whole Is More than The Sum of Its Parts," demonstrated how relational body image may be understood as a unique configuration of interconnected factors within a specific relationship. Three subthemes then highlighted how interpersonal, idiographic, and systemic factors come together to influence subjective experiences of relational body image. The present results suggest that personalized treatment targets within specific relationships may be a worthwhile focus for future body image interventions.

Experimental evidence that browsing for activewear lowers explicit body image attitudes and implicit self-esteem in women

Online apparel shopping is popular amongst women and offers salient visual information for making body image and self-worth judgements. Apparel segments which emphasize the value of women's bodies are particularly effective for eliciting low body image and self-worth. Across two studies, we investigated the association between self-reported and experimental online activewear exposure on women's self-worth, body image, appearance attitudes, mood and gaze behavior. In Study 1, participants (N = 399) completed a survey collecting their online apparel shopping habits, body appreciation, self-esteem, appearance comparison tendencies and self-objectification attitudes. Activewear was the second-most popular apparel segment amongst women (after casualwear) and weekly activewear browse time was positively correlated with appearance comparison tendencies, desires to be muscular/athletic and body shame. In Study 2, participants (N = 126) were randomly allocated to browse an activewear, casualwear or homewares website and completed pre and post measures of mood, body image, implicit self-esteem and body gaze behavior. In the activewear condition, there was a significant reduction in positive body image and implicit self-esteem scores. There were no experimental effects for body gaze behavior. These findings illustrate that apparel choices have value for understanding the aetiology of maladaptive body image attitudes and low self-esteem in women.

Ecological momentary assessment of mood regulation eating expectancies in eating disorders: Convergent and predictive validity

OBJECTIVE

Eating expectancies (EE) are the anticipation of various benefits or detriments from eating, with mood regulation being a salient type of EE associated with eating disorders. This study examined the convergent and predictive validity of ecological momentary assessment (EMA) mood regulation EE items, including mood improvement and mood worsening EE.

METHODS

Thirty women with binge-eating pathology completed a 14-day EMA protocol, which included measures of mood regulation EE, affect, appetite, appearance- and body-related factors and disordered-eating behaviours.

RESULTS

Greater within-subjects hunger and lower within-subjects positive affect and fullness were related to elevated mood improvement EE. Higher within-subjects appearance concerns, fullness, body social comparisons and thinness pressure were associated with higher mood worsening EE. Greater within-subjects mood worsening EE predicted greater likelihood of vomiting at the subsequent time point, but there were no within-subjects associations between mood improvement EE and behaviours. Yet, greater between-subjects mood worsening EE were associated with more restraint/restriction and binge eating, and greater between-subjects mood improvement EE were associated with more binge eating.

CONCLUSIONS

Findings support the convergent validity of EMA mood regulation EE items. There was limited predictive validity evidence, suggesting complexities in how mood regulation EE predict behaviour in daily life.

#BoPo: Does viewing body positive TikTok content improve body satisfaction and mood?

Body positivity - often referenced on social media as "#BoPo" - encourages acceptance towards all body types, including one's own body, and challenges the societal ideal of the very thin body. The current study examined whether viewing body-positive TikTok content improves state mood and body satisfaction. Participants were female undergraduate students (N = 156) who completed an online study where they were randomly assigned to view either body-positive, body-focused, or control TikTok videos for five minutes. Before and after viewing the TikTok content, participants completed questionnaire items to assess state affect and body satisfaction alongside other variables. Mixed between-within subject ANOVAs demonstrated that participants in the body-positive condition experienced an increase in body satisfaction and a decrease in negative affect after viewing the body-positive TikTok videos. In contrast, those in the body-focused condition experienced a decline in body satisfaction and positive affect and an increase in negative affect. This study provides preliminary evidence that TikTok content may be used as a positive outlet for body image, depending on the type of content being viewed.

Mirror, mirror, on the social media … WeChat Moments usage and negative body image among female college students: Evidence from ecological momentary assessment data

Negative body image is prevalent among women and may lead to physical and mental health problems. Social media-including China's most popular platform, WeChat Moments-aggregates multiple aspects of appearance-related pressure and therefore is an important risk factor for negative body image. The current study examines the relationship between WeChat Moments usage and body image among female college students and the mediating mechanism of body surveillance. A sample of 151 female college students completed a 7-day ecological momentary assessment (EMA), responded to three surveys per day, and provided a total of 2949 EMA responses. We used multilevel structural equation modeling (MSEM) to examine the hypothesized models at both the between- and within-individual levels. The results showed that both overall WeChat Moments usage and appearance-related exposure on WeChat Moments were inversely and indirectly related to body image through the mediating role of body surveillance at the between-individual level. However, both overall WeChat Moments usage and appearance-related exposure on WeChat Moments were positively and indirectly related to body image through body surveillance at the within-individual level. Our findings indicate that WeChat Moments usage is associated with college women's body image differently at the between- and within-individual level, and body surveillance serves as a crucial underlying mechanism.

Body image explains differences in intuitive eating between men and women: Examining indirect effects across negative and positive body image

Intuitive eating is an adaptive and flexible form of eating. Men report higher rates of intuitive eating than women. Objectification processes are proposed to underlie this (binary) gender difference due to the intense body-related pressures that disrupt body image in women. The current study is the first known to test whether body image indirectly explains lower levels of intuitive eating in women relative to men. A cross-sectional sample of 498 adults aged 18-74 years recruited through Prolific completed an online survey assessing intuitive eating and negative and positive body image indicators. Women reported poorer body image and lower levels of intuitive eating compared to men. Significant indirect effects suggested body image explained gender differences in intuitive eating, controlling for age and body mass index. In women relative to men, greater body surveillance and lower aesthetic satisfaction explained lower total intuitive eating and reliance on hunger and satiety, greater aesthetic investment explained lower total intuitive eating and eating for physical reasons, and lower functionality investment explained lower body-food choice congruence. More research is needed, but findings suggest programs may benefit from decreasing critical views of appearance and strengthening functionality investment in women to reduce gender differences in intuitive eating.

Body, eating, and exercise comparison orientation measure (BEECOM): Cross-cultural adaptation and psychometric properties among Brazilian female university students

The Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) is an instrument that aims to quantify behaviors related to social comparison, specifically comparisons related to the body, eating and exercise, and was originally developed using a nonclinical population of American university women. The objective of this study was to perform a cross-cultural adaptation and verify the psychometric qualities of the BEECOM for young Brazilian adult women aged 18-35 years. In the present study, the cross-cultural adaptation of the instrument was performed through its translation, back-translation and evaluation by the target population. The instrument proved to be easy to understand among young women. Then, the psychometric qualities of the instrument were evaluated using a sample of 716 women (M_age = 22.47 ± 3.10). Exploratory and confirmatory factor analysis demonstrated the presence of three factors and satisfactory adjustment indexes. The BEECOM presented an invariant measurement across white vs. nonwhite and physically active vs. non-active individuals. In addition, the instrument showed adequate reliability and convergent validity. In conclusion, the BEECOM is a useful tool to evaluate social comparison behaviors related to eating disorders and body image in young Brazilian female adults, enabling further research on these constructs and supporting the development of preventive strategies.

Social Comparison and Female Adolescents' Selfie Behaviors: Body Surveillance as the Mediator and Self-Esteem as the Moderator

The current study aimed to examine whether body surveillance mediated the relation between social comparison and selfie behaviors, and whether this mediating process was moderated by self-esteem. A sample of 339 female adolescents were recruited to participate in the present study and completed self-report measures of selfie behaviors, upward and downward appearance comparisons with peers, self-objectification and self-esteem. Results indicated that body surveillance mediated the association between upward physical appearance comparison and selfie behaviors. In addition, self-esteem moderated the relation between body surveillance and selfie behaviors. These findings add to the extant literature by suggesting that selfies may be some new ways of body surveillance and physical appearance comparison, which have some theoretical and practical implications.

Examination of momentary maintenance factors and eating disorder behaviors and cognitions using ecological momentary assessment

The integrative cognitive-affective therapy (ICAT) momentary maintenance model proposes a number of situational factors that precipitate eating disorder (ED) behaviors and cognitions. The current study examines momentary situational triggers in relation to a broad range of ED symptoms in a diagnostically heterogeneous sample of individuals with ED psychopathology. In the current study, 30 women with binge eating pathology completed a 14-day ecological momentary assessment (EMA) protocol during which they responded to five random signals throughout the day. During signaled assessments, participants completed measures of self-criticism, interpersonal problems, self-regulation of binge eating, appearance concerns, and cognitive and behavioral ED symptoms. Multilevel models were used to examine prospective associations between hypothesized ICAT maintenance factors and ED symptoms. Within-subjects self-criticism prospectively predicted vomiting, restriction, preoccupation with thoughts of food, and urges to eat. Within-subjects interpersonal problems prospectively predicted vomiting, and within-subjects appearance concerns prospectively predicted preoccupation with thoughts of food. There were no significant predictors of binge eating. These results provide some support for hypothesized momentary situational triggers of ED symptoms in the momentary maintenance model of ICAT using naturalistic, momentary assessment. Specifically, it may be particularly useful for interventions such as ICAT to address momentary self-criticism when targeting a range of ED symptoms.

Appearance Comparisons and Eating Pathology: A Moderated Serial Mediation Analysis Exploring Body Image Flexibility and Body Appreciation as Mediators and Self-Compassion as Moderator

Comparing one's body against the bodies of others is related to lower positive body image and higher eating pathology. Underlying mechanisms as well as protective factors of these relationships are yet to be discovered. The present study examined body image flexibility and body appreciation as potential mediators of the association between appearance comparisons and eating disorder psychopathology. Additionally, it was tested whether self-compassion moderates the mediation effects. In an online sample comprising 250 women (M_age = 42.66, SD = 12.24), the inverse relationship between appearance comparisons and body appreciation was mediated by body image flexibility and the positive relationship between appearance comparisons and eating disorder psychopathology was mediated by body image flexibility and serially mediated by body image flexibility and body appreciation, when controlling for body mass index and age. Simple mediations were further moderated by self-compassion, such that indirect effects were attenuated at high levels of self-compassion. Promoting body image flexibility may be one potential target for helping women to engage in less maladaptive and more adaptive ways of treating the body when comparing one's appearance. Building self-compassion may be another potential target that may protect body image flexibility and its correlates in the face of appearance comparisons.

The validity and reliability of the Farsi version of the Body, Eating, and Exercise Comparison Orientation Measure (F-BEECOM) among Iranian male and female students

Body-, eating-, and exercise-related social comparison tendencies are implicated in body dissatisfaction and disordered eating among Western women. To date, no published study examines eating- and exercise-related comparisons in a male or non-Western sample. The current series of studies fills these gaps in the literature by translating and validating the existing measure of these comparisons (the 18-item Body, Eating, and Exercise Comparison Orientation Measure [BEECOM]) in samples of Iranian men and women. In Studies 1 and 2, female (n = 284) and male (n = 302) participants completed the translated Farsi BEECOM. Scores were analyzed by exploratory factor analyses (EFA) revealing two different three factor, 15-item scale structures for men and women. In Studies 3 and 4, participants (female n = 384; male n = 253) completed measures of social comparison and psychological functioning in one session. These data were analyzed using confirmatory factor analyses (CFA) and Pearson correlations. Each CFA yielded adequately fitting models. Results support the use of two different 15-item Farsi BEECOM measures with women and men and highlight unique gender differences in social comparison tendencies. The resulting F-BEECOM demonstrates strong psychometric properties and will be a useful research tool in Iranian women and men.

There are no short-term longitudinal associations among interoceptive accuracy, external body orientation, and body image dissatisfaction

Background

Objectification theory assumes that individuals with low level of interoceptive accuracy may develop an external orientation for information concerning their body. Past research has found associations between interoceptive accuracy and body image concerns. We aimed to explore temporal relationships between the tendency to monitor one's body from a third-party perspective, body image dissatisfaction, and interoceptive accuracy.

Method

In a short longitudinal research, 38 Hungarian and 59 Norwegian university students completed the Schandry heartbeat tracking task and filled out baseline and follow-up questionnaires assessing private body consciousness, body surveillance, and body image dissatisfaction 8 weeks apart.

Results

Interoceptive accuracy and indicators of external body orientation did not predict body image dissatisfaction after controlling for gender, nationality, and body image dissatisfaction at baseline. Similarly, body surveillance was not predicted by baseline levels of interoceptive accuracy and body image dissatisfaction.

Conclusion

Contrary to the tenets of objectification theory, body image dissatisfaction and body surveillance are not predicted by interoceptive accuracy over a short period of time among young individuals.

Past research suggests that an individual's ability to detect their own internal signals may have important implications for body monitoring and body image.

We did not find the expected temporal associations among interoceptive accuracy and body image-related variables.

Culture and gender were predictors of body image dissatisfaction, an important consideration when designing interventions targeting body image concerns.

An Ecological Momentary Assessment of Self-improvement and Self-evaluation Body Comparisons: Associations with College Women's Body Dissatisfaction and Exercise

Upward body comparisons are prevalent among college women and associated with body dissatisfaction and disordered eating. However, less is known about distinguishing features of the comparisons themselves as they occur in daily life. The primary purpose of the present study was to examine whether two types of upward body comparisons previously studied experimentally (self-improvement and self-evaluation) are differentially associated with body- and exercise-related outcomes in real-life settings using ecological momentary assessment (EMA). Undergraduate women (N = 74) between 18-25 years (Mage = 20.4, SD = 1.63) completed five surveys on smartphones daily for seven days. EMA measures assessed body comparisons, body dissatisfaction, and exercise cognitions and behaviors. Baseline body dissatisfaction, comparison tendency, and exercise behavior were examined as moderators. Multilevel analyses revealed that both self-improvement and self-evaluation were associated with greater exercise thoughts (ps < .05), but not with changes in body dissatisfaction (ps> .05). Moderator analyses revealed differences between the two types and their associations with outcomes for select subgroups. For example, self-improvement comparisons were associated with fewer exercise thoughts among participants with high baseline exercise behaviors (p < .01). Further research is needed to understand the differences between self-improvement and self-evaluation and the potential protective mechanisms of self-improvement.

The protective role of self-compassion for women's positive body image: an open replication and extension

The development and maintenance of positive body image in women may be disrupted by sociocultural appearance-related pressures. Therefore, it is critical to explore factors that may safeguard women's positive body image. A recent study by Homan and Tylka (2015) found that in a large sample (N = 263) of female MTurk workers and university-aged women, both appearance-contingent self-worth and body-based social comparisons were linked to less positive body image, but these links were attenuated in the face of high self-compassion. This research, an independent direct replication of the original study, supported the original findings. In a new, larger sample (N = 363 female-identified MTurk workers), signals were detected that were similar in size and magnitude to the original study. Specifically, while appearance-contingent self-worth and body-based social comparisons were negatively linked to body appreciation, those who endorsed higher levels of self-compassion reported a more positive body image, even in the presence of these potential threats. Findings are extended to eating- and exercise-based social comparisons. All materials, including the replication protocol, data management plan, dataset, SPSS syntax, and output are publicly available on the Open Science Framework at: https://osf.io/r274y/. Implications for research and practice are discussed.

Body image in and out of the lab: Correspondence between lab-based attentional bias data and body shape dissatisfaction experiences in daily life

Accumulating lab-based studies have identified attentional biases in processing of negative appearance-related information among individuals with elevated trait body shape and weight dissatisfaction (BD). How these biases translate into experiences of BD in daily life remains unclear and, hence, was the focus of the present study. Thirty-eight women aged between 18-40 years completed a baseline survey and modified dot-probe task with both fat and thin appearance-related stimuli in a laboratory setting. Participants also downloaded a smartphone app that prompted them 10 times per day for 7 days to rate current body dissatisfaction. Results revealed that heightened BD in daily life tended to be transitory, and followed by a substantially lower rating of BD by the next survey (∼1-2 h later). For individuals with elevated trait BD and facilitated attention towards thin body images, this reduction in state BD was more gradual. Surprisingly, delayed disengagement towards thin body images was associated with greater reduction in state BD. Consistent with the hypothesis, moderating effects were not observed when initial state BD level was low. Susceptibility for immediate, short-term attentional biases towards appearance-related information may be a vulnerability factor for the prolonged persistence of negative body image experiences in daily life.

Methods to Assess Social Comparison Processes Within Persons in Daily Life: A Scoping Review

Self-evaluations relative to others (i.e., social comparisons) have well-established implications for health and well-being, and are typically assessed via global, retrospective self-report. Yet, comparison is inherently a dynamic, within-person process; comparisons occur at different times, on a range of dimensions, with consequences that can vary by context. Global, retrospective assessment forces aggregation across contexts and reduces ecological validity, limiting its utility for informing a nuanced understanding of comparisons in daily life. Research across social and clinical psychology has implemented methods to assess comparisons naturalistically, involving intensive, repeated assessments of comparison occurrence, characteristics, and consequences in everyday life (via ecological momentary assessment or daily diaries). Although promising, this work to date lacks an overarching conceptual framework for guiding decisions about assessment design and implementation. To address this gap, the aims of this scoping review were: (1) to summarize available literature on within-person naturalistic assessment of social comparison, and (2) to provide a set of key considerations to inform future social comparison research using within-person naturalistic assessment. Searches in PubMed, PsycInfo, and CINAHL identified relevant articles published before June 2019. Articles were included if they described at least 3 comparison assessments within each participant, taken in the natural environment, and spaced no more than ~24 h apart (i.e., repeated momentary or daily assessment). In articles meeting these criteria (33 unique studies across 36 published papers), we summarized aspects of the comparison assessment, including recording methods, direction (e.g., upward, downward), target (e.g., friend, stranger), and dimension (e.g., status, appearance). Most studies assessed appearance comparisons (vs. other comparison dimensions) and collected information in response to signals (rather than initiated by participants). However, there was considerable heterogeneity in the number of assessments, assessment periods, recording modalities, and comparison predictors and outcomes assessed. Findings broadly establish heterogeneity in the aspects of comparison considered critical for within-person naturalistic assessment. We describe key decision points for future work to help advance within-person naturalistic assessment methods and improve the utility of such approaches to inform research, theory, and intervention.

Self-objectification and eating disorder pathology in an ethnically diverse sample of adult women: cross-sectional and short-term longitudinal associations

BACKGROUND

Extensive support exists for objectification theory's original aim of explaining patterns of women's mental health risk through a sociocultural lens. One pathway in objectification theory proposes a mediational role of body shame in the relationship between self-objectification and eating disorder (ED) pathology. Robust past cross-sectional research supports this proposed pathway, but largely in non-Hispanic Caucasian, college-aged samples; this pathway has yet to be empirically demonstrated longitudinally. Given previously documented concerns regarding direct measurement of body shame, we tested two measures of body shame as mediators in both cross-sectional and longitudinal models in a diverse sample of adult women.

METHOD

Utilizing snowball sampling via email, we recruited age and racially/ethnically diverse women predominantly within the United States. Participants completed online surveys assessing self-objectification (operationalized as body surveillance), body shame, and ED pathology at baseline, 3-months and 6-months.

RESULTS

Racial/ethnic minority (n = 139) and non-Hispanic Caucasian (n = 181) adult women completed the measures. Cross-sectional moderated mediation models indicated that racial/ethnic status did not moderate relationships, and that body shame significantly mediated the relation between body surveillance and ED pathology at each time point. The longitudinal model, analyzed using cross-lagged panel analyses, was nonsignificant, as body surveillance failed to predict future body shame when controlling for past body shame.

CONCLUSIONS

Racial/ethnic status did not moderate relations at any time point. Cross-sectional findings replicated past research; the longitudinal model did not support a core mediation pathway linking self-objectification to ED pathology through body shame. Because self-objectification putatively develops earlier in life, future research also should examine these relations in younger diverse samples over a longer time period.

Body image states in everyday life: Evidence from ecological momentary assessment methodology

This review highlights the contributions of Professor Thomas Cash to the scholarship of body image experiences in daily life, including his influence on subsequent research in this field. Cash's arguments for capturing a broad range of state-based body image experiences have been heeded, with recent studies exploring positive body image constructs as well as the more studied negative body image experiences. Appearance comparisons are the most commonly studied contextual influence on body image, and they seem to have a consistent effect. However, the experiences of body image in sexual contexts, and among adolescents, those who are pregnant, or have other physical characteristics that may increase the salience of appearance warrant further attention. Findings generally support Cash's contention that trait body image relates to likelihood and level of experience of body image in daily life, though the moderating effects of trait aspects on state-based relationships remains unclear. The discussion concludes with consideration of the impact of assessment schedules on obtained results. It is also discussed how accumulated knowledge regarding state-based body image experiences may be leveraged in treatment contexts, particularly in light of clear evidence that repeated assessment of body image in daily life increases self-awareness of one's body image characteristics.

The Spanish Body Image State Scale: Factor Structure, Reliability and Validity in a Colombian Population

OBJECTIVE

Body image is a construct highly dependent on culture and ethnicity. Furthermore, recent studies reveal that body image is not only a trait, but also a momentary state subject to change in diverse situational contexts. However, cultural influences on momentary body image have not been sufficiently investigated. To assess the influence of Latin American culture on momentary body image and to enable its comparison to Western countries, the Spanish translation of an existing state body image scale such as the Body Image States Scale (BISS) is needed. In addition, the factor structure, reliability and general validity of the Spanish BISS (S-BISS) should be evaluated prior to its application in diverse situational contexts.

METHOD

We conducted a cross-sectional study evaluating 1137 individuals between the ages of 18 and 28 years from Barranquilla, Colombia, South America. The original BISS, which assesses body satisfaction, was translated from English to Spanish. Factorial structure, scale score reliability and convergent/divergent validity were assessed.

RESULTS

Exploratory and confirmatory factor analyses revealed that a one-factor model with correlated items best described the factorial structure present in the BISS questionnaire. The coefficient of scale score reliability was α = 0.92 (McDonalds ω = 0.93), with similar results for men and women. Significant differences between males and females were found with lesser body satisfaction in females (W = 163260, p = 0.016). Lower S-BISS scores indicating less body satisfaction were associated with higher BMI (r = -0.287, p < 0.001) and obtained in participants who were currently on a diet (t 1135 = -3.98, p < 0.001). The S-BISS was negatively correlated with a trait body image measurement assessing body dissatisfaction (Body Shape Questionnaire, r = -0.577, p < 0.001) and a psychopathology questionnaire (Brief Symptom Inventory 53, r = -0.331, p < 0.001).

CONCLUSION

The S-BISS is a valid and reliable instrument to assess body image in the Colombian population, and exhibits similar psychometric properties to those of the original version. Future studies should examine whether the S-BISS captures change in state body image when applied in diverse situational contexts.

Body-, Eating-, and Exercise-Related Comparisons During Eating Disorder Recovery and Validation of the BEECOM-R

Social comparison tendencies are strongly associated with body dissatisfaction and disordered eating. In the current study, we quantitatively examined the structure and predictive value of these constructs during eating disorder recovery. We revised an existing measure of body-, eating-, and exercise-related social comparisons, the Body, Eating, and Exercise Comparison Orientation Measure (BEECOM), to improve psychometric properties. We also assessed the psychometric properties of the shortened Body, Eating, and Exercise Comparison Orientation Measure-Revised (BEECOM-R) in a comparison sample, resulting in an abbreviated measure suitable for recovering, clinical, and non-clinical samples. Finally, we used the revised measure to examine the additive influence of body-, eating-, and exercise-related comparisons on shape and weight dissatisfaction and disordered eating cognitions among 150 women (ages of 18–35 years) in self-identified recovery. Results suggest that body-, eating-, and exercise-related social comparisons all continue to correlate with body dissatisfaction and disordered eating during recovery. A minority of participants reported these comparisons to be helpful during the recovery process. We recommend social comparison as a clinical target for most women seeking support for eating pathology. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/ 10.1177/0361684319851718

Appearance comparison and other appearance-related influences on body dissatisfaction in everyday life

Although appearance comparisons, self-monitoring, and appearance-related comments have been linked to body dissatisfaction in prior studies, the combined and unique influences of these variables on state body dissatisfaction in daily life has yet to be explored. The present study addressed this gap, and also evaluated whether these state-based effects were stronger for individuals with trait-level body image disturbances (internalization and body dissatisfaction). Eighty-four women completed baseline measures of trait internalization and body dissatisfaction, and then reported momentary experiences of body dissatisfaction, appearance self-monitoring, appearance-related comments, and appearance-based comparisons at up to 10 random times daily for seven days. Multilevel analyses confirmed that both appearance comparisons and commentary (both negative and positive) were predictive of changes in state body dissatisfaction when modelled individually as well as in a combined (full) model. Appearance self-monitoring was not a significant predictor, either individually or in the full model. These within-person relationships were not moderated by individual differences in trait body dissatisfaction and internalization of appearance standards. Accordingly, experiences of body dissatisfaction in daily life may be a common reaction to negative appearance comments and unflattering comparisons, yet positive comments and/or efforts to avoid appearance-based comparisons may have a positive effect on one's body image.

Snaps, Selfies, and Shares: How Three Popular Social Media Platforms Contribute to the Sociocultural Model of Disordered Eating Among Young Women

The current study aimed to integrate and test the sociocultural model of disordered eating with theories explaining the impact of mass media on the development of disordered eating for users of three popular social networking platforms. Young women social networking site (SNS) users (age 18-24) who had never received an eating disorder diagnosis (N = 637) completed questions capturing their SNS gratifications and usage, body surveillance, social comparisons, body dissatisfaction, and eating pathology. Measures were administered in one online session. Model relationships were similar across users of all three SNS platforms: Facebook, Instagram, and Snapchat. Users of all platforms demonstrated a significant positive relationship between upward comparisons and disordered eating outcomes, and between body surveillance and disordered eating outcomes, although differences between models did emerge. Empirical findings support extending the sociocultural model of disordered eating to include SNS uses and gratifications.

Risk and maintenance factors for young women's DSM-5 eating disorders

Recent research with young women attending colleges, who are at the average age of eating disorder (ED) onset, established that the ED symptoms are not only prevalent but also relatively stable over the college period. Nonetheless, our knowledge regarding the course and modifiable factors associated with both the onset and maintenance of diagnosable (DSM-5) EDs in this population is limited. The objective of this report was to address these key research gaps. Data were examined from 2713 women who completed assessments of potential vulnerability factors and EDs in the autumn semester of the first (baseline) and fourth (follow-up) college years. A total of 13.1% of the sample met DSM-5 criteria for an ED diagnosis at baseline. At 4-year follow-up, 7.6% of the sample met DSM-5 criteria for an ED, with 67.5% of these cases representing women who had maintained an ED diagnosis from baseline, and 32.5% representing new onset EDs. Elevated appearance-ideal internalization, body dissatisfaction, self-objectification, dieting, and negative affectivity at baseline as well as changes in these factors between assessments all predicted onset and maintenance of DSM-5 EDs at 4-year follow-up. Self-objectification (thinking about and monitoring the body's appearance from an external observer's perspective) was the largest contributor to both ED onset and maintenance. In addition to enhancing our knowledge about the course of young women's (DSM-5) EDs during college, this work highlights potentially similar psychological foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are outlined.

The Daily Frequency, Type, and Effects of Appearance Comparisons on Disordered Eating

Using experience sampling methodology, we examined the effects of frequency and occurrence of appearance-based comparisons on disordered eating behaviors (binge eating, restrictive behaviors, and weight-related exercise). A total of 161 Australian women (aged 18–48) completed a baseline measure of eating pathology. An iPhone application prompted participants 6 times daily for 7 days to self-report on appearance comparisons and disordered eating behaviors since the last assessment. We hypothesized that contemporaneously reported occurrences of both upward and downward appearance comparisons, when compared to noncomparison situations, and frequency of upward comparisons would predict disordered eating behaviors. In prospective (lagged) analyses, only upward comparisons (relative to noncomparison situations) significantly predicted the likelihood of disordered eating outcomes. Trait eating pathology had a direct effect on each disordered eating variable and also moderated the influence of upward appearance comparisons (relative to noncomparison assessments) on binge-eating episodes. The lack of a differentiated effect between contemporaneously reported occurrences of upward and downward comparisons suggests that both forms of comparison increase the likelihood of disordered eating. Women may benefit from preventive programs that focus on the detrimental consequences of appearance comparisons on disordered eating; such programs may equip women with strategies to help reduce the frequency of these comparisons.

Eating disorder-related social comparison in college women's everyday lives

OBJECTIVE

This study examined: frequency of upward and downward body, eating, and exercise comparisons; context in which these comparisons occur; and body, eating, and exercise comparison direction as predictors of concurrent body dissatisfaction and disordered eating thoughts, urges, and behaviors in college women's everyday lives using ecological momentary assessment (EMA).

METHOD

Participants were 232 college women who completed a two-week EMA protocol, using their personal electronic devices to answer questions three times per day.

RESULTS

First, body, eating, and exercise comparisons were common. Second, when these comparisons were made, they were typically upward. Third, body comparisons were most oftentimes made about weight and shape and eating comparisons about healthiness and amount of food. Exercise comparisons were made on a wider variety of dimensions. Fourth, most body and eating comparisons were made with strangers and close friends, respectively, while exercise comparisons were made with a variety of individuals. Upward comparisons were usually made with acquaintances and strangers. Fifth, results shed light on where college women compare themselves. Sixth, upward comparisons were found to have negative consequences, and downward comparisons were generally not found to have a buffering effect on eating pathology.

DISCUSSION

Results suggest targeting not only body but also eating and exercise comparisons in intervention. Also, prevention/intervention approaches should not promote engagement in downward comparisons, as they were not found to be protective and were even harmful at times. Clinicians should be attuned to the categories on which, with whom, and where college women are most likely to compare.

The impact of weight misperception on health-related quality of life in Korean adults (KNHANES 2007-2014): a community-based cross-sectional study

BACKGROUND/OBJECTIVES

Weight perception, especially misperception, might affect health-related quality of life (HRQoL); however, related research is scarce and results remain equivocal. We examined the association between HRQoL and weight misperception by comparing obesity level as measured by body mass index (BMI) and weight perception in Korean adults.

METHODS

Study subjects were 43 883 adults aged 19 years or older from cycles IV (2007-2009), V (2010-2012) and VI (2013-2014) of the Korean National Health and Nutrition Examination Survey. Multiple regression analyses comprising both logit and tobit models were conducted to evaluate the independent effect of obesity level as measured by BMI, weight perception and weight misperception on HRQoL after adjusting for demographics, socioeconomic status and number of chronic diseases. We also performed multiple regressions to explore the association between weight misperception and HRQoL stratified by BMI status.

RESULTS

Obesity level as measured by BMI and weight perception were independently associated with low HRQoL in both separate and combined analyses. Weight misperception, including underestimation and overestimation, had a significantly negative impact on HRQoL. In subgroup analysis, subjects with BMI ranges from normal to overweight who misperceived their weight also had a high risk of low HRQoL. Overestimation of weight among obese subjects associated with low HRQoL, whereas underestimation of weight showed no significant association.

CONCLUSIONS

Both obesity level as measured by BMI and perceiving weight as fat were significant risk factors for low HRQoL. Subjects who incorrectly perceived their weight relative to their BMI status were more likely to report impaired HRQoL, particularly subjects with BMI in the normal to overweight range. Based on these findings, we recommend political and clinical efforts to better inform individuals about healthy weight status and promote accurate weight perception.

Change Narratives That Elude Quantification: A Mixed-Methods Analysis of How People with Chronic Pain Perceive Pain Rehabilitation

Chronic pain negatively impacts health, well-being, and social participation. Effective rehabilitation often hinges on long-term changes in pain-related perceptions and behaviors. However, there are important gaps in understanding how patients perceive these changes. The present pilot study addresses this gap by using qualitative and quantitative methodologies to explore how patients perceive and experience changes in function, participation, and pain-related factors following a chronic pain rehabilitation program. A mixed-method design was used in which the core method was qualitative. Descriptive quantitative data was used to further characterize the sample. Semistructured interviews were conducted 1-6 months following treatment completion. Questionnaires were administered before and after treatment and at follow-up. Interview data was analyzed thematically. Participants' individual descriptive data was compared to established cut-scores and criteria for change. A major theme of personal growth emerged in the qualitative analysis. Participants also discussed the factors that facilitated personal growth and the ongoing challenges to this growth. The quantitative data revealed limited improvement on measures of pain, disability, catastrophizing, and depression. These findings suggest that, despite limited improvement on treatment-related questionnaires, patients can experience an important and enduring sense of personal growth. Clinical and theoretical implications are discussed.

Development and validation of makeup and sexualized clothing questionnaires

BACKGROUND

Body acceptance programs on college campuses indicated that collegiate women often report feeling pressure to dress in a sexualized manner, and use makeup to enhance beauty. Currently, no quantitative measures exist to assess attitudes and daily behaviors that may arise in response to perceived pressure to wear makeup or dress in a provocative manner. The goal of the current studies was to develop brief self-report questionnaires aimed at assessing makeup and sexualized clothing use and attitudes in young women.

METHODS

An exploratory factor analysis in a sample of 403 undergraduate women was used in Study 1 to create items to measure the pressure women feel to wear makeup and sexualized clothing. A confirmatory factor analysis (N = 153) was used in Study 2 to confirm the factor structure found in Study 1. An incremental validity analysis was also conducted in Study 2. Across both studies, participants completed online questionnaires.

RESULTS

In Study 1, items were developed for two questionnaires to assess perceived pressure to wear makeup and discomfort when not wearing makeup, and perceived pressure to wear sexualized clothing, and body image concerns with regards to sexualized clothing. The exploratory factor analyses revealed Unconfident and Unease scales for the Makeup Questionnaire (MUQ) and Body Dissatisfaction and Pressure scales for the Sexualized Clothing Questionnaire (SCQ). In Study 2, the confirmatory factor analyses confirmed the factor structure for the MUQ and SCQ. The incremental validity analysis revealed that these measures can be used to predict self-objectification and shape and weight concern in women.

CONCLUSION

These studies provide preliminary support for the factor structure of two novel questionnaires aimed at assessing perceived pressure to wear makeup and sexualized clothing.

Fat Talk and Body Image Disturbance

Although the link between fat talk and body dissatisfaction is well established, the link between fat talk and other body image disturbance components remains underexplored. Our meta-analytic review explored the cross-sectional, experimental, and longitudinal relations between fat talk and body dissatisfaction, body surveillance, body shame, pressure to be thin, thin-ideal internalization, body checking, and appearance-based comparisons. We identified 35 relevant studies via electronic databases. Meta-analyses provided effect size estimates based on study design and whether fat talk was the predictor or outcome of body image disturbance. Results showed that fat talk is related to a broader range of body image constructs than just body dissatisfaction and that accumulated evidence from longitudinal and experimental studies—although limited in number—suggests it is more plausible that fat talk is a risk factor for these body image constructs, rather than a consequence of them. Nevertheless, the suggestion that fat talk may play a role in the causal sequence of body image issues highlights this as a potential area of intervention for researchers and clinicians. Given that fat talk is common and often well intentioned, awareness-raising exercises for parents and peers may be necessary to curb its incidence and impacts. 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 .

Mediators of the relationship between thin-ideal internalization and body dissatisfaction in the natural environment

Social comparisons (i.e., body, eating, exercise) and body surveillance were tested as mediators of the thin-ideal internalization-body dissatisfaction relationship using ecological momentary assessment (EMA). Participants were 232 college women who completed a 2-week EMA protocol, responding to questions three times per day. Multilevel path analysis was used to examine a 2-1-1 mediation model (thin-ideal internalization assessed as trait; between-person effects examined) and a 1-1-1 model (component of thin-ideal internalization [thin-ideal importance] assessed momentarily; within- and between-person effects examined). For the 2-1-1 model, only body comparison and body surveillance were significant specific mediators of the between-person effect. For the 1-1-1 model, all four variables were significant specific mediators of the within-person effect. Only body comparison was a significant specific mediator of the between-person effect. At the state level, many processes explain the thin-ideal internalization-body dissatisfaction relationship. However, at the trait level, body comparison and body surveillance are more important explanatory factors.

Ecological Momentary Assessment in Eating Disorder and Obesity Research: a Review of the Recent Literature

Our current understanding of the etiology and maintenance of eating disorders and obesity continues to be far from complete. Similarly, our understanding of determinants of both successful and unsuccessful weight loss surgery is also quite limited. While a number of research methodologies have been applied to these areas, one methodology that has recently seen a rise in popularity is the use of ecological momentary assessment (EMA). EMA allows one to study a variety of variables of interest in the natural environment. The study of eating disorders, obesity, and bariatric surgery has all been conducted using EMA recently. The current study is a review of these areas and summarizes the recent literature (past 3 years) in eating disorders, obesity, and bariatric surgery using EMA methodology.

A naturalistic examination of social comparisons and disordered eating thoughts, urges, and behaviors in college women

OBJECTIVE

We examined the effects of body, eating, and exercise social comparisons on prospective disordered eating thoughts and urges (i.e., restriction thoughts, exercise thoughts, vomiting thoughts, binge eating urges) and behaviors (i.e., restriction attempts, exercising for weight/shape reasons, vomiting, binge eating) among college women using ecological momentary assessment (EMA).

METHOD

Participants were 232 college women who completed a 2-week EMA protocol, in which they used their personal electronic devices to answer questions three times per day. Generalized estimating equation models were used to assess body, eating, and exercise comparisons as predictors of disordered eating thoughts, urges, and behaviors at the next report, adjusting for body dissatisfaction, negative affect, and the disordered eating thought/urge/behavior at the prior report, as well as body mass index.

RESULTS

Body comparisons prospectively predicted more intense levels of certain disordered eating thoughts (i.e., thoughts about restriction and exercise). Eating comparisons prospectively predicted an increased likelihood of subsequent engagement in all disordered eating behaviors examined except vomiting. Exercise comparisons prospectively predicted less-intense thoughts about exercise and an increased likelihood of subsequent vomiting.

DISCUSSION

Social comparisons are associated with later disordered eating thoughts and behaviors in the natural environment and may need to be specifically targeted in eating disorder prevention and intervention efforts. Targeting body comparisons may be helpful in terms of reducing disordered eating thoughts, but eating and exercise comparisons are also important and may need to be addressed in order to decrease engagement in actual disordered eating behaviors.