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Paraskeva N, Pegram G, Goel R, Mandhaani M, Suneja V, White P, Diedrichs PC. A cognitive dissonance body image intervention 'Free Being Me' delivered by guide leaders to adolescent girl guides in India: A pilot and acceptability trial. Body Image 2024; 48:101658. [PMID: 38141491 DOI: 10.1016/j.bodyim.2023.101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 11/08/2023] [Accepted: 11/25/2023] [Indexed: 12/25/2023]
Abstract
This pilot study assessed the acceptability and pre-post intervention effects of a cognitive dissonance-based body image intervention, Free Being Me, delivered by Guide leaders to adolescent girls in India. Girls aged 11-14 years (Mage = 12.6, N = 117), who were members of the national scouting and guiding association of India, received the intervention across five weekly 1-hour group sessions. The primary outcome (body esteem) and secondary outcomes (self-esteem, internalisation of appearance ideals, negative and positive affect, and life disengagement) were measured pre-intervention and immediately post-intervention. The intervention was acceptable. Adolescent girls reported high levels of comfort (89%), enjoyment (90%), and perceived importance (92%) with suggestions for improvement including more interactive activities. Facilitator adherence and competence delivering Free Being Me was rated good. Significant within-groups pre-post intervention improvements in body esteem (Cohen's d = 0.28) and reductions in internalisation of appearance ideals (Cohen's d = 0.49) were identified. No changes to self-esteem, negative or positive affect, or life disengagement were observed. This study suggests that Free Being Me is acceptable for community-based delivery and Guide leader format with promising pre-post intervention effects. Going forward, a randomised controlled trial is necessary to make confident interpretations on the effectiveness of Free Being Me.
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Affiliation(s)
- Nicole Paraskeva
- Centre for Appearance Research, University of the West of England, Bristol, UK.
| | - Georgina Pegram
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | | | | | - Vanya Suneja
- O.P Jindal Global University, Sonipat, Haryana, India
| | - Paul White
- Applied Statistics Group, University of the West of England, UK
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Simpson CC, Boutté RL, Burnette CB, Weinstock M, Goel N, Mazzeo SE. Cultural adaptation of an integrated eating disorders prevention and healthy weight management program. J Eat Disord 2023; 11:232. [PMID: 38124164 PMCID: PMC10734179 DOI: 10.1186/s40337-023-00950-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Both eating disorder (ED) prevention and weight management interventions often focus on the thin ideal. Yet, many Black and Latina women do not view thinness as their body ideal. This study used focus groups to investigate the influence of race, ethnicity, and culture on appearance ideals and inform the cultural adaptation and integration of two established programs addressing EDs and weight management: the Body Project, and Healthy Weight Interventions. METHODS White (n = 10), Black (n = 14), and Latina (n = 6) women participated in racially and ethnically homogenous focus groups. RESULTS Thematic analysis identified several themes, including: (1) diverse beauty standards across groups, (2) lack of acknowledgement of racialized beauty standards in prevention and cultural appropriation, (3) culturally-specific impacts of standards, (4) harm of appearance-related comments, (5) limitations of available resources, (6) stigma/minimization of mental health, (7) barriers to inclusive programming, and (8) facilitators of inclusive programming. CONCLUSIONS Results suggested that current programs' emphasis on thinness limit their relevance for women of color, and perpetuate the misconception that EDs primarily affect White women. Findings highlight the need for culturally responsive prevention.
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Affiliation(s)
| | - Rachel L Boutté
- Department of Family and Preventive Medicine, Rush Medical College, Chicago, IL, USA
| | - C Blair Burnette
- Department of Psychology, Michigan State University, Lansing, MI, USA
| | - Madison Weinstock
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA
| | - Neha Goel
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA.
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Wisting L, Stice E, Ghaderi A, Dahlgren CL. Effectiveness of virtually delivered Body Project groups to prevent eating disorders in young women at risk: a protocol for a randomized controlled trial. J Eat Disord 2023; 11:209. [PMID: 38001544 PMCID: PMC10668509 DOI: 10.1186/s40337-023-00932-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) are a group of mental illnesses associated with significant psychological and physiological consequences. Overall, only about one-fifth of individuals with EDs receive treatment and treatment is effective for only about one-third for those who receive care. The development and implementation of effective prevention approaches for those at risk is therefore pivotal. The Body Project is the most effective ED prevention program for at-risk women according to several meta-analyses, but reach is limited since delivery, traditionally, has been in-person. Moreover, peer-led Body Project groups have been reported to produce stronger effects than clinician-led Body Project groups when delivered in-person. This has not yet been examined for virtually delivered Body Project groups. This study therefore seeks to investigate the effect of virtual Body Project groups delivered by peers versus clinicians on ED risk factors, ED symptoms, and prospective ED onset. METHODS Young women with body image concerns aged 16-25 years (N = 441) will be included in the study and randomized to three conditions: (i) virtually delivered Body Project groups led by clinicians; (ii) virtually delivered Body Project groups led by peers; and (iii) psychoeducational control group. Participants will complete assessments at five timepoints over two years (pretest, posttest, 6-months, 1-year, and 2-years). DISCUSSION Further research is needed to examine approaches to increase the potential for broad implementation of prevention of EDs. The virtual modality of the Body Project could markedly expand the reach for young women at risk. If findings confirm that peers can deliver virtual Body Project groups as effectively as clinicians, this will further enhance the implementation potential. TRIAL REGISTRATION The present study has been registered on clinicaltrials.gov (NCT05993728).
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Affiliation(s)
- Line Wisting
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4956, Nydalen, Oslo, 0424, Norway.
| | - Eric Stice
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, USA
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Chao T, Jackson T. Causal effects of appearance-related social exclusion on state body dissatisfaction among young Chinese adults. Acta Psychol (Amst) 2023; 240:104032. [PMID: 37717555 DOI: 10.1016/j.actpsy.2023.104032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/31/2023] [Accepted: 09/12/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVES Numerous studies have linked experiences of appearance-related interpersonal rejection to body dissatisfaction (BD), though few experimental studies have been conducted. This study assessed causal effects of appearance-related social exclusion during an online Cyberball game on state BD as well as potential moderators of this association. METHODS Young Chinese adults (60 women, 37 men; age 20.08 ± 1.32 years) were asked to provide an image of themselves that would be sent to other players prior to a visual perception study involving Cyberball, a virtual ball-tossing game that is used to elicit temporary social exclusion effects. Participants completed a trait Fear of Negative Appearance Evaluation (FNAE) measure before or after engaging in the Cyberball task in addition to post-task state measures of BD and positive mood facets. RESULTS Participants randomly assigned to the social exclusion condition (i.e., receiving 2 of 30 possible throws) reported significantly higher post-Cyberball state BD and significant happiness/energy level/self-confidence deficits compared to peers in a social inclusion condition (i.e., receiving 12 out of 30 throws). A hierarchical regression analysis indicated social exclusion condition membership and trait FNAE elevations, but not their interaction, were significant predictors of higher state BD scores, independent of the impact of gender. CONCLUSIONS Social exclusion experiences linked to physical appearance are a significant causal influence on increases in state BD and positive mood decrements among young Chinese adults.
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Affiliation(s)
- Tong Chao
- Department of Psychology, University of Macau, Macao, S.A.R
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao, S.A.R..
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Carrard I, Cekic S, Bucher Della Torre S. A randomized controlled trial to evaluate the acceptability and effectiveness of two eating disorders prevention interventions: the HEIDI BP-HW project. BMC Womens Health 2023; 23:446. [PMID: 37612687 PMCID: PMC10463671 DOI: 10.1186/s12905-023-02607-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Eating disorders (ED) are common in Switzerland, as in other Western countries, with a prevalence of any ED of 3.5%. However, no specific prevention intervention has been evaluated in the French-speaking part of the country. In this study, we assessed the acceptability and effectiveness of two well-validated eating disorders prevention interventions: the Body Project intervention (BP), based on cognitive dissonance techniques, and the Healthy Weight intervention (HW), based on the implementation of a healthy lifestyle. METHODS Forty female students, aged 18-28, with body dissatisfaction, were randomized into three arms: a BP group, an HW group, and a waiting-list control group (WLCG). The primary outcome measure was body dissatisfaction. Secondary outcomes were thin-ideal internalization, dietary restraint, negative affect, and ED psychopathology. Thirty-three participants completed the assessments before and after the one-month interventions or waiting period. A follow-up measurement was conducted one month after the interventions to assess the stability of the results. RESULTS Both interventions, delivered via a virtual web platform, were considered acceptable. The reduction in body dissatisfaction was greater in the BP group (r = 0.7; p < 0.01) or the HW group (r = 0.6; p < 0.01) than in the WLCG, with large effect sizes. Dietary restraint and shape concern were also significantly reduced in the BP group (r = 0.6 and r = 0.7, respectively; p < 0.01) and HW group (r = 0.5 and r = 0.5, respectively; p < 0.05) compared to the WLCG, with moderate to large effect sizes. The results obtained in each intervention group were stable at the one-month follow-up. CONCLUSIONS This study showed encouraging results in young women with body dissatisfaction, arguing in favor of the French adaptations of the BP and HW interventions. However, the feasibility of recruitment was difficult, partly due to the pandemic situation at the time of the study, and should be further considered to improve dissemination. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04558073, 22/09/2020 and Swiss National Clinical Trial Portal (SNCTP000003978).
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Affiliation(s)
- Isabelle Carrard
- Department of Nutrition and dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.
| | - Sezen Cekic
- Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Sophie Bucher Della Torre
- Department of Nutrition and dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
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Kim J, Aryee LMD, Bang H, Prajogo S, Choi YK, Hoch JS, Prado EL. Effectiveness of Digital Mental Health Tools to Reduce Depressive and Anxiety Symptoms in Low- and Middle-Income Countries: Systematic Review and Meta-analysis. JMIR Ment Health 2023; 10:e43066. [PMID: 36939820 PMCID: PMC10131603 DOI: 10.2196/43066] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Depression and anxiety contribute to an estimated 74.6 million years of life with disability, and 80% of this burden occurs in low- and middle-income countries (LMICs), where there is a large gap in care. OBJECTIVE We aimed to systematically synthesize available evidence and quantify the effectiveness of digital mental health interventions in reducing depression and anxiety in LMICs. METHODS In this systematic review and meta-analysis, we searched PubMed, Embase, and Cochrane databases from the inception date to February 2022. We included randomized controlled trials conducted in LMICs that compared groups that received digital health interventions with controls (active control, treatment as usual, or no intervention) on depression or anxiety symptoms. Two reviewers independently extracted summary data reported in the papers and performed study quality assessments. The outcomes were postintervention measures of depression or anxiety symptoms (Hedges g). We calculated the pooled effect size weighted by inverse variance. RESULTS Among 11,196 retrieved records, we included 80 studies in the meta-analysis (12,070 participants n=6052, 50.14% in the intervention group and n=6018, 49.85% in the control group) and 96 studies in the systematic review. The pooled effect sizes were -0.61 (95% CI -0.78 to -0.44; n=67 comparisons) for depression and -0.73 (95% CI -0.93 to -0.53; n=65 comparisons) for anxiety, indicating that digital health intervention groups had lower postintervention depression and anxiety symptoms compared with controls. Although heterogeneity was considerable (I2=0.94 for depression and 0.95 for anxiety), we found notable sources of variability between the studies, including intervention content, depression or anxiety symptom severity, control type, and age. Grading of Recommendations, Assessments, Development, and Evaluation showed that the evidence quality was overall high. CONCLUSIONS Digital mental health tools are moderately to highly effective in reducing depression and anxiety symptoms in LMICs. Thus, they could be effective options to close the gap in depression and anxiety care in LMICs, where the usual mental health care is minimal. TRIAL REGISTRATION PROSPERO CRD42021289709; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=289709.
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Affiliation(s)
- Jiyeong Kim
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Lois M D Aryee
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Heejung Bang
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Steffi Prajogo
- Johns Hopkins Bayview Medical Center, Baltimore, MD, United States
| | - Yong K Choi
- Department of Health Information Management, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jeffrey S Hoch
- Division of Health Policy and Management, Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Elizabeth L Prado
- Department of Nutrition, Institute for Global Nutrition, University of California, Davis, Davis, CA, United States
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Wang Y, Wang J, Geng J, Wang H, Lei L. Body talk on social networking sites and restrained eating among adolescents: A test of a multiple mediation model. Body Image 2023; 45:145-152. [PMID: 36924748 DOI: 10.1016/j.bodyim.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
The present study aimed to examine the link between body talk on social networking sites (SNS body talk) and restrained eating as well as the mediating roles of fear of negative appearance evaluation (FNAE) and body shame in this relationship. Furthermore, the moderating role of gender in the mediation model was also examined. A sample of 1481 Chinese middle and high school students (720 girls, mean age = 15.49 ± 1.84) completed self-reported measures of SNS body talk, FNAE, body shame, and restrained eating. Results showed that SNS body talk was positively associated with restrained eating. FNAE and body shame mediated the association between SNS body talk and restrained eating, separately and serially. Furthermore, gender difference emerged in the path from SNS body talk to body shame and the path from FNAE to body shame. Findings of the present study enrich the literature on social media and body image and eating behaviors, and have important implications for reducing negative body image and disordered eating among adolescents.
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Affiliation(s)
- Yuhui Wang
- Faculty of Humanities and Social Sciences, Beijing University of Technology, Beijing 100124, China; Beijing Social Governance Research Center, Beijing University of Technology, Beijing 100124, China
| | - Jing Wang
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Jingyu Geng
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Hongxia Wang
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Li Lei
- School of Education, Renmin University of China, Beijing 100872, China.
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Yamamiya Y, Omori M. How prepartum appearance-related attitudes influence body image and weight-control behaviors of pregnant Japanese women across pregnancy: Latent growth curve modeling analyses. Body Image 2023; 44:53-63. [PMID: 36481540 DOI: 10.1016/j.bodyim.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Abstract
A thin female physique is idealized in modernized societies, leading many pregnant women to experience body dissatisfaction and avoid weight gain, as pregnancy directs their body away from the sociocultural ideal of thinness. However, not all pregnant women report body dissatisfaction and/or weight-control behavior. We aimed to discern how prepartum weight-related attitudes-thin-ideal internalization, drive for thinness, and appearance comparison tendency-influence changes in negative attitudes toward a pregnant body, body image, and weight-control behavior across pregnancy. Data were longitudinally collected from 208 Japanese pregnant women (Mage = 27.0, SD = 1.74) across three pregnancy periods. Results indicated that overall, negative attitudes toward appearance change during pregnancy, weight-control behaviors, and restrained eating significantly changed across pregnancy. Moreover, those with higher prepartum thin-ideal internalization showed greater decreases in negative attitudes toward appearance change during pregnancy and greater increases in body dissatisfaction, whereas those with higher prepartum drive for thinness and appearance comparison tendency showed greater decreases in restrained eating across pregnancy. Our findings suggest that pregnant women with certain prepartum weight-related attitudes may experience an aggravation of body dissatisfaction while following dietary regimen during pregnancy. Thus, prevention programs may selectively help them reduce their negative body image during pregnancy.
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Affiliation(s)
- Yuko Yamamiya
- Ochanomizu University, Japan; Temple University, Japan Campus, Japan.
| | - Mika Omori
- Ochanomizu University, Japan; Tohoku University, Japan
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Ciao AC, Duvall A, Pascual S, Lawley KA. Expert peer facilitation of the EVERYbody Project: A randomized-controlled evaluation of a diversity-focused, dissonance-based, universal body image program for college students. Int J Eat Disord 2023; 56:372-383. [PMID: 36380601 DOI: 10.1002/eat.23852] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE A novel peer facilitation model was used to deliver a two session, dissonance-based, inclusive body image intervention that critically examines how internalized size-based oppression intersects with race, class, gender, sexuality, and ability. METHOD The EVERYbody Project was open to all college students and delivered by "expert" peer facilitators with body image and diversity experience and advanced facilitation skills. Recruitment was halted due to COVID-19; 90 students in the Northwest US (M age = 19.83 years, SD = 2.38; 80% female-identified, 13% male-identified, 7% gender expansive) were randomized to receive the EVERYbody Project or a video-based, low-dissonance comparison intervention. RESULTS Around half of students (56%) held one or more specific socially marginalized identity (26% with a racial or ethnic identity other than white and non-Hispanic, 39% with a sexual identity other than straight, 7% with a gender identity other than cisgender). The EVERYbody Project produced greater reductions in three outcomes associated with poor body image (internalized appearance norms, body dissatisfaction, and negative affect) compared to the video intervention through 3-month follow-up (ps < .003) with medium between group effects. Both conditions experienced small reductions in eating disorder psychopathology over time. DISCUSSION Expert peer facilitation may be a viable delivery model for inclusive, diversity-focused dissonance-based body image programs. PUBLIC SIGNIFICANCE This study explored a novel facilitation approach for a diversity-focused body image program for college students. A brief (4 h) dissonance-based program was open to all college students and delivered by "expert" diverse peer leaders who were screened for facilitation readiness. Body image and related outcomes were improved through 3-month follow-up relative to a comparison condition, suggesting that expert peer facilitation may be a viable option for delivering universal, inclusive body image programming.
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Affiliation(s)
- Anna C Ciao
- Department of Psychology, Western Washington University, Bellingham, Washington, USA
| | - Ally Duvall
- Department of Psychology, Western Washington University, Bellingham, Washington, USA
| | - Summer Pascual
- Department of Psychology, Western Washington University, Bellingham, Washington, USA
| | - Kendall A Lawley
- Department of Psychology, Western Washington University, Bellingham, Washington, USA.,Department of Epidemiology, University of Washington, Seattle, Washington, USA
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Validation of the Body Acceptance by Others Scale-2 (BAOS-2) and assessment of its associations with prospective changes in body image among young adults in China. Body Image 2022; 43:112-124. [PMID: 36113281 DOI: 10.1016/j.bodyim.2022.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022]
Abstract
The Body Acceptance by Others Scale-2 (BAOS-2) was developed to assess overall perceived body acceptance by others. In two studies, we evaluated its structure, reliability and validity among young adults in China. In Study 1, 435 women and 322 men completed newly translated simplified Chinese versions of the BAOS-2 and Functionality Appreciation Scale (FAS), conceptually related body image questionnaires and demographic items. Exploratory factor analyses supported a 13-item unidimensional BAOS-2 structure across men and women. Internal consistency, test-retest reliability, convergent validity and discriminant validity were also supported. Study 2 (307 men, 396 women) replicated the original gender-invariant BAOS-2 structure in confirmatory factor analysis and bolstered evidence for convergent, discriminant and incremental validity. Predictive validity, examined via longitudinal analyses, indicated baseline BAOS-2 scores and/or concomitant changes in BAOS-2 scores over time were related to improvements on other positive and negative body image measures at a six-month follow-up. Supplementary analyses replicated the original unidimensional FAS factor structure and provided considerable support for its psychometrics across samples. In sum, this research supported psychometric properties of the BAOS-2 among young adults in China and underscored its potential utility in predicting changes in other body image experiences over time.
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Willis HA, Gonzalez JC, Call CC, Quezada D, Galán CA. Culturally Responsive Telepsychology & mHealth Interventions for Racial-Ethnic Minoritized Youth: Research Gaps and Future Directions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:1053-1069. [PMID: 36227174 PMCID: PMC9627988 DOI: 10.1080/15374416.2022.2124516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Telepsychology and mHealth (TPmH) services for youth and their families have become increasingly prevalent in recent years. However, significant limitations in theory, research, and policy introduce questions about the effectiveness of such interventions, particularly for racial-ethnic minoritized youth and their families, who already contend with inequities in mental health treatment access and outcomes. Although TPmH have the potential to reduce barriers to mental health services in ways that may benefit racial-ethnic minoritized youth and their families, the mental health field must first grapple with limitations in culturally responsive TPmH work to avoid perpetuating existing mental health inequities. As such, this article begins by briefly reviewing extant literature on (1) TPmH for youth, (2) culturally adapted or culturally responsive evidence-based interventions for racial-ethnic minoritized youth and families, and (3) the intersection of TPmH and culturally responsive interventions. Informed by the gaps identified by this review, we provide recommendations for future directions in culturally responsive TPmH for racial-ethnic minoritized youth and families. These recommendations have been organized into four overarching categories: (1) conceptual and theoretical recommendations, (2) research priorities, (3) practice and policy recommendations, and (4) engagement and access recommendations. These recommendations offer novel ideas for researchers, clinicians, funding agencies, policy-makers, and other key stakeholders and are intended to facilitate equity in TPmH for racial-ethnic minoritized youth and their families.
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Affiliation(s)
| | - Juan Carlos Gonzalez
- Department of Counseling, Clinical, & School Psychology, University of California
| | | | - David Quezada
- Department of Psychology, University of Southern California
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Chen M, Yin W, Sung-Chan P, Wang Z, Shi J. The Interactive Role of Family Functioning among BMI Status, Physical Activity, and High-Fat Food in Adolescents: Evidence from Shanghai, China. Nutrients 2022; 14:nu14194053. [PMID: 36235707 PMCID: PMC9572029 DOI: 10.3390/nu14194053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: Family functioning (FF), physical activity (PA), and high-fat food consumption (HF) are associated with adolescents being overweight and obese; however, little is known about their interactions. Therefore, this study aimed to examine how they work jointly on adolescent obesity with BMI as the outcome variable. Methods: A cross-sectional survey utilizing a cluster sampling design was conducted. Multinomial logistic regressions, multiplication interaction (MI), and marginal effects (MEs) were tested. Results: Active PA (non-overweight vs. obesity: OR = 2.260, 95% CI [1.318, 3.874]; overweight vs. obesity: OR = 2.096, 95% CI [1.167, 3.766]), healthy HF (non-overweight vs. obesity: OR = 2.048, 95% CI [1.105, 3.796]) and healthy FF (overweight vs. obesity: OR = 2.084, 95% CI [1.099, 3.952]) reduced obesity risk. Overweight students with healthy FF were less likely to become obese regardless of PA (inactive: OR = 2.181, 95% CI [1.114, 4.272]; active: OR = 3.870, 95% CI [1.719, 8.713]) or HF (unhealthy: OR = 4.615, 95% CI [1.049, 20.306]; healthy: OR = 5.116, 95% CI [1.352, 19.362]). The MEs of inactive PA and unhealthy FF were −0.071, 0.035, and 0.036 for non-overweight, overweight, and obese individuals, respectively (p < 0.05); the MEs of HF and healthy FF individuals were −0.267 and 0.198 for non-overweight and obese individuals, respectively (p < 0.05). Conclusions: Unhealthy FF regulated the influence of inactive PA or unhealthy HF on adolescent obesity, altogether leading to a higher risk of obesity.
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Affiliation(s)
- Mingyue Chen
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Wei Yin
- Department of Social and Behavioural Sciences, College of Liberal Arts and Social Sciences, City University of Hong Kong, Hong Kong, China
| | - Pauline Sung-Chan
- Hong Kong Institute of Economics & Business Strategy, HKU School of Business, The University of Hong Kong, Hong Kong, China
- Correspondence: (P.S.-C.); (Z.W.); (J.S.)
| | - Zhaoxin Wang
- The First Affiliated Hospital of Hainan Medical University, Haikou 571199, China
- School of Management, Hainan Medical University, Haikou 571199, China
- Correspondence: (P.S.-C.); (Z.W.); (J.S.)
| | - Jianwei Shi
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China
- Department of Social Medicine and Health Management, School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
- Correspondence: (P.S.-C.); (Z.W.); (J.S.)
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Virtual prevention of eating disorders in children, adolescents, and emerging adults: a scoping review. J Eat Disord 2022; 10:94. [PMID: 35794629 PMCID: PMC9258006 DOI: 10.1186/s40337-022-00616-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/24/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic, there was a necessity for eating disorder (ED) outpatient treatment to be delivered virtually. Given this transition, and the surge in new ED cases, there was an urgent need to investigate virtually delivered ED prevention programs. This review aimed to identify the available evidence on virtual ED prevention programs for children, adolescents, and emerging adults. METHOD Using scoping review methodology, seven databases were searched for studies published from January 2000 to April 2021 reporting on virtually delivered ED prevention interventions for children and adolescents (< 18 years) and emerging adults (18-25 years). Studies were excluded if they contained adults (> 25 years) and individuals with clinical ED diagnoses. Abstracts and full-text papers were reviewed independently by two reviewers. Data was extracted on study type, methodology, age, sample size, virtual intervention, outcomes, and results. In April 2022, we used a forward citation chaining process to identify any relevant articles from April 2021 to April 2022. RESULTS Of 5129 unique studies identified, 67 met eligibility criteria, which included asynchronous (n = 35) and synchronous (n = 18) internet-based programs, other e-technology including mobile apps (n = 3) and text messaging interventions (n = 1), computer-based programs (n = 6), and online caregiver interventions focused on child outcomes (n = 4). Few studies mainly included children and adolescents (n = 18), whereas the vast majority included emerging adults (n = 49). For children and adolescents, the most widely researched programs were Student Bodies and its adapted versions (n = 4), eBody Project (n = 2), and Parents Act Now (n = 2). For emerging adults, the most widely researched programs were Student Bodies and its adapted versions (n = 16), eBody Project (n = 6) and Expand Your Horizon (n = 4). These interventions were effective at reducing various symptoms and ED risk. Some studies demonstrated that virtual prevention intervention efficacy resembled in-person delivery. CONCLUSION Virtual prevention interventions for EDs can be effective, however more research is needed studying their impact on children and adolescents and on improving access for vulnerable groups. Additional efficacy studies are required, such as for text messaging and mobile app ED prevention interventions. Evidence-based recommendations for virtual ED prevention for children, adolescents, and emerging adults at-risk for EDs should be prioritized.
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14
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Wu Y, Alleva JM, Broers NJ, Mulkens S. Attitudes towards cosmetic surgery among women in China and the Netherlands. PLoS One 2022; 17:e0267451. [PMID: 35446909 PMCID: PMC9022849 DOI: 10.1371/journal.pone.0267451] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/09/2022] [Indexed: 11/24/2022] Open
Abstract
Around the world, an increasing number of people, predominantly women, are choosing to undergo cosmetic surgery-despite the associated health risks. This study aimed to promote a better cross-cultural understanding of the correlates and predictors of favorable attitudes toward cosmetic surgery among women in China (an Eastern country where cosmetic surgery is increasing most rapidly) and the Netherlands (a Western country). Questionnaire data were obtained from 763 adult women; 245 were Chinese women in China (Mage = 29.71), 265 were Chinese women in the Netherlands (Mage = 25.81), and 253 were Dutch women (Mage = 29.22). Facial appearance concerns and materialistic belief were significant predictors of favorable attitudes towards cosmetic surgery for all three cultural groups. Body appreciation was a significant positive predictor among Chinese women in both China and the Netherlands, whereas age and beauty-ideal internalization were significant positive predictors only among Chinese women in China. The findings and their implications are discussed with respect to the characteristics of Chinese culture that could explain the identified differences between Chinese and Dutch women.
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Affiliation(s)
- Yi Wu
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jessica M. Alleva
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Nick J. Broers
- Department of Methodology and Statistics, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sandra Mulkens
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine, and Life Sciences; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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15
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Chinese translation of the Clinical Impairment Assessment (CIA 3.0): Psychometric properties and measurement invariance across sex and age in adolescents, young adults, and adult men. Eat Behav 2022; 45:101623. [PMID: 35303545 DOI: 10.1016/j.eatbeh.2022.101623] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/23/2021] [Accepted: 03/06/2022] [Indexed: 11/22/2022]
Abstract
The Clinical Impairment Assessment (CIA) is the most widely used instrument for assessing psychosocial impairment related to eating disorders (EDs). The CIA was translated into Chinese based on standard procedures. The psychometric properties of the Chinese CIA (C-CIA) were assessed among four adolescent and adult samples [i.e., 792 junior high school students (47.0% boys; Mage = 13.09 years), 1324 senior high school students (44.2% boys; Mage = 16.06 years), 812 undergraduate students (36.3% boys; Mage = 18.88 years), and 406 male adults from a general population (Mage = 28.53 years)]. The three-factor structure of the CIA was replicated. Excellent internal consistencies of the C-CIA were revealed, α = 0.93-0.98. The C-CIA showed moderate and good test-retest reliability in a six-month interval for junior high school students (ICC = 0.69) and senior high school students (ICC = 0.76), respectively. The C-CIA had good test-retest reliability in a two-week interval for undergraduate students (ICC = 0.78) and general adult men (ICC = 0.81). Our results supported good construct validity, known-group validity of the C-CIA, and measurement invariance across sex and age. These findings suggest that the C-CIA can be a useful tool assessing psychosocial impairment related to EDs for Chinese adolescents, young adults, and adult men.
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16
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Wu Y, Mulkens S, Alleva JM. Body image and acceptance of cosmetic surgery in China and the Netherlands: A qualitative study on cultural differences and similarities. Body Image 2022; 40:30-49. [PMID: 34801810 DOI: 10.1016/j.bodyim.2021.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/19/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
There is an established relationship between acceptance of cosmetic surgery and psychological factors, including body image. However, qualitative research among diverse cultural groups is needed to provide a more fine-grained understanding of the influences on women's attitudes towards cosmetic surgery. In this study, 20 Chinese and 20 Dutch women aged 18-50 years (MChinese = 34.20; MDutch = 34.70) participated in one-on-one semi-structured interviews. Data were analyzed using reflexive thematic analysis. We identified three themes that captured the factors that women perceived to foster favorable attitudes towards cosmetic surgery: (a) sociocultural pressures (e.g., normalization of cosmetic surgery, appearance-focused peers); (b) intrapersonal characteristics (e.g., beauty-ideal internalization, social comparison); and (c) benefits of beauty (e.g., attracting men, socioeconomic benefits). Conversely, two themes captured the factors perceived to reduce favorable attitudes towards cosmetic surgery: (a) intrapersonal characteristics (e.g., unconditional body acceptance, self-confidence); and (b) external considerations (e.g., health risks, financial costs). Overall, Chinese and Dutch participants shared many similarities in their opinions about what might affect cosmetic surgery consideration. The most striking cross-cultural differences concerned perceived socioeconomic benefits of beauty (mainly Chinese women) and women's conceptualization of body appreciation. This study may enable a more comprehensive understanding about the factors influencing Chinese and Dutch women's attitudes towards cosmetic surgery, and the nuances in these relationships across these cultures.
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Affiliation(s)
- Yi Wu
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Sandra Mulkens
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine, and Life Sciences; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jessica M Alleva
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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17
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Liu ZH, Cai H, Bai W, Liu S, Liu H, Chen X, Qi H, Cheung T, Jackson T, Liu R, Xiang YT. Gender Differences in Body Appreciation and Its Associations With Psychiatric Symptoms Among Chinese College Students: A Nationwide Survey. Front Psychiatry 2022; 13:771398. [PMID: 35250658 PMCID: PMC8892204 DOI: 10.3389/fpsyt.2022.771398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Body appreciation (BA hereafter), which reflects approval, acceptance, and respect for one's body while also rejecting media-promoted appearance ideals as the only form of human beauty, is an important aspect of positive body image. Much of the BA literature has been conducted on samples from Western nations but less is known about BA or its correlates in Asian cultural contexts wherein concerns with body image are also common. Toward addressing this gap, we examined gender differences in BA and its associations with common psychiatric symptoms (i.e., depressive symptoms, anxiety symptoms, and suicidality) within a national college student sample from China. METHOD This cross-sectional, nationwide study was conducted between December 27, 2020, and January 18, 2021, based on snowball sampling. Aside from measures of demographics and background factors, Chinese versions of the Body Appreciation Scale-2 (BAS-2), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and a standard item on suicidal ideation and planning were administered to assess BA, depressive and anxiety symptoms, and suicidality, respectively. RESULTS In total, 2,058 college students (665 men, 1,393 women) in China were assessed. An analysis of covariance revealed that the men had a significantly higher average BA level than did women [F (1,2058) = 13.244, P < 0.001, Cohen's d = 0.193]. Hierarchical multiple regression analyses revealed BA was negatively associated with symptoms of depression, anxiety, and suicidality within the entire sample (depressive symptoms, β = -0.129, P < 0.001; anxiety symptoms, β = -0.101, P < 0.001; suicidality, OR = 0.788 P = 0.020) and among women (depressive symptoms, β = -0.172, P < 0.001; anxiety symptoms, β = -0.131, P < 0.001; suicidality, OR = 0.639 P = 0.001) but not men. CONCLUSION Chinese college women reported lower BA than their male peers did. Furthermore, among women but not men, elevations in BA corresponded with protective mental health experiences including lower levels of depressive symptoms, anxiety symptoms and suicidality. Findings underscore the potential utility of including BA in mental health assessments of Chinese college students, especially women. Findings also provide foundations for continued research on interventions to increase BA among at-risk young women in China.
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Affiliation(s)
- Zi-Han Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Taipa, Macao SAR, China
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Taipa, Macao SAR, China
| | - Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Taipa, Macao SAR, China
| | - Shou Liu
- Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Han Qi
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, Macao SAR, China
| | - Rui Liu
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Taipa, Macao SAR, China
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18
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Gan DZQ, McGillivray L, Han J, Christensen H, Torok M. Effect of Engagement With Digital Interventions on Mental Health Outcomes: A Systematic Review and Meta-Analysis. Front Digit Health 2021; 3:764079. [PMID: 34806079 PMCID: PMC8599127 DOI: 10.3389/fdgth.2021.764079] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/29/2021] [Indexed: 01/19/2023] Open
Abstract
Digital mental health interventions (DMHIs) present a promising way to address gaps in mental health service provision. However, the relationship between user engagement and outcomes in the context of these interventions has not been established. This study addressed the current state of evidence on the relationship between engagement with DMHIs and mental health outcomes. MEDLINE, PsycINFO, and EmBASE databases were searched from inception to August 1, 2021. Original or secondary analyses of randomized controlled trials (RCTs) were included if they examined the relationship between DMHI engagement and post-intervention outcome(s). Thirty-five studies were eligible for inclusion in the narrative review and 25 studies had sufficient data for meta-analysis. Random-effects meta-analyses indicated that greater engagement was significantly associated with post-intervention mental health improvements, regardless of whether this relationship was explored using correlational [r = 0.24, 95% CI (0.17, 0.32), Z = 6.29, p < 0.001] or between-groups designs [Hedges' g = 0.40, 95% CI (0.097, 0.705), p = 0.010]. This association was also consistent regardless of intervention type (unguided/guided), diagnostic status, or mental health condition targeted. This is the first review providing empirical evidence that engagement with DMHIs is associated with therapeutic gains. Implications and future directions are discussed. Systematic Review Registration: PROSPERO, identifier: CRD 42020184706.
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Affiliation(s)
- Daniel Z Q Gan
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Lauren McGillivray
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Jin Han
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
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19
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Spanhel K, Balci S, Feldhahn F, Bengel J, Baumeister H, Sander LB. Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review. NPJ Digit Med 2021; 4:128. [PMID: 34433875 PMCID: PMC8387403 DOI: 10.1038/s41746-021-00498-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 08/03/2021] [Indexed: 02/07/2023] Open
Abstract
Providing accessible and effective healthcare solutions for people living in low- and middle-income countries, migrants, and indigenous people is central to reduce the global mental health treatment gap. Internet- and mobile-based interventions (IMI) are considered scalable psychological interventions to reduce the burden of mental disorders and are culturally adapted for implementation in these target groups. In October 2020, the databases PsycInfo, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were systematically searched for studies that culturally adapted IMI for mental disorders. Among 9438 screened records, we identified 55 eligible articles. We extracted 17 content, methodological, and procedural components of culturally adapting IMI, aiming to consider specific situations and perspectives of the target populations. Adherence and effectiveness of the adapted IMI seemed similar to the original IMI; yet, no included study conducted a direct comparison. The presented taxonomy of cultural adaptation of IMI for mental disorders provides a basis for future studies investigating the relevance and necessity of their cultural adaptation.PROSPERO registration number: CRD42019142320.
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Affiliation(s)
- Kerstin Spanhel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany.
| | - Sumeyye Balci
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Felicitas Feldhahn
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Juergen Bengel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lasse B Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
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20
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Jackson T, Ye X, Hall BJ, Chen H. "Have You Taken the A4 Challenge?" Correlates and Impact of a Thin Ideal Expression From Chinese Social Media. Front Psychol 2021; 12:669014. [PMID: 34163409 PMCID: PMC8215108 DOI: 10.3389/fpsyg.2021.669014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
In three studies, we assessed knowledge, correlates, and effects of the A4 challenge, an expression of the thin ideal from Chinese social media. In Study 1, gender differences in familiarity with the A4 challenge were assessed among 225 women and 151 men. Compared to men, women and female peers from participant social networks were more familiar with and likely to have taken the challenge themselves. In Study 2, body image experiences of women who passed the A4 challenge (N = 45) and average weight peers who did not pass the challenge (N = 75) were assessed. The former group reported fewer weight concerns and less social pressure to lose weight but no group differences were observed with respect to binge-eating, dieting, or other compensatory weight loss behaviors. As such, eating disorder symptoms did not account for the experience of passing the A4 challenge. In Study 3, changes in state body dissatisfaction were assessed among 205 women randomly assigned to view images of (1) thin peers successfully passing the challenge vs. (2) thin or (3) average size controls. The absence of condition differences in post-exposure state body dissatisfaction indicated exposure to A4 challenge portrayals per se did not cause increases in negative appearance self-evaluations for women in general. However, among women who were exposed to A4 challenge images, but not control group women exposure to other images, trait body dissatisfaction predicted increased post-exposure state dissatisfaction, independent of pre-exposure state dissatisfaction. Implications are discussed in relation to effects of exposure to the A4 challenge and conceptualizing the task as a "challenge."
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Affiliation(s)
- Todd Jackson
- Department of Psychology, University of Macau, Taipa, China
| | - Xiaoxuan Ye
- School of Psychology, Southwest University, Chongqing, China
| | - Brian J. Hall
- School of Global Public Health, New York University Shanghai, Shanghai, China
| | - Hong Chen
- School of Psychology, Southwest University, Chongqing, China
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