Investing in the ideal: does objectified body consciousness mediate the association between appearance contingent self-worth and appearance self-esteem in women?

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.

Global and appearance-contingent self-esteem: Associations with health and attractiveness exercise reasons

Whilst some individuals exercise for health-related reasons, others appear to exercise to bolster physical attractiveness. For the latter, this is often attributed to dissatisfaction with appearance. Few studies, however, have explored if differences in self-esteem may relate to diverse exercise reasons. The present study investigated whether global self-esteem, appearance-contingent self-worth, and appearance satisfaction may be differentially associated with health and attractiveness exercise reasons. It was further sought to explore whether these relations coincided with different motivational regulations. Adults from the east midlands of the United Kingdom (N = 209; 75% female, 25% male; mean age = 29.77 years) completed measures relating to their global and appearance-contingent self-esteem, appearance satisfaction, exercise intentions, and motivations. Structural equation modelling revealed that global self-esteem was positively associated with appearance satisfaction and health reasons for exercise, whereas appearance-contingent self-esteem related to lower appearance satisfaction and attractiveness reasons. Appearance satisfaction had no association with either exercise reason but was associated with intrinsic motivation and lower controlled exercise motivations. Health exercise reasons were positively associated with intrinsic, identified, and introjected motivation, whereas attractiveness reasons were exclusively related to external motivation. The findings highlight the conceptual importance of differentiating the level and contingency of exercisers' self-esteem. The findings may also have substantive value for exercise practitioners in understanding different reasons for exercise.

Self-compassion and body image in pregnancy and postpartum: A randomized pilot trial of a brief self-compassion meditation intervention

The current study evaluated the efficacy of a three-week self-compassion (SC) meditation intervention in improving body image and SC during pregnancy and postpartum. Participants (n = 71; age = 31.92 ± 3.98 years; white = 61, 85.9%; intervention = 35, 49.3%; pregnant = 33, 46.5%; postpartum = 38, 53.5%) were recruited from a health coaching program and 35 were randomly assigned into a three-week SC meditation intervention while 36 were randomly assigned to a waitlist control condition. Linear regressions using full-information maximum likelihood estimation examined the effect of intervention group on body image and SC outcomes controlling for baseline level of outcome, pregnancy or postpartum status, previous meditation experience, and physical activity. Results indicated women in the intervention group reported significantly reduced body shame and body dissatisfaction and improved body appreciation and self-compassion compared to women in the control group. Implementation of a brief SC meditation intervention during pregnancy and postpartum has potential to improve mental health outcomes related to body image. Future work should replicate this study with a larger, more diverse sample of women.

Which are the Effects of Body-Objectification and Instagram-Related Practices on Male Body Esteem? A Cross-Sectional Study

OBJECTIVE

According to the objectification framework, media pressure toward body models promotes the internalization of beauty ideals that negatively influence individuals' body image and self-esteem. Historically, women have been the main target of sociocultural pressures. However, research has recently suggested that self-objectification is a male phenomenon as well, which can be inscribed in men's body experiences. Nevertheless, fewer studies have specifically focused on the male experience and general consequences of body-objectification are yet to be extensively analyzed regarding males' body image features. The current cross-sectional study explores the consequences of body-objectification on male body esteem, specifically testing the predictive role of exercising/dietary habits, body-objectification features, and SNS-related practices on male body esteem.

METHOD

A total of 238 male participants (mean age = 24.28 years, SD = 4.32) have been involved in an online survey. Three hierarchical analyses were performed to test the influence of objectified body consciousness and social networking-related experiences (i.e. Instagram intensity use, photo manipulation, selfie feedback investment) on young men's body esteem with specific reference to the weight, appearance, and attribution features of the Body Esteem Scale.

RESULTS

Findings highlighted that body shame played an interesting key role, influencing negatively all the body esteem dimensions, thus highlighting that attention needs to be deserved on this feature of OBC regarding males' experience. On the contrary, appearance control-related dimensions positively influenced body esteem. Overall, findings confirmed that objectification theory can adequately mark a pathway by which media imagery is internalized also by men and may negatively affect their body esteem.

CONCLUSIONS

Despite some limitations, this study may contribute to enlarging our knowledge on male body image and self-objectification experience and support literature shattering the stereotype that body dissatisfaction is a "female-exclusive" issue. Likewise, beyond some questioning positions, these findings also encourage further exploration of a healthier "control dimension", including body appearance-related activities and beliefs.

Women's attractiveness contingent self-esteem, romantic rejection, and body dissatisfaction

The centrality of attractiveness to social evaluations of women puts women at particular risk of body dissatisfaction. However, it is less clear who these social standards most affect and the situations in which they are most salient. Women whose self-esteem is more contingent on standards of attractiveness (ACSE) should be particularly vulnerable to body dissatisfaction, particularly in contexts that provide negative attractiveness-relevant feedback such as romantic rejection. The current research tested whether women higher in ACSE experienced greater body dissatisfaction in the context of naturally-occurring experiences of romantic rejection. In Study 1, women (N = 168) identified and recalled a range of prior rejection experiences and reported their body dissatisfaction. Women higher in ACSE recalled greater body dissatisfaction in the context of romantic rejection. In Study 2, women (N = 101) recorded daily experiences of romantic rejection and body dissatisfaction (N = 885 daily records). Women higher in ACSE experienced greater within-person increases in body dissatisfaction on days they reported romantic rejection. The results emphasize the relevance of romantic rejection for understanding women's body dissatisfaction and help explain inconsistencies in the literature by illustrating that higher ACSE is associated with greater body dissatisfaction in contexts that provide negative attractiveness-related feedback.

Gender and Cultural Differences in the Relationships between Self-Esteem Contingency, Body Talk, and Body Esteem

This study analyzed the positive and negative body talk of male and female adolescents cross-culturally with an emphasis on the role of appearance-contingent and others' approval-contingent self-worth. A cross-national survey in Austria, Belgium, Spain, and South Korea among 12- to 16-year-olds (982 female and 993 male) found that (1) positive body talk was positively related and negative body talk was negatively related to body esteem; (2) appearance contingency was positively related to negative body talk; (3) appearance contingency increased positive body talk among girls (except Korean girls); and (4) contingency on other's approval increased positive body talk among boys in all four countries. Overall, gender differences were more prominent than cultural differences and positive body talk was instrumental in promoting adolescents' body esteem.

Body weight contingent self-worth predicts depression in adolescent girls: The roles of self-esteem instability and interpersonal sexual objectification

This 3-year longitudinal study examined the extent to which body weight contingent self-worth (CSW) predicted depressive symptoms in 439 adolescent girls and the roles of unstable self-esteem and interpersonal sexual objectification in this association. Half-longitudinal mediation showed that the indirect effect of body weight CSW on depression via instability of self-esteem was significant. Prior levels of body weight CSW predicted increases in unstable self-esteem, which predicted increments in depressive symptoms over time. However, earlier levels of depression did not significantly predict increases in self-esteem instability. Moderation analyses indicated that the indirect effect was conditional upon individuals' experience of interpersonal sexual objectification. The positive link between body weight CSW and unstable self-esteem was stronger in girls who experienced more interpersonal sexual objectification. The direct effect of body weight CSW on depression was also moderated by interpersonal sexual objectification. Taken together, basing self-worth on body weight appears to be a risk factor for depression through its association with unstable self-esteem in adolescent girls and sexually objectifying experiences serve to exacerbate the connection between body weight CSW and adverse outcomes.

The Relationships among Self-Worth Contingency on Others' Approval, Appearance Comparisons on Facebook, and Adolescent Girls' Body Esteem: A Cross-Cultural Study

The present study examined the relationship between appearance-related social comparison on social networking services (SNSs) and body esteem in a cross-cultural context (three European countries, i.e., Austria, Belgium, and Spain, versus one Asian country, i.e., South Korea). The role of self-worth contingency on others' approval was considered to be a psychological and cultural factor. Utilizing a large-scale cross-national survey of early and middle adolescents in 2017, the responses of female adolescents (N = 981) were analyzed. The results generally support the findings from previous studies but also reveal cultural differences. Appearance comparison on Facebook negatively influenced girls' body esteem in all European countries, but not in South Korea. Self-worth contingency on others' approval negatively influenced girls' body esteem across all four countries. Finally, a positive relationship between self-worth contingency on others' approval and appearance comparison on Facebook was found in all European countries, but not among Korean girls. These findings suggest the importance of self-worth contingency on others' approval and cultural contexts can be used to study the effects of body image-related SNS use.

Women's Pathological Narcissism and its Relationship with Social Appearance Anxiety: The Mediating Role of Body Shame

OBJECTIVE

Attention to personal appearance and observers' judgments are integral components of narcissism. However, empirical evidence focused on the association between grandiose/vulnerable traits of narcissism and social appearance anxieties is limited. Moreover, body shame represents a topic of debated interest in the field of narcissism and women's experience of self-consciousness. The aim of the present study is to evaluate the unexplored relationship between covert and overt facets of pathological narcissism and social appearance anxiety, analyzing the mediating role of objectified body shame.

METHOD

Pathological vulnerable and grandiose narcissism, social appearance anxiety and body shame were assessed in a convenience sample of 775 young women (M=24.1, SD=4.52).

RESULTS

Body shame fully mediated the association between pathological narcissism and social appearance anxiety, especially for vulnerable narcissists' women.

CONCLUSIONS

As expected, vulnerable narcissism had a positive association with social appearance anxieties, and body shame acted as a mediating risky factor. Moreover, as hypothesized and differently from recent findings, also overt narcissism was related to body shame and appearance anxieties. These findings suggest that feelings of shame are essential to deeper understand the narcissistic core features and outcomes. Research and clinical implications are discussed.

The Appearance-Related Social Media Consciousness Scale: Development and validation with adolescents

Appearance-related social media consciousness (ASMC) is defined as the extent to which individuals' thoughts and behaviors reflect ongoing awareness of whether they might look attractive to a social media audience. In this 3-study paper, we report the development and validation of the ASMC Scale for adolescents. In Study 1, we developed 18 items and received input from adolescent focus groups and content experts, resulting in 13 items. In Study 2, we administered these items to a high school sample (N = 1227; 51.8 % girls; M_age = 15.72), completing an exploratory factor analysis and a confirmatory factor analysis on two split halves. Results supported a single-factor solution with configural, metric, and partial scalar gender invariance. In Study 3, we administered the scale to a second high school sample (N = 226; 58.4 % girls; M_age = 16.25). ASMC scores demonstrated strong internal consistency, convergent and incremental validity, and test-retest reliability (measure re-administered for n = 207). Higher ASMC was associated with higher depressive and disordered eating symptoms, controlling for time on social media, gender, race/ethnicity, and body surveillance. Girls reported higher mean scores than boys. Findings support the use of this 13-item scale in reliably assessing adolescents' ASMC, which may have important implications for mental health in the age of social media.

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.

Objectified Body Consciousness, Body Image Control in Photos, and Problematic Social Networking: The Role of Appearance Control Beliefs

At present, adolescents' photo-taking and photo-sharing on social media represent ubiquitous practices and objectified body consciousness (OBC) might offer a useful framework to explore online self-presentation and social networking site (SNS) use. Indeed, SNS might represent a highly accessible medium for socializing with self-objectification. However, the relationship between OBC components and problematic SNS use is still understudied. The present study evaluated the previously unexplored predictive role of appearance control beliefs on problematic SNS use, testing the mediating effect of body image control in photos (BICP) across male and female groups. A total of 693 adolescents (55% females; mean age 16 years) participated in the study. Results showed the negatively predictive role of appearance control beliefs on control over body image in photos. Moreover, BICP mediated the appearance control beliefs' negative effect on problematic SNS use in girls. The present study tested the unexplored effect of appearance control beliefs upon problematic SNS use, contributing to the OBC research field and the ongoing debate concerning predictive and protective factors in problematic SNS use.

Selling health and happiness how influencers communicate on Instagram about dieting and exercise: mixed methods research

Background

Eating disorders among adolescents are an ongoing public health concern. Sustainable health promotion programmes require a thorough understanding of the social context in which minors engage. Initial studies show that young people make extensive use of social networks in order to exchange experiences and gather information. During this process their (buying) behaviour is significantly affected by so-called influencers.

Methods

The exploratory research studies non-campaign driven health communication on dieting and exercise by influencers in social networks with a focus on content, techniques and visible impact. In a mixed methods approach, we initially analysed 1000 posts from influencers on Instagram quantitatively. Subsequently we conducted an in-depth content analysis of 9 extreme and 27 typical communication threads.

Results

Influencers gain the trust and friendship of their followers by designing body-shape focused visual content and targeted communication techniques. They identify and define diet and exercise as factors to be controlled for body perfection. By consuming dietary supplements and wearing tight-fitting branded sportswear, influencers promise a simplified way of optimizing one’s appearance as the key to happiness. Direct and surreptitious advertising of industry-specific products constitutes the communicative focus. At the same time, minors identify with the roles and ideals demonstrated by influencers and their needs are satisfied on several different levels. This creates a relationship of dependency between influencers and their followers.

Conclusions

The dynamics in the field of health communication by influencers on social networks will become increasingly important in the coming years. This is largely due to the targeted demand on the part of (mainly) underage users and the high attractiveness of influencer marketing on the part of companies. Influencers suggest a dependence on happiness, well-being, health and beauty. Only those who create a body shaped through control and discipline are healthy and beautiful - and can be happy. The indirectly communicated conclusions, which can be considered as extremely critical, illustrate the need for action in order to protect and positively accompany young people in their psychological and physical development. The shift of authority figures within Generation Z, as well as identified communication techniques, can be considered and may be harnessed by targeted, group-oriented campaign designs.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7387-8) contains supplementary material, which is available to authorized users.

Facebook, body esteem, and body surveillance in adult women: The moderating role of self-compassion and appearance-contingent self-worth

This study examined how Facebook use and specific Facebook activities were associated with body esteem and body surveillance in adult women. This study also examined whether self-compassion and appearance-contingent self-worth moderated the relationship between Facebook appearance comparison and body esteem, and the relationship between Facebook appearance comparison and body surveillance. Self-report measures were administered to adult women (N = 232) between the ages of 20 and 72 (M = 35.91) recruited through MTurk. Results indicated that Facebook appearance-exposure and Facebook appearance comparison significantly related to body surveillance, whereas only Facebook appearance comparison significantly related to body esteem. Overall Facebook use and Facebook intensity were not significantly associated with either body esteem or body surveillance. Self-compassion and appearance-contingent self-worth significantly related to body esteem and body surveillance. However, neither self-compassion nor appearance-contingent self-worth significantly moderated the relationship between Facebook appearance comparison and body surveillance. Similarly, a lack of significant moderation was found for the relationship between Facebook appearance comparison and body esteem. The importance of studying body image and Facebook activities in adult women is discussed. Additionally, the importance for researchers to examine how specific Facebook activities, beyond Facebook use, are linked with body image in this population is also highlighted.

Focusing on one's own appearance leads to body shame in women but not men: The mediating role of body surveillance and appearance-contingent self-worth

Previous research has shown that some appearance-focused situations lead to increased self-objectification, especially among women. The present research explored, with an experimental design, whether the simple fact of thinking about one's own physical appearance increases body shame through body surveillance and appearance-contingent self-worth in men and women. Our main prediction was that focusing on one's own appearance would increase both women's body surveillance and appearance-contingent self-worth, and that both variables in turn would increase women's body shame. Among men, while we expected body surveillance and appearance-contingent self-worth to be related to body shame, we believed that thinking about their physical appearance would be less likely to increase their body surveillance and appearance-contingent self-worth. Spanish young men (n = 123) and women (n = 140) were randomly assigned to an appearance group, in which they wrote about their appearance, or a personality group, in which they wrote about their personality. The results confirmed our prediction for women. Among men, the indirect effects were not significant, and focusing on one's own appearance did not increase body surveillance or appearance-contingent self-worth. Since body shame has been associated with pervasive negative consequences, knowledge about its antecedents has practical and theoretical significance.

The self and eating disorders

In our review, we focus on self-related constructs in the context of eating disorders with four aims. First, we examine a variety of self-related constructs that have been theoretically and empirically linked to the development and course of eating disorders. In addition to the more well-researched constructs of self-esteem and self-efficacy, we also report on findings related to selflessness, contingent self-worth, self-objectification, ego-syntonicity, self-concept clarity, self-compassion, social comparison, self-oriented perfectionism/self-criticism, and narcissism. Second, we discuss self-related constructs that may be especially relevant to comorbidities common among those with eating disorders. Third, we review intervention and prevention programs where self-related constructs play a prominent role. Lastly, we share future research directions regarding self-related constructs and eating disorders that we believe will advance a deeper understanding of the role of the self in the eating disorders.

The Associations of Gender With Social Participation of Burn Survivors: A Life Impact Burn Recovery Evaluation Profile Study

Burn injury can be debilitating and affect survivors' quality of life in a profound fashion. Burn injury may also lead to serious psychosocial challenges that have not been adequately studied and addressed. Specifically, there has been limited research into the associations of burn injury on community reintegration based on gender. This work analyzed data from 601 burn survivors who completed field testing of a new measure of social participation for burn survivors, the Life Impact Burn Recovery Evaluation (LIBRE) Profile. Differences in item responses between men and women were examined. Scores on the six LIBRE Profile scales were then compared between men and women using analysis of variance and adjusted linear multivariate regression modeling. Overall, men scored significantly better than women on four of the six LIBRE Profile scales: Sexual Relationships, Social Interactions, Work & Employment, and Romantic Relationships. Differences were not substantially reduced after adjustment for demographic characteristics and burn size. Men scored better than women in most of the areas measured by the LIBRE Profile. These gender differences are potentially important for managing burn patients during the post-injury recovery period.

Representation of Women in Video Games: A Systematic Review of Literature in Consideration of Adult Female Wellbeing

This study aims to provide a comprehensive systematic review of the literature relating to the representation of women within video games in consideration of adult female wellbeing. The research question of the study assessed whether the representation of women in video games leads to female self-objectification and negative body image in adult women. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review method was used; comprising a thorough keyword database search, followed by literature screening and data extraction. Adult women were the focus of the study, with video games as the study exposure. Only 2 of the 22 studies directly assessed female wellbeing in relation to video game play. Results showed that women do report self-objectification and low levels of self-efficacy, as a result of exposure to objectified female content within video games, compared with participants exposed to nonobjectified content. Male and female belief in real-life female competence was jeopardized after exposure to objectified content of women within video games. Results demonstrated that female characters within video games are unevenly represented compared with male characters, with female characters mostly shown as subordinate to the male hero of the game, objectified, and hypersexualized with disproportionate body parts. The review also uncovered the propensity for men exposed to objectified and sexualized female characters within video games to hold sexist attitudes toward women in a real-life setting, and being more lenient to accept cultural rape myths.

Relating shape/weight based self-esteem, depression, and anxiety with weight and perceived physical health among young adults

Simultaneous contributions of self-esteem, depression, and anxiety to weight and perceived physical health in young adults is understudied. A diverse sample of 424 young adults completed measures of shape/weight based self-esteem, depression, anxiety, and perceived physical health. Height and weight were measured to calculate body mass index (BMI). Latent profile analysis was conducted to derive patterns of depression, anxiety, and shape/weight based self-esteem. Then, we examined the association of the profiles with weight status and perceived physical health. Three profiles emerged: (1) High Shape/Weight Influence (HSWI); (2) Low Shape/Weight, Depression, & Anxiety Influence (LSWDAI); and (3) High Depression & Anxiety Influence (HDAI). The HSWI profile had significantly higher BMI than the LSWDAI and HDAI profiles, and significantly lower perceived physical health than the LSWDAI profile. Over emphasis on shape/weight, regardless of depression and anxiety, is associated with elevated weight and negative internalized health views.

Exploring the relationship between appearance-contingent self-worth and self-esteem: The roles of self-objectification and appearance anxiety

Previous work has shown that both an appearance-contingent self-worth (i.e., staking one's overall self-evaluation on one's physical appearance) and self-objectification are associated with higher appearance anxiety and lower self-esteem among women. Although prior evidence separately links both appearance-contingent self-worth and self-objectification to these negative outcomes, no work has examined the mediating processes that may underlie this relationship. With the current project, we examined the relationship between appearance-contingent self-worth and self-objectification, and the degree to which this relationship is associated with higher appearance anxiety and lower overall self-esteem. We hypothesized that appearance-contingent self-worth would be positively associated with self-objectification; in turn, we expected self-objectification to be related to higher appearance anxiety, and ultimately, lower self-esteem. Across two studies, one cross-sectional (N=208) and one short-term longitudinal (N=191), we found compelling support for this hypothesis. These findings have practical and theoretical significance for both the self-objectification and contingent self-worth literatures.

"I Kinda Feel Like Wonder Woman": An Interpretative Phenomenological Analysis of Pole Fitness and Positive Body Image

The purpose of this research was to describe and interpret the positive body image experiences of women actively engaged in pole fitness. A total of seven women between the ages of 20 and 36 years participated in semistructured one-on-one interviews and follow-up interviews. Participant observation was also used to generate data. Data were analyzed using an interpretative phenomenological analysis approach, and the positive body image experiences of women are represented by five themes: (a) observation and exposure fostering body acceptance, (b) performance promoting self-confidence, (c) personal growth and sexual expression, (d) unconditional community support creates comfort, and (e) body appreciation through physical skill development. Findings suggest that women engaging in pole fitness may experience positive body image, and the words of participants provide insight into the components of pole fitness that may foster positive body image. Pole fitness may provide a unique exercise context whereby women can develop and maintain positive body image.

Contingencies of Self-Worth and Psychological Distress in Iranian Patients Seeking Cosmetic Surgery: Integrative Self-Knowledge as Mediator

BACKGROUND

Although previous studies have shown that people applying for cosmetic surgery experience high-intensity psychological distress, important variables that function as protective factors have rarely been the subject of study in this population. Therefore, this study aims to investigate the role of low and high self-knowledge in experiencing psychological distress and contingencies of self-worth to appearance and approval from others and to identify the mediatory role of the integrative self-knowledge in patients seeking cosmetic surgery.

METHODS

Eighty-eight patients seeking cosmetic surgery were selected and completed the contingencies of self-worth and integrative self-knowledge scales, as well as the depression, anxiety and stress scale. Data were analyzed using multivariate analysis of variance (MANOVA) and path analysis using 5000 bootstrap resampling.

RESULTS

The results of MANOVA showed that patients seeking cosmetic surgery with high self-knowledge had lower levels of depression, anxiety and stress compared to patients with low self-knowledge. They also gained lower scores in contingencies of self-worth to appearance and approval from others. The results of path analysis indicated that self-knowledge is a complete mediator in the relationship between contingencies of self-worth to appearance and approval from others and psychological distress.

CONCLUSION

Based on the results of this study, it can be concluded that self-knowledge as a protective factor plays a major role in relation to the psychological distress experienced by the patients seeking cosmetic surgery. In fact, by increasing self-knowledge among this group of patients, their psychological distress can be decreased.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The 'switch on-switch off model': Strategies used by nurses to mentally prepare and disengage from work

There is considerable research on the experience of nurses during both their work and non-work time. However, we know relatively little about the strategies nurses use immediately before and immediately after their shift. This crossover period, from one shift to another, has critical impact for patient outcomes. The aim of this qualitative study was to explore strategies nurses employ to mentally prepare for their shift (switch on), and mentally disengage after the end of it (switch off). Eleven Greek hospital nurses were recruited for the study. Interviews were audio-taped and analysed using a content analysis approach. Five themes were identified as strategies nurses use to mentally prepare and disengage from their shift: (i) personal care/grooming; (ii) religious rituals; (iii) nicotine/caffeine; (iv) social interaction; and (v) listening to music. Nurses reported using the same strategies before and after their shift, but for different purposes. The authors propose a 'switch on-switch off' model to describe the process of mental preparation and mental disengagement from work. The switch-on/off approach represents an opportunity to increase nurses' resilience and identify individual and organizational factors that contribute to patient outcomes.

Narcissism as a moderator of satisfaction with body image in young women with extreme underweight and obesity

Objective

Body weight and age constitute main determinants of body image in women. We analyzed the role of narcissism as a moderator of body image in young women representing various extremes of body weight.

Methods

The study included 325 women between 18 and 35 years, qualified into three BMI categories: obese women (BMI > 30.0, n = 72), severely underweight women who did not satisfy the remaining criteria of anorexia (BMI < 17.5, n = 85), and women with normal body weight (21.7 < “ideal BMI” > 22.7, n = 168). Satisfaction with body image was determined with Multidimensional Body-Self Relations Questionnaire and Body Esteem Scale, while narcissism was measured with Narcissistic Personality Inventory.

Principal Findings

We revealed that narcissism has significant impact on the body image of women who are extremely underweight or obese. Vanity and Leadership were narcissism dimensions which played significant role in slim women, as compared to Vanity and Self-Sufficiency in obese women.

Conclusion

The role of narcissism as a modulator of self-satisfaction with one’s body varies depending on BMI level: extremely underweight women and obese individuals constitute groups in which narcissism has the strongest impact on the self-satisfaction with body.