Socialization and selection effects in the association between weight conscious peer groups and thin-ideal internalization: A co-twin control study

Mixed methods pilot evaluation of interpersonal psychotherapy for body image for adolescents

Body dissatisfaction is common in adolescence and associated with poor outcomes. The aim of this mixed method pilot evaluation was to determine acceptability, feasibility and preliminary efficacy of Interpersonal Psychotherapy for Body Image (IPT-BI), a school-based group intervention for young people with high levels of body dissatisfaction. Eighteen participants (11-13 years, 78% female) took part in two IPT-BI groups (n = 10; n = 8). Feasibility was measured by recruitment and attrition rates; acceptability using a treatment satisfaction questionnaire and focus groups; and clinical outcomes at baseline, each session and post intervention. The majority of young people (72%, n = 18/25) who were referred or expressed interest went on to take part. Average session attendance was 100% and 89%. Participants expressed high levels of treatment satisfaction with 94% (n = 16/17) rating IPT-BI as 'quite helpful' or 'very helpful' and 94% (n = 16/17) stating they would recommend it to others. Preliminary exploration of efficacy showed significant improvements in body image and significant reductions in interpersonal difficulties and appearance-based conversations. Young people valued specific IPT-BI skills (role play, communication strategies), alongside generic therapeutic factors (therapeutic alliance, group cohesion). IPT-BI is feasible and acceptable with promising provisional clinical outcomes indicating the need for a fully powered randomised controlled trial.

Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know

PURPOSE OF REVIEW

The current report aims to summarize recent advances about the relationship between non-suicidal self-injury (NSSI) and eating disordered (ED) behaviors and highlights meaningful directions for future research.

RECENT FINDINGS

While there is solid evidence indicating a robust cross-sectional association between NSSI and ED behaviors, emerging evidence suggests that the temporal relationship between these behaviors may be bidirectional. Shared functions and risk factors may explain why these behaviors often co-develop. At the same time, little is still known about the psychosocial consequences of comorbid NSSI and ED engagement, and there is a lack of intervention studies that target these behaviors simultaneously. It is well-established that NSSI and ED behaviors frequently co-occur. The field should now turn to longitudinal designs to advance our understanding of the longer-term developmental and the shorter-term momentary relationship of these behaviors in daily life. Providing insight into these areas will help guide the deployment of evidence-based interventions that match the needs of clients who report comorbid NSSI and ED behaviors.

Adult Separation Anxiety Disorder Symptomology as a Risk Factor for Thin-Ideal Internalization: The Role of Self-Concept Clarity

The study of when and how individuals compare themselves against standards has been an enduring focus for clinical and social psychology researchers in efforts to facilitate well-being and health. Our study focused on internalization of the societal thin-ideal standard for feminine attractiveness, a construct that has proven to be very important in women's psychological health. Although multiple adverse consequences of thin-ideal internalization have been documented, the understanding of variability in the extent of thin-ideal internalization across women (e.g., why do some women strongly internalize thin-ideal standards when others do not?) is much less well developed. This research was conducted to explore the role of adult separation anxiety disorder (ASAD) symptomology and conceptions of the self in young women's propensity to internalize the thin-ideal attractiveness standard. Results show that elevated ASAD symptoms are associated with greater thin-ideal internalization. A structural equations model demonstrates the reason for this association; young women with higher ASAD symptomology exhibit lower self-concept clarity, which drives greater thin-ideal internalization. This research makes novel practical and conceptual contributions by (a) delineating a new risk factor for the development of thin-ideal internalization, (b) highlighting a previously undocumented vulnerability of women who experience ASAD symptoms, and (c) documenting the relationship between ASAD and lower self-concept clarity. Implications for mental health practitioners are discussed.

What drives the association between weight-conscious peer groups and disordered eating? Disentangling genetic and environmental selection from pure socialization effects

Previous studies suggest strong associations between exposure to weight-conscious peer groups and increased levels of disordered eating. This association has been attributed to socialization effects (i.e., membership leads to disordered eating); however, selection effects (i.e., selecting into peer groups based on genetic and/or environmental predispositions toward disordered eating) could contribute to or even account for these associations. The current study was the first to use a co-twin control design to disentangle these types of selection factors from socialization effects. Participants included 610 female twins (ages 8-14) drawn from the Michigan State University Twin Registry. To comprehensively examine a range of eating pathology, several disordered eating attitudes and behaviors (e.g., body dissatisfaction, binge eating) were examined via self-report questionnaires. Questionnaires also were used to assess peer group emphasis on body weight and shape. Replicating previous results, significant individual-level associations were found between membership in weight-conscious peer groups and disordered eating. However, co-twin control analyses indicated that these associations were largely due to genetic and/or shared environmental selection factors rather than pure socialization effects. Importantly, results remained unchanged when controlling for pubertal status, suggesting that effects do not vary across developmental stage. Overall, these findings question whether associations between weight-conscious peer groups and disordered eating are due entirely to socialization processes. Future studies are needed to identify the specific genetic and/or shared environmental factors that may drive selection into weight-conscious peer groups.