The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations

Personal genital satisfaction is associated with differences in perception of male and female sexual anatomy and function

BACKGROUND

Prior studies primarily of men correlated low personal genital satisfaction (PGS) with decreased sexual activity; however, the association between PGS and genital anatomy perceptions is unknown, and there is a paucity of studies examining women.

AIM

We assessed the relationship between genital satisfaction, survey respondent sexual activity, and perceptions of anatomy and function.

METHODS

A 54-item REDCap survey was distributed to any-gendered volunteers ≥18 years of age through ResearchMatch from January to March 2023. Responses were split into (1) high PGS and (2) low PGS. Analysis was performed using chi-square tests on survey responses and a Mann Whitney U test on median satisfaction level.

OUTCOMES

Outcomes were genital anatomy perceptions, sexual activity, and respondents' PGS.

RESULTS

Of the 649 respondents who started the survey, 560 (86.3%) completed it. Median PGS was 7 of 10, forming subgroups of high (≥7 of 10) satisfaction (n = 317 of 560 [56.6%]) and low (<7 of 10) satisfaction (n = 243 of 560 [43.4%]). The mean age was 45.8 ± 16.8 years, and demographics were notable for 72.1% women (n = 404 of 560), 83.2% White (n = 466 of 560), 47.9% married (n = 268 of 560), and 75.5% bachelor's degree holders (n = 423 of 560). Comparing high- and low-PGS groups, more low-PGS respondents felt normal flaccid penis length to be <2 inches (11.1% vs 5.1%; P = .008). High-PGS respondents more often responded that it is normal for women to have orgasms over half the time (20.8% vs 13.2%; P = .0002) or to identify as being sexually active (81.1% vs 71.6%; P = .008). Women were more likely than men to report larger normal testicle sizes as 60.1 to 90 mL (24.5% vs 10.3%; P < .0001), whereas more men felt that normal testicle size was 7 to 15 mL (26.3% vs 11.4%; P < .0001). Orgasm length perceptions also differed: more women felt female orgasm length was 2.6 to 5 seconds (36.6% vs 16.7%; P < .0001), and more men believed female orgasms to be longer, at 7.6 to 10 seconds (29.5% vs 17.3%; P = .002), 10.1 to 12.5 seconds (11.5% vs 5.2%; P = .0008), and >12.5 seconds (12.2% vs 5.7%; P = .009). Respondents' views on their genitalia differed by gender, with women more likely to feel that their genitals are normal compared with men (89.4% vs 75.0%; P < .0001).

CLINICAL IMPLICATIONS

PGS may be a useful screening tool given its association with sexual activity.

STRENGTHS AND LIMITATIONS

Our large-scale survey assesses public perceptions of genital anatomy and function. Limitations include a lack of gender nonbinary perceptions.

CONCLUSION

Gender and PGS interact with perceptions of male anatomy and female sexual activity, and the frequency of sexual activity was higher among high-PGS respondents; however, the direction of these interactions remains unclear and requires future causal analysis.

Sample characteristics for quantitative analyses in Body Image: Issues of generalisability

Psychological research frequently encounters criticism regarding the representativeness of the samples under study, highlighting concerns about the external validity of the obtained results. Here, we conducted a comprehensive survey of all the quantitative samples from the journal Body Image for 2021 (n = 149 samples). Our primary objective was to examine the extent to which the sampled populations deviated from the population at large, which could potentially compromise the generalizability of findings. We identified that a substantial number of these samples came from student populations (n = 44) and the majority were from the United States, United Kingdom, and Australia. Only a small number of samples (n = 9) employed direct measurements of body mass index (BMI), while the majority relied on self-reported data (n = 93). For a subset of samples in the journal, which were drawn from the general population, we compared whether these differed from population reference values in terms of age and BMI. Using Monte Carlo simulations, we found that samples tended to be younger and score lower on BMI than reference values obtained from the broader population. Samples drawn from female university students also tended to be lower on BMI than age-matched reference samples. We discuss the implications of our findings and make recommendations on sampling and inference. We conclude that a clearer specification of the parameters or conditions under which findings are expected to generalise has the potential to enhance the overall rigor and validity of this field of research.

Translation and validation of a Romanian version of the Breast Appreciation Scale (BrAS)

The 9-item Breast Appreciation Scale (BrAS; Swami et al., 2022) is a recently developed instrument that assesses a woman's positive breasted experiences. To date, however, the psychometric properties of the BrAS have only been investigated in English-speaking women. Here, we report on the translation and validation of a novel, Romanian version of the BrAS. A total of 555 cisgender women from Romania completed a Romanian translation of the BrAS along with additional measures of body image and psychological well-being. Exploratory and confirmatory factor analysis identified a stable unidimensional model of the BrAS, with all nine items retained. Additionally, the Romanian BrAS evidenced complete invariance (i.e., through to latent mean invariance) across mothers and non-mothers, though mothers had higher observed scores than non-mothers. Evidence of convergent, concurrent, and incremental validity was very strong when based on observed BrAS scores, but slightly weaker when based on latent BrAS scores. In particular, greater latent breast appreciation was significantly associated with higher body appreciation, lower breast size dissatisfaction, and higher self-esteem. Overall, these results suggest that the psychometric properties of the Romanian BrAS are robust and that the instrument can be effectively deployed in this linguistic context.

Emotion in Motion: Weight Bias Internalization, Exercise Avoidance, and Fitness-Related Self-Conscious Emotions

Weight bias internalization (WBI), the process of internalizing negative attitudes and stereotypes towards overweight individuals, significantly impacts self-worth and health behaviors, such as exercise avoidance. In the current study, we focused on the mediating role of fitness-related self-conscious emotions, particularly shame and guilt. A cross-sectional study involving 150 self-described overweight Dutch women (age M = 49.63 ± 10.72) was conducted online. Participants completed measures assessing weight bias internalization, exercise avoidance, and body/fitness-related self-conscious emotions. Data were analyzed using linear regression and mediation analysis, controlling for age, BMI, and exercise frequency. The results show that weight bias internalization, guilt-free shame, and shame-free guilt uniquely predict exercise avoidance. Guilt-free shame partially mediated the relationship between weight bias internalization and exercise avoidance, indicating that increased internalized weight bias led to higher levels of guilt-free shame, which in turn contributed to exercise avoidance. Shame-free guilt did not act as a unique mediator. These findings underscore the importance of addressing weight bias internalization and fitness-related self-conscious emotions, particularly guilt-free shame, in interventions targeting exercise avoidance among overweight individuals. Strategies promoting self-compassion and reducing shame may prove beneficial in improving exercise behaviors and overall well-being.

Breastfeeding self-efficacy, body image, body acceptance, and partner support: Associations in Israeli postpartum women

PROBLEM

Research suggests that breastfeeding self-efficacy (i.e., a mother's perceived ability and confidence to breastfeed her new-born) is associated with body image experiences and wider psychosocial factors. However, much of this work is focused on negative body image and has relied on samples from predominantly Westernised, industrialised nations.

BACKGROUND

To extend knowledge, we sought to examine the extent to which indices of positive body image (body appreciation), negative body image (body dissatisfaction, breast size dissatisfaction), and psychosocial factors (body acceptance by others, postpartum partner support) are associated with breastfeeding self-efficacy in sample of mothers from Israel.

HYPOTHESIS

We hypothesised that body appreciation, body dissatisfaction, breast size dissatisfaction, body acceptance by others, and postpartum partner support would each be significantly associated with breastfeeding self-efficacy in Israeli mothers.

METHOD

A total of 352 mothers from Israel, with an infant aged six months or younger, were asked to complete an online survey that measured the aforementioned constructs.

FINDINGS

Correlational and linear model analyses indicated that only body appreciation was significantly associated with breastfeeding self-efficacy. Body acceptance by others was significantly associated with breastfeeding self-efficacy in correlational but not regression analyses. These effects were consistent across primiparous and multiparous mothers.

DISCUSSION

In Israeli mothers, at least, a limited set of body image and body image-related indices appear to be associated with breastfeeding self-efficacy.

CONCLUSION

Overall, these findings suggest that positive body image may be associated with breastfeeding self-efficacy in women from Israel, though more research is needed.

The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice

White supremacy and racial inequities have long pervaded psychological research, including body image scholarship and practice. The experiences of white, heterosexual, able-bodied, cisgender (predominantly college) women from wealthy, Westernized nations have been centered throughout body image research and practice, thereby perpetuating myths of invulnerability among racialized groups and casting white ideals and experiences as the standard by which marginalized bodies are compared. Body image is shaped by multiple axes of oppression that exist within systemic and structural systems, ultimately privileging certain bodies above others. In this position paper, we highlight how white supremacy has shaped body image research and practice. In doing so, we first review the history of body image research and explain how participant sampling, measurement, interpretive frameworks, and dissemination of research have upheld and reinforced white supremacy. Next, grounded in inclusivity and intersectionality, we advance the Sociostructural-Intersectional Body Image (SIBI) framework to more fully understand the body image experiences of those with racialized and minoritized bodies, while challenging and seeking to upend white supremacy in body image research and practice. We encourage other scholars to utilize the SIBI framework to better understand body inequities and the body image experiences of all people, in all bodies.

Conspiracy Theories, Trust in Science, and Knowledge during the Third Wave of the COVID-19 Pandemic in Cyprus

Conspiracy theories flourish during periods of crisis. One way to counteract the believability of conspiracy theories is trust in science and knowledge about the "perceived threat", such as the SARS-CoV-2 virus. A total of 363 adults from Cyprus were recruited via convenience and snowball sampling methods. The data were collected via an internet-based questionnaire that examined participants' belief in 17 conspiracy theory statements, trust in science and scientists, knowledge about the symptoms and the spread of the SARS-CoV-2 virus, phobic anxiety, hostility, somatization, and personality traits based on the Big Five. The results suggest (a) the overall belief in conspiracy theories in Cyprus is low, even though a notable percentage holds a neutral stance towards these theories; (b) trust in science and knowledge about the symptoms and the spread of the SARS-CoV-2 virus is negatively related to conspiracy theories, indicating the importance of trusting science and having knowledge as a means to counteract conspiracy theories; (c) young adults, those residing in rural areas, and those with a low education level are more likely to believe in conspiracy theories; (d) there are no significant associations between conspiracy theories and the psychological dimensions of phobic anxiety, hostility, and somatization; (e) there is difficulty in identifying specific traits related to conspiracy ideation. Public health officials could benefit from the findings when communicating information during periods of crisis.

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

How prepartum appearance-related attitudes influence body image and weight-control behaviors of pregnant Japanese women across pregnancy: Latent growth curve modeling analyses

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.

Body Self-Perception After Breast Reconstruction in Young Female Patients Affected by Poland Syndrome

BACKGROUND

Cosmetic and social aspects of breast anomalies in Poland syndrome are not negligible. Early diagnosis and appropriate therapeutic timing may have a positive impact on quality of life.

METHODS

Females affected by Poland syndrome, who had breast reconstruction between 2014 and 2018, were asked to complete the Body Uneasiness Test and the postoperative Breast-Q. Correlation between scores was evaluated. Correlation between scores was statistically evaluated.

RESULTS

Thirty patients who had completed breast reconstruction at 20.9 ± 6.5 yo fulfilled the questionnaires at the average age of 26.5 ± 8.1 yo. BUT scores were similar to healthy population considering different age groups, with the exception of Compulsive Self-Monitoring subscale for 16-17-year age group. A correlation between Depersonalization and "Thighs" and "Legs" was present. On average, satisfaction with breast resulted 79.1%, satisfaction with surgical outcome was 94.9%, psychosocial well-being was 78.5%, sexual well-being was 75.3%, and relative physical well-being in chest and upper body was 36.9%. Global Uneasiness, Avoidance, Weight Phobia, Body Image Concern and Depersonalization were significantly correlated with lower psychosocial well-being. Avoidance was significantly correlated with lower sexual well-being.

CONCLUSIONS

Breast reconstruction in Poland syndrome can help to improve quality of life. However, general body uneasiness can affect satisfaction with the final result.

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 http://www.springer.com/00266 .

Body image as a global mental health concern

Body image concerns related to weight or other dimensions of appearance are now prevalent on a global scale. This paper reviews the theoretical frameworks that account for the global similarities and regional differences in rates and presentation of body image concerns, as well as reviewing the extant data. Given the harmful consequences of body image concerns in terms of mental and physical health, their global burden is high. Interventions to mitigate these concerns at the individual and systemic level are warranted.

Measuring positive breast experience: Development and psychometric evaluation of the Breast Appreciation Scale (BrAS)

Existing measures of women's breasted experiences have focused on negative experiences, which de-centres women's meaning-making and relationships with their breasts. To rectify this, we developed a novel measure of women's positive breasted experiences, the Breast Appreciation Scale (BrAS), and examined the psychometric properties of this novel measure across four studies. Study 1, with 307 United Kingdom women, led to the extraction of a 9-item, unidimensional model of BrAS scores that showed adequate composite reliability and 4-week test-retest reliability. Study 2, with 297 United Kingdom women, showed that the unidimensional model of BrAS scores had adequate fit and evidenced convergent, concurrent, discriminant, and incremental validity. Study 3, with 295 women from the United Kingdom, provided additional support for factorial validity and concurrent validity, and additionally provided evidence of known-groups validity insofar as mothers had greater breast appreciation than non-mothers. Study 4 showed that the BrAS was scalar invariant across women from Australia, the United Kingdom, and the United States (N = 573) and provided additional evidence of concurrent validity. Based on these results, we conclude that the BrAS is a psychometrically valid measure of women's positive breasted experiences that can be utilised in future research.

Rural-urban differences in body appreciation and associations with life satisfaction in adults from Sabah, Malaysia

Studies of body appreciation have typically focused on measurement of the construct in urban populations and there remains very little research on body appreciation in rural communities. To fill this gap, the present study examined rural-urban differences in body appreciation in an adult Kadazan-Dusun sample from the state of Sabah in Malaysia. Participants from rural (n = 215) and urban (n = 219) locales in the West Coast administrative district of Sabah were asked to complete Malay versions of the Body Appreciation Scale-2 (BAS-2) and the Satisfaction With Life Scale, and to provide their demographic details. Multi-group confirmatory factor analysis evidenced both partial metric invariance (by allowing loadings for three items to vary) and partial scalar invariance (by freeing the intercept for one item) on the BAS-2. Between-group analyses indicated that rural participants had significantly greater body appreciation than urban participants overall. Additionally, urban men had significantly greater body appreciation than urban women, but there was no gender difference in the rural subsample. Finally, correlational analyses indicated that body appreciation was significantly associated with life satisfaction in both the rural and urban subsamples. The present results highlight the importance of further considering the phenomenology of body appreciation in rural communities.

The Influence of Personality on Health Complaints and Quality of Life in Women With Breast Implants

BACKGROUND

A causal relation between systemic symptoms and breast implants has not been established. Psychological factors, such as personality and psychological distress, are strongly associated with the development of medically unexplained symptoms. It can be hypothesized that psychological factors may be related to the development of breast implant illness (BII).

OBJECTIVES

This study was conducted to evaluate the correlation between self-reported health complaints, health- and breast-related quality of life (QoL), and personality, in women with cosmetic breast implants.

METHODS

Women who attended the plastic surgery outpatient clinic of Maastricht University Medical Center between October 2020 and October 2021 for reasons related to their implants and women recruited for a BII study at the Center during this period were invited to participate in this study. Only women who underwent cosmetic breast augmentation were eligible. Participants completed a physical complaints score form and the BREAST-Q, SF-36, and EPQ-RSS questionnaires via an online survey.

RESULTS

In total, 201 women completed the questionnaires. Extroversion and social desirability were predominant personality traits in women with breast implants, followed by neuroticism. Relatively high levels of neuroticism were found compared with normative data. Neuroticism correlated significantly with health status and breast-related QoL. Physical and mental health-related QoL had the strongest correlations with neuroticism (β = -3.94, β = -4.86, P < 0.001).

CONCLUSIONS

Personality can play a role in the development of complaints. High levels of neuroticism are seen in cosmetic surgery patients and are negatively correlated with subjective health and patient-reported outcomes in women with breast implants. Therefore, neuroticism may be a factor in the development of BII.

LEVEL OF EVIDENCE: 4

Morphometric study of post menarcheal nulliparous breasts, their clinical relevance and relationship with body size indicators in a Nigerian population

Background

The female breast is a symbol of femininity and aesthetics having a great psychosocial impact on the woman's sense of wellbeing and self-esteem. To optimize satisfaction of patients in cosmetic and reconstructive breast surgeries, there is a need to define the dominant breast size and shape that connotes feminine attractiveness. This necessitates the knowledge of ideal data for normal nulliparous female breast parameters and volume for various body sizes in the particular population, nationality, and race.

Aim

To establish reference data for normal breast parameters and volumes for the various body sizes amongst the Nigerian population and to determine their relationships with other body parameters.

Patients and Methods

A total of 528 breasts from 264 Nigerian undergraduate post-menarcheal nulliparous students of the University of Nigeria Enugu Campus aged between 17 and 29 years were measured. Thirty-one (31) anthropomorphic parameters and five body size anthropometric indicators were measured. Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 21(IBM) and were summarized using various descriptive statistics tools.

Results

The mean nipple-nipple distance is 23.37 ± 3.10. The mean left Midclavicle-nipple Length (22.17 ± 3.5 cm) is significantly (P = 0.04) higher than the right (21.79 ± 3.3 cm) just as the mean left (12.60 ± 2.5) medial radius is significantly (P = 0.0001) longer than the right (12.45 ± 2.4 cm). The mean left nipple projection (0.37 ±0.2 cm) and left vertical surface dimension (32.27 ± 5.7 cm) are significantly (P > 0.05) longer than the right (0.33 ±0.2) and (31.76 ± 5.2 cm). Also the mean volume for the left breast (605.26 ± 280.52 cm) is significantly (0.0001) higher than that of the right breast (592.53 ± 278.69). Breast volume correlated well with most of the breast parameters, BMI, and other anthropometric variables. Most breasts were ptotic (51%, 55%), especially the left breasts. Breast dimensions were asymmetrical in >50% of subjects, where the left breasts were seen to have slightly greater breast dimensions than right.

Conclusion

Breast values and related body size parameters were noted to be comparatively higher than earlier reported values mostly for the Asian population.

The impact of nature exposure on body image and happiness: an experience sampling study

Exposure to nature is associated with improved psychological well-being and positive body image. Here, we examined whether everyday exposure to natural environments is associated with state body image outcomes (and, for comparative reasons, state happiness) using an experience sampling method. One-hundred-and-seven participants completed a 30-day experience sampling phase in which they reported their state body image (body weight, body shape, and physical appearance satisfaction), state happiness, and features of the surrounding environment (total = 6,025 responses) at three random time-points each day. Results indicated that being outdoors was associated with significantly higher state body image on all three indicators, but effect sizes were lower compared to effects on state happiness. Specific environment type was also important, with blue-spaces and wood- and grasslands, respectively, having stronger effects than other environments. These results provide evidence that everyday exposure to natural environments is associated with more positive state body image and greater happiness.

Developing a model linking self-reported nature exposure and positive body image: A study protocol for the body image in nature survey (BINS)

Exposure to natural environments has been shown to be associated with more positive body image, but much of the existing research is limited to Western European nations and little is known about the robustness of these associations in other national contexts. In this protocol paper, we present a conceptual model of the direct and indirect associations (i.e., via self-compassion, connectedness to nature, and restorative experiences in nature) between nature exposure and body appreciation. This model brings together conceptualisations from existing research, but also extends it in a number of important ways. The model will be tested through the Body Image in Nature Survey (BINS), a researcher-crowdsourced project involving researchers in multiple nations worldwide. Data collection began in December 2020 and is expected to be completed in February 2022. Data will be analysed to examine the extent to which our conceptual model is robust across nations, as well as other sociodemographic characteristics. We will also determine the extent to which key variables included in our survey are invariant across nations and associated with cultural, socioeconomic, and gender-related factors. The BINS will likely have important implications for the development of nature-based interventions to promote healthier body appreciation in diverse national contexts.

Psychotherapeutic intervention on breast self-examination based on Health Belief Model

The aim of this research was to verify the effectiveness of a Health Belief Model-based intervention in increasing knowledge and changing beliefs about breast cancer and its early detection as well as in improving breast self-examination behaviors. This randomized controlled clinical trial involved 210 women. The program was implemented by email and involved sending daily messages to participants for 30 days. The women in the intervention group received messages aimed at increasing the practice of breast self-examination behavior. Participants in the control group received messages promoting general health. Before and after the intervention there were evaluated the application of breast self-examination, level of knowledge, beliefs associated with health (susceptibility to develop breast cancer, disease severity, benefits of self-examination, barriers to achieving this behavior, cues to action, self-efficacy in performing self-examination). At the end of the program, a significant improvement in the perception of disease severity and the benefits of breast self-examination was obtained, as well as a significant increase in the percentage of participants who achieved this behavior. The results obtained are arguments for it to be implemented by health care providers who want to promote self-examination as a method of early detection of breast cancer.

Women with larger breasts are less satisfied with their breasts: Implications for quality of life and physical activity participation

Introduction:

Although low breast satisfaction has been associated with a range of potential negative health implications, little is known about key factors that influence breast satisfaction across the lifespan. This study aimed to determine the impacts of age, body mass and breast size on breast satisfaction and how breast satisfaction impacts psychosocial and sexual well-being-related quality of life outcomes and physical activity behaviours.

Methods:

Three hundred and forty-five women (age range: 18.1–83.7 years) had their body mass (kg), standing height (cm) and breast volume (ml) measured. A 13-item questionnaire comprising the Breast-Q and Active Australia Survey was used to assess breast satisfaction, quality of life outcomes and participation in physical activity.

Results:

Breast satisfaction was influenced by breast size, such that women with larger breasts were less satisfied with their breasts compared to their counterparts with smaller breasts. Greater breast satisfaction was associated with improved psychosocial and sexual well-being-related measures of quality of life, and time spent participating in physical activity.

Conclusion:

Interventions to improve breast satisfaction among women across the breast size spectrum should be encouraged in public health initiatives to better engage and encourage positive health behaviours and reduce potential adverse health implications.

Potential Impacts of Body Image Perception in Female Equestrians

Female body image (BI) has been investigated in many sports yet, in female-dominated equestrianism, there is a paucity of BI research. This study aimed to identify self-perceptions of BI, rider perceptions of judge and coach bias, relationships between BI and self-consciousness and effect of breast size. A four-part, 27 question survey (GoogleForms) was completed by female equestrians (n = 493). The second smallest BI was considered ideal for equestrianism (χ² = 352.751, P < .001) regardless of age, own BI or level of riding commitment. There was a perception judges favor riders with smaller frames (χ² = 54.2111, P < .001) and an association between riders with a larger BI feeling self-conscious when riding (χ² = 87.514, P < .001). More respondents perceived the ideal equestrian BI to be smaller than theirs (Median = -1.5, W = 7777.00, P < .001) and an association between those dissatisfied with their BI and self-consciousness when riding was seen (χ² = 83.649, P < .001). Perception of the ideal equestrian frame is smaller than many riders' own BI, and a larger BI perception negatively impacts self-confidence, potentially hindering performance and participation. Female riders with a larger frame feel they are perceived negatively by judges and further study is indicated to investigate the extent of this potential bias on subjective judging in equestrian disciplines.

Science mapping research on body image: A bibliometric review of publications in Body Image, 2004-2020

Science mapping is a methodology that combines quantitative analysis, classification, and visualisation to identify the composition and inter-relationships between bibliographic objects. Here, we used bibliometric science mapping to identify the overarching structure, evolution of research themes and research fronts, and geographic spread of body image research. We examined 2,783 keywords in 1,107 articles published in Body Image between 2004 and 2020, selected as being representative of body image research during this period. Co-occurrence analysis of the keywords enabled us to identify five general themes in the literature: "clinical and weight-related issues", "body image and disordered eating", "positive body image and objectification", "media effects", and "ethnicity/race". Burst analysis allowed us to identify research fronts in this research, with work on social media and positive body image in particular being identified as emergent. Finally, co-author analysis indicated that body image research networks are heavily focused on a small handful of nations, although there is evidence of a recent shift toward greater geographic spread. Our results, and the provision of interactive maps and extensive tables, should allow readers to examine connections between research clusters and areas, generate novel research ideas, and more fully understand the evolution and future trajectories of body image research.

Self-Assessed Effects of Pornography Use on Personal Sex Life: Results from a Large-Scale Study of Norwegian Adults

Objectives: The study explored characteristics associated with the self-assessed effects of pornography use on one's personal sex life. Methods: Data were collected in a probability-based sample of Norwegian adults (n = 4,160). Results: Most participants (41.3%) did not believe that pornography affected their sex life. More participants reported positive (33.2%) than mixed/negative (25.5%) effects of pornography use. Sociodemographic and sexual characteristics that predicted these self-assessments were examined. Among participants in a steady relationship, emotional intimacy and relationship satisfaction were unrelated to the self-assessed effects. Conclusions: The current study findings add to scant literature about the self-assessed effects of pornography usage.

Psychological predictors of intention and avoidance of attending organized mammography screening in Norway: applying the Extended Parallel Process Model

Background

Mammography screening is the main method for early detection of breast cancer in Norway. Few studies have focused on psychological determinants of both attendance and non-attendance of publicly available mammography screening programs. The aim of the current study, guided by the Extended Parallel Process Model, was to examine how psychological factors influence defensive avoidance of breast cancer screening and intention to attend mammography.

Methods

Cross-sectional survey data from a community sample of women living in Norway aged ≥ 18 (N = 270), and without a history of breast cancer, was collected from September 2018 to June 2019 and used to investigate the relationships between the Extended Parallel Process Model (EPPM) constructs and two outcomes: defensive avoidance of breast cancer screening and intention to attend mammography within the next two years. After adjusting for confounding factors, the hierarchical multiple linear regression analyses was conducted to assess the ability of the independent variables based on the EPPM to predict the two outcome variables. Significance level was chosen at p < 0.05.

Results

Multivariate analyses showed that defensive avoidance of breast cancer screening was predicted by lower perceived susceptibility to breast cancer (β =  − 0.22, p = 0.001), lower response efficacy of mammography screening (β =  − 0.33, p = 0.001), higher breast cancer fear (β = 0.15, p = 0.014), and checking breasts for lumps (β =  − 0.23, p = 0.001). Intention to attend mammography within the next two years was predicted by higher response efficacy of mammography screening (β = 0.13, p = 0.032), having a lower educational level (β =  − 0.10, p = 0.041), and regular previous mammography attendance compared to never attending (β = 0.49, p = 0.001).

Conclusions

The study revealed that defensive avoidance of breast cancer screening and intention to attend mammography were not predicted by the same pattern of psychological factors. Our findings suggest future health promotion campaigns need to focus not only on the psychological factors that encourage women’s decision to attend the screening, but also to counter factors that contribute to women’s decision to avoid it.

Cross-cultural measurement invariance of the Body Appreciation Scale-2 across five countries

The Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a, 2015b) is a widely used measure of positive body image within many cultures and countries; yet, cross-cultural examinations are few. The present study aimed to investigate the measurement invariance of the BAS-2 across adults from five countries: Iran, Japan, Poland, Serbia, and the U.S. The sample included 2944 participants ranging in age from 18 to 82 years. The findings provided evidence that the BAS-2's one-dimensional structure is the same in these countries. Partial metric invariance (when some but not all items contribute to a latent construct equally for groups) indicated that nine out of 10 items contributed to the latent body appreciation construct to a similar degree across the countries. When a Multiple Indicators Multiple Causes (MIMIC) model was applied with participants' age and gender as covariates, evidence of differential item functioning was found. Results suggest that both age and gender influenced body appreciation, indicating that the body appreciation factor means are different at different levels of the covariates. In conclusion, cross-culturally body appreciation may be shaped by country, language, age, and gender correlates to different degrees. In future research, measurement invariance analyses should be conducted prior to cultural group comparisons on the BAS-2.

Asian versus Western appearance media influences and changes in body image concerns of young Chinese women: A 12-month prospective study

Appearance-related media from the United States and other Western nations has been implicated in explanations of increased body images concerns among non-Western women. However, researchers have rarely examined the impact of endogenous appearance media versus Western appearance media on body image issues, particularly within longitudinal research designs. Therefore, in this 12-month prospective study, we assessed associations of experiences with appearance media imported from Western nations versus appearance media from China and other Asian nations on body image concerns and cosmetic surgery interest among young Chinese women. Participating women (N = 1836) completed self-report measures tapping specific sources of appearance dissatisfaction (fatness, facial features, stature), cosmetic surgery interest, and appearance media influences at baseline and a 12-month follow-up. The women reported significantly more pressure from and stronger preferences for appearance depictions in Asian than Western media. Elevations in appearance pressure and preferences from Asian media explained more unique variance in specific body image concerns at follow-up than did complementary Western media influences. Contrary to "Westernization" hypotheses, Asian appearance media influences are more salient for young Chinese women and should be prioritized as targets of interventions to reduce body image disturbances in this group.