Embodiment: Cultural and gender differences and associations with life satisfaction

The Experience of Embodiment Scale: An examination of its psychometric properties in women from the Republic of Cyprus

The Experience of Embodiment Scale (EES) is a recently developed instrument that assesses experiences of living in the body. Here, we prepared a novel Greek translation of the EES and examined its psychometric properties. We initially prepared a Greek translation of the EES using a 5-step procedure recommended for test adaptation studies. Next, in a cross-sectional study, we asked a sample of 933 women from Cyprus to complete the Greek EES, alongside additional, previously validated measures assessing body appreciation, psychological well-being (self-esteem, life satisfaction), eating restriction, perfectionism, and internalisation of appearance ideals. Our analyses showed that EES factorial models based on confirmatory factor analysis (CFA) roundly had poor fit. Conversely, models based on exploratory structural equation modelling (ESEM)-which accounts for the fact that EES items cross-load across factors-had adequate fit to the data. Additionally, we found that both higher-order and bifactor-ESEM models that controlled for the uniqueness of negatively worded items had adequate fit. The bifactor-ESEM model had the best fit of all the models tested, and was invariant across ethnicity (Greeks and Greek-Cypriots) and was unaffected by differential item functioning based on age and body mass index. Additionally, construct validity of the final, optimal model was adequate, especially for its G-factor, as indicated by significant associations with additional constructs in expected directions. These results suggest that a bifactor-ESEM model of the Greek EES has adequate psychometric properties. Our work highlights important psychometric issues relating to the manner in which the EES should (or could) be conceptualised and modelled, which should be considered more fully in future work.

Self-perceived body weight and weight status: analysis of concordance by age group and sex

OBJECTIVES

Previous studies suggest that there is discordance between actual weight status and body-weight perception. This fact has implications when it comes to designing public health interventions. The aim of this study was to estimate the prevalence of the different categories of weight status and body-weight perception and to analyse their concordance in a representative Spanish population sample.

STUDY DESIGN

Cross-sectional study.

METHODS

Data were sourced from the 2018 Galician Risk Behaviour Data System, with the target population being all persons aged 16 years and above. We collected data on self-perceived body weight and assessed weight status on the basis of body mass index (BMI). BMI was estimated using self-reported measures of weight and height. To estimate concordance, Cohen's kappa coefficient, both unweighted and weighted with Cicchetti weights, was calculated.

RESULTS

Data were obtained for 7853 individuals aged 16 years and above, whereas the overall unweighted concordance was 0.393 (95%CI: 0.377-0.409), with an agreement percentage of 61.6%, weighted concordance was 0.503 (0.490-0.517), with an agreement percentage of 86.6%. The highest concordance between self-perceived body weight and weight status was observed in women. By age group, the highest concordance was observed in the youngest group (16-24 years) for the BMI categories of underweight and overweight, and in the 45-64 age group for the category of obesity.

CONCLUSIONS

The results highlight the existence of differences between self-perceived body weight and weight status, according to sex and age.

Body Weight Satisfaction, Comments, Nutrition and Injury Risk in 489 Adolescent Elite Athletes

Exposure to critical body weight comments in youth athletes could lead to decreased self-esteem, affect body image, and increase the risk of eating disorders and cause depressive symptoms. The aim was to explore differences between sex, body mass index, sports type, with regards to body weight satisfaction, exposure to critical body weight comments from their coach and nutrition status in adolescent elite athletes. A questionnaire about body weight, critical body weight comments and nutrition was distributed to 489 adolescent elite athletes and injury prevalence was monitored across 20 weeks. The results showed that almost one in four athletes (n=116, 24%) was not satisfied with their weight and 12% (n=59) had received critical body weight comments from their coach. Of the athletes who were unsatisfied with their body weight (n=116), 47% wanted to lose weight (n=55). A significant (p<0.05) higher proportion of ice hockey players and swimmers used nutritional supplements, were unsatisfied with their body weight, and were more exposed to critical body weight comments compared to athletes from other sports. Adolescent elite athletes as young as 15-16 years old are exposed to critical body weight comments from their coach and experience challenges with body weight satisfaction that is partly dependent on the sport-specific context.

Inhabiting the body: Exploring the link between embodiment and identity in community adolescents

The intricate relationship between the body and identity has been highlighted in previous studies. However, a holistic approach to the body that focuses on embodiment is lacking in research examining body - identity linkages. The current study (N = 917 adolescents; 58% female; Mage = 16.17, range = 14-19 years) examined the psychometric properties of a Dutch translation of the Experience of Embodiment Scale (EES) and explored the link between embodiment and personal identity. First, confirmatory factor analysis revealed a second-order factor structure for the EES and adequate reliability coefficients were obtained. Metric invariance across gender was demonstrated for the first- and second-order factors. Second, path analysis demonstrated that experiencing embodiment was positively associated with adaptive identity work. Third, five identity statuses emerged using cluster analysis. Adolescents in statuses reflecting less adaptive identity functioning displayed lower levels of embodiment. The EES shows promising indications of reliability and factor structure for assessing adolescents' Experience of Embodiment, and the present study demonstrates that embodiment is meaningfully related to identity functioning. These findings support the call for the adoption of a positive psychology framework within this research field, with attention given to more broadly defined body-related concepts such as embodiment.

Life satisfaction and its influencing factors for bedridden patients with stroke

OBJECTIVES

This study aimed to evaluate the life satisfaction of bedridden patients with stroke and explore its relationship with demographic, social, and medical factors.

MATERIAL AND METHODS

This multicenter cross-sectional study was conducted in two steps. The Longshi scale was used to select the study population and assess patients' ability to perform activities of daily living. Subsequently, a multidimensional questionnaire was used to obtain the participants' information and evaluate their level of life satisfaction. The chi-squared test and binary logistic regression methods were employed to analyze the factors influencing the life satisfaction of bedridden patients with stroke.

RESULTS

A total of 3,639 bedridden patients with stroke were included in this study, of them, only 27.2% reported satisfaction with their current lives. Factors associated with higher life satisfaction include female sex, older age, and primary school education or lower (P<0.05). Patients who had experienced a single stroke episode had chronic diseases, and rated their health as good were more satisfied with their lives than those who did not. The results of the binary logistic regression confirmed that age, education, religion, household income, cohabitation, social participation, number of chronic diseases, self-rated health status, and disability level significantly influenced the life satisfaction of bedridden patients with stroke (P<0.05).

CONCLUSION

Our study showed that the overall life satisfaction of bedridden patients with stroke was low, with several factors influencing their life satisfaction. Therefore, effective measures should be implemented to improve life satisfaction and quality of life.

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.

Expanding the social lens: A quantitative study of the developmental theory of embodiment

The developmental theory of embodiment (DTE) is a research-based theory of social factors that shape the experience of embodiment, a construct that is strongly correlated with body esteem and body appreciation. The DTE is anchored in prospective and retrospective qualitative research studies with cisgender girls and women of diverse backgrounds. This paper describes the first comprehensive quantitative study of factors in the social environment the DTE delineates as shaping the experience of embodiment involving a cross-sectional design, among 412 cisgender women. The 13 quantitative social factors correlated positively with the Experience of Embodiment Scale and accounted together for over 60% of its score variance. The findings of significant positive correlations between all social factors and of a large shared variance amongst these factors in a simultaneous multiple regression predicting the experience of embodiment are in line with the DTE and with a multi-level model of causality central to public health perspectives, whereby social structures and positions, such as those related to gender, shape multiple lower-level protective and risk factors. Future studies of the theory should include prospective designs with samples of varied backgrounds along different dimensions of social location.

Media Internalized Pressure and Restrained Eating Behavior in College Students: The Multiple Mediating Effects of Body Esteem and Social Physique Anxiety

Background

Restrained eating behavior has become the norm in college students' lives, and considering the harm it causes to college students, it is necessary to explore the factors associated with it. The aim of this study was to explore the association between media internalized pressure, body esteem, social physique anxiety, and restrained eating behavior.

Methods

The participants in this study were 1,032 Chinese college students (439 males and 593 females) and had a mean age of 20.22 years (SD = 1.277). They completed the Sociocultural Attitudes Toward Appearance Questionnaire-3, Body Esteem Scale (BES), Social Physique Anxiety Scale (SPAS), and Dutch Eating Behavior Questionnaire (DEBQ).

Results

The results showed that media internalized pressure was significantly and positively associated with college students' restrained eating behavior, that body esteem and social physique anxiety played a mediating role between media internalized pressure and restrained eating behavior, respectively, and that body esteem and social physique anxiety can also play a chained mediating role.

Conclusion

This study reveals the relationship between media internalized pressure and restrained eating behavior, and the important role played by body esteem and social physique anxiety. Future interventions targeting restrained eating should focus on the aspects of body esteem and social physique anxiety.

Body image self-consciousness, sexting, and sexual satisfaction among midlife Canadians

Life circumstances at midlife are often different than those for younger adults (e.g., relationship type and duration, physical health, experience of sexual problems), and these circumstances impact experiences of sexuality and sexual behaviour. Past research on sexual behaviours like sexting, which has been primarily conducted on young people, may not generalize to middle-aged adults. Sexting may be a beneficial activity for midlife adults in long-term relationships who are seeking private and convenient ways to communicate sexual interest. Furthermore, as in younger samples, sexting may be associated with body image and sexual satisfaction. A cross-sectional study with a sample of 640 midlife (40–59 years old) married Canadians was conducted to address these suppositions. Structural equation modelling was used to test the factorial validity of a body image self-consciousness (BISC) scale and to investigate the connections between BISC, sexting frequency (to communicate sexual interest, to initiate sexual activity, and that include a picture), and sexual satisfaction. Almost one-half of participants (43%) reported sexting to communicate sexual interest, 37% sexted to initiate sexual activity, and 18% sexted sexy pictures of themselves. Women with lower levels of BISC were more likely to sext (communicate, initiate, and pictures), and men with lower levels of BISC were more likely to send sexts with pictures. Both men and women with lower levels of BISC and those who engaged in sexting to communicate sexual interest had higher levels of sexual satisfaction. Sexting may be an opportunity for busy marital partners to engage in technology-mediated sexual activity when apart. The current results indicate that technology-mediated sexual communication has similar psychological mechanisms to face-to-face interactions and that sexting may be a beneficial behaviour for sexual satisfaction within midlife marriages.

Disordered eating through the lens of positive psychology: The role of embodiment, self-esteem and identity coherence

Applying a positive psychology perspective, this study aimed to identify potential intra-individual factors that might protect against the development of disordered eating in a community sample of young women and men (N = 510; 56 % women; M_age = 24.3). Based on existing literature, the study included the general resilience factors of self-esteem and identity coherence as well as two dimensions of positive embodiment (positive body connection and comfort, and agency and functionality). All factors were negatively correlated with disordered eating among women and men. Hierarchical regression analyses indicated that positive embodiment, specifically positive body connection, was a significant predictor of lower degrees of disordered eating symptoms in both women and men, followed by self-esteem. The overall prediction model accounted for 42.6 % in the variation of disordered eating symptoms for women and 23.9 % for men. Prevention and treatment interventions promoting health factors that protect against the development of eating disorders are much needed. The present study informs such efforts by emphasizing the promotion of positive embodiment.

Translation and psychometric evaluation of the Experience of Embodiment Scale in a Swedish community sample of young women and men

This report describes a Swedish translation and psychometric evaluation of the Experience of Embodiment Scale (EES; Piran, Teall, & Counsell, 2020), an instrument for assessing a wide range of positive and negative experiences of living in the body. A community sample (N = 545) of Swedish young women (56%) and men (M_age = 24.4; SD = 0.52) completed the Swedish translation of the EES. To explore its construct validity, participants also completed measures of body esteem, disordered eating, internalization of appearance ideals, drive for muscularity and leanness, body mass index, life satisfaction, self-esteem, and psychological distress. Exploratory factor analyses (performed separately for women and men) revealed structures of the Swedish EES similar to those displayed during the development and first evaluations of the scale in North America. However, among men, the factors of agency and sexual desire combined to form one factor. On total scale level, the Swedish EES showed good internal consistency (McDonald's ω = .95 for women; ω = .94 for men), convergent validity, and incremental validity. Overall, the present findings support the Swedish version of the EES and the EES's cross-national use to assess the construct of embodiment, as well as its use among men.

Body image concerns in individuals diagnosed with benign gynaecological conditions: scoping review and meta-synthesis

Background

Benign gynaecological conditions (BCGs) and body image-related concerns are commonly experienced by reproductive-aged female-identified individuals. Qualitative evidence from cancer populations identifies a link between diseases of the sexual organs and body image distress encompassing appearance, sensory and functional aspects. Most BCGs and the impacts on body image have been studied separately. However, commonalities exist between these conditions including chronicity, diagnostic delays, and menstrual-related social stigma. This systematic scoping review and meta-synthesis aimed to compare and contrast the experience of body image in the benign conditions of endometriosis, polycystic ovarian cysts, uterine fibroids, and vulvar intraepithelial neoplasia.

Method

Electronic databases (MEDLINE, PsycINFO, Scopus, CINAHL, Embase, and Allied and Complementary Medicine) were searched in February 2020 and relevant articles were examined to identify papers that qualitatively explored the relationship between body image and BCGs. Meta-synthesis was used to analyse the 17 papers that met the inclusion criteria.

Results

Six main themes evolved from this iterative analysis: loss of control; regained control; silence – menstrual concealment; cultural differences; feeling abnormal, and functional impairment. Body image concerns were widespread although impacts on individual’s lives were dependent on the unique symptom profile of each disease which interacted with socio-cultural factors, daily functioning, and feminine identity. Body image concerns were a common, but hidden, experience rarely screened in routine clinical settings despite causing significant distress.

Conclusions

The chronicity and severity of individuals unique symptom profile often determined the intensity and type of body image concerns individuals described. Across conditions, body image concerns were often left untreated, were concealed, and were associated with reduced quality of life.