Media effects of experimental presentation of the ideal physique on eating disorder symptoms: A meta-analysis of laboratory studies

Relationships between media influence, body image and sociocultural appearance ideals in Latin America: A systematic literature review

The rapidly growing body of research investigating media influence on body image in Latin America has not been previously comprehensively synthesised. We systematically reviewed studies of the relationships between media use/influence, body image, and sociocultural appearance ideals in Latin America (CRD42021254607). We searched PsycINFO/Medline, Pubmed, Web of Science, ERIC, Scopus, ProQuest Dissertations, SciElo, and LILACS for quantitative and qualitative peer-reviewed articles and doctoral theses in English, Spanish, and Portuguese. Research conducted in Latin America, published 1991-2023, measuring a) media use/influence, and b) body image or appearance ideals was included. 68 articles met inclusion criteria, and quality appraisal concluded that most were of medium/high quality. A narrative review found consistent quantitative relationships, stronger in women than men, between media use/internalisation of media ideals and both body dissatisfaction and thinner appearance ideals. In contrast, participants in qualitative studies acknowledged media influence on their body image, but perceived greater influence from family and peers. Limitations included a predominance of cross-sectional research from Brazil and Mexico with adolescents and young adults. Additional longitudinal, experimental, and interventional work from elsewhere in Latin America is needed, recruiting more diverse samples and assessing more culturally salient appearance aspects (e.g., skin tone and hair texture).

Better than average Bopo: Identifying which body positive social media content is most helpful for body image among women

Body positive social media content, and especially content that does not contain photos of bodies, has been shown to be helpful for body image compared to idealized social media content. However, body positive content is heterogenous and little is known regarding which types of content may be most helpful. This study examined self-reported body image and mood effects of different types of body positive content among women. A sample of 176 women, mean (SD) age = 21.77 (2.35) was recruited. Participants viewed body positive stimuli that were grouped into 14 different categories to represent the heterogenous nature of this social media content, including a text only category. Each image was rated in terms of its perceived effect on body image and mood. Findings suggested that the text-only category was rated most highly in terms of generating positive feelings towards the body and positive affect. Moreover, the comparative benefit of the text-only category was larger among women with higher BMI, and participants reporting closer proximity to the images, although not consistently across outcomes. Further work focused on understanding the effects of different types of body positive content is warranted.

Smartphone use and its association with body image distortion and weight loss behaviours among adolescents in Saudi Arabia

BACKGROUND

Concerns about the harmful effects of smartphone use on teenage development have been raised as the use of cell phones among adolescents has risen.

OBJECTIVE

This study aimed to examine the associations of smartphone usage patterns with Body Image Distortion (BID) and weight loss behaviors among adolescent smartphone users in Saudi Arabia.

METHODS

This population-based, cross-sectional study was conducted from July to October 2022. We assessed the mean daily length of smartphone use and classified it into quartiles using data from a self-reported survey and data on weekday and weekend use. Self-reported body weight and height were collected via an online survey. Out of the 11384 adolescents, the majority was females (65.7%) and was secondary school students (68.9%).

RESULTS

The prolonged smartphone use (301 min/d) was found in 36.4% of adolescents, 181-300 min/d in 27.6% of respondents, 121-180 min/d in 22.4% of respondents, while the modest smartphone use (1-120 min/d) was found only in 13.6% of participants. The duration of smartphone use was significantly associated with BID (P= 0.000); students with middle perceived stress levels (51.4%) and no depressive symptoms (68.9%) used smartphones 121-180 min/d sparingly. However, prolonged smartphone use was significantly associated with the presence of depressive symptoms (42.6%) and high perceived stress levels (21.5%). Weight loss behaviors were significantly associated with smartphone use duration. Modest smartphone use was significantly found in students with normal weight (P= 0.00, 71.9%); however, aerobic physical activity weight loss strategy (P= 0.00, 30.9%) was correlated with prolonged smartphone use.

CONCLUSION

Adequate parental advice is required to assist teenagers in developing healthy smartphone usage practices. Digital platform companies may increase their social responsibility for the information generated and delivered on their networks, boosting its beneficial effect.

The relationship between body dissatisfaction and attentional bias to thin bodies in Malaysian Chinese and White Australian women: a dot probe study

Studies suggest that an attentional bias to thin bodies is common among those with high levels of body dissatisfaction, which is a risk factor for, and symptom of, various eating disorders. However, these studies have predominantly been conducted in Western countries with body stimuli involving images of White people. In a preregistered study, we recruited 150 Malaysian Chinese women and 150 White Australian women for a study using standardized images of East Asian and White Australian bodies. To measure attentional bias to thin bodies, participants completed a dot probe task which presented images of women who self-identified their ethnicity as East Asian or as White Australian. Contrary to previous findings, we found no evidence for an association between body dissatisfaction and attentional bias to thin bodies. This lack of association was not affected by participant ethnicity (Malaysian Chinese versus White Australian) or ethnic congruency between participants and body stimuli (own-ethnicity versus other-ethnicity). However, the internal consistency of the dot probe task was poor. These results suggest that either the relationship between body dissatisfaction and attentional bias to thin bodies is not robust, or the dot probe task may not be a reliable measure of attentional bias to body size.

The developmental theory of embodiment: Quantitative measurement of facilitative and adverse experiences in the social environment

The present program of research involved developing and evaluating three fully structured measures of facilitative and adverse social experiences during adulthood described by the developmental theory of embodiment (DTE) as shaping the quality of the experiences of living in the body. The Physical Freedom Scale - adulthood (PFSa) addresses physical experiences, the Mental Freedom Scale - adulthood (MFSa) assesses exposure to social environments that either facilitate or constrict freedom from constraining social discourses, and the Social Power and Relational Connections Scale - adulthood (SPRCSa) covers experiences of accessing, or being barred from, social power and empowering relational connections. The pilot study ( N = 92) involved item revision and deletion. Study 1 (N = 412) involved factor analyses of the three scales, leading to the emergence of six, three, and four factors in the PFSa, MFSa, and SPRCSa, respectively. The study also provided initial support for the internal consistency of the scales and subscales, as well as their convergent validity. Study 2 (N = 373) confirmed the factor structure of the scales from study 2. Study 3 (N = 64) demonstrated that the scales and their factors were stable over a 3-week period. The scales can be used to study integrated sociocultural models of embodiment.

Risk factors for eating disorders: findings from a rapid review

BACKGROUND

Risk factors represent a range of complex variables associated with the onset, development, and course of eating disorders. Understanding these risk factors is vital for the refinement of aetiological models, which may inform the development of targeted, evidence-based prevention, early intervention, and treatment programs. This Rapid Review aimed to identify and summarise research studies conducted within the last 12 years, focusing on risk factors associated with eating disorders.

METHODS

The current review forms part of a series of Rapid Reviews to be published in a special issue in the Journal of Eating Disorders, funded by the Australian Government to inform the development of the National Eating Disorder Research and Translation Strategy 2021-2031. Three databases were searched for studies published between 2009 and 2021, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, or population studies). Data pertaining to risk factors for eating disorders were synthesised and outlined in the current paper.

RESULTS

A total of 284 studies were included. The findings were divided into nine main categories: (1) genetics, (2) gastrointestinal microbiota and autoimmune reactions, (3) childhood and early adolescent exposures, (4) personality traits and comorbid mental health conditions, (5) gender, (6) socio-economic status, (7) ethnic minority, (8) body image and social influence, and (9) elite sports. A substantial amount of research exists supporting the role of inherited genetic risk in the development of eating disorders, with biological risk factors, such as the role of gut microbiota in dysregulation of appetite, an area of emerging evidence. Abuse, trauma and childhood obesity are strongly linked to eating disorders, however less conclusive evidence exists regarding developmental factors such as role of in-utero exposure to hormones. Comorbidities between eating disorders and mental health disorders, including personality and mood disorders, have been found to increase the severity of eating disorder symptomatology. Higher education attainment, body image-related factors, and use of appearance-focused social media are also associated with increased risk of eating disorder symptoms.

CONCLUSION

Eating disorders are associated with multiple risk factors. An extensive amount of research has been conducted in the field; however, further studies are required to assess the causal nature of the risk factors identified in the current review. This will assist in understanding the sequelae of eating disorder development and in turn allow for enhancement of existing interventions and ultimately improved outcomes for individuals.

Eating Disorder Examination-Questionnaire and Clinical Impairment Assessment norms for intersectional identities using an MTurk sample

OBJECTIVE

There are limited data to guide the interpretation of scores on measures of eating-disorder psychopathology among underrepresented individuals. We aimed to provide norms for the Eating Disorder Examination-Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA) across racial/ethnic, gender, and sexual identities, and sexual orientations and their intersections by recruiting a diverse sample of Amazon MTurk workers (MTurkers; N = 1782).

METHOD

We created a comprehensive, quantitative assessment of racial/ethnic identification, gender identification, sex assigned at birth, current sexual identification, and sexual orientation called the Demographic Assessment of Racial, Sexual, and Gender Identities (DARSGI). We calculated normative data for each demographic category response option.

RESULTS

Our sample was comprised of 68% underrepresented racial/ethnic identities, 42% underrepresented gender identities, 13% underrepresented sexes, and 49% underrepresented sexual orientations. We reported means and standard deviations for each demographic category response option and, where possible, mean estimates by percentile across intersectional groups. EDE-Q Global Score for a subset of identities and intersections in the current study were higher than previously reported norms for those identities/intersections.

DISCUSSION

This is the most thorough reporting of norms for the EDE-Q and CIA among racial/ethnic, sexual, and gender identities, and sexual orientations and the first reporting on multiple intersections, filling some of the gaps for commonly used measures of eating-disorder psychopathology. These norms may be used to contextualize eating-disorder psychopathology reported by underrepresented individuals. The data from the current study may help inform research on the prevention and treatment of eating-disorder psychopathology in underrepresented groups.

PUBLIC SIGNIFICANCE

We provide the most thorough reporting on racial/ethnic, sexual, and gender identities, and sexual orientations for the Eating Disorder Examination - Questionnaire and Clinical Impairment Assessment, and the first reporting on intersections, which fills some of the gaps for commonly used measures of eating-disorder psychopathology. These norms help inform research on the prevention and treatment of eating-disorder psychopathology in underrepresented groups.

Evidence-based policy solutions to prevent eating disorders: Do disclaimer labels on fashion advertisements mitigate negative impact on adult women?

Exposure to media images portraying the thin ideal is associated with increased body dissatisfaction and disordered eating in women. Organizations and policymakers globally have proposed polices requiring warning or disclaimer labels on altered images. Research examining efficacy of disclaimer labels is growing but has largely overlooked adult women. This study extends current research by exploring novel disclaimer labels in a sample of adult women. Women (N = 872) recruited via Amazon's MTurk were randomly assigned to view 20 fashion advertisements with one of five labels: 1) no label; 2) general-digital-alteration label; 3) health-warning label; 4) specific-weight label; or 5) facial features/cosmetic label. Results revealed a significant increase in body dissatisfaction after advertisement exposure, irrespective of label group. Women who viewed advertisements with labels and recalled the labels reported lower body satisfaction and intention to purchase products compared to those who viewed advertisements with no label. Age appears to play an important role in how disclaimer labels affect women. Younger women of color appear to be more negatively impacted by the facial features/cosmetic label than older women of color. Findings are consistent with previous studies indicating no protective effect of disclaimer labels suggesting the need for more effective preventive strategies.

Sociocultural drivers of body image and eating disorder risk in rural Nicaraguan women

OBJECTIVE

Technological and economic globalisation has been suggested as a cause of increasing rates of body dissatisfaction and eating disorders globally, especially as regards the impact of mass media on internalised body ideals. This process is rarely observed in action, however. The current work investigates multiple aspects of body ideals, body image, sociocultural attitudes and eating attitudes in 62 Creole and Mestizo women living in communities at differing stages of technological development on the Caribbean coast of Nicaragua METHOD/RESULTS: In Study 1, women used 3D avatar software to create their own 'ideal' body without the constraints of ready-made stimuli. Analyses of resulting avatars showed that components of the ideal body shape (upper and lower body curvaceousness) but not body size (body mass) were associated with levels of film and television consumption. In Study 2, women completed measures of variables in the sociocultural model of eating disorder risk. As expected, body dissatisfaction mediated the relationship between internalisation of sociocultural body ideals and pathological eating attitudes. In contrast, body appreciation reduced pathological eating attitudes, via reduced body dissatisfaction. Finally, Study 3 measured sociocultural influences, body image and eating attitudes at 2 or 3 timepoints per woman; body dissatisfaction covaried with pathological eating attitudes across time. Ethnicity varied in its effects across studies.

DISCUSSION

Together these data show that even at early stages of media acculturation, women may show similar patterns of association between sociocultural internalisation, body dissatisfaction and eating disorder risk as in high income nations. However, they also demonstrate unique aspects of this population's body shape ideals, and the independent protective effect of body appreciation.

The values you endorse set the body you see: The protective effect of intrinsic life goals on men's body dissatisfaction

The mass media portrayal of a muscular body type ideal has been increasingly tied to men's body image dissatisfaction. We examined the role of self-determination theory's intrinsic life goals within this body image ideal and its potential as a moderator of this dissatisfaction. We first tested the moderating effect of intrinsic life goals on the link between magazine consumption and body image dissatisfaction via an online questionnaire (Study 1; N = 826), then experimentally manipulated these goals and exposure to images of muscular male models (Study 2; N = 150). A robust protective effect of intrinsic goals on body image satisfaction was observed - the relationship between magazine consumption and body image dissatisfaction was only significant among individuals with a lower level of intrinsic life goal orientation. When participants' intrinsic goals were momentarily heightened, they reported significantly less body image dissatisfaction, compared to those not receiving a strengthening of these goals. The results are the first to find a protective effect of intrinsic life goals on men's body image, and have important implications for intervention.

Does the tripartite influence model of body image and eating pathology function similarly across racial/ethnic groups of White, Black, Latina, and Asian women?

The tripartite influence model suggests that appearance pressures from family, peers, and the media contribute to thin-ideal internalization, which leads to increased body dissatisfaction and subsequent eating disorder pathology. The tripartite influence model was initially developed and tested among primarily White samples, and emerging research suggests racial/ethnic differences in mean levels of particular model constructs. Consequently, the model's appropriateness for understanding eating disorder risk in racial/ethnic minorities warrants investigation to determine its usefulness in explicating eating disorder risk in diverse populations. Participants in the current study were White (n = 1167), Black (n = 212), Latina (n = 203), and Asian (n = 176) women from five geographically disparate college campuses in the United States. Participants completed the Sociocultural Attitudes Towards Appearance Questionnaire-4, the Multidimensional Body-Self Relations Questionnaire - Appearance Evaluation Subscale, and the Eating Disorder Examination-Questionnaire. Analysis of variance was used to compare mean levels of each construct across racial/ethnic groups. Multigroup structural equation modeling was used to assess the appropriateness of the tripartite influence model for each racial/ethnic group, and to examine differences in the strength of the model pathways across groups. There were significant mean level differences across groups for most model constructs. However, results indicated similar model fit across racial/ethnic groups, with few differences in the strength of model pathways. Findings suggest that although some groups report lower levels of proposed risk factors, the sociocultural risk processes for eating pathology identified through the tripartite influence model are similar across racial/ethnic groups of young adult women. Such information can be used to inform culturally-sensitive interventions.

"Have You Taken the A4 Challenge?" Correlates and Impact of a Thin Ideal Expression From Chinese Social Media

In three studies, we assessed knowledge, correlates, and effects of the A4 challenge, an expression of the thin ideal from Chinese social media. In Study 1, gender differences in familiarity with the A4 challenge were assessed among 225 women and 151 men. Compared to men, women and female peers from participant social networks were more familiar with and likely to have taken the challenge themselves. In Study 2, body image experiences of women who passed the A4 challenge (N = 45) and average weight peers who did not pass the challenge (N = 75) were assessed. The former group reported fewer weight concerns and less social pressure to lose weight but no group differences were observed with respect to binge-eating, dieting, or other compensatory weight loss behaviors. As such, eating disorder symptoms did not account for the experience of passing the A4 challenge. In Study 3, changes in state body dissatisfaction were assessed among 205 women randomly assigned to view images of (1) thin peers successfully passing the challenge vs. (2) thin or (3) average size controls. The absence of condition differences in post-exposure state body dissatisfaction indicated exposure to A4 challenge portrayals per se did not cause increases in negative appearance self-evaluations for women in general. However, among women who were exposed to A4 challenge images, but not control group women exposure to other images, trait body dissatisfaction predicted increased post-exposure state dissatisfaction, independent of pre-exposure state dissatisfaction. Implications are discussed in relation to effects of exposure to the A4 challenge and conceptualizing the task as a "challenge."

A test of the tripartite influence model of disordered eating among men

Studies of the Tripartite Influence Model conducted with female samples suggest that thinness-oriented pressures, internalization, and appearance comparisons may be risk factors for disordered eating. However, limited work has investigated this model among men utilizing measures specifically designed to assess both muscularity- and thinness-oriented processes, which characterize male body image concerns. To address this gap, the current study examined the Tripartite Influence Model of disordered eating among men using a battery of such measures. A convenience sample of 265 male undergraduates completed validated, self-report measures of disordered eating, muscularity- and thinness-oriented appearance pressures, internalization, and appearance comparisons. Path analyses supported a slightly modified version of the Tripartite Influence Model, indicating direct and indirect paths from sociocultural pressures to disordered eating via internalization and appearance comparisons. These results provide support for a version of the Tripartite Influence Model among men. Specifically, muscularity- and thinness-oriented pressures appear to be related to disordered eating among college men via indirect pathways involving thin internalization, muscular internalization, and appearance comparisons. Future work is needed, however, to examine whether the model would generalize to muscularity-oriented disordered eating.

The differential impact of viewing fitspiration and thinspiration images on men's body image concerns: An experimental ecological momentary assessment study

To date, little is known about the impact of fitspiration and thinspiration exposure on men, as previous studies on these social media trends were primarily conducted on women. Male participants (n = 223) completed baseline measures of trait body image, then used a smartphone application to complete up to six state-based assessments daily for seven days. In each assessment, participants were randomly assigned to one of three image conditions (fitspiration, thinspiration, or neutral). Before and after viewing each image, they reported state body fat dissatisfaction, muscularity dissatisfaction, negative mood, and urge to engage in behaviours to reduce body fat and increase muscularity. Multi-level analyses revealed that compared to viewing neutral images, viewing fitspiration images increased men's body dissatisfaction, whereas viewing thinspiration images decreased body dissatisfaction. Viewing either fit- or thinspiration images also led to lower mood and greater urges to increase muscularity, whereas only fitspiration images increased urges to reduce body fat. Men with greater baseline muscularity dissatisfaction and higher appearance comparison were most vulnerable to muscularity dissatisfaction after viewing fitspiration images. Findings suggest the importance of limiting exposure to fitspiration imagery and implementing social media literacy programmes for men and well as women.

Internet Usage by Women with Eating Disorders during Illness and Recovery

Internet usage may have both positive and negative impacts on people with eating disorders. In research to date, most of the focus has been put on the harms connected with platforms that support people in continuing their disorder. Less studied have been the benefits of other technology platforms used by people with eating disorders. When these different platforms were investigated, users were rarely interviewed about their experience. To fill this gap, we conducted 30 interviews with participants aged 16 to 28, all female, living in the Czech Republic. The interviews focused on their experiences with the harmful and helpful impacts of the internet on the course of their eating disorders. The data were analyzed via thematic analysis. The results provided insight into the participants' experience with the following online environments: 1) nonprofessional pro-eating disorder platforms; 2) nonprofessional pro-recovery platforms; 3) social networking sites (SNS); 4) platforms for counting calories and setting weight goals; 5) platforms about food, exercise, and lifestyle; and 6) platforms providing professional help. The participants noted many benefits these platforms could provide; however, their ability to achieve the benefits was affected by their motivation for treatment. As a result, even platforms designed to support recovery could be used for illness maintenance. The results are discussed in the context of research on the changing motivations for recovery in people with eating disorders and the theory of different processes connected to the course of the eating disorders according to the differential interactivity of digital platforms.

Muscles and the Media: A Natural Experiment Across Cultures in Men's Body Image

An increasing number of studies are evidencing relationships between the drive for muscularity and potentially harmful behavioral strategies, such as unhealthy dieting and steroid use amongst men in WEIRD (Western, Educated, Industrialized, Rich, Democratic) populations. As such Western appearance standards proliferate around the world via the media, men who live in other cultural contexts are also at risk of potentially negative effects from aspiring to the “muscular ideal.” However, few studies have explored these relationships in non-WEIRD populations. We investigated men’s body ideals and body image in two non-WEIRD, non-White populations, Uganda (Africa) and Nicaragua (Central America), and compared them with an ethnically diverse sample of men in the United Kingdom. We also examined whether socio-cultural factors including media and ethnicity, predicted the drive for muscularity and body change behaviors among our participants. Results showed that Ugandan men had the least desire for muscularity relative to men in the United Kingdom. Supporting the Tripartite model we found that media and peer influences significantly predicted the drive for muscularity, particularly among men from White British and Nicaraguan Miskitu ethnic groups. By contrast, Creole / Garifuna and Mestizo men from Nicaragua were more likely to want to increase muscularity relative to Black African men from Uganda. Overall, our findings support previous research in demonstrating that there are cultural differences in the kind of body men desire, and that men from WEIRD and non-WEIRD populations may experience similar pressures to aspire to and attain a muscular body type.

Bedeutung von Instagram und Fitspiration-Bildern für die muskeldysmorphe Symptomatik

Hintergrund

Das männliche Körperideal unterscheidet sich von dem weiblichen durch eine Orientierung am muskulösen Körperbau. Diese Studie untersucht, inwiefern der Konsum von Instagram das Streben nach Muskulosität und muskeldysmorpher Symptomatik bei Männern vorhersagt. Darüber hinaus wird geprüft, ob relevante Mediatoren die Zusammenhänge in einer männlichen Stichprobe beeinflussen.

Methodik

Es wurden sportliche, Instagram nutzende Männer befragt (n = 203). Neben der Nutzungshäufigkeit von Instagram im Allgemeinen und der Betrachtung von Fitspiration-Bildern im Speziellen wurden das Streben nach Muskulosität, die Ausprägung muskeldysmorpher Symptomatik, die Tendenz zu aussehensbezogenen Vergleichen und die Internalisierung des medialen Schönheitsideals erfasst.

Ergebnisse

Gruppenvergleiche wiesen auf Unterschiede zwischen Männern, die zusätzlich Ballsport ausübten, zu solchen, die hauptsächlich Kraftsport trieben, hin. Die Internalisierung des medialen Schönheitsideals mediierte den Zusammenhang zwischen der allgemeinen und spezifischen Nutzungshäufigkeit von Instagram und dem Streben nach Muskulosität sowie der Ausprägung muskeldysmorpher Symptomatik.

Diskussion

Die Ergebnisse zeigen den Zusammenhang zwischen der Nutzungshäufigkeit von Instagram und Facetten des männlichen Körperbilds. Sie verdeutlichen ebenfalls die Bedeutung der Internalisierung des medialen Schönheitsideals bei der Nutzung sozialer Medien. Kraftsport ausübende Männer wiesen im Selbstbericht ein höheres Risiko für eine muskeldysmorphe Symptomatik auf. Die Nutzung sozialer Medien könnte im Rahmen einer muskeldysmorphen Störung eine aufrechterhaltende Funktion einnehmen.

Body-related cognitive distortions (thought-shape fusion body) associated with thin-ideal exposure in female students-An ecological momentary assessment study

Etiological models of eating disorders (EDs) describe body dissatisfaction (BD)as one of the major influences fostering dysfunctional body-related behaviour and disordered eating behaviour. BD is influenced by repeated exposure to thin ideals that evoke high self-ideal discrepancy and result in body-related cognitive distortions such as thought-shape fusion body (TSF-B). The aim of this study was to investigate the covariation of daily media exposure and the experience of TSF-B in a naturalistic setting. It was further analysed whether TSF-B is associated with self-ideal discrepancy, dysfunctional body-related behaviour, and disordered eating behaviour. Moreover, person-related predictors of TSF-B were explored. Altogether, 51healthy female students (mean age 21.06years, SD = 1.76) participated in an ecological momentary assessment study with four daily surveys during 10consecutive days. Exposure with thin ideals in contrast to exposure to unspecific media contents went along with the experience of TSF-B. TSF-B was associated with higher self-ideal discrepancy and dysfunctional body-related behaviour as well as more pronounced disordered eating behaviour, suggesting that TSF-B is a common phenomenon in young healthy females' everyday life. A main effect of trait measures (e.g., pre-existing BD) on TSF-B was observable but has no moderating effect. Thus, a specific vulnerability has not been detected.

Body-cult television advertisement recall among young women suffering from anorexia nervosa or bulimia nervosa

Abstract Advertising conveys an aesthetic model that seems to have a negative influence on young women. However, it is unclear whether the media are the cause, or only act as a reinforcement of disorders related to body image, such as those associated with eating behavior (anorexia or bulimia). This study measures the influence that advertising (measured by recall scores) during a television program has on women with eating disorders (anorexia or bulimia) compared to healthy women. Experimental study of exploratory nature performed on a sample of young women with eating disorders and a control group. The influence of advertising was estimated by recall scores, obtained after viewing a real television program, which included two commercial breaks containing two kinds of ads: body cult advertising (showing thinness or promoting it) and neutral advertising. Young women with eating disorders better recall advertisements showing thinness and products for weight loss and pay less attention to other types targeted at their age and gender group. Television advertising seems to be more of a reinforcement for these women who are already dissatisfied with their body, rather than a direct cause of their body image disorder.

Examining psychosocial correlates of physical activity and sedentary behavior in youth with and without HIV

The objectives of this study were to examine differences in physical activity behaviors as a function of human immunodeficiency virus (HIV) status and sex, to test differences in physical activity self-efficacy (PASE), body weight satisfaction (BWS), and enjoyment of physical activity as a function of HIV status, and to determine if PASE, BWS, and enjoyment are associated with daily physical activity (daily PA), muscle strengthening activities, and sedentary behavior of youth with and without HIV. A total of 250 HIV positive (HIV+) and HIV negative (HIV-) youth from Botswana aged 12-23 years (Mean = 17.87, SD = 2.24) participated in the study. The HIV+ group (n = 88) was recruited from a previous 12-month antiretroviral therapy (ART) and nutrition intervention study. The HIV- group (n = 162) was randomly selected from public junior and senior (secondary) high schools in and around Gaborone. Participants' PASE, BWS, enjoyment of physical activity, daily PA, muscle strengthening, body mass index (BMI), and sedentary behavior were obtained using items from the Youth Risk Behavior Surveillance Survey. Multivariate analysis of variance (MANOVA) showed that the HIV- group (M = 1.20, SE = 0.06, CI = 1.08 to 1.32) had significantly higher daily PA than the HIV+ group (M = 0.99, SE = 0.08, CI = 0.82 to 1.15). The HIV- group (M = 0.91, SE = 0.06, CI = 0.79 to 1.03) also reported participating significantly more in muscle strengthening activities than the HIV+ group (M = 0.63, SD = 0.08, CI = 0.47 to 0.78). Multiple regression analyses showed that higher PASE (p < .001) and greater enjoyment of PA (p < .01) were predictive of higher daily PA. HIV- participants had higher PASE but lower BWS compared to HIV+ participants. Sex and age differences were observed in muscle strengthening activities and sedentary behavior. This study supports previous findings on the association of efficacy beliefs to daily PA and muscle strengthening activities. The findings have implications for PA interventions aimed at health promotion and mitigation of the effects of living with HIV/AIDS.

Cognitive-behavioral roots of body image therapy and prevention

The existing array of evidence-based body image prevention and intervention approaches has evolved over time. However, the majority originated directly or indirectly from a cognitive-behavioral conceptualisation of body image pioneered by Thomas F. Cash. In this way, it is difficult to overstate the impact Tom Cash has had on body image intervention research and practice. His ground-breaking work, building on the work of Schilder and Fisher, was the first to provide a comprehensive model of body image that reflected the broad range of influences and consequences of body image. His differentiation of the components of body image as a construct and between body image traits and states allowed us to identify and influence targets for intervention. Moreover, the intervention strategies that Tom Cash employed are still used today and laid the foundations for contemporary intervention programs. There is a gap of more than 15 years between the first and last of us receiving our PhDs, yet Cash's work has been an important influence on us all. We are extremely grateful for the theoretical and practical tools that he has given to our field. In this paper, we will outline how Cash's work has informed contemporary body image intervention and prevention. We will describe Cash's theory and intervention tools before discussing how this work paved the way for subsequent research and practice.

A Narrative Review on Female Physique Athletes: The Physiological and Psychological Implications of Weight Management Practices

Physique competitions are events in which aesthetic appearance and posing ability are valued above physical performance. Female physique athletes are required to possess high lean body mass and extremely low fat mass in competition. As such, extended periods of reduced energy intake and intensive training regimens are used with acute weight loss practices at the end of the precompetition phase. This represents an increased risk for chronic low energy availability and associated symptoms of relative energy deficiency in sport, compromising both psychological and physiological health. Available literature suggests that a large proportion of female physique athletes report menstrual irregularities (e.g., amenorrhea and oligomenorrhea), which are unlikely to normalize immediately postcompetition. Furthermore, the tendency to reduce intakes of numerous essential micronutrients is prominent among those using restrictive eating patterns. Following competition, reduced resting metabolic rate, and hyperphagia, is also a concern for these female athletes, which can result in frequent weight cycling, distorted body image, and disordered eating/eating disorders. Overall, female physique athletes are an understudied population, and the need for more robust studies to detect low energy availability and associated health effects is warranted. This narrative review aims to define the natural female physique athlete, explore some of the physiological and psychological implications of weight management practices experienced by female physique athletes, and propose future research directions.

An exploration of 'fitspiration' content on YouTube and its impacts on consumers

The 'Fitspiration' movement may endorse problematic body image and behaviour. This study aims to expand the understanding of 'fitspiration' by examining its presence on YouTube. Analysis was conducted in accordance with Tiggemann and Zaccardo and Santarossa et al. Thematic analysis of videos revealed three themes; 'Fitness and beauty', 'Trust me-I'm a YouTuber', and 'Health for the right reasons'. Thematic analysis of comments revealed themes 'YouTube fitness community', 'Body appearance dissatisfaction', and 'YouTuber fitness role models'. Fitness YouTubers were found to promote unhealthy behaviours to achieve fitness, and commenters expressed belief in and replication of their advice.

A methodological review of meta-analyses of the effectiveness of clinical psychology treatments

This article presents a methodological review of 54 meta-analyses of the effectiveness of clinical psychological treatments, using standardized mean differences as the effect size index. We statistically analyzed the distribution of the number of studies of the meta-analyses, the distribution of the sample sizes in the studies of each meta-analysis, the distribution of the effect sizes in each of the meta-analyses, the distribution of the between-studies variance values, and the Pearson correlations between effect size and sample size in each meta-analysis. The results are presented as a function of the type of standardized mean difference: posttest standardized mean difference, standardized mean change from pretest to posttest, and standardized mean change difference between groups. These findings will help researchers design future Monte Carlo and theoretical studies on the performance of meta-analytic procedures, based on the manipulation of realistic model assumptions and parameters of the meta-analyses. Furthermore, the analysis of the distribution of the mean effect sizes through the meta-analyses provides a specific guide for the interpretation of the clinical significance of the different types of standardized mean differences within the field of the evaluation of clinical psychological interventions.

Women's Use of Social Media: What Is the Evidence About Their Impact on Weight Management and Body Image?

PURPOSE OF THE REVIEW

This review aims to summarize recent research on the effects of social media-delivered weight management interventions on weight loss and the impact of social media use on body image concerns in women and adolescent girls.

RECENT FINDINGS

Evidence supports the feasibility, but not the efficacy, of studies using single-component social media-delivered weight management interventions (i.e., including no other modes of intervention delivery) in women. Studies conducted in adolescent girls and women suggest that the impact of social media on body image outcomes is mostly detrimental, but is dependent on the context (e.g., exposure to idealized social media appearance images), peers' feedback, and constructs, such as appearance comparison tendency. More research is needed to conclude on the efficacy of social media-delivered interventions on both weight and body image outcomes and to understand how and when exposure to social media could promote effective weight management and also advocate positive body image in women.

Appearance comparison and other appearance-related influences on body dissatisfaction in everyday life

Although appearance comparisons, self-monitoring, and appearance-related comments have been linked to body dissatisfaction in prior studies, the combined and unique influences of these variables on state body dissatisfaction in daily life has yet to be explored. The present study addressed this gap, and also evaluated whether these state-based effects were stronger for individuals with trait-level body image disturbances (internalization and body dissatisfaction). Eighty-four women completed baseline measures of trait internalization and body dissatisfaction, and then reported momentary experiences of body dissatisfaction, appearance self-monitoring, appearance-related comments, and appearance-based comparisons at up to 10 random times daily for seven days. Multilevel analyses confirmed that both appearance comparisons and commentary (both negative and positive) were predictive of changes in state body dissatisfaction when modelled individually as well as in a combined (full) model. Appearance self-monitoring was not a significant predictor, either individually or in the full model. These within-person relationships were not moderated by individual differences in trait body dissatisfaction and internalization of appearance standards. Accordingly, experiences of body dissatisfaction in daily life may be a common reaction to negative appearance comments and unflattering comparisons, yet positive comments and/or efforts to avoid appearance-based comparisons may have a positive effect on one's body image.

Digital Manipulation of Images of Models' Appearance in Advertising: Strategies for Action Through Law and Corporate Social Responsibility Incentives to Protect Public Health

CONTEXT

Widespread digital retouching of advertising imagery in the fashion, beauty, and other consumer industries promotes unrealistic beauty standards that have harmful effects on public health. In particular, exposure to misleading beauty imagery is linked with greater body dissatisfaction, worse mood, poorer self-esteem, and increased risk for disordered eating behaviors. Moreover, given the social, psychological, medical, and economic burden of eating disorders, there is an urgent need to address environmental risk factors and to scale up prevention efforts by increasing the regulation of digitally altered advertising imagery.

METHODS

This manuscript summarizes the health research literature linking digital retouching of advertising to increased risk of eating disorders, disordered weight and appearance control behaviors, and body dissatisfaction in consumers, followed by a review of global policy initiatives designed to regulate digital retouching to reduce health harms to consumers. Next, we turn to the US legal context, reporting on findings generated through legal research via Westlaw and LexisNexis, congressional records, federal agency websites, law review articles, and Supreme Court opinions, in addition to consulting legal experts on both tax law and the First Amendment, to evaluate the viability of various policy initiatives proposed to strengthen regulation on digital retouching in the United States.

FINDINGS

Influencing advertising practices via tax incentives combined with corporate social responsibility initiatives may be the most constitutionally feasible options for the US legal context to reduce the use of digitally alternated images of models' bodies in advertising.

CONCLUSIONS

Policy and corporate initiatives to curtail use of digitally altered images found to be harmful to mental and behavioral health of consumers could reduce the burden of eating disorders, disordered weight and appearance control behaviors, and body dissatisfaction and thereby improve population health in the United States.

Is it Important to Talk About Technologies with Eating Disorder Clients? The Health-Care Professional Perspective

Nowadays, the use of digital technology is an important issue that should be addressed during the treatment of people who have eating disorders. The involvement or absence of this issue reflects the understanding, experience, and atttude of health-care professionals toward their clients' use of technology. The aim of the present study was to investigate the perceptions of health-care professionals and their assessment of their clients' usage of digital technology while developing strategies for treatment. Semistructured interviews with 30 professionals were performed from October 2015 to June 2016 and a thematic analysis was used to analyze the data. The health-care professionals' views could be summarized in three thematic groups: (1) technology use is not relevant for the cooperation; (2) technology use is relevant for the cooperation and addressed generally; and (3) technology use is relevant for the cooperation and addressed specifically. The results are discussed in relation to the theoretical model presented by Rodgers about the impact of technology on disordered eating behaviors and the implications for practice.

Oversexualization among emerging adults: Preliminary associations with romantic attachment and intimacy

This study examined romantic attachment and intimacy as correlates of oversexualized behaviours and attitudes among emerging adults. A sample of 587 participants (494 women, 93 men) aged between 18 and 29 completed a series of online questionnaires assessing oversexualization, romantic attachment, and intimacy. Hierarchical regression analyses were performed to explore the associations between these variables and examine the moderating role of sex. Results revealed that attachment-related anxiety was associated with overinvestment in sexual appearance, sexual objectification, and performance-based sexuality. This last association was stronger for men than for women. Attachment-related avoidance was associated with seduction and lower meaningfulness of sexuality. In addition, while sexualized language was related to a better perception of emotional, social, sexual, and recreational intimacy, meaningfulness of sexuality was positively related to all dimensions of intimacy. Conversely, sexual objectification was related to lower recreational intimacy, seductive attitude was related to lower emotional intimacy, and overinvestment in one’s sexualized appearance was related to lower sexual intimacy. For men only, overinvestment in sexualized appearance was also related to higher perceived social intimacy Theoretical and clinical implications of these results are discussed.

Approach and avoidance: Relations with the thin body ideal in women with disordered eating behavior

Recent research suggests that automatic cognitive biases are linked to body dissatisfaction and disordered eating behavior. However, little is known about automatic action tendencies in the field of body image research. The aim of the present study was to examine approach and avoidance biases toward the thin body ideal and normal weight bodies and whether these are pronounced in individuals showing disordered eating behavior. Participants were divided into a group with disordered eating behavior (n = 55) and without disordered eating behavior (n = 45). To assess approach and avoidance tendencies, the Approach-Avoidance Task was used during which the participants were instructed to approach or avoid thin and normal weight body pictures. Our results indicated faster push than pull movements towards thin and normal weight body pictures. However, participants with and without disordered eating behavior did not differ with regard to their reactions. Furthermore, we found positive associations between the avoidance of normal weight body pictures and perceived pressure to confirm to media ideals. Future research is warranted to replicate our findings and to extend our knowledge on approach and avoidance biases toward body pictures in patients suffering from eating disorders.

Warning labels on fashion images: Short- and longer-term effects on body dissatisfaction, eating disorder symptoms, and eating behavior

OBJECTIVE

Fashion warning labels that caution readers about digitally altered images have been recommended and adopted by several countries to prevent body dissatisfaction and eating disorders. This study investigated the short- and longer-term influence of fashion warning labels on affect, body dissatisfaction, eating disorder symptoms, and snack consumption using a randomized-controlled experiment.

METHOD

Female undergraduates (n = 118) were randomized to view and rate responses to fashion images either with or without a warning label. They then consumed snacks and completed questionnaires. Sixty-four participants (54%) completed follow-up online surveys asking them to view and rate new fashion images with or without warning labels once per week for 4 weeks. Primary outcomes were affect, body dissatisfaction, eating disorder symptoms, and kilocalories consumed.

RESULTS

Overall, fashion warning labels had no short-term effects on affect, body dissatisfaction, or kilocalories consumed in the lab. However, individuals who reported engaging in restrictive eating consumed fewer kilocalories when exposed to advertisements with warning labels (M = 170.33, SD = 120.78) versus no labels (M = 286.46, SD = 166.30), p = .008. Warning labels also had no protective effects after repeated exposure over 4 weeks on affect or eating disorder symptoms, and significantly increased appearance orientation (p = .001).

DISCUSSION

Warning labels on media images are unlikely to be an effective policy tool to prevent negative affect, body dissatisfaction, and eating disorder symptoms, and, in some cases, may exacerbate these concerns.

Eating Attitudes of Women Living With a Vision Impairment

Internalization of cultural standards of attractiveness and subscription to gender-based discourses are significant predictors of disordered eating attitudes in fully sighted women. Yet, whether these variables predict the disordered eating attitudes of women who are legally blind is underexplored. In the current study, we examined how internalization of White European cultural standards of attractiveness and subscription to gender-based discourses (body surveillance and self-silencing) and body shame predicted the disordered eating attitudes of 80, primarily White, heterosexual, Australian women who are legally blind. Participants completed an online survey comprising existing validated measures of all variables. A path analysis was performed using the Hayes PROCESS approach. As predicted, in women living with vision impairment, body surveillance, self-silencing, and shame fully mediated the relation between internalization of cultural standards of attractiveness and disordered eating attitudes. Results showed that in much the same way as sighted women, women living with vision impairment are susceptible to internalizing harmful messages related to socio-cultural standards of attractiveness. We provide further support for including subscription to gender-based discourses in research on women’s body-image disturbances. Data will be available for other researchers from the author via email. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index

Pornography use in sexual minority males: Associations with body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life

OBJECTIVE

We examined two hypotheses regarding the potential association of pornography use with body image-related and eating disorder-related psychopathology among sexual minority males (i.e. non-heterosexual males). Our primary hypothesis was that pornography use would be associated with males' body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life impairment; our secondary hypothesis was that the type of pornography, namely, professional versus amateur pornography, which contains idealised and non-idealised (i.e. regular) bodies, respectively, would moderate these associations.

METHODS

A sample of 2733 sexual minority males living in Australia and New Zealand completed an online survey that contained measures of pornography use, body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life.

RESULTS

Almost all (98.2%) participants reported pornography use with a median use of 5.33 hours per month. Multivariate analyses revealed that increased pornography use was associated with greater dissatisfaction with muscularity, body fat and height; greater eating disorder symptoms; more frequent thoughts about using anabolic steroids; and lower quality of life. Effect sizes for these associations were uniformly small. Neither relationship status nor genital dissatisfaction was associated with pornography use. The association between pornography use and thoughts about using anabolic steroids was stronger for viewers of professional pornography than viewers of amateur pornography.

CONCLUSION

The findings suggest that the use of pornography is weakly associated with body dissatisfaction and related variables and that the type of pornography (amateur vs professional) viewed may be a moderating factor in some cases. Within the limits of a cross-sectional study design, these findings may have implications for clinicians who treat individuals with eating disorders, body dysmorphic disorder, anabolic-androgenic steroid dependence and related concerns.

Cognitive Distortions Associated with Imagination of the Thin Ideal: Validation of the Thought-Shape Fusion Body Questionnaire (TSF-B)

Thought-shape fusion (TSF) describes the experience of body-related cognitive distortions associated with eating disorder (ED) pathology. In the laboratory TSF has been activated by thoughts about fattening/forbidden foods and thin ideals. This study aims at validating a questionnaire to assess the trait susceptibility to TSF (i.e., body-related cognitive distortions) associated with the imagination of thin ideals, and developing an adapted version of the original TSF trait questionnaire, the Thought-Shape Fusion Body Questionnaire (TSF-B). Healthy control women (HC, n = 317) and women diagnosed with subthreshold and clinical EDs (n = 243) completed an online-questionnaire. The factor structure of the TSF-B questionnaire was examined using exploratory (EFA) and subsequent confirmatory factor analysis (CFA). EFA pointed to a two-factor solution, confirmed by CFA. Subscale 1 was named Imagination of thin ideals, containing five items referring to the imagination of female thin ideals. Subscale 2 was named Striving for own thin ideal, with seven items about pursuing/abandoning attempts to reach one’s own thin ideal. The total scale and both subscales showed good convergent validity, excellent reliability, and good ability to discriminate between individuals with subthreshold/clinical EDs and HCs. Results indicate that cognitive distortions are also related to the imagination of thin ideals, and are associated with ED pathology. With two subscales, the TSF-B trait questionnaire appropriately measures this construct. Future studies should clarify whether TSF-B is predictive for the development and course of EDs. Assessing cognitive distortions with the TSF-B questionnaire could improve understanding of EDs and stimulate the development of cognitively oriented interventions. Clinical Trial Registration Number: DRKS-ID: DRKS00005709.

Sexualizing Media Use and Self-Objectification: A Meta-Analysis

Objectification theorists suggest that exposure to sexualizing media increases self-objectification among individuals. Correlational and experimental research examining this relation has received growing attention. The aim of this meta-analysis was to investigate the influence of sexualizing media use on self-objectification among women and men. For this purpose, we analyzed 54 papers yielding 50 independent studies and 261 effect sizes. The data revealed a positive, moderate effect of sexualizing media on self-objectification (r = .19). The effect was significant and robust, 95% CI [.15, .23], p < .0001. We identified a conditional effect of media type, suggesting that the use of video games and/or online media led to stronger self-objectification effects when compared to television use. Other sample characteristics or study characteristics did not moderate the overall effect. Thus, our findings highlight the importance of sexualizing media exposure on women’s and men’s objectified self-concept. We discuss future research directions and implications for practice. We hope that the article will stimulate researchers in their future work to address the research gaps outlined here. Moreover, we hope that the findings will encourage practitioners and parents to reflect on the role of the use of sexualizing media in the development of individuals’ self-objectification. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl10.1177/0361684317743019

Risk and maintenance factors for young women's DSM-5 eating disorders

Recent research with young women attending colleges, who are at the average age of eating disorder (ED) onset, established that the ED symptoms are not only prevalent but also relatively stable over the college period. Nonetheless, our knowledge regarding the course and modifiable factors associated with both the onset and maintenance of diagnosable (DSM-5) EDs in this population is limited. The objective of this report was to address these key research gaps. Data were examined from 2713 women who completed assessments of potential vulnerability factors and EDs in the autumn semester of the first (baseline) and fourth (follow-up) college years. A total of 13.1% of the sample met DSM-5 criteria for an ED diagnosis at baseline. At 4-year follow-up, 7.6% of the sample met DSM-5 criteria for an ED, with 67.5% of these cases representing women who had maintained an ED diagnosis from baseline, and 32.5% representing new onset EDs. Elevated appearance-ideal internalization, body dissatisfaction, self-objectification, dieting, and negative affectivity at baseline as well as changes in these factors between assessments all predicted onset and maintenance of DSM-5 EDs at 4-year follow-up. Self-objectification (thinking about and monitoring the body's appearance from an external observer's perspective) was the largest contributor to both ED onset and maintenance. In addition to enhancing our knowledge about the course of young women's (DSM-5) EDs during college, this work highlights potentially similar psychological foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are outlined.

Association Among Internet Usage, Body Image and Eating Behaviors of Secondary School Students

Background

Presently, the internet plays a big role in daily life, especially for adolescents. In this age group, they are more concerned about their face and body shape. Despite the numerous studies on the effect traditional media has on body image, very few have focused on the effect of newer forms of media (e.g. online media). And almost none have looked at the relationship between time spent online and body image.

Aim

To study the associations between time spent on the internet, body image satisfaction and eating behaviors of students grades 7 to 12 in the Thai educational system.

Methods

The sample group included 620 students, who were selected using simple random sampling from 6 secondary schools in Bangkok. Data were collected using the Media and Internet use behavior questionnaires, The Body-Esteem Scale for Adolescents and Adults: Thai version (BESAA), Drive for Muscularity Scale (DMS: males only), The Rosenberg Self-Esteem Scale: Thai version, Eating Attitude Test-26: Thai version (EAT-26) and the eating behaviors at risk of obesity questionnaire.

Results

Mean (sd) age of the sample was 15.7 (1.9) years, 246 participants (39.7%) were male and 374 (60.3%) were female. Using the internet and social networks for content related to body image and eating behaviors, was negatively associated with body image satisfaction but positively associated with inappropriate eating attitudes/behaviors, binging, purging, use of laxatives/diuretics and drive for muscularity with respect to behaviors and attitudes, and was associated with eating behaviors that carried a risk for obesity.

Conclusions

Time spent on internet, especially engaged in activities related to self-image, and eating attitudes and behaviors, were associated with a decrease in body image satisfaction and problematic eating behaviors.

Do universal media literacy programs have an effect on weight and shape concern by influencing media internalization?

The current study examined whether media internalization, found to mediate the relationship between selected prevention programs and outcomes, mediated the impact of two universal prevention programs that targeted risk factors for eating disorders and obesity, namely weight concern, and shape concern. Students randomized to a media literacy (Media Smart) program (N = 269, 65% females, mean age 12.97 years) and a healthy lifestyle (Life Smart) program (N = 347, 69% females, mean age 13.07 years) were included in the analyses. There were four waves of data (baseline, end of intervention, 6- and 12-month follow-up). Latent growth curve modeling was used to explore whether group assignment influenced levels of media internalization, and whether that in turn influenced change over time of our two outcome variables. Being randomly allocated to Media Smart as opposed to Life Smart resulted in less growth of both outcome variables through the influence on decreasing levels of media internalization. Findings provided support for the suggestion that media literacy programs exert an impact on outcomes related to eating disorder risk through changes to media internalization. Future research should examine whether these mechanisms of change differ between girls and boys.

The effects of priming in a cued dot-probe task on appearance-related attentional biases in women

The dot-probe task (DPT) is a reaction time measure of attentional bias. Research using this task has found inconsistent patterns of appearance-related attentional biases in women. This study examined the effects of a novel priming variation of the DPT, which incorporated additional cues into each trial of the task, on measurement of such biases. The study also examined associations between these biases and body image, a component of eating disorder symptomatology. A convenience sample of women from the general community (N = 103) completed body image measures online and attended a laboratory session to complete one of four DPTs: (1) an appearance-cued DPT containing images of thin-ideal models between each trial; (2) neutral-cued DPT containing images of forests; (3) time-delayed DPT controlling for time in place of an image; or (4) typical DPT containing only word stimuli. Women who completed the appearance-cued DPT demonstrated a stronger attentional bias for positive, but not negative, appearance words than women who completed the other DPT versions. Furthermore, for the appearance-cued and time-delayed DPTs, this bias correlated with poorer body image across several indicators (appearance evaluation, body dissatisfaction, self-evaluative salience of appearance, and state body satisfaction). Although it was unexpected that no attentional bias for negative-appearance words was found, the attentional bias for positive-appearance words may suggest that effects were driven by the ego-threat of positive-appearance words. Further research is warranted to determine whether such biases contribute to and maintain body image disturbance and disordered eating.

A vicious cycle among cognitions and behaviors enhancing risk for eating disorders

BACKGROUND

Establishing the sequence in which risk factors for eating disorders (ED) emerge would enable more effective ED prevention. Thus, in our study we investigated reciprocal and indirect associations between three cognitive and behavioral ED determinants (appearance orientation, appearance worries, and dieting) emphasized in the transdiagnostic model of ED.

METHODS

Data were collected in a non-clinical group of adolescents at Time 1 (T1), and then 2-months (Time 2, T2) and 13-months later (Time 3, T3). Participants (N = 1260) aged 13-19 completed a questionnaire encompassing their nutrition behaviors, beliefs about appearance, health and well-being. Weight and height were measured objectively.

RESULTS

Higher levels of appearance orientation (T1) were associated with higher levels of appearance worries (T2) which in turn predicted dieting (T3). Dieting (T1) predicted higher levels of appearance orientation (T2) which in turn predicted higher levels of appearance worries (T3). Higher levels of appearance worries (T1) were associated with higher levels of appearance orientation (T2) which in turn predicted dieting (T3). Also, higher levels of appearance worries (T1) were associated with dieting (T2), and higher levels of appearance orientation (T3).

CONCLUSIONS

The three transdiagnostic model variables formed a vicious cycle. Therefore, higher levels of one of ED determinants (appearance orientation, appearance worries or dieting) increase the likelihood of the elevated levels of two other ED determinants at follow-ups and thus enhances the risk for ED.

Social comparisons with media images are cognitively inefficient even for women who say they feel pressure from the media

The present study investigated whether social comparisons with media images are cognitively efficient (demanding minimal mental effort) or cognitively effortful processes, in a sample of female undergraduate students (N=151) who reported feeling pressure from the media regarding their appearance. Two groups were shown 12 images of thin and attractive female models. One group was asked to memorize a complex 8-digit number during exposure to the images (Cognitively Busy condition), while the other memorized a much simpler number (Free View condition). A third group (Control condition) viewed images without people. Participants in the Free View condition demonstrated significantly increased negative mood and lowered appearance satisfaction from before to after exposure, while participants in the Cognitively Busy and Control conditions did not. We argue that these results suggest social comparisons with media images are at least somewhat cognitively effortful even among women who say they feel pressure from the media.

Altered exposure-related reshaping of body appreciation in adolescent patients with anorexia nervosa

Several studies suggest a relation between repeated exposure to extremely thin bodies in media and the perceptual and emotional disturbances of body representation in anorexia nervosa (AN). In this study, we utilized an exposure paradigm to investigate how perceptual experience modulates body appreciation in adolescents with AN as compared to healthy adolescents. Twenty AN patients and 20 healthy controls were exposed to pictures of thin or round models and were then required to express liking judgments about bodies of variable weight. Brief exposure to round models increased the liking judgments of round bodies but not those of thin bodies in healthy adolescents. Furthermore, exposure to round models increased the liking judgments of both thin and round bodies in adolescents with AN. Patients did not show any change of liking judgments after exposure to thin models. These results point to weak norm-based reshaping of body appreciation in AN patients.

Effects of emotional acceptance and rumination on media-induced body dissatisfaction in anorexia and bulimia nervosa

INTRODUCTION

Body dissatisfaction is an important risk and maintaining factor for eating disorders. The aim of the present study was to experimentally test the effects of two emotion regulation strategies - acceptance and rumination - on media-induced body dissatisfaction in eating disorders.

METHOD

After watching pictures of thin models, women with anorexia nervosa (AN; n = 39) and bulimia nervosa (BN; n = 39) were encouraged to either use emotional acceptance or rumination to cope with their feelings. Body dissatisfaction and mood were repeatedly assessed.

RESULTS

Acceptance significantly improved body dissatisfaction in women with BN. Rumination led to a significant increase of body dissatisfaction in both eating disorder groups. Results were independent from mood changes.

DISCUSSION

Findings highlight the importance ruminative thinking may have in the aggravation of dissatisfaction with the own body in AN and BN. Results suggest that emotional acceptance is a useful strategy to regulate body dissatisfaction after exposure to thin-ideal media in BN.

Predicting onset and maintenance of men's eating disorders

BACKGROUND/OBJECTIVE

Eating disorders (EDs) represent serious yet understudied mental health issues, particularly amongst young adult men attending colleges, who are at the average age of onset. Despite this and recent evidence that in young adult men the core ED symptoms are prevalent and remain relatively stable over the college period, little is known about factors associated with both the onset and maintenance of diagnosable EDs in this population. This work sought to address these research gaps.

METHOD

Logistic regression analyses were conducted using data from an on-going longitudinal study of eating and mental health issues to examine the influence of theoretically relevant factors in predicting the onset and maintenance of men's (DSM-5) EDs at 4-year follow-up (N = 2,507).

RESULTS

Body dissatisfaction, self-objectification, appearance-ideal internalization, dieting, and negative affectivity were all predictors of ED onset and maintenance. Self-objectification was the largest contributor to both ED onset and maintenance.

CONCLUSIONS

The findings highlight potentially similar psychosocial foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are discussed.