Body image and adolescence: A behavioral impairment model

Nutrition and behavioral health in cystic fibrosis: Eating and body image

People with CF (pwCF) are at high risk for malnutrition, making nutritional management a critical aspect of CF care. Over the past several decades, optimal nutritional status for pwCF has been defined by body mass index (BMI) based on evidence linking suboptimal BMI to decreased lung function and life expectancy, although more recent changes in CF care may also bring changes to how nutritional health is defined. The historical focus on weight, BMI, and nutrition as key parts of multidisciplinary CF care starting at an early age places pwCF at increased risk for body image concerns and disordered eating. The landscape of CF care is evolving with the approval of highly effective modulator therapies (HEMT) and resulting improvements in growth; however, issues related to body image and eating remain important to consider, especially as past difficulties gaining weight may shift to discomfort with one's weight gain and/or physical appearance. This review aims to describe how body image concerns and disordered eating occur in pwCF across the lifespan; to discuss evidence-based approaches to addressing these concerns; and to identify future directions for research and clinical practice in assessing and treating eating disorders and body image concerns in this population.

Body image concern and demographic characteristics as predictors of anxiety in adolescent girls

OBJECTIVES

Adolescence is a critical and sensitive period of growth, marked by significant physical and psychological changes. During this time, adolescents often experience increased anxiety and concerns about their body image. This study aims to examine body image concern and demographic characteristics as predictors of anxiety in adolescent girls.

METHODS

This cross-sectional study included 381 female students aged 12-13 from Babol city. The participants were selected based on predefined inclusion criteria. Multi-stage sampling method was employed, and the samples were selected from six middle schools. The data collection tools consisted of a demographic information questionnaire, Littleton's body image concern scale, and Zung's anxiety scale.

RESULTS

The mean score for body image concern was 16.59±44.82, while the mean score for anxiety was 10.53±37.31. When investigating the relationship between body image concern and anxiety, a significant and positive correlation between these two variables was observed during regression analysis (p<0.001). Both univariate and multivariate regression analyses indicated that for every one-unit increase in students' body image concern score, their overall anxiety score increased by an average of 0.34 units in both models (B: 0.34, 95 % CI: 0.29-0.39) (p<0.001). Additionally, in univariate regression analyses students who received puberty information from sources other than their mother exhibited 2.68 units higher anxiety levels, which was statistically significant (B: 2.68, 95 % CI: 0.38-4.98) (p<0.001) and, concerning the preferred source of information, students who favored a non-mother source experienced 3.91 units increase in their anxiety score (B: 3.91, 95 % CI: 1.74-6.08) (p<0.001). The results of multivariate regression analysis showed that with the presence of all independent variables in the model, 30 % of the dependent variable changes can be predicted (explained) (R 2 =0.302).

CONCLUSIONS

The findings indicated a positive association between body image concerns and anxiety among students. Moreover, students who relied on sources other than their mother for obtaining information about puberty displayed higher levels of anxiety. Consequently, it is imperative to implement preventive and supportive programs targeting adolescents as well as empowering mothers to effectively deal with these issues.

Prevalence of Obesity and Dental Caries in High School Adolescents during the First Decade of Saudi Vision 2030: A Cross-Sectional Study

Saudi Vision 2030 was launched in 2016. Obesity and dental caries are both highly prevalent in Saudi adolescents and have been targeted by the Vision's health initiatives. The aim is to assess their prevalence in adolescents during the first decade since the launch of the Vision. This cross-sectional study was conducted in Jeddah, Saudi Arabia using a stratified sample of 571 high school students, with an average age of 16.7 (0.6). Their height and weight were measured, and their body mass index (BMI) was calculated. The decayed, missed, and filled scores (DMFTs) were recorded after an oral examination. Non-parametric tests were used to assess the associations of DMFT with BMI, sex, and school type; and its predictors were assessed. One-third of males were overweight/obese compared with 22% of females. Males exhibited higher DMFTs than females. DMFTs were higher among public school students than among their private school counterparts. No significant association was observed between DMFT and BMI. Sex and school type were significant predictors of DMFT. The prevalence of obesity has slowly decreased in adolescents, but the prevalence of dental caries has not. There was no significant relationship between these conditions. Saudi Vision 2030's current preventive/educational initiatives may be more effective in combating obesity than dental caries.

The relations of psychotic-like experiences (PLEs) and depressive symptoms and the bias of depressive symptoms during the clustering among Chinese adolescents: Findings from the network perspective

BACKGROUND

There are rare studies about the network structure of psychotic-like experiences (PLEs) and depressive symptoms among adolescents. Studies have widely acknowledged that PLEs in adolescents confer a higher risk of depressive symptoms, but the complex interactions remain inadequately understood. Our study aimed to examine the hierarchy and inter-associations of PLEs and depressive symptoms in a large adolescent sample from the network analysis perspective.

METHODS

A total of 5008 Chinese adolescents were enrolled in our sample. Community Assessment of Psychic Experiences-42 (CAPE-42) was applied to build the network. Centrality indexes were calculated to represent the significance of nodes in the network. Community detection was conducted to figure out the specific clustering of nodes. Demographic information was collected for the sub-network comparisons. Accuracy and stability of the network were also tested.

RESULTS

"Failure", "External control", and "Lack of activity" were the most central nodes. The main bridge nodes linking PLEs and depressive symptoms were "Failure", "Guilty", and "No future". Positive PLE "Odd looks" and negative PLE "Unable to terminate" are the two PLEs that were most relevant to depressive nodes. Community detection further demonstrated the bias of depressive nodes in the data-driven clustering. Comparative sub-network analysis suggested that age was the only demographic factor related to the current network.

CONCLUSION

In this study of a large adolescent sample, we first demonstrated the network structure and specific clustering preference of PLEs and depressive symptoms. Our findings may enhance the understanding of the relationship between PLE and depressive symptoms.

Subjective Well-Being and Self-Assessed Health of Adolescents: A Longitudinal Cohort Study

BACKGROUND

The aim of this study was to investigate the stability and predictors of subjective well-being and self-perceived health in adolescents over a two-year period, focusing on the importance of mental health in overall well-being.

METHODS

Participants in this longitudinal cohort study were surveyed at the ages of 15 (n = 441) and 17 (n = 354) through questionnaires. The data were analyzed using both descriptive and inferential statistical methods. Hierarchical regression was employed to investigate significant predictors of subjective well-being. The subjective well-being and self-perceived health dimensions showed a consistent level of stability throughout the two-year period of secondary education. Additionally, there was a significant correlation between well-being at the beginning and end of this education period. Furthermore, self-perceived health dimensions, particularly general health, vitality, and mental health, were positively associated with well-being at the end of secondary education, highlighting their role in overall subjective well-being. The regression analysis revealed that self-perceived health factors, notably "General health" and "Mental health", significantly predicted overall subjective well-being, enhancing the model's explanatory power beyond gender and economic status. Nevertheless, baseline subjective well-being has the strongest predictive effect on final well-being.

CONCLUSIONS

This study highlights the importance of psychological and health factors, particularly mental health, that affect the overall well-being of adolescents and emphasizes the need to focus on and improve these factors in order to improve subjective well-being.

Intolerable feelings of uncertainty within the body: Associations between interoceptive awareness, intolerance of uncertainty, and body dissatisfaction

BACKGROUND

Adolescence is a period marked by important physical and social changes, which often leads to an increase of body dissatisfaction. Recent studies have shown an association between interoception and body dissatisfaction in female adolescents. One variable that may contribute to the association between interoceptive awareness and body dissatisfaction is intolerance of uncertainty (IU). This study aims to investigate multiple facets of interoceptive awareness, IU, and their relations with body dissatisfaction in adolescent girls.

METHODS

In a cross-sectional study, a convenience sample of 307 adolescent girls (mean age = 17.73; SD = 1.02) was recruited in the Netherlands in 2022. Three questionnaires were completed measuring interoceptive awareness, IU, and body dissatisfaction. A moderation analyses using a multiple hierarchical regression was used to investigate associations between variables.

RESULTS

Correlation analyses indicated that several facets of lower interoceptive awareness (Not distracting, Not worrying and Trusting) were related to higher levels of body dissatisfaction. IU only marginally moderated the relationship between several domains of interoceptive awareness (Notice, Attention regulation and Emotional awareness) and body dissatisfaction.

DISCUSSION

Findings suggest that experiencing bodily signals as ambiguous and uncertain may result in more complex body image issues. Within certain domains of interoceptive awareness, IU may affect the process of appraising bodily signals. Furthermore, adolescent girls who do not feel safe in their body and who find it difficult to distract their thoughts when experiencing pain or discomfort in their body may be particularly at risk for developing more complex body image disturbances and may benefit from interventions improving both interoceptive awareness and IU. Moreover, future research should focus on interoceptive awareness and IU as potential underlying mechanisms for body image issues.

Longitudinal Associations Between Body-Related Self-Conscious Emotions and Weight Control Status During Adolescence

PURPOSE

Half of adolescents are trying to change their weight and body-related self-conscious emotions may influence these intentions. We estimated associations between body-related shame, guilt, embarrassment, envy, authentic pride, and hubristic pride and weight control status (trying to maintain, lose, or gain weight) throughout adolescence in girls and boys.

METHODS

Six annual cycles of self-administered questionnaires were collected from age 12-17 in the Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study (n = 776). Average associations over all cycles were estimated with generalized estimating equations to describe the relationship between emotions (predictors) and weight control status (outcome). To explore the impact of changes in emotions on weight control status, fixed effects logistic regressions were used. Separate models were conducted for each emotion and for boys and girls.

RESULTS

On average, boys and girls with higher scores for negative emotions (shame, guilt, embarrassment and, exclusively among girls, envy) had higher odds of trying to lose weight. Higher scores for positive emotions (authentic and hubristic pride) were associated with lower odds of trying to lose weight among girls. Higher scores for authentic pride were associated with trying to gain weight among boys. Girls with increases in any of the negative emotions presented higher odds of trying to lose weight. Girls with increases in hubristic pride had increased odds of trying to maintain weight.

DISCUSSION

Body-related self-conscious emotions may be promising healthy-weight intervention targets as they represent important predictors of weight control status, particularly in girls.

Back to School after Corona Virus Disease of 2019: New Relationships, Distance Schooling, and Experienced Routine

The Corona Virus Disease of 2019 (COVID-19) pandemic has upset the students' daily routine, forcing them at first into a sudden transition to distance learning and then to a return to school modelled on the basis of infection containment measures. The present research involved 157 students from schools in central Italy with a mean age of 13.58 years old to investigate the affective impact of the pandemic on the school experience and its components (recess, oral testing, relationships with classmates, and relationship pupils-teachers). The results show that only a few have experienced school interruption in a traumatic way: they have appreciated neither distance learning, nor the return to school; for these teenagers, the school of the past has died. Other adolescents and pre-adolescents tried to replace the face-to-face mode with distance learning, maintaining certain attention to the school even during the quarantine. However, the online mode did not keep its promise. Those who have invested more in digital innovation find it difficult to return to normality today. For all of them, socialization mediated by school experience is decisive in supporting the return to ordinary life after the pandemic.

Predictive factors of disordered eating among adolescents in Bosnia and Herzegovina

BACKGROUND

Due to excessive concerns and focus on weight control and body shape, adolescents often resort to inappropriate behaviours and attitudes towards eating, resulting in physical and psychological issues. This study aimed to assess possible relationships and predictor variables between disordered eating and age, BMI, body appreciation, self-esteem, quality of family interactions, psychosocial health and childhood trauma experience in adolescents of both sexes in the city of Mostar (Bosnia and Herzegovina).

MATERIALS AND METHODS

A cross-sectional study was carried out on a suitable sample of 724 high-school students aged 14-19 years. The following tools have been used: socio-demographic questionnaire, The Eating Attitudes Test (EAT-26), Body Mass Index (BMI), Body Appreciation Scale (BAS), Rosenberg's Self-Esteem Scale, Quality of Family Interaction Scale (KOBI), and Paediatric Quality of Life Inventory, version 4.0 (PedsQLTM) and Childhood trauma Questionnaire (CTQ). Collected data were analyzed in SPSS v. 20.0 software using Pearson's correlation coefficient and multiple regression analysis.

RESULTS

Body appreciation is the most significant predictor for developing disordered eating across the entire sample of adolescents (β = -0.325, P < 0.05) and individually for male adolescents (β = -0.199, P = 0.010) and female adolescents (β = -0.379, P < 0.001). In addition to this variable, BMI has proved to be a statistically significant predictor in explaining the eating behaviours of female adolescents (β = 0.185, P < 0.001), while this happens to be self-esteem for male adolescents (β = -0.211, P < 0.022).

CONCLUSION

The most significant risk factors for developing disordered eating in adolescents are body appreciation, BMI and self-esteem. Results of this research can contribute to enhancement of intervention programmes which promote a positive body image and aim to prevent disordered eating in adolescents of both sexes.

Parental Stress on Children's Appearance, Body Dissatisfaction, and Eating Behaviours in Chinese Children: A Pathway Analysis

Purpose

This study aimed to analyze the association pathways of parental stress on children's appearance, body dissatisfaction, and eating behaviours in Chinese children and adolescents.

Patients and Methods

The children aged 8-15 years were selected from 2 nine-year schools using stratified cluster random sampling. The appearance-related social stress questionnaire and the body dissatisfaction subscale of EDI-1 were used to investigate parental stress on children's appearance and body dissatisfaction, respectively. The self-administered eating frequency questionnaire was used to investigate children's eating behaviours.

Results

Body dissatisfaction in girls mediated associations between BMI, parental teasing, parental injustice and ignorance, parental encouragement and healthy eating behaviour: BMI → body dissatisfaction → healthy eating behaviour, parental teasing → body dissatisfaction → healthy eating behaviour, parental injustice and ignorance → body dissatisfaction → healthy eating behaviour, parental encouragement → body dissatisfaction → healthy eating behaviour. Parental injustice and ignorance directly and negatively predicted healthy eating behaviour in girls. In boys and girls, parental teasing was a direct predictor factor of unhealthy eating behaviour.

Conclusion

Parental teasing, parental injustice and ignorance, parental encouragement, and BMI through body dissatisfaction positively predicted healthy eating behaviour in girls, parental injustice and ignorance directly negatively predicted healthy eating behaviour in girls, and parental teasing directly positively predicted unhealthy eating behaviour in girls and boys. Therefore, parental pressure on children's appearance may pay important role in children's eating behaviours.

Body Image Dissatisfaction and Aggressive Behavior Among Chinese Children at Different Pubdertal Stages: A Path Analysis

Background

Body image dissatisfaction and aggressive behavior have become important public health problem in children and adolescents, and body image dissatisfaction may increase the occurrence of aggressive behavior. The aim of this study was to explore the correlation between body image dissatisfaction and aggressive behavior among Chinese children in different developmental stages.

Methods

The stratified cluster sampling method was used to effectively survey 518 children aged 8–15 years. The Body Shape Questionnaire and the Buss-Warren Aggressive Questionnaire scale were used to measure body image dissatisfaction and aggressive behavior. Pubertal development stages were divided into three stages according to Tanner criteria.

Results

There was a main correlation path of body image dissatisfaction - hostility - anger - indirect aggression - physical aggression in boys with stage I and stage II and in girls with stage I and stage III. In addition, there were direct paths of hostility - indirect aggression, hostility - verbal aggression, anger - physical aggression, and anger - verbal aggression in boys with stage I; hostility - indirect aggression, hostility - verbal aggression, and anger - physical aggression in boys with stage II and in girls with stage I; and anger - physical aggression, and anger - verbal aggression in girls with stage III.

Conclusion

Body image dissatisfaction might positively correlate with aggression through hostility among Chinese children and adolescents, and their association paths were different in different puberty stages.

Adverse Influences of Nonstrabismic Amblyopia on Quality of Life of Teenagers in China

The aim of this study was to explore the influences of nonstrabismic amblyopia on quality of life in adolescents. Health-related quality of life (HRQoL) scale, a multidimensional construct that indicates a fundamental health outcome, was used to measure physical and psychosocial functioning of the adolescents. Forty teenagers with nonstrabismic amblyopia and 40 control teenagers without nonstrabismic amblyopia were recruited between April 2019 and July 2021. The anthropometric measures, body image, physical activity outcome, and HRQoL scores including physical health, emotional functioning, social functioning, and school functioning were compared between the two groups. The results revealed that teenagers with nonstrabismic amblyopia had less weekly sedentary time (P < 0.001), weekly total steps (P < 0.001), and worse school functioning (P = 0.0211) than control teenagers. No significant difference was found in anthropometric measures and body image between the two groups (P > 0.05). This study implied the needs for teenagers with nonstrabismic amblyopia to enhance physical activities. Teachers and parents are encouraged to pay more attention to teenagers with nonstrabismic amblyopia to improve their school functioning.

Body image and association with BMI, and purgative behaviours for weight control in adolescents aged 11-14 years

We aimed to evaluate the association of overweight/obesity based in BMI and purgative behaviours with body image (BI). Methods: Cross-sectional study, with probabilistic sample of 976 adolescents, aged 11-14 years, from the city of Florianópolis, Brazil. Multivariate analyses were performed. Overweight (including obesity) and four variables related to purgative methods for body weight control or eating behaviour were evaluated as outcomes, while BI satisfaction was the primary independent variable in each model. Models were controlled for age, sex, type of school (public or private), intake of fruit and vegetables, number of daily meals, and physical activity scores levels. A total of 31·4 % of adolescents wanted to enlarge their silhouette and 45·6 % wanted to reduce it. Among overweight/obese adolescents, 9·6 % were satisfied with their bodies, while 89·8 % wanted to reduce it, while among the not overweight/obese adolescents, 45·4 % wanted to enlarge their silhouette (P < 0·001). Multivariate analysis showed that the odds for overweight/obesity is higher among adolescents who wanted to reduce their silhouette (OR = 11·20; 95 % CI = 5·55, 22·58). Adolescents who want to reduce their silhouette are more likely to use diuretics (OR = 3·08; CI = 1·78, 5·32) and to use laxatives (OR = 2·10; CI = 1·20, 3·68). A significant association was also found between dissatisfaction with BI and overeating (among those who want to enlarge their silhouette: OR = 1·78; CI = 1·12, 2·85 and among those who want to reduce their silhouette: OR = 1·81; CI = 1·03, 3·19). Conclusion: BI dissatisfaction was associated with overweight/obesity, as well with overeating, and the use of purgative methods.

Non-Suicidal Self-Injury: A School-Based Peer Education Program for Adolescents During COVID-19 Pandemic

Introduction: Non-suicidal self-injury (NSSI) constitutes a major health concern among youth. However, less is known about the useful ways to prevent NSSI. As such, the NSSI- Peer Education Program (NSSI-PEP) aims to intervene on the vulnerability factors that predispose to NSSI by applying a peer education approach. The NSSI-PEP is grounded on the psychoanalytic tradition's tenets, implementing modules targeting four crucial risk factors for NSSI: pubertal transformation, body image, self-esteem, and emotion regulation. Methods: Selected 8th grade students were trained to serve as peer educators and held a peer-education intervention for 6th and 7th grade students. Pre- and post-intervention assessments were conducted in order to evaluate the program's effectiveness. Results: Results revealed preliminary support for the program's feasibility, as students reported greater emotion regulation abilities (p = 0.038) and significant changes in self-esteem (p<0.001), personal alienation (p = 0.005), body image (p < 0.001), and maturity fear (p < 0.001). Also, NSSI-PEP was positively evaluated by participants. Discussion: Our pilot study provides preliminary empirical support for the NSSI-PEP, representing a promising way to address areas of vulnerability for NSSI onset. Findings may also help current policies to promote targeted preventive activities and produce sizable benefits to society.

Emotional Eating in Adolescence: Effects of Emotion Regulation, Weight Status and Negative Body Image

Emotional eating is associated with an increased risk of binge eating, eating in the absence of hunger and obesity risk. While previous studies with children and adolescents suggest that emotion regulation may be a key predictor of this dysregulated eating behavior, little is known about what other factors may be influencing the link between emotional regulation and emotional eating in adolescence. This multi-method longitudinal study (n = 138) utilized linear regression models to examine associations between childhood emotion regulation, adolescent weight status and negative body image, and emotional eating at age 17. Emotion regulation predicted adolescent emotional eating and this link was moderated by weight status (β = 1.19, p < 0.01) and negative body image (β = -0.34, p < 0.01). Higher engagement in emotional eating was predicted by lower emotional regulation scores among normal-weight teens (β = -0.46, p < 0.001) but not among overweight/obese teens (β = 0.32, p > 0.10). Higher scores on emotion regulation were significantly associated with lower emotional eating at high (β = -1.59, p < 0.001) and low (β = -1.00, p < 0.01) levels of negative body image. Engagement in emotional eating was predicted by higher negative body image among overweight/obese teens only (β = 0.70, p < 0.001). Our findings show that while better childhood emotion regulation skills are associated with lower emotional eating, weight status and negative body image influence this link and should be considered as important foci in future interventions that aim to reduce emotional eating in adolescence.

Prevalence and Determinants of Bad Sleep Perception among Italian Children and Adolescents

Although sleep problems at young ages are well investigated, the prevalence of bad sleepers and the determinants of sleep quality perception remain unexplored in these populations. For this purpose, we addressed these issues in a sample of children (n = 307), preadolescents (n = 717), and adolescents (n = 406) who completed the School Sleep Habits Survey, addressing sleep quality perception, sleep habits, sleep features, daytime behavior and sleep disturbances, circadian preference, and dreaming. The sample was split in “good sleepers” and “bad sleepers”, based on the answer to the question item assessing overall subjective sleep quality. Being a bad sleeper was reported by 11.7% of the sample, with significant between-groups differences (children: 8.3%; preadolescents: 11.3%; adolescents: 15.3%; p = 0.01). At all ages, relative to good sleepers, bad sleepers showed higher eveningness, sleepiness, and depression, longer sleep latency, more frequent insufficient sleep, nocturnal awakenings, sleep–wake behavioral problems, and unpleasant dreams (all p’s ≤ 0.01). Sleep quality perception was predicted: in children, by depressed mood, eveningness, and unpleasant dreams (all p’s ≤ 0.01); in preadolescents, by sleep latency, awakening frequency, depressed mood, sufficiency of sleep, and unpleasant dreams (all p’s < 0.01); in adolescents, by awakening frequency, depressed mood, and sufficiency of sleep (all p’s < 0.001). In children, bad subjective sleep quality appears to be mainly determined by daytime psychological features, for example, depressed mood, whereas at later ages, sleep characteristics, such as frequent awakenings, add to the former determinants. This could depend on (a) the appearance, with increasing age, of objective sleep modifications and (b) a greater attention paid by adolescents to their sleep characteristics.

Is There Bacterial Growth Inside the Tunica Vaginalis Cavity in Patients With Unsalvageable Testicular Torsion?

OBJECTIVE

To describe if there is bacterial growth on the tunica vaginalis cavity on patients with testicular torsion submitted to orchiectomy.

MATERIAL AND METHODS

We prospectively analyzed 176 patients with testicular torsion submitted to orchiectomy at our facility between January 2018 and January 2020. Sixty-five were included in this study and samples of the tunica vaginalis cavity were sent to the laboratory for gram staining, culturing and antibiotic sensitivity testing. Wound healing was also evaluated at a minimum of 3 checkpoints (days 15, 45, and 90 after surgery). Student's t test was used for comparison of quantitative data between negative and positive cultures (P < .05). The Mann-Whitney test was used to verify associations between categorical variables and negative vs. positive cultures (P < .05).

RESULTS

Of the 65 patients included in the study, with median age of 18 years (IQR 15-21), culture was negative in 58 cases (89.2%). Median time lapse from symptoms to surgery was 6.90 days (IQR 3.92-10.73). Right testicular torsion was almost twice as common as on the left side (63.07% vs 36.93%). Hydrocele was present in 47 patients (72.3%) and all wounds were healed in 84.60%, 96.90%, and 100% of the cases on the 15th, 45th, and 90th days after surgery, respectively.

CONCLUSION

In the great majority of patients with testicular torsion treated with orchiectomy in our study, we did not observe bacterial growth in the tunica vaginalis cavity, and all patients' wounds were completely healed within 90 days after surgery.

Validation of a Spanish Version of the Physical Appearance Comparison Scales

Physical appearance comparison has been widely studied because of its strong relationship with body dissatisfaction and disordered eating. The main objective of this study was to validate the physical appearance comparison scales (PACS-Revised and PACS-3) in a sample of Spanish men and women and examine their psychometric properties. The sample consisted of 1151 participants (age M = 22.31, SD = 3.40). A unidimensional structure was corroborated in the PACS-R, and three factors in the PACS-3 (proximal, distal, and muscularity comparisons). The PACS-R and PACS-3 showed full scalar invariance across sex. The internal consistency for the PACS-R and subscales of PACS-3 were satisfactory. Positive statistically significant relationships were found with measures of disordered eating (EAT-26) and dysmorphic concern (DCQ). Hierarchical multiple regression analyses demonstrated that the PACS-3 discretely improved the prediction of disordered eating over PACS-R, but did not show improvement in the prediction of dysmorphic concern beyond the PACS-R. These findings suggest that the PACS-R and PACS-3 may be useful tools for evaluating the tendency of men and women to compare their physical appearance.

The dark side of Instagram: Predictor model of dysmorphic concerns

Dysmorphic concern are excessive preoccupation about one or several physical characteristics perceived as defects, usually unnoticeable by others. This study was intended to explore the relationship between Instagram use and dysmorphic concerns through appearance-related comparisons, ideas of reference and problems with emotion regulation, and find out whether this relationship is moderated by gender.

METHOD

The sample was comprised of 796 participants (Mage  = 22.49; SD = 3.56; 54% women).

RESULTS

The results showed a non-significant direct effect between Instagram use and dysmorphic concerns. However, the relationship between these variables was statistically significant through appearance-related comparisons, ideas of reference about "laughing, commenting" and difficulties in emotion regulation. Gender did not moderate any relationship.

CONCLUSIONS

Men and women who made the most use of Instagram were equally vulnerable to dysmorphic concerns when they tended to compare their appearance with other users, had problems regulating their emotions, and showed interpretative biases related to the belief that others could make comments about them or laugh at them because of their imperfections. The implications of the study are discussed.

Factor structure and psychometric properties of the Spanish version of the Body Image Avoidance Questionnaire (BIAQ)

PURPOSE

The main objective of this study was to analyse the factor structure and psychometric properties of a Spanish validation of the Body Image Avoidance Questionnaire (BIAQ) in a community sample of adolescents.

METHODS

A total of 4283 people (55.9% girls, aged 12-18) participated.

RESULTS

Confirmatory factor analysis corroborated four first-order factors related to a second-order factor including the total BIAQ score, with excellent fit and invariance across sex. The total internal consistency of the questionnaire was adequate, although two factors showed low reliability. Strong relationships were found with scales evaluating preoccupation with weight and dysmorphic concerns, and moderate correlations with dissatisfaction and investment in appearance. It was found that 24.06% of adolescents with body image disturbance could be at risk of developing a body image disorder.

CONCLUSIONS

The results of this study support the use of the Spanish translation of the BIAQ for assessing behavioural characteristic of body image disturbance.

LEVEL OF EVIDENCE

V, cross-sectional descriptive study.

Factors Related to Depressive Symptoms Among Multicultural Adolescents in Korea

This study aimed to compare related factors of depressive symptoms among multicultural adolescents in South Korea. Cross-sectional data were collected from 1,325 students studying in ninth grade (mean age: 14.97 ± 0.36 years) who had one Korean parent and one foreign-born parent. The score of depressive symptoms among girls (1.777 ± 0.550) was higher than boys (1.647 ± 0.512). The regression model-including demographic, psychological, and social factors-explained 38.3% of depressive symptoms among boys and 27.9% among girls. Body image satisfaction was the most powerful factor related to depressive symptoms in both boys and girls. Gender-differentiated factors identified in this study such as demographic, psychological, and social factors need to be studied while planning gender-tailored intervention programs to help relieve depressive symptoms among multicultural adolescents.

Lifestyle, body mass index and wellness in youth: Strengthens and weakness in Italian youth

This study investigated the psychological wellbeing and body perception among young Italian people. Drinking, eating, and sexual behaviors have been examined in relation to body mass index (BMI) and psychological well-being by EPOCH framework. This was a cross-sectional observational study conducted on Italian adolescent and young adult population through an online survey. Qualitative and quantitative data on lifestyle, BMI classes, and psychological characteristics of wellness in youth were obtained from a sample of 1221 Italian participants using a self-report questionnaire on body perception and habits, a socio-demographics inventory, and the EPOCH measure. Findings suggest that being underweight or overweight is associated with various factors, including gender, self-control regarding food, perception of one’s body, and the happiness domain. EPOCH framework revealed the psychological wellness of girls and young women did not seem strongly affected by BMI, though Perseverance and Happiness seemed reduced with increasing BMI. The Engagement, Optimism, and Connectedness domains were not significantly affected by the BMI variable. On the contrary, Perseverance and Happiness seemed reduced with increasing BMI and were related to physical shape. Our study offers a new perspective: promoting the development of positive psychological characteristics since adolescence to boost quality of life by improving wellness, by EPOCH approach could be functional reinforcing specific psychological aspects in young generations regarding future wellness, improving the positive perception and management of their own health.

Examining the structure of ideas of reference in clinical and community samples

AIMS

This study addresses the psychometric properties of a Spanish validation of the REF scale of ideas of reference (IRs) in detecting and following at-risk mental states and psychosis.

METHODS

A total of 9447 participants were distributed in three groups: 676 patients with various diagnoses-154 with psychotic disorders, 6291 youths aged 11 to 20, and 2480 adult participants aged 21 to 84.

RESULTS

Youths had higher scores than adults on IRs, observing a progressive decrease and stabilization in the twenties. Exploratory factor analysis provided a structure for the overall IRs score, with five first-order dimensions and one second-order dimension. Confirmatory factor analysis supported the structure with excellent fit. The REF scale was invariant across sex and samples. The internal consistency of the complete scale was excellent and acceptable across the five first-order factors. Strong relationships were found with the positive dimension of the community assessment of psychic experience-42, as well as with aberrant salience. Low and moderate relationships were found with public self-consciousness, anxiety, and depression. Youths and patients diagnosed with schizophrenia and other psychotic disorders had a high mean IRs frequency. Male sex, greater age (among the adults), and the "causal explanations", "Songs, newspapers, books" and "laughing and commenting" REF subscales showed predictive power in the diagnostic categories of schizophrenia and other psychotic disorders.

CONCLUSIONS

The results provide satisfactory that the REF scale could be used to study psychosis.

A Review of Psychosocial Factors of Marfan Syndrome: Adolescents, Adults, Families, and Providers

The purpose of this article was to review the current literature on psychosocial implications of Marfan syndrome (MFS) and its impact on adolescents, adults, their families and to provide important considerations for providers. Since the previous reviews in 2015, numerous studies have been published that are included in the current review. This literature review was conducted using PubMed, Medline, PsychINFO, ERIC, Web of Science, and Academic Search Premier databases and only articles that studied psychosocial factors that influence MFS patients as adolescents, adults, family members, or their interactions with providers were included in this review. Of the 522 articles reviewed, 41 were selected based on the inclusion and exclusion criteria. All articles were peer-reviewed. MFS has various implications that can impact one's life; studies have shown that MFS causes a negative impact on an individual's formative years, quality of life, reproductive decision-making, work participation, and satisfaction with life. Clinicians and multidisciplinary teams should be aware of these factors to provide support focusing on coping strategies for the patient and their family.

A study on the interplay between emerging adulthood and eating disorder symptomatology in young adults

PURPOSE

The primary aim of this study was to investigate the interplay between Arnett's five features of emerging adulthood and ED symptomatology. The secondary aim of the study was to investigate possible gender differences concerning the relation between emerging adulthood and ED symptomatology.

METHODS

337 university students (252 females and 85 males) participated in this study. Each participant was asked to anonymously complete the following questionnaires: Inventory of the Dimensions of Emerging Adulthood (IDEA), Eating Attitudes Test (EAT-26), and Social Physique Anxiety Scale (SPAS).

RESULTS

The female group scored higher in the EAT-26 diet, SPAS, IDEA self-focus and IDEA total score measurements. Additionally, in the female group, identity exploration was correlated with EAT-26 total and bulimia, experimentation/possibilities with EAT-26 total and diet, and negativity/instability with EAT-26 total, diet and bulimia as well as SPAS score. In the male groups, the only significant correlation was between SPAS and instability/negativity. Finally, identity exploration could predict a higher probability of developing ED (EAT ≥ 20) for both the female and male groups.

CONCLUSIONS

Emerging adulthood and ED were found to have a close relationship, especially for females. Identity exploration was the emerging adulthood factor that showed the highest relation to ED symptomatology in both the male and female groups. More research is necessary to investigate the specifics of this relationship.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

A meta-analysis of the relationships between body checking, body image avoidance, body image dissatisfaction, mood, and disordered eating

OBJECTIVE

Body checking (BC) and body image avoidance (BIA) have been proposed as etiological and maintaining mechanisms for eating disorder (ED) pathology. To date, no comprehensive review summarizes the relationships of BC and BIA with ED pathology, body image dissatisfaction, or mood/affect.

METHOD

Meta-analyses examined the relationships of BC and BIA with ED pathology, body image dissatisfaction, and mood/affect. Gender, publication status, and presence or absence of ED diagnoses were examined as potential moderators.

RESULTS

Results showed strong relationships between BC and ED pathology (ρ = 0.588) and BC and body image dissatisfaction (ρ = 0.631) and a moderate relationship between BC and mood/affect (ρ = 0.385). Similarly, results showed strong relationships between BIA and ED pathology (ρ = 0.553) and BIA and body image dissatisfaction (ρ = 0.543) and a moderate relationship between BIA and mood/affect (ρ = 0.392). Overall, limited evidence supported publication bias; however, publication bias may exist in the relationship between BIA and body image dissatisfaction in the literature. Subgroup moderator analyses suggested that gender moderates the strength of the relationships between BC and ED pathology, body image dissatisfaction, and mood/affect and between BIA and body image dissatisfaction.

DISCUSSION

Results are consistent with cognitive-behavioral models of ED pathology that suggest BC and BIA are behavioral expressions of overvaluation of weight and shape. Notably, more published research has investigated BC than BIA. Future studies, incorporating methods such as meta-analytic structural equation modeling, should examine these variables to further test cognitive-behavioral models of ED development and maintenance.

'Self body-management and thinness in youth: survey study on Italian girls'

Adherence to the thinness model, self-acceptance such as self-esteem is psychological dynamics influencing the young age and emerging adulthood of women life. The purpose of this study was to investigate the girls and young women' ability to deal with the adherence to thinness model according to their self-body management thought daily self-perception of ownhabits and aptitude. We analysed their emotional patterns and body management to elucidate the Italian phenomenon. A cross-sectional study was conducted on 2287 Italian female distribute in range age 15-25 years old and distributed in girl and young women groups. We conducted a Survey study by snowball sampling technique. Our results showed that girls had higher emotional pattern scores when their weight and shape fit the thinness model: skinny girls felt positively about their body even if when they did not take adequate care of it. Italian girls consider the underweight body mass index an adherence model. Findings suggest the urgent need to plan prevention programme to model healthy behaviours about their daily good practice overcoming social and cultural models based on appearance.