Risk factors for body dissatisfaction in adolescent girls: a longitudinal investigation

Perceived body size across sex and weight categories and its association with body size dissatisfaction: a cross-sectional study among early primary school children in Norway

BACKGROUND

Inaccurate perceptions of body size, known as body size misperception (BSM), may be linked to body size dissatisfaction (BSD) and unhealthy eating behaviours. However, these associations remain inconclusive and not fully understood in young children. This study aimed to investigate the prevalence of BSM across sex and weight categories and to further assess the association between BSM and BSD in 8-to 9-year-old children.

METHODS

This cross-sectional study of 209 primary school children (51% boys) from central Norway was performed during the national height and weight screening program in third grade. Researcher-assisted questionnaires and Stunkard's figure rating scales adapted for children were used to assess two dimensions of body image: BSM (perceived-actual body size) and BSD (perceived-ideal body size). The agreement between children's ideal and actual body size was also evaluated (actual-ideal body size). Associations between BSM and BSD were examined by multinomial logistic regression, adjusting for sex, Body Mass Index (BMI), socioeconomic status, ethnicity, and residence.

RESULTS

BSM was frequently observed (81%), with most children overestimating their body size (67%). Boys tended to overestimate their body size more frequently (75% vs. 59%, p = 0.014) and indicated a larger mean ideal body size than girls (silhouette fig. 4.2 [95% CI 4.0, 4.5] vs. 3.9 [95% CI 3.7, 4.1], p = 0.012). According to BMI, overestimation was common among children with underweight (100%) and average weight (78%), whereas underestimation of body size was prevalent among children with overweight/obesity (59%). Although 23% desired at least one body size figure smaller or larger than their perceived size, interpreted as BSD, no difference was observed between mean perceived and mean ideal body size (silhouette fig. 4.1 in both groups). No significant association was found between BSM and BSD, for either underestimation (OR 1.32 [95% CI 0.33, 5.32]) or overestimation (OR 0.99 [95% CI 0.38, 2.58]) of body size.

CONCLUSIONS

Boys and girls from all weight categories frequently misperceived their body size toward their ideal body size, with overestimation of underweight and average weight status and underestimation of overweight status being most frequently reported. No association was found between BSM and BSD, however, the long-term health consequences of BSM should be further elucidated.

The association between social comparison in social media, body image concerns and eating disorder symptoms: A systematic review and meta-analysis

Research has found that high social media use is associated with a greater tendency to compare oneself with others, which in turn may heighten body image concerns and problematic eating behaviours. The aim of this systematic review and meta-analysis was to examine the mean association between online social comparison and body image concerns, eating disorder behaviours and positive body image. Eligible articles published between 2008 and 2024 were searched for in scientific databases. A random-effects meta-analysis was conducted to investigate the direct correlation between social comparison and body image and eating disorder outcomes. Results from 83 studies with 55,440 participants indicated that the weighted average correlation between higher online social comparison and greater body image concerns was significant (r = .454; 95 % CI = 0.409-0.498), as was the correlation between higher social comparison and eating disorder symptoms (r = 0.36; 95 % CI: 0.28-0.43). The mean association between higher social comparison and lower positive body image was also significant (r = -0.242; 95 % CI: -0.329 to -0.155). Meta-regression analysis revealed that the quality of studies, type of social media, country, type of social comparison, percentage of female participants moderated the associations. Findings revealed a moderate size association between higher online social comparison tendencies and worse body image and eating disorder symptoms outcomes, highlighting the need to develop interventions and policies to minimize appearance comparisons on social media.

A model of relationships of teammate relations, body image, and eating behaviors among athletes

Recent studies have identified athletes to be at elevated risk for developing disordered eating habits. However, few studies have investigated the association between teammate interactions and athletes' relationships with food and their body. To address this gap, the current study examined a model in which teammate appearance pressures were associated with disordered eating behaviors and body image concerns among varsity and club athletes who competed in a variety of sports at a US university. A sample of 156 university athletes, mean age = 20.7 years (SD = 1.2) (19.2 % varsity, 80.8 % club, 63.5 % female-identifying), completed self-report measures that assessed teammate pressures, depth of teammate relationships, internalization of athletic body ideals, teammate body comparisons, weight and shape concerns, and muscularity oriented disordered eating behaviors. Path analysis was used to test the hypothetical model, which after modification revealed a good fit to the data. The findings suggest that social frameworks are useful for conceptualizing relationships between teammate pressures and associated body image concerns and disordered eating behaviors. Further, the findings provide insight into how team environments may play an important role in shaping athletes' body image and relationship with food and support the development of prevention interventions that can be implemented at team levels.

Predictors of depression among Chinese college students: a machine learning approach

BACKGROUND

Depression is highly prevalent among college students, posing a significant public health challenge. Identifying key predictors of depression is essential for developing effective interventions. This study aimed to analyze potential depression risk factors among Chinese college students using the Random Forest Algorithm (RFA) and to explore gender differences in risk patterns.

METHODS

A cross-sectional study was conducted with 10,043 undergraduate students from Guizhou Normal University. Thirty-three variables were analyzed using RFA. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), with a score of ≥ 16 indicating depression risk. The variables included sociodemographic characteristics, physical and psychological health indicators, behavioral and lifestyle factors, socioeconomic conditions, and family mental health history.

RESULTS

The RFA identified several factors associated with depression risk, with suicidal ideation, anxiety, and sleep quality exhibiting the strongest associations. Other significant predictors included academic stress, BMI, vital capacity, psychological resilience, physical fitness test scores, major satisfaction, and social network use. The model achieved an accuracy of 87.5% and an AUC of 0.927. Gender-stratified analysis suggested different patterns: physical fitness indicators showed stronger associations with depression risk among male students, while BMI was more strongly associated with depression risk among female students.

CONCLUSIONS

This cross-sectional study identified factors associated with depression risk among Chinese college students, with psychological factors showing the strongest associations. Gender-specific patterns were observed, suggesting the importance of considering gender differences when developing mental health interventions. However, longitudinal studies are required to establish causal relationships and validate these findings through intervention trials.

Longitudinal Associations among Identity, Internalization of Appearance Ideals, Body Image, and Eating Disorder Symptoms in Community Adolescents and Emerging Adults: Adaptive and Maladaptive Pathways

Previous research examined the role of identity confusion and body dissatisfaction in eating disorder symptoms, but an integrative perspective including identity synthesis and positive body image is lacking. The current study used three-wave longitudinal data (T1: N = 403; 52.1% female; Mage = 14.85, SD = 0.89) spanning two years to examine the directionality of effects among identity, internalization of appearance ideals, body image, and eating disorder symptoms, with attention to adaptive mechanisms. Results revealed a maladaptive pathway in which internalizing appearance ideals posed a risk for body dissatisfaction and eating disorder symptoms. Conversely, an adaptive pathway highlighted the potential protective role of positive body image regarding identity formation and internalization of appearance ideals. This study provides further insight into the critical role of appearance ideal internalization in the development of eating disorders and the potential value of positive body image. Future research and prevention/intervention efforts should focus on promoting resilience to appearance ideal internalization and enhancing positive body image in the context of identity struggles and eating disorder symptoms.

Eating disorders in medical students: prevalence, risk factors, comparison with the general population

Objectives

The main objectives were to investigate the prevalence of ED and associated risk factors among medical students in Romania, as well as to determine which variables may predict ED and to explore the differences between medical students and the general population.

Methods

The Eating Disorders Inventory questionnaire (EDI-3) was applied. Also, the body mass index of the students was calculated, socio-demographic information regarding personal and family medical history was collected (mental and chronic diseases, self-reported sleep difficulties in the past 6 months, family history of obesity) and potentially risky events (history of ridicule, major negative events, social pressure to be thin from family, friends, media).

Results

37.1% students are at risk of eating disorders, 41% females and 23% males, according to the EDI-3. 14.42% were underweight, 65.05% normal weight, 16.99% overweight and 3.53% obese. Compared to the nationally representative sample in Romania, medical students had significantly higher scores for ED risk and for all other psychological factors.

Conclusion

Medical students have a high risk of developing ED, even higher than the general population. Several factors were associated with the ED risk, including female gender, experiencing sleeping difficulties, feelings of ridicule, family pressure and media pressure, prior ED history, high BMI, negative events and family history of mental illness. The regression analysis showed that family pressure is a strong predictor for ED risk.

Insecure attachment styles in adolescents at risk for eating disorders

The present study examines insecure attachment styles in female adolescents, who are at risk for developing eating disorders. A second goal was to investigate whether attachment styles differentiate between high risk for anorexia and high risk for bulimia. A total of 150 adolescents were divided into four risk groups: High risk for anorexia, high risk for bulimia, medium risk and control group. The attachment styles were assessed using the Experience in Close Relationships Scale and the Relationship Questionnaire. Anxiety Attachment, but not Avoidance Attachment, was found to characterize those adolescents who are at risk for ED (AN + BN), and especially for those at high-risk for BN. The present results do not support the notion of an avoidance of emotional intimacy, characterizing the avoidant attachment style of those presenting with AN. Preoccupied Attachment style was found to characterize high-risk for BN, but not high-risk for AN, while the Insecure, Fearful, and Dismissing Attachment types did not differentiate between these two high-risk groups. This study highlights the dominant attachment style in adolescents at high risk for developing ED: The Anxiety Attachment style for AN and BN, and the Preoccupied Attachment style for BN but not for AN.

Correction of the Tuberous Breast with Fat Grafting and Implant: Techniques, Evaluation with BREAST-Q, and Preliminary Results

BACKGROUND

The correction of tuberous breast deformity with fat grafting has gained popularity in recent years, but it remains unclear whether this new technique can produce patient satisfaction levels comparable to those achieved with implant-based correction.

METHODS

This study aimed to compare patients' satisfaction and quality of life using the BREAST-Q questionnaire after correction of tuberous breast deformity with fat grafting and implants. Twenty-four patients (36 breasts) were included in our study. Thirteen patients (15 breasts) had a correction with lipofilling (mean 2.67 interventions) and 11 patients (21 breasts) had an implant-based correction (mean 1 intervention).

RESULTS

Both fat and implant treatments showed statistically significant improvements in breast satisfaction (p value=0.001, 0.002, respectively), psychosocial (p value=0.003, 0.003, respectively), and sexual satisfaction (p value=0.008, 0.002, respectively) between the pre-treatment and post-treatment stages. However, the only statistically significant differences between the treatments were observed in the physical condition pre-treatment (p value=0.008) and sexual condition post-treatment (p value=0.030). The outcome of both treatments was not statistically different. Furthermore, the outcome exhibited a statistically significant positive linear relationship with breast satisfaction for both treatments.

CONCLUSIONS

This study suggests that lipofilling can achieve breast and outcome satisfaction comparable to that of implants, although this parity in results comes at the cost of more interventions. These preliminary results lend support to the notion that, as surgeons have access to two equally effective techniques, it is crucial to provide appropriate guidance to patients to ensure their satisfaction.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Appearance-related cyberbullying and its association with the desire to alter physical appearance among adolescent females

Cyberbullying is associated with various mental health concerns in adolescents, including body dissatisfaction and disordered eating behaviours. However, there is a significant research gap concerning the unique effects of appearance-related cyberbullying (ARC) on adolescent mental health. This study examined the prevalence and psychological consequences of ARC among middle to late adolescent females (aged 14-19 years, Mage = 15.98, N = 336). Participants completed an online survey regarding their experiences of ARC, body image variables, and eating disorder symptomology. Findings indicate the widespread occurrence of ARC among adolescent females, with body shape and size emerging as predominant targets. Experiences of ARC-victimisation positively correlated with increased concerns about body shape, body shame, and eating disorder symptomology. Conversely, experiences of ARC-victimisation were negatively correlated with body esteem and body appreciation. Finally, appearance-related cybervictimisation was significantly associated with adolescent females' desire to pursue appearance alterations through methods such as dieting and exercising, altering self-presentation, and undergoing cosmetic procedures due to perceived experiences of ARC. These findings highlight the urgent need for preventative measures, such as age-appropriate social media policies and health promotion programs that encourage positive online behaviour, and strategies to address the impacts of ARC to protect the mental well-being of adolescent females.

Perceptions of height and weight screening and associations with body image: a cross-sectional study in early primary school children

BACKGROUND

Despite parental concern, few studies have investigated children's experiences with school-based screening of growth deviations. This study aimed to explore perceptions of height and weight screening and associations with body size dissatisfaction (BSD) among third-grade children aged 8-9 years in central Norway.

METHODS

In a cross-sectional study between November 2021 and April 2022, perceptions of height and weight screening and BSD were assessed individually among 209 children (49% girls) through researcher-assisted interviews.

RESULTS

Most children indicated satisfaction with the screening by selecting a happy emoji, whereas only 1% indicated dissatisfaction, by selecting an unhappy emoji. However, 23%-30% selected a neutral emoji, indicating either neutrality or a response between satisfaction and dissatisfaction. No difference in the perception of height and weight screening was found between genders or body mass index (BMI). Children with parents from non-Western countries had a higher risk of being less satisfied with the height screening (OR=3.0, 95% CI 1.2 to 7.3) than those from Western origin, and children attending schools with lower socioeconomic status (SES) had increased risk of being less satisfied with both height (OR=5.5, 95% CI 2.2 to 13.5) and weight screening (OR=4.0, 95% CI 1.7 to 9.3), compared with children from schools with medium-high SES. Twenty-three percent reported BSD, in which 14% and 9% desired a thinner or larger body, respectively, independent of gender and BMI. No association was found between BSD and the perception of weighing (OR=1.1, 95% CI 0.6 to 2.4), however, BSD was associated with being more satisfied with height screening (OR=0.3, 95% CI 0.1 to 0.8).

CONCLUSION

In the present sample, most children indicated satisfaction with school-based height and weight screening, with no differences between gender or BMI category. However, more children of non-Western origin and from areas with low SES reported less satisfaction with the screening, independent of BSD.

Comparison of body image and peer relations among girls with normal, early, and late menarche

BACKGROUND

The onset of menstruation is a turning point in women's sexual maturity that, unlike other stages of growth, occurs abruptly and is a critical stage in girls' lives. The present study investigated body image and peer relations among girls with early, late, and normal menarche.

MATERIALS AND METHODS

This casual-comparative descriptive study included female students aged 9-17 in Isfahan. The participants were selected using multistage cluster random sampling. Out of 5,984 students, 56, 37, and 43 were selected for the normal, early, and late menarche groups. The Body Image Concern Inventory and Index of Peer Relations were the two tools used in this study. Moreover, the data were analyzed using a covariance statistical test.

RESULTS

Girls with early menarche had better peer relations than those with late menarche (P = 0.01). In addition, there was a significant difference between adolescents with normal and late menarche in terms of body image (P = 0.01). Girls who experienced late menarche were more concerned about their body image and appearance; however, girls with early menarche experienced more impaired performance (P = 0.05).

CONCLUSION

The first menstrual cycle, or menarche, affects psychological variables such as body image and peer relations. The later the menarche, the fewer problems in regard to body image and peer relations.

Dissemination of a dissonance-based body image promotion program for mothers and daughters in church settings: A controlled pilot study of Reclaiming Beauty

This proof of concept, controlled pilot study expands on existing dissonance-based body image promotion programs by testing a modified version of the Body Project for 136 mothers and daughters aged 11-18 years old in church settings called Reclaiming Beauty. Mothers (n = 30) and their daughters (n = 35) who participated in Reclaiming Beauty were compared to mothers (n = 32) and daughters (n = 39) in a waitlist, assessment-only, control group on body image, eating psychopathology, and risk factor measures (thin-ideal internalization, physical appearance comparison) at pre-, post-, and 6-month-follow-up assessments. Intent-to-treat, multilevel modeling indicated that mothers and daughters in the Reclaiming Beauty group experienced significant improvement in body appreciation, body shape concerns, eating psychopathology, thin-ideal internalization, and physical appearance comparison over a six-month period compared to control participants. Changes in thin-ideal internalization and appearance comparison did not predict body image and eating psychopathology at follow-up. Baseline levels of body satisfaction did not moderate the effect of the program, except for its effect on body shape concerns. Findings provide preliminary support for delivering a dissonance-based body image promotion intervention to mothers and their daughters and the feasibility of leveraging the mother-daughter relationship as well as delivering interventions in church settings.

Body Uneasiness, Body Figure Perception, and Body Weight: Factor Structure and Longitudinal Measurement Invariance of a Set of Attitudinal and Perceptual Body Image Assessment Tools in Adolescents

Body image is a multifaceted construct that includes attitudinal and perceptual components, but its attention has mainly been focused on the facet of body dissatisfaction. The present longitudinal study extended the validation of a multifacet attitudinal questionnaire, the Body Uneasiness Test (BUT), against perceptions of body shape and weight. A convenient sample of adolescents took part in a 2-year unbalanced panel study (5 waves). The participants completed the BUT questionnaire and selected their perceived actual, ideal, and reflected body figures along the Contour Drawing Rating Scale; ideal/actual and ideal/normative body mass index discrepancies were also included. After replicating the expected five-factor structure of the BUT items, results from confirmatory factor analysis revealed that the five BUT scales loaded on an attitudinal dimension, whereas the perceived body figures and the discrepancy indices were on a perceptive domain. Such a two-domain structure of body image measures showed gender and seasonal (1-year) measurement invariance, whereas longitudinal 6-month and 18-month invariance partially failed. Overall, the present findings support the validity of the Body Uneasiness Test in adolescence, further demonstrating a preliminary multidimensional structure of body image onto which attitudinal and perceptual body image-related measures were projected.

How evaluative pairings improve body dissatisfaction in adult women: evidence from a randomized-controlled online study

BACKGROUND

Many young women are dissatisfied with their bodies. This study investigated the effect on current body dissatisfaction levels of a newly developed evaluative conditioning procedure that paired self-similar and self-dissimilar images of bodies with positive and neutral affective images, respectively. We hypothesized that learning the contingency that self-similar bodies predict positive affectivity is one process that could aid in explaining how these procedures function.

METHODS

Adult women without disordered eating pathology participated in an online experiment with random assignment to an intervention or a control condition. All participants initially rated body images in self-similarity and were subsequently asked to categorize positive and neutral images by valence as quickly and accurately as possible. In the intervention condition, self-similar bodies systematically preceded positive images, and self-dissimilar images preceded neutral images, creating a similar body → positive contingency. Pairings in the control condition were unsystematic such that no contingency was present. We measured categorization latencies and accuracies to infer contingency learning as well as current body dissatisfaction immediately before and after exposure to the pairings. All participants further completed measures of trait body image concerns and disordered eating psychopathology at baseline, which we examined as moderators of an expected relation between condition assignment, contingency learning, and body dissatisfaction improvements.

RESULTS

We analyzed data from N = 173 women fulfilling the inclusion criteria. Moderated mediation analyses showed that assignment to the intervention (vs. control) condition predicted increased similar body → positive contingency learning, which in turn predicted improved body dissatisfaction post-intervention, but only among women with higher pre-existing trait body image concerns or disordered eating levels.

CONCLUSIONS

The findings point toward the relevancy of further exploring the utility of pairing procedures. Similar body → positive contingency learning predicted improved body dissatisfaction in individuals with normatively high body image concerns, which suggests pairing procedures could help inform future research on reducing body dissatisfaction.

Do risk factors differentiate DSM-5 and drive for thinness severity groups for anorexia nervosa?

BACKGROUND

The current study examined whether risk factors for anorexia nervosa (AN) were related to different levels of severity based on (a) the DSM-5/body mass index (BMI) and (b) drive for thinness (DT) severity ratings.

METHODS

The sample comprised 153 pairs of individuals with a lifetime diagnosis AN per DSM-IV criteria and their non-ED sisters (N = 306, mean age = 26.53; mean current BMI = 20.42 kg/m2). The Oxford risk factor interview was used to establish AN-related risk factors. Individuals were categorised into the DSM-5 severity groups based on their lowest BMI, while the DT subscale from the eating disorder inventory-2 was used to classify individuals with AN into low and high DT groups.

RESULTS

Multinominal regression models showed similar risk factors (e.g., perfectionism, having a history of being teased about weight and shape) contributed to the development of AN using the DSM-5 and DT severity ratings. Follow-up analyses across the severity groups for both indices revealed that only childhood perfectionism was found to be more common in the extreme severe DSM-5 BMI severity group compared to the severe DSM-5 group.

CONCLUSION

Overall, this study found little evidence for AN risk factors being related to the DSM-5 and DT severity ratings. However, given the novelty of this study, replication of the current results is warranted.

Body dissatisfaction and low self-esteem in elementary school-aged children: the role of media pressure and trust in parent-child relationships

Studies have indicated that the media plays a role in the development of body dissatisfaction in children. Nevertheless, there is limited understanding of the protective factors that may reduce this association, such as the parent-child relationship. Therefore, this study investigates children's body dissatisfaction and self-esteem and the role of media pressure and a trust in parent-child relationships herein. A sample of n = 246 participants (59.8% girls, aged 8-10) was recruited. Children completed self-report questionnaires that assessed body dissatisfaction, self-esteem, media pressure, and trust in parent-child relationships. Results revealed that higher scores on media pressure were linked to increased body dissatisfaction and decreased self-esteem. On the other hand, higher scores on trust in mother and father were associated with lower levels of body dissatisfaction and higher levels of self-esteem. However, the presence of trust in parent-child relationships did not attenuate the impact of media pressure on body dissatisfaction or self-esteem. Further investigation is necessary to gain a deeper understanding of how sociocultural and interpersonal factors interact and contribute to the development of body image problems. While current prevention and intervention programs predominantly focus on the individual, it may be beneficial to place greater emphasis on the family environment.

The Association Between Childhood Maltreatment and Body (dis)satisfaction in Adolescents and Young Adults from the General Population

Adolescents with a history of childhood maltreatment are vulnerable to body dissatisfaction and associated psychopathology such as eating disorders. The aim of this study was to expand the understanding of the association between childhood maltreatment and body dissatisfaction in adolescents and young adults. In an epidemiological cohort study, N = 1,001 participants aged 14-21 years from Dresden, Germany, completed self-report measures on childhood maltreatment, body image, and self-esteem. Lifetime mental disorders were assessed in standardized clinical interviews. Data analyses included multiple regression and mediation analyses. More than one-third of the participants reported experiences of childhood maltreatment (37.4%), in which emotional neglect and abuse were the most frequent subtypes. Individuals with a history of childhood maltreatment showed significantly less satisfaction with their physical appearance than participants without such adverse experiences. In a single mediator model, self-esteem emerged as potential mediator in the association between child maltreatment and body (dis)satisfaction. Experiences of childhood maltreatment may be considered as risk factor for the development of body dissatisfaction in adolescents, and the role of potential mediator variables such as self-esteem warrants further prospective research.

Protocol of a cluster randomised trial of BodyKind: a school-based body image programme for adolescents

BACKGROUND

Poor body image is prevalent among adolescents and associated with several negative outcomes for their physical and psychological health. There is a pressing need to address this growing public health concern, yet there are few evidence-informed universal programmes for older adolescents that address contemporary body image concerns (i.e., social media). BodyKind is a four lesson, school-based, teacher led, universal body image programme that incorporates empirically supported principles of cognitive dissonance, self-compassion, compassion for others and social activism, to support positive body image development. Building on previous pilot trials in the USA, this paper outlines the protocol for a cluster randomised control trial (cRCT) and implementation evaluation of the BodyKind programme which was culturally adapted for the Irish cultural context.

METHODS

We aim to recruit 600 students aged 15-17 years in Transition Year (4th year) across 26 second-level schools in Ireland. Using minimisation, schools will be randomly assigned to receive BodyKind (intervention condition, n=300) or classes as usual (waitlist control, n=300). Teachers in intervention groups will receive training and deliver the programme to students over four weeks, at a rate of one lesson per week. Primary outcomes of body appreciation, body dissatisfaction and psychological wellbeing and secondary outcomes of self-compassion, compassion for others, body ideal internalisation, social justice motives and appearance-based social media use will be assessed at pre-, post- and 2 month follow up. Mediation and moderation analyses will be conducted to identify how and for whom the intervention works best. An implementation evaluation will assess the quality of programme implementation across schools and how this may influence intervention outcomes. Waitlist control schools will receive the programme after the 2-month follow up.

CONCLUSION

This study will be the first to implement a cRCT and an implementation evaluation to assess the impact of this multicomponent school-based body image programme designed to support healthy body image development. If shown to be effective, BodyKind will have the potential to improve adolescent body image and wellbeing and inform efforts to implement sustainable and scalable programmes in schools.

TRIAL REGISTRATION

The trial was retrospectively registered on 10/10/2023 on ClinicalTrials.gov NCT06076993 .

Association of Chrononutrition Indices with Anthropometric Parameters, Academic Performance, and Psychoemotional State of Adolescents: A Cross-Sectional Study

Adolescents are an at-risk group for circadian misalignment. The contribution of sleep-wake rhythm instability to the psychoemotional, cognitive, and weight disorders of adolescents has been studied in sufficient detail. At the same time, there is insufficient information about the association between chrononutrition indices and the well-being of adolescents. The aim of this study is to investigate the relationship between chrononutrition indices and academic achievement, psychoemotional state, and anthropometric indicators in adolescents. The study involved 12,759 students in grades 6-11 of secondary schools, aged 14.2 ± 1.7 years old; 57.2% of whom were girls. Participants provided personal data, frequency and time of meals during the day and at night, on weekdays and weekends, and completed the Zung Self-Rating Depression Scale and the Yale Food Addiction Scale. There is a U-shaped association between eating mid-phase (EPFc), eating jetlag (EJL), and eating window (EW) with GPA, ZSDSI, and FA. At the same time, the frequency of night eating (NE) is linearly associated with the studied parameters. NE is the strongest predictor of ZSDSI (β = 0.24), FA (β = 0.04), and GPA (β = -0.22). EPFc, EJL, and EW practically do not differ in the strength of their association with the studied indicators. ZSDSI is most closely associated with the chrononutrition indices. There is a weak negative association between BMI and EW (β = -0.03) and NE (β = -0.04). Thus, circadian eating disorders are more often observed in adolescents with poor academic performance, high levels of depression, and food addiction.

Automatic pro-thin/anti-fat biases can develop without previous visual exposure to body shapes

Endorsement of the thin beauty ideal increases risk for future body dissatisfaction and eating disorders among women. Visual-based media is theorized to be a central pathway through which the thin ideal is internalized. This internalization process results in formation of automatic pro-thin and anti-fat attitudes. However, it is often difficult to separate the contribution of visual-based media and other forms of communication in the creation of such attitudes. Using a novel auditory implicit association test, we show that women with congenital blindness with no previous exposure to body shapes develop automatic pro-thin and anti-fat attitudes to the same extent as sighted women. This result was replicated in studies conducted in two countries involving a combined total of 62 women with blindness and 80 sighted women. Results suggest that internalization of the thin ideal can occur without visual exposure to images of the thin beauty ideal or visual exposure to one's own body.

Is There an Association between Food Consumption According to the Degree of Processing and Body Image (Dis)satisfaction in Adolescents?

(1) Background: Adolescence is characterized by changes in eating habits, with increased consumption of ultra-processed foods and reduced intake of unprocessed or minimally processed foods, which can affect body image satisfaction. Thus, this study aims to verify the association of food consumption according to the degree of processing with body image (dis)satisfaction in adolescents from the 1997/1998 birth cohort of São Luís, Maranhão. (2) Methods: A cross-sectional study was conducted with 2515 adolescents aged between 18 and 19. Food consumption was stratified based on the NOVA classification in culinary preparations, processed foods, and ultra-processed foods, categorized into tertiles. Body image (dis)satisfaction was evaluated based on the Stunkard Body Scale and was classified as satisfaction, dissatisfaction with thinness, and dissatisfaction with excess weight. Multinomial logistic regression was used for associations. (3) Results: Among the adolescents, 77% considered themselves dissatisfied with their body image, with 42.8% dissatisfied with being thin and 34.2% dissatisfied with excess weight. However, food consumption, according to the degree of processing, was not associated with body image (dis)satisfaction. (4) Conclusion: This work highlighted the prevalence of body image dissatisfaction among adolescents but found no association between body (dis)satisfaction and food consumption according to the degree of processing.

Body image and Black African women: A comparative study of Kenya and Nigeria

Very few cross-national studies on body image focus on Black African women. In this study, a comparative analytical approach and sociocultural theory framework was utilized in examining measures of body image among 209 Kenyan and Nigerian women aged 18-69 (M = 34.4, SD = 7.81). We examined both weight-related and non-weight-related aspects of appearance, including hair texture, skin tone, and other racialized features. The regional samples were compared on scores of internalized Eurocentric beauty ideals, skin color satisfaction, objectified body consciousness, racialized body image satisfaction, and other demographic metrics. Kenyan and Nigerian women showed differences across multiple body image measures. Nigerian women showed thinner body ideals compared to Kenyan women and also endorsed higher skin color satisfaction, racialized body dissatisfaction, and internalized Eurocentric beauty idealization. Kenyan women showed higher levels of objectified body consciousness. An indirect effect of nationality was observed with internalized Eurocentric beauty ideals mediating differences in racialized body dissatisfaction and objectified body shame. Attention to regional variation in appearance satisfaction may deepen understandings of the particular sociocultural influences impacting body image among populations of Black African women.

Normative body image development: A longitudinal meta-analysis of mean-level change

This meta-analysis synthesized longitudinal data on mean-level change in body image, focusing on the constructs of body satisfaction and dissatisfaction, body esteem, perceived attractiveness, valuation, self-objectification, and body shame. We searched five databases and accessed unpublished data to identify studies that assessed body image at two or more time points over six months or longer. Analyses were based on data from 142 samples representing a total of 128,254 participants. The age associated with the midpoint of measurement intervals ranged from 6 to 54 years. Multilevel metaregression models examined standardized yearly mean change, and the potential moderators of body image construct, gender, birth cohort, attrition rate, age, and time lag. Boys and men showed fluctuations in overall body image with net-improvements between ages 10 and 24. Girls and women showed worsening body image between ages 10 and 16, but improvements between ages 16 and 24. Change was greatest between ages 10 and 14, and stabilized around age 24. We found no effect of construct, birth cohort, or attrition rate. Results suggest a need to revise understandings of normative body image development: sensitive periods may occur somewhat earlier than previously believed, and body image may show mean-level improvements during certain age ranges.

Reduction of drive for thinness and body dissatisfaction in people with self-reported dysregulated eating behaviors after intermittent theta burst stimulation (iTBS) of the left dorsolateral prefrontal cortex

Aim

This study aimed to explore the effect of intermittent theta burst stimulation (iTBS) of the right and left dorsolateral prefrontal cortex (DLPFC) in people with self-reported dysregulated eating behaviors but without a diagnosis of eating disorders (EDs).

Methods

Participants were randomly divided into two equivalent groups according to the side (right or left) of the hemisphere to be stimulated and they were tested before and after a single iTBS session. Outcome measurements were scores on self-report questionnaires assessing psychological dimensions related to eating behaviors (EDI-3), anxiety (STAI-Y), and tonic electrodermal activity.

Results

The iTBS interfered with both psychological and neurophysiological measures. Significant variations of physiological arousal after iTBS of both the right and left DLPFC were witnessed by increased mean amplitude of non-specific skin conductance responses. With regard to the psychological measures, the iTBS on the left DLPFC significantly reduced the scores of the EDI-3 subscales drive for thinness and body dissatisfaction. Interestingly, these two scales are two of the three EDI-3 clinic scales (drive for thinness, body dissatisfaction, and bulimia) used as specific markers to assess the onset and/or maintenance of eating disorders.

Conclusion

Our results show that the left DLPFC iTBS has an impact on the psychological dimensions that are risk factors for the onset of eating disorders, suggesting that an altered hemispheric asymmetry similar to that encountered in clinical populations is present in normal subjects even in the absence of clinical symptoms.

Internalization of the Western Standard of Beauty and Body Satisfaction: Evaluation Utilizing COPS and SATAQ-3 Questionnaires among Girls with Scoliosis

Background and Objectives: Patients with adolescent idiopathic scoliosis (AIS) more frequently present significant back-related body image disturbances compared with healthy controls. The study aimed to adapt two screening questionnaires: Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-3) and Cosmetic Procedure Screening Questionnaire (COPS), that could identify AIS patients, especially those threatened with body image disorders and might predict dissatisfaction with a desired-by-patients cosmetic result of treatment. Materials and Methods: In total, 34 AIS patients who undergo Cheneau brace treatment were asked to complete SATAQ-3 and COPS. Results: AIS patients presented a high level of internalization. Clinical and radiological factors that play a crucial role in the evaluation and decision process during brace treatment were not significantly associated with COPS and SATAQ-3 total scores. The SATAQ-3 total score and COPS results were also not related to sociodemographic parameters of the analyzed group. Conclusions: The presented study confirms the usefulness of the questionnaires, which aimed to isolate sociocultural risk factors of body image disorders in scoliosis patients as predictors of treatment dissatisfaction and worse compliance.

Into and Through the School-to-Prison Pipeline: The Impact of Colorism on the Criminalization of Black Girls

Colorism is a social construct privileging lighter-skinned people of color with proximity to European features over their darker-skinned counterparts. Despite the significant role in the lives of Black women and girls, colorism is an overlooked and understudied phenomenon, particularly regarding how it shapes their punishment and criminalization in schools. We conceptualize colorism as a social determinant of Black girls’ psychological well-being and outcomes. Darker-skinned Black girls face disproportionately severe school discipline, negative evaluation by teachers and peers, and are inundated with stereotypical messages that influence their sense of self—which increase vulnerability to trauma and psychological distress. Once inside the legal system, colorism plays a role in moving dark-skinned Black girls further into and through the pipeline at every stage of legal processing. The goal of the paper is to (1) highlight the role of colorism in the criminalization of Black girls, (2) identify school, forensic, and counseling/clinical psychology’s role in reducing the impact of colorism on Black girls’ lived experience as it relates to mental health and criminalization, and (3) identify psychological research and policy needs to mitigate the impact of colorism on Black girls’ life outcomes.

Social comparisons on social media: online appearance-related activity and body dissatisfaction in adolescent girls

INTRODUCTION

Adolescents' engagement with online social networking platforms is advancing at an exponential rate and research is needed to investigate any impact on young users' mental health. This study examined appearance-related activity (e.g. looking at photos of friends) on social media and body dissatisfaction among adolescent girls.

METHODS

Self-report measures of online appearance-related activity, social comparisons to female target groups, internalization of the thin ideal, body dissatisfaction, and self-esteem were administered to 210 girls (mean age = 15.16 years).

RESULTS

Body dissatisfaction was significantly related to (i) time spent engaged in social comparisons and (ii) upward social comparisons with various female targets while online. Evaluating oneself less favorably than the target group of close friends was most strongly associated with poorer body image appraisals. Serial multiple mediation analysis revealed that even after controlling for age and self-esteem, time spent engaged in social comparisons significantly mediated the relationship between online appearance-related activity and body dissatisfaction. This association was then further partially mediated by internalization of the thin ideal, which significantly mediated the relationship between time engaged in social comparisons and body dissatisfaction.

DISCUSSION

Results are discussed in terms of online social media platforms representing an additional appearance culture environment for adolescent girls. The effects of this on the mental health of vulnerable users and how future research should investigate protective factors that may buffer young girls from the adverse effects of social media are considered.

Examining the Prospective Bidirectional Associations between Subjective and Objective Attractiveness and Adolescent Internalizing Symptoms and Life Satisfaction

Research has consistently shown that more physically attractive individuals are perceived by others to be happier and better psychologically adjusted than those perceived as less attractive. However, due to the lack of longitudinal research in adolescents, it is still unclear whether poor mental health predicts or is predicted by either objective or subjective attractiveness during this critical developmental period. The purpose of the current study was to examine prospective bidirectional associations between both subjective and objective ratings of attractiveness, life satisfaction and symptoms of social anxiety, depression and eating disorders (i.e., internalizing symptoms) from early to mid-adolescence. Participants (T1: N = 528, 49.9% girls; M_age = 11.19; SD = 0.55) were followed annually over four time points. The cross-lagged panel model results revealed evidence of prospective associations between both forms of attractiveness and life satisfaction and internalizing symptoms, which were driven more by changes in the mental health outcomes than by changes in the subjective and objective attractiveness ratings. The results also indicated that the pattern, strength, and direction of the associations tested were robust across boys and girls, and white and non-white ethnic groups. Overall, the findings suggest that it is important to find effective ways of educating adolescents who are unhappy with their appearance that making changes to improve their mental health, rather than focusing on their physical appearance, will have benefits not only for how they perceive themselves but also for how they are perceived by others.

Prevalence of body image dissatisfaction among youth in the United Arab Emirates: gender, age, and body mass index differences

The term body image dissatisfaction (BID) describes the negative perceptions that a person carries about his or her own body. This study aimed to determine the prevalence of BID among youth in the UAE and how it is affected by three variables: sex, age, and body mass index (BMI). Participants were 728 UAE federal university students who responded to the Body Shape Questionnaire. Results indicated that 36.7% of students are dissatisfied with their body image. Gender differences analysis showed a higher level of BID for men than with women. No significant differences were observed for BID among the four age groups. Significant differences were shown for BID among the four common BMI/weight categories (underweight, normal, overweight, obesity. On the light of the results, the study suggested offering awareness programs for youth about healthy practices in daily life and including health education in schools and colleges curriculum. The study discussed the findings in relation to the available literature in the area and suggested some directions and topics for future research.

Body dissatisfaction and disordered eating within the mother-daughter dyad: An actor-partner interdependence approach

Research on body image and eating within the mother-daughter dyad tends to emphasize the influence that mothers may have on daughters, with little focus on the concomitant influence that daughters may have on mothers. Utilizing the Actor-Partner Interdependence Model (APIM) within a sample of mothers and their daughters within three age ranges (middle school, high school, and college, N = 356 dyads), we examined relations between mother and daughter body dissatisfaction and restrictive eating and bulimic symptoms. Results indicated that mother and daughter body dissatisfaction significantly predicted their own eating pathology (actor effects). Although no significant partner main effects occurred, a notable actor-partner interaction was obtained; mothers' body dissatisfaction significantly predicted higher levels of their own restrained eating only when their daughters were ages 16 and older. In addition, a moderated actor effect was found for bulimic symptoms, such that the relation between a daughter's body dissatisfaction and her own bulimic symptoms became progressively stronger as her age increased. Overall, the findings provide replication of actor effects, with partial support for mutuality of mother and daughter influence.

Development and preliminary validation of the Coach Self-Efficacy Body Image Scale (CSEBIS)

Body image concerns are a commonly cited reason for sport drop out. Researchers have begun to explore the influence of coaches on athletes' body image. However, no measure exists to accurately and easily assess interventions or predict coaches' body image supportive behaviors. Using Self-Efficacy Theory as a conceptual framework, the Coach Self-Efficacy Body Image Scale (CSEBIS) was developed. Content validity was judged by a panel of experts (N = 3) and through interviews with coaches (N = 4) across various sports and experience levels. Following initial item iteration, the CSEBIS was assessed with 682 coaches for reliability and validity. The 27 items across four subscales (knowledge, recognition, engagement, disengagement) showed good reliability (internal consistency, test-retest reliability, inter-item and item-total correlations), validity (convergent and discriminant validity, differentiation between known groups), factor structure, and model invariance across gender. Developing and initially validating the CSEBIS contributes to the existing literature by providing researchers with a novel scale to measure coaches' confidence in identifying and addressing body image concerns among their athletes. Following further testing, this instrument may be used to assess the effectiveness of body image education and intervention efforts in sport, and the impact of coaches' attitudes and behaviors on athletes' body image.

Eating disorders among middle school students in a Chinese population: Prevalence and associated clinical correlates

INTRODUCTION

Eating disorders are regarded to be associated with many psychological and behavioral problems. Moreover, adolescence has been reported to be the key period for developing eating habits, and eating disorders typically emerge in adolescence and early adulthood. This study aimed to investigate the prevalence of eating disorders and explore the associated factors among adolescents in Hunan province, China METHODS: A total of 1610 middle school students from Hunan province, China, were enrolled in this study. The participants were aged from 11 to 16 years old. The following data were collected: demographic variables, Body Mass Index (BMI), suicidal behaviors, non-suicidal self-injury, depression, anxiety, stress (depression - anxiety - stress scale, DASS-21), childhood trauma (Childhood Trauma Questionnaire, CTQ), symptoms of social anxiety (Social Anxiety Scale-Adolescents, SAS-A), and eating problems (Eating Attitudes Test, EAT-26).

RESULTS

The estimated prevalence of eating disorders was 8.9%. Compared with participants without eating disorders, participants with eating disorders were more likely to be at a younger age, obese and overweight, and have a history of non-suicidal self-injury, suicidal ideation, suicidal plans, suicide attempts, emotional abuse, physical abuse, emotional neglect, and physical neglect; more likely to experience stress, anxiety or depression as well as have high scores of social avoidance and distress related to general social contexts. Anxiety, emotional neglect, physical neglect, obesity, and overweight were still significant in the binary logistic regression model after controlling for confounding factors. Additionally, younger age, emotional abuse, physical abuse, stress, anxiety, depression, social avoidance, and distress related to general social contexts were significantly correlated with the EAT-26 scores in correlation analysis CONCLUSIONS: Eating disorders are quite common among middle school students. Moreover, eating disorders are associated with younger age, non-suicidal self-injury, suicidal ideation, suicide attempts, stress, anxiety, depression, emotional abuse, physical abuse, emotional neglect, physical neglect, social avoidance, and distress related to general social contents and BMI. This study provides a reference for school counselors and clinicians in the prevention and treatment of eating disorders.

Is Childhood Maltreatment Associated with Body Image Disturbances in Adulthood? A Systematic Review and Meta-Analysis

PURPOSE

We aimed to synthesize the evidence for an association between childhood maltreatment and body image disturbances in adulthood. Information on maltreatment subtypes and mediator variables was included to gain further insights into the mechanisms of the association. In addition, we aimed to examine the role of body image disturbances in the development of negative mental health outcomes associated with childhood maltreatment.

METHODS

Based on a comprehensive search strategy, eligible studies were identified in PubMed, Scopus, and Web of Science. The eligibility assessment was performed by two reviewers, and 132 articles were studied full-text. To reduce heterogeneity, only non-clinical samples were included in the meta-analysis. A meta-regression was computed to examine the influence of maltreatment subtype on body image disturbances.

RESULTS

Our results provide evidence for a robust association between childhood maltreatment and cognitive-affective body image, both in clinical and community samples. Included studies (N = 40) indicate that body image disturbances are especially pronounced in individuals suffering from Posttraumatic Stress Disorder (PTSD) after childhood maltreatment. The meta-analysis included 12 studies with a total of 15.481 participants, and indicates a small overall effect size (r = 0.21, 95% CI = [0.16, 0.26], p < .001). Meta-regression revealed no significant impact of maltreatment subtype in non-clinical samples.

CONCLUSION

Childhood maltreatment should be considered as a distal risk factor for the development of a negative cognitive-affective body image. We argue for future longitudinal studies which allow a better understanding of the pathways linking childhood maltreatment, body image disturbances and associated psychopathology.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40653-021-00379-5.

Social network addiction symptoms and body dissatisfaction in young women: exploring the mediating role of awareness of appearance pressure and internalization of the thin ideal

BACKGROUND

Previous studies testing for a direct relationship between social networking sites (SNS) addiction and body dissatisfaction (BD) have yielded inconsistent results. Here, we aimed to identify underlying processes that could mediate this relationship. Specifically, we studied the relationship between SNS addiction symptoms and BD through the awareness of appearance pressures and the internalization of beauty ideals, both individually and serially: SNS addiction → Awareness → BD; SNS addiction → Internalization → BD; SNS addiction → Awareness → Internalization → BD.

METHOD

A total of 368 female undergraduates with SNS accounts completed scales to assess SNS addiction symptoms (Social Network Addiction Questionnaire), BD (Body Shape Questionnaire), awareness, and internalization (Sociocultural Attitudes Towards Appearance Questionnaire-4; awareness and internalization scales). A theoretical serial mediation model was constructed to examine the proposed relationships. Body mass index was included as a covariate to control the influence of this important variable.

RESULTS

The results indicated that both awareness and internalization independently mediated the relationship between SNS addiction symptoms and BD. Also, there was a significant serial mediation effect; women with more SNS addiction symptoms tended to be more aware of appearance pressure, which was associated with the internalization of beauty ideals. In turn, this internalization was positively related to BD symptoms.

CONCLUSIONS

These findings shed light on the indirect relationship between SNS addiction and BD, demonstrating independent and accumulative mediating effects of awareness and internalization.

Body dissatisfaction and disordered eating in the perinatal period: an underrecognized high-risk timeframe and the opportunity to intervene

The normal physical changes associated with pregnancy may increase the risk of body dissatisfaction, which is associated with negative mental health outcomes including depression and disordered eating. The purpose of this study was to explore body image and eating concerns among a sample of participants in pregnancy and postpartum and to assess interest and suggestions for a relevant intervention. This was a cross-sectional survey study requiring 10-15 min to complete. Individuals were eligible to participate in the study if they were pregnant or within 1 year postpartum, between the ages of 18 and 45, able to read and write in English, and provided online informed consent. The survey included measures and open-text questions to explore body image, eating behaviors, and related concerns in the perinatal period and to inform the development of an intervention. There were 161 participants, and over 50% were dissatisfied with their body image; 52% were among pregnant participants and 56.2% of postpartum participants. Approximately 80% reported that they would have appreciated the opportunity to participate in a program focused on body acceptance or expectations of body changes in pregnancy and postpartum. We identified intervention preferences as well as commonly reported themes regarding experiences of body image and eating concerns in pregnancy and postpartum. Body dissatisfaction and eating concerns are prevalent issues in pregnancy and postpartum, and our findings underscore an opportunity to tailor an intervention relevant to body image and disordered eating for the perinatal population.

The Impact of Teasing and Bullying Victimization on Disordered Eating and Body Image Disturbance Among Adolescents: A Systematic Review

Adolescence is a developmental period in which disordered eating and negative body image are highly prevalent, yet their risk factors are insufficiently understood and targeted. Despite research implicating both teasing and bullying victimization in the development of eating disorders, these strands of research are yet to be integrated. This systematic review hence aimed to identify whether teasing and bullying victimization are associated with greater risk of eating disorders and body image disturbance for adolescents. Systematic searches of PsycINFO and PubMed databases identified 79 papers that included quantitative analyses of the relationship between weight-related or nonspecific teasing or bullying victimization and disordered eating or body image disturbance. Overall, studies indicated that adolescents who are teased or bullied are more likely to experience disordered eating and negative body image compared to nonvictimized adolescents. This was more consistently observed in cross-sectional studies than in longitudinal findings. We identify several methodological limitations of the literature, including the infrequent consideration of potential mediating and moderating variables. Finally, we outline future directions such as temporal sequencing of the complex interrelationships among teasing and bullying, disordered eating, and body image disturbance in adolescents.

Adolescent girls' body appreciation: influences of compassion and social safeness, and association with disordered eating

PURPOSE

Adolescence has been stated as a period in which body image and eating difficulties' have its greatest expression, especially in females. Nonetheless, protective factors, such as body appreciation and compassion, are not thoroughly studied in this developmental stage. The current study hypothesized that competences for self-compassion and receiving others' compassion associate positively with social safeness, and the three variables with body appreciation. Moreover, the association between body appreciation and disordered eating was analysed. A sample of Portuguese female adolescents was used.

METHODS

205 participants, aged between 12 and 18, completed a set of self-report measures in the school context. Data were explored via descriptive, correlational and path analysis.

RESULTS

Path analysis indicated that self-compassion and receiving compassion from others associate positively with feelings of social safeness which, in turn, associate with higher body appreciation. All the variables in study associated indirectly and negatively with disordered eating, and body appreciation presented a direct and negative association with disordered eating.

CONCLUSION

Findings of the current study may suggest the pertinence of developing programs for female adolescents that include the cultivation of compassionate and affiliative skills to promote positive body image and to prevent or intervene with disordered eating symptoms, with potential effects on overall well-being and mental health.

LEVEL OF EVIDENCE

Cross-sectional descriptive study, Level V.

A Moderated Mediation Model of Perceived Effect of Fitspiration Images on Self: The Influence of Media Literacy and BMI

The present study investigated the relationship between internal locus of control and the perceived impact of Instagram fitspiration images on the self with media literacy as the mediating role in this relationship. This study also examined the importance of body mass index (BMI) as a moderating factor in the mediated model, where higher BMIs could weaken the relationship between internal locus of control and the perceived effect of fitspiration images mediated through media literacy. A sample of 321 Malaysian university students who were fitspiration viewers filled out a self-report questionnaire assessing internal locus of control, media literacy, perceived effect of fitspiration images on self, body satisfaction and BMI. The data analysis was performed using SPSS PROCESS macro. Results show that internal locus of control is negatively associated with the perceived impact of fitspiration images on self, mediated by media literacy. However, BMI moderates the mediated relationship such that the negative relationship between internal locus of control and the perceived effect of fitspiration images through media literacy does not exert an effect on those with high BMI. These results accentuate the value of incorporating a potential mediator and moderator into the direct relationship between internal locus of control and perceived effect of media ideals on self to provide an enhanced understanding of this process and offer practical insights about the protective role of media literacy and negative effects of high BMI.

Body-Related Attitudes, Personality, and Identity in Female Adolescents with Anorexia Nervosa or Other Mental Disorders

The psychological integration of body-related attitudes (BodyRA) is a critical developmental task in adolescence. Adolescents must adapt to their changing body image and body satisfaction. For young people, BodyRA (body dissatisfaction, bulimia, and drive for thinness) are connected to insecurities, which can disturb identity integration and personality development. Our goal was to evaluate the importance of BodyRA also for other mental disorders other than anorexia nervosa (AN), and the association between BodyRA with temperament and personality traits and identity diffusion. Data for the period of 2012 to 2019 were retrospectively analyzed from a convenience sample of patients in a child and adolescent psychiatric hospital (n = 114). The patients were 13 to 17 years of age and had a BMI of 11.9−36.1 kg/m2. As expected, BodyRA were found to be more pronounced in AN, as well as in borderline personality disorder (BPD), depression (DD), and attention deficit hyperactivity disorder (ADHD). BodyRA correlated significantly with internalizing problems in patients with DD (r = 0.428−0.565, p < 0.01) and BPD (r = 0.680, p < 0.01) as well as with BMI (r = 0.404, p < 0.01) in patients with DD. Moreover, we detected significant correlations with impaired identity development in patients with DD (r = 0.482−0.565, p < 0.01) and BPD (r = 0.681−0.703, p < 0.01). BodyRA also correlated significantly with the personality traits of harm avoidance (r = 0.377−0.541, p < 0.01) and self-directedness (r = −0.537−−0.635, p < 0.01) in DD. These personality traits and bulimia were used as predictors for identity diffusion in the investigated disorders of this study. We conclude that BodyRA, harm avoidance and self-directedness are associated with identity development in adolescent females with mental disorders.

Mediating Effects of Intimacy Between Body Talk and Girls' Body Dissatisfaction: The Forgotten Sibling Relationship

Teasing and pressure from family members influences the development of body dissatisfaction. Body dissatisfaction is a common experience for girls and can lead to eating disorders. However, most body image disturbance research to date neglects the possible influence of siblings. In light of this, the present study investigated the associations between sibling negative appearance-based talk, intimacy, and body dissatisfaction. The sample consisted of 113 mostly White, female adolescents, whose ages ranged from 12 to 19 years with a mean age of 14.85 (SD = 1.62). This study first examined direct associations between negative body talk, including appearance related teasing and pressure from siblings, and girls' body dissatisfaction. Second, indirect effects models with intimacy included were examined. There were significant direct links between appearance related pressure from siblings and body dissatisfaction, and significant indirect effects such that sibling teasing and pressure were associated with sibling intimacy, which was associated with body dissatisfaction. These results indicate that siblings play an important role in the development of girls' body dissatisfaction.

Body Mass Index, Physical Activity, and Body Image in Adolescents

Body image dissatisfaction is a concern for adolescents’ mental and physical well-being, and the role of body mass index (BMI) and physical activity (PA) in it is still unclear. This study investigates the associations of BMI and PA with body image, separately for boys and girls, in a large sample of Finnish adolescents. We also examine the associations of BMI with body image in varying PA levels. A total of 10,496 adolescents (girls 52.6%) were included in the analyses. Body image was assessed using a pictorial tool, and categorized as wishing for a smaller body, being satisfied, and wishing for a bigger body. BMI (kg/m²) was categorized as thin, normal weight, and overweight/obese. Self-reported PA was divided into three similar-sized categories as low, moderate, and high PA levels. Adjusted ordinal regression analyses were conducted. Our results show that adolescents with thinness had higher odds of wishing for a bigger body compared to their normal-weight peers, while adolescents with overweight/obesity had smaller odds of wishing for a bigger body. Adolescents in low and middle PA levels had lower odds of wishing for a bigger body compared to adolescents in the high PA level. Yet, the PA level modified the associations between BMI and body image, especially in adolescents with thinness and more so in girls than in boys. These findings highlight the need to pay attention to healthy weight gain and PA in adolescents to support their body image satisfaction.

I. Shalfawi S. Progression in training volume and perceived psychological and physiological training distress in Norwegian student athletes: A cross-sectional study

This cross-sectional study examined self-reported weekly training volume and perceived training distress in Norwegian student athletes according to gender, type of sport, school program, and school year. The Norwegian version of the Multicomponent Training Distress Scale (MTDS-N) was completed by 608 student athletes (M age = 17.29 ± .94). Univariate and multivariate techniques were used in data analyses. Results revealed significant differences in weekly training volume between sport types. No significant differences in weekly training volume were found for gender, school year, or school program. However, a multivariate effect was found for gender, with females perceiving higher levels of training distress than males. A multivariate interaction effect between school year and training volume was also observed. We recommend that practitioners use a conceptual framework to periodize training and monitor training distress in student athletes, particularly in females, to preserve physiological and psychological well-being and ensure a progressive training overload leading to positive performance development.

Screen Time and Body Image in Icelandic Adolescents: Sex-Specific Cross-Sectional and Longitudinal Associations

Studies of adolescent body image and screen use are mostly limited to girls, and longitudinal data are scarce. We examined cross-sectional and longitudinal associations between these variables in mid-adolescent boys and girls. Data was collected when participants were at age 15 and 17, by questionnaire and objective measurements (n = 152 had complete data). Sex-specific linear regression was used to explore cross-sectional and longitudinal associations of self-reported screen use (total use, and time spent in gaming, TV/DVD/internet-based watching and internet use for communication) and body image, adjusting for vigorous physical activity, symptoms of depression, and body composition. Screen time was negatively associated with body image at both time points, although more strongly at age 15, and for girls only. Gaming and TV/DVD/internet watching was more strongly associated with body image than internet use for communication. Girls with above median screen time at both ages had 14% lower body image score at age 17 than girls with below median screen time at both time points. Our results suggest that screen use is likely to play a role in the development of body dissatisfaction among adolescent females. Limiting screen time may, therefore, help to mitigate body dissatisfaction in adolescent girls.

Temperament and psychopathology in early childhood predict body dissatisfaction and eating disorder symptoms in adolescence

Eating disorders (ED) are highly impairing and dangerous conditions that typically onset in adolescence. However, very few prospective studies have examined early childhood risk factors for ED pathology. Given well-established links between temperament and psychopathology, examination of these factors could inform prevention efforts. The current multi-method, multi-informant prospective longitudinal study tested whether laboratory-observed and parent-reported temperament and psychiatric disorders at ages 3 and 6 (N = 609) predict body dissatisfaction at ages 12 and 15 and dimensional symptoms of EDs (anorexia nervosa [AN] and bulimia nervosa [BN]) at age 15 (n = 458) in a community sample. Results indicated that early childhood temperament (positive and negative emotionality, perceptual sensitivity, impulsivity, less shyness) and childhood psychopathology (anxiety, oppositional defiant, attention deficit/hyperactivity, and depressive disorders), predicted body dissatisfaction in adolescence. In addition, childhood perceptual sensitivity and oppositional defiant and depressive disorders predicted AN symptoms. Demographic characteristics (female sex, lower levels of fathers' education, and parental marital status) in childhood predicted body dissatisfaction and AN symptoms. No temperament or psychopathology variables predicted BN symptoms. This study is an important first step toward continuing to identify areas of focus for future research on early childhood risk factors for ED symptoms and body dissatisfaction.

The Effects of Reducing Social Media Use on Body Esteem Among Transitional-Aged Youth

Introduction. Social media use (SMU) and body image concerns are highly prevalent in youth. Although several studies have shown that high SMU is crosssectionally associated with lower body esteem, experimental evidence is lacking. This pilot study experimentally evaluated the effects of reducing SMU on body esteem among transitional aged youth (TAY) with emotional distress. Methods. Thirty-eight undergraduate students presenting with elevated symptoms of anxiety/depression were randomly assigned to the intervention (n = 16), where SMU was restricted to 60 minutes/day, or to the control group (n = 22), where SMU was not restricted. SMU was monitored via screen-time trackers in participants’ smartphone submitted daily during baseline (1-week) and intervention (3-week) periods. Baseline and post-intervention measurements were taken to assess appearance and weight esteem as well as symptoms of anxiety and depression as secondary outcomes. Results. A significant group × time interaction emerged indicating that the intervention participants showed a significantly greater increase in appearance esteem over the 4 weeks compared to controls. There was no significant between-group difference on change in weight esteem. A significant group × time interaction emerge on anxiety indicating that intervention participants showed a significantly greater improvement in anxiety over the study period compared to controls. There was no significant between-group difference on change in depressive symptoms. Discussion. Reducing SMU may be a feasible and effective method of improving appearance esteem and reducing anxiety in a high-risk population of TAY with emotional distress; however, more high-quality randomized controlled trials are needed to confirm findings.

[Investigating the relationship between social media use and body image among adolescents: A systematic review]

OBJECTIVES

This study aimed to update the scientific knowledge concerning the relationship between the use of social networking sites and body image among adolescents.

METHODS

A preregistered systematic review was conducted following PRISMA guidelines and allowed to include 30 peer-reviewed articles for qualitative analysis, consisting of 26 unique samples (n=31,331; M_age=14.89; SD_age=1.07). The search was conducted on Pubmed, PsychInfo and Scopus focusing on studies that included any social network site use and body image measures while being based on general population adolescent samples. Social networking site use referred: 1) to any online activities such as browsing, posting, editing selfies, liking, commenting; 2) to any exposure to appearance-related content; or 3) to a measure of frequency use. The scope of social networking sites considered in the present review was extended to online video-sharing platforms and online dating applications due to their relationship with appearance. Body image as considered through MeSH terms referred to a wide range of possible outcomes including body and facial dissatisfaction, dysmorphophobia, body surveillance, self-objectification, body shame, weight concerns, self-monitoring. Any mental health outcome was extracted when available although its absence was not an exclusion criterion..

RESULTS

Among the 30 studies included in the review, 22 were cross-sectional, seven were longitudinal and one had an experimental design. Overall, among studies based on unique samples, 18 studies included both males and females (n=28,081; M_age 14.84; SD_age=1.06), seven were based exclusively on female samples (n=2,507; M_age 14.87; SD_age=1.19), while one study recruited only male adolescents (n=743; M_age 15.90; SD_age=0.54). Only six studies were based on representative samples. These studies reported a robust association between frequency of social networking site use and negative body image among both females and males. In addition, exposure to appearance-related content was also deleterious to body image. The association between the use of social media and negative body image may involve negative mental health outcomes, such as depressive symptoms, low body esteem and problematic use of social media. Measuring specific activities on social network sites or exposure to appearance-related content (e.g. selfies editing; selfies posting) may be more accurate than using a frequency of overall use (e.g. during the past month) when predicting body image. Studies addressing underlying processes supported that the relationship between use of social media and body image may not be direct but rather involve intermediary steps on both cognitive and social levels, namely internalization of the thin ideal, self-objectification, peer appearance-related feedback, ascendant social comparison with peers and celebrities. Also, it remains unclear whether mental health mediates this relationship.

CONCLUSIONS

The association between the use of social networking sites and negative body image is robustly supported in the literature. However, studies measuring frequency of overall use may instead be predicting negative body image with a nested measure of the use of social network sites, namely specific activities involving appearance-related content. Due to the observed discrepancies between self-reported frequency of social networking site use and actual use in methodological literature, future research may rather measure behaviors commonly encountered on a given platform. Furthermore, there is a need to distinguish specific site categories such as highly visual social media when focusing on body image outcomes. . Focusing on specific social media platforms may in turn lead to more targeted prevention regarding a safe utilization of social networking sites among adolescents. Despite the growing body of research concerning the association between social media and body image, the current review underlines that additional longitudinal and experimental studies are needed to investigate potential bidirectional effects, as well as studies based on representative samples to improve generalization to adolescent populations.

Weight Stigma and Mental Health in Youth: A Systematic Review and Meta-Analysis

OBJECTIVE

Over the past two decades, there has been a steady increase in research focused on the association between weight-based stigma and mental health outcomes in children and adolescents. The present study is a systematic review and meta-analysis of the associations between weight stigma and mental health in youth.

METHODS

A systematic search of PubMed, PsychInfo, and Embase databases was conducted in January 2020. Inclusion criteria included the following: (a) examined an association between weight stigma and a mental health outcome, (b) mean sample age <18 (+1 standard deviation) years, (c) written in English, and (d) peer reviewed. Forty eligible articles were identified. The moderating effects of age, sex (percent female), weight status (percent with overweight/obesity), and study quality were examined.

RESULTS

Overall, meta-analytic findings using a random-effects model indicated a statistically significant moderate association between weight stigma and poorer mental health outcomes (r = .32, 95% confidence interval [0.292, 0.347], p < .001). Age and study quality each moderated the association between weight stigma and mental health. Generally, the study quality was fair to poor, with many studies lacking validated measurement of weight stigma.

CONCLUSIONS

Although there was a significant association between weight stigma and mental health in youth, study quality hinders the current body of literature. Furthermore, findings highlight the lack of consideration of internalized weight stigma in child populations, the importance of using validated measures of weight stigma, and the need for increased awareness of how these associations affect populations of diverse backgrounds.