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Livet A, Boers E, Laroque F, Afzali MH, McVey G, Conrod PJ. Pathways from adolescent screen time to eating related symptoms: a multilevel longitudinal mediation analysis through self-esteem. Psychol Health 2024; 39:1167-1182. [PMID: 36345595 DOI: 10.1080/08870446.2022.2141239] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Screen time and self-esteem have been shown to be important correlates of eating disorders in adolescence. However, there is an absence of longitudinal studies that distinguish between time-varying factors, accounting for parallel developmental changes and common underlying vulnerability. DESIGN A total of 3,801 adolescents were administered self-report measures, annually, over the course of 5 years. The association of screen time (social media use, television watching, video gaming) on eating related symptoms was analyzed using a longitudinal Bayesian multilevel path analysis framework. Self-esteem was examined as a mediating factor in this model. This study investigated direct and indirect associations at between-person, concurrent within-person, and lagged-within-person levels, while controlling for gender. RESULTS The findings revealed that all types of screen time exposure were significantly associated with eating related symptoms at between and within-person levels. A significant association at the lagged-within person level was only revealed for social media use. Self-esteem was found to be a significant mediating factor between screen time and eating related symptoms. CONCLUSION An increase in social media use one year was associated with increased of eating related symptoms two years later through lower self-esteem. Implications for prevention are discussed.
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Affiliation(s)
- Audrey Livet
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Elroy Boers
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Flavie Laroque
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mohammad H Afzali
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Gail McVey
- Eating Disorders Ontario, University Health Network, Center for Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Patricia J Conrod
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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2
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Rodgers RF, Gordon AR, Burke NL, Ciao A. Parents and caregivers as key players in the prevention and identification of body image concerns and eating disorders among early adolescents. Eat Disord 2024:1-24. [PMID: 38913912 DOI: 10.1080/10640266.2024.2366546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Early adolescence (ages 11-14 years) is a key period for the emergence of body image and eating concerns, and early identification and access to treatment are imperative for positive outcomes. Despite research identifying this critical developmental period, few prevention resources are available for early adolescents. Parents are key players for this age group and important socializing agents. As such, they are well positioned to help youth access resources or support where needed. However, programs to position and involve parents as interventionists are lacking. Our aims are two-fold. First, we review the evidence for the effectiveness of parents as body image interventionists and the existing data regarding parental needs. Second, we provide directions for future research and outline a framework for empowering parents as interventionists, identifying key domains in which parents may play a role in addressing body image and eating concerns among early adolescents. Based on the extent literature, these domains include facilitating engagement with or co-utilizing intervention content to decrease body image and eating concerns in at-risk children, which may also help to increase parents' effectiveness in their efforts to support youth. In addition, parents may deliver content to decrease or reverse risk-factors and early symptoms, or disrupt the early disorder phase of illness. To date, parents constitute an underutilized resource in eating disorder and disordered eating prevention, and efforts should be made to increase the evidence-based strategies to leverage their relationship with at-risk children.
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Affiliation(s)
- Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Anna Ciao
- Department of Psychology, Western Washington University, Bellingham, Washington, USA
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Kaiser CK, Edwards Z, Austin EW. Media Literacy Practices to Prevent Obesity and Eating Disorders in Youth. Curr Obes Rep 2024; 13:186-194. [PMID: 38183580 DOI: 10.1007/s13679-023-00547-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE OF REVIEW Obesity and eating disorders share common issues related to media use and effects, especially in the USA. Current research increasingly demonstrates that media literacy can address this problem. This narrative review highlights current media literacy-based research for obesity and eating disorder prevention among youth. RECENT FINDINGS Current research using media literacy techniques to prevent obesity indicates that these interventions improve nutrition outcomes, improve family communication about food, improve critical thinking about food advertisements, reduce sugar and fat intake, and reduce screen use for parents and youth. In addition, eating disorder research reveals that media literacy techniques lead to higher scores of body satisfaction and self-esteem, with lower scores of perfectionism, thinness, and ideal masculinity. There is a need for media literacy-based interventions to focus on family communication to prevent obesity and eating disorders. Furthermore, there should be more focus on identified levels of prevention and specific clinical outcomes.
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Affiliation(s)
- Christopher Kit Kaiser
- Washington State Department of Social & Health Services, Behavioral Health Administration, Western State Hospital, 9601 Steilacoom Blvd SW, Building 8, Room 109, Lakewood, WA, USA.
| | - Zena Edwards
- Extension Youth & Families, Washington State University Extension, Vancouver, WA, USA
| | - Erica Weintraub Austin
- The Edward R. Murrow College of Communication, Washington State University, Pullman, WA, 99164-2520, USA
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Craddock N, Budhraja M, Garbett KM, Nasution K, Gentili C, Rizkiah C, Haime Z, Ayu Saraswati L, Medise BE, White P, Diedrichs PC, Williamson H. Evaluating a school-based body image lesson in Indonesia: A randomised controlled trial. Body Image 2024; 48:101654. [PMID: 38056068 DOI: 10.1016/j.bodyim.2023.101654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023]
Abstract
Negative body image is a common public health concern among adolescents, globally. The aim of the current study was to evaluate the effectiveness, implementation fidelity, and acceptability of a single session, school-based universal body image intervention in Indonesia. A total of 1926 adolescents (59.4 % girls) and 12 school guidance counsellors (lesson facilitators) from nine state junior secondary schools in Surabaya, East Java took part in a two-arm open parallel cluster randomised controlled trial. In response to the changing circumstances due to the COVID-19 pandemic, half of the lessons were conducted in person and half were delivered online. Results showed that the lesson did not significantly improve adolescent body image or secondary outcomes relative to the control, though there was no evidence of harm. There were no substantive findings regarding intervention effectiveness by gender. The mode of intervention delivery (online vs. in-person) did not significantly influence the main findings. Implementation fidelity varied widely, and the lesson content and pedagogy were largely acceptable, though there was a strong preference for in-person lesson delivery. Findings have implications for researchers aiming to improve adolescent body image in low- and middle-income countries. Lessons learned can inform future school-based efforts to support adolescent body image.
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Affiliation(s)
- Nadia Craddock
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK.
| | - Mahira Budhraja
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
| | - Kirsty M Garbett
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
| | | | - Caterina Gentili
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
| | | | - Zoë Haime
- Population Health Sciences, Medical School, University of Bristol, UK
| | - L Ayu Saraswati
- University of Hawai`i, Manoa, Department of Women, Gender and Sexuality Studies, Honolulu, HI 96822, USA
| | | | - Paul White
- University of the West of England, Bristol BS16 1QY, UK
| | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
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5
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Landor AM, Ramseyer Winter VL, Thurston IB, Chan J, Craddock N, Ladd BA, Tylka TL, Swami V, Watson LB, Choukas-Bradley S. The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice. Body Image 2024; 48:101674. [PMID: 38154289 DOI: 10.1016/j.bodyim.2023.101674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/30/2023]
Abstract
White supremacy and racial inequities have long pervaded psychological research, including body image scholarship and practice. The experiences of white, heterosexual, able-bodied, cisgender (predominantly college) women from wealthy, Westernized nations have been centered throughout body image research and practice, thereby perpetuating myths of invulnerability among racialized groups and casting white ideals and experiences as the standard by which marginalized bodies are compared. Body image is shaped by multiple axes of oppression that exist within systemic and structural systems, ultimately privileging certain bodies above others. In this position paper, we highlight how white supremacy has shaped body image research and practice. In doing so, we first review the history of body image research and explain how participant sampling, measurement, interpretive frameworks, and dissemination of research have upheld and reinforced white supremacy. Next, grounded in inclusivity and intersectionality, we advance the Sociostructural-Intersectional Body Image (SIBI) framework to more fully understand the body image experiences of those with racialized and minoritized bodies, while challenging and seeking to upend white supremacy in body image research and practice. We encourage other scholars to utilize the SIBI framework to better understand body inequities and the body image experiences of all people, in all bodies.
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Affiliation(s)
- Antoinette M Landor
- Human Development and Family Science, University of Missouri, Columbia, MO, United States; Center for Body Image Research & Policy, University of Missouri, Columbia, MO, United States
| | - Virginia L Ramseyer Winter
- Center for Body Image Research & Policy, University of Missouri, Columbia, MO, United States; School of Social Work, University of Missouri, Columbia, MO, United States.
| | - Idia Binitie Thurston
- Department of Psychological and Brain Sciences, Northeastern University, Boston, MA, United States; Department of Health Behavior, Northeastern University, Boston, MA, United States
| | - Jamie Chan
- School of Psychology, University of Sussex, Falmer, United Kingdom
| | - Nadia Craddock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Brianna A Ladd
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, MD, United States
| | - Tracy L Tylka
- Department of Psychology, Ohio State University, Marion and Columbus, OH, United States
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
| | - Laurel B Watson
- Department of Psychology & Counseling, University of Missouri-Kansas City, Kansas City, MO, United States
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Atkinson MJ, Parnell J, Diedrichs PC. Task shifting eating disorders prevention: A pilot study of selective interventions adapted for teacher-led universal delivery in secondary schools. Int J Eat Disord 2024; 57:327-340. [PMID: 38006281 DOI: 10.1002/eat.24100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVE Increasing effectiveness and sustainability of universal school-based eating disorder prevention is needed. This study adapted two existing selective prevention programmes for universal delivery, investigating feasibility, acceptability, and preliminary effects when delivered by trained teachers to classes of mixed-gender adolescents. METHOD A three-arm controlled pilot study with Year 9 students (N = 288; Mage = 13.61 SDage = .50). Three schools in south Wales and south-west England were allocated to mindfulness-based intervention (MBI), dissonance-based intervention (DBI), or classes-as-usual (CAU) control. Self-reported eating disorder risk factors were collected at baseline, 6-week post-intervention, and 2-month follow-up. Focus groups were conducted post-intervention. RESULTS Delivery and evaluation were feasible, allowing for flexibility in scheduling, with good retention. Student and teacher ratings indicated moderate acceptability of both interventions, with recommendations for refinement. Mixed model analyses, controlling for baseline, showed significant effects of condition across post-intervention and follow-up for body esteem (DBI > CAU; Cohen's d = .34) and positive affect (MBI > CAU, d = .58). For girls only, both MBI and DBI improved body satisfaction and internalization, and the MBI additionally resulted in improved weight and shape concerns, negative affect, and life disengagement (d's = .39-1.12), across post-intervention and follow-up. DISCUSSION Selective eating disorder prevention programmes based on cognitive dissonance and mindfulness can be delivered universally in schools, by teachers, allowing for appropriate flexibility necessary for real world implementation. Moderate acceptability indicates areas for improving content and delivery; positive effects on key outcomes are encouraging. These findings provide support for further robust evaluation. PUBLIC SIGNIFICANCE Existing universal eating disorder prevention is limited by small effects and reliance on highly trained facilitators. This study is the first to adapt mindfulness- and dissonance-based interventions for delivery by teachers, to adolescents of all genders in a classroom setting. Delivery was largely feasible and acceptable, and both interventions showed significant effects across key risk factors for eating disorders, with larger effect sizes than found previously. This underpins further robust evaluation.
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Affiliation(s)
- Melissa J Atkinson
- Department of Psychology, University of Bath, Bath, UK
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Jade Parnell
- Centre for Appearance Research, University of the West of England, Bristol, UK
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7
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Piątkowska-Chmiel I, Krawiec P, Ziętara KJ, Pawłowski P, Samardakiewicz M, Pac-Kożuchowska E, Herbet M. The Impact of Chronic Stress Related to COVID-19 on Eating Behaviors and the Risk of Obesity in Children and Adolescents. Nutrients 2023; 16:54. [PMID: 38201884 PMCID: PMC10780384 DOI: 10.3390/nu16010054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
During the COVID-19 pandemic, an increase in the incidence of overweight and obesity in children was observed. It appears that unhealthy food choices, an unbalanced diet, and a sedentary lifestyle, as well as experiencing stress related to the pandemic, may be contributing to this disturbing trend. Chronic stress is a significant factor contributing to eating disorders and obesity in youngsters, involving medical, molecular, and psychological elements. Individuals under chronic stress often focus on appearance and weight, leading to negative body image and disrupted relationships with food, resulting in unhealthy eating behaviors. Chronic stress also impacts hormonal balance, reducing the satiety hormone leptin and elevating the appetite-stimulating hormone ghrelin, fostering increased hunger and uncontrolled snacking. Two systems, the hypothalamic-pituitary-adrenal axis and the sympathetic system with the adrenal medulla, are activated in response to stress, causing impaired secretion of noradrenaline and cortisol. Stress-related obesity mechanisms encompass oxidative stress, neuroinflammation, insulin resistance, and neurohormonal and neurotransmission disorders. Stress induces insulin resistance, elevating obesity risk by disrupting blood sugar regulation and fat storage. Stress also affects the gut microbiome, potentially influencing chronic inflammation and metabolic processes linked to obesity. In conclusion, chronic stress is a multifaceted risk factor for eating disorders and obesity in children, necessitating a comprehensive understanding of effective preventive and intervention strategies amid the escalating prevalence of childhood overweight and obesity.
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Affiliation(s)
- Iwona Piątkowska-Chmiel
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8b Street, 20-090 Lublin, Poland;
| | - Paulina Krawiec
- Department of Paediatrics and Gastroenterology, Medical University of Lublin, Al. Racławickie 1 Street, 20-059 Lublin, Poland; (P.K.); (E.P.-K.)
| | - Karolina Joanna Ziętara
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (K.J.Z.); (P.P.)
| | - Piotr Pawłowski
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (K.J.Z.); (P.P.)
| | - Marzena Samardakiewicz
- Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, Chodźki 7 Street, 20-093 Lublin, Poland;
| | - Elżbieta Pac-Kożuchowska
- Department of Paediatrics and Gastroenterology, Medical University of Lublin, Al. Racławickie 1 Street, 20-059 Lublin, Poland; (P.K.); (E.P.-K.)
| | - Mariola Herbet
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8b Street, 20-090 Lublin, Poland;
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Fazel M, Soneson E. Current evidence and opportunities in child and adolescent public mental health: a research review. J Child Psychol Psychiatry 2023; 64:1699-1719. [PMID: 37771261 DOI: 10.1111/jcpp.13889] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents. METHODS This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions. RESULTS In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements. CONCLUSIONS There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.
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Affiliation(s)
- Mina Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Emma Soneson
- Department of Psychiatry, University of Oxford, Oxford, UK
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Hemmings A, Sharpe H, Allen K, Bartel H, Campbell IC, Desrivières S, Dobson RJ, Folarin AA, French T, Kelly J, Micali N, Raman S, Treasure J, Abbas R, Heslop B, Street T, Schmidt U. EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People): project outline. BJPsych Bull 2023; 47:328-336. [PMID: 36545688 PMCID: PMC10694679 DOI: 10.1192/bjb.2022.83] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022] Open
Abstract
EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People) is an ambitious research project aiming to revolutionise how eating disorders are perceived, prevented and treated. Six integrated workstreams will address key questions, including: What are young people's experiences of eating disorders and recovery? What are the unique and shared risk factors in different groups? What helps or hinders recovery? How do the brain and behaviour change from early- to later-stage illness? How can we intervene earlier, quicker and in a more personalised way? This 4-year project, involving over 1000 participants, integrates arts, design and humanities with advanced neurobiological, psychosocial and bioinformatics approaches. Young people with lived experience of eating disorders are at the heart of EDIFY, serving as advisors and co-producers throughout. Ultimately, this work will expand public and professional perceptions of eating disorders, uplift under-represented voices and stimulate much-needed advances in policy and practice.
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Affiliation(s)
- Amelia Hemmings
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Karina Allen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Iain C. Campbell
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sylvane Desrivières
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard J.B. Dobson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK London, University College London, London, UK
- National Institute for Health and Care Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
- National Institute for Health and Care Research Biomedical Research Centre at University College London NHS Foundation Trust, London, UK
| | - Amos A. Folarin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
- National Institute for Health and Care Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | | | | | - Nadia Micali
- University College London, London, UK
- Psychiatric Research Centre Ballerup, Ballerup, Denmark
| | | | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | | | | | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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10
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Millán-Jiménez A, Fernández-Fontán IM, Sobrino-Toro M, Fernández-Torres B. Protein supplement consumption prevalence, habits and complications in adolescents. An Pediatr (Barc) 2023; 99:240-251. [PMID: 37770287 DOI: 10.1016/j.anpede.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION The consumption of nutritional and protein supplements by adolescents may have important consequences for their health. METHODS Prospective observational study based on a survey of adolescents enrolled in 6 schools selected at random in the city of Seville. Our primary objective was to determine the actual consumption of dietary supplements in the adolescent population and quantifying their protein content. RESULTS We obtained a total of 263 valid responses that showed a prevalence of consumption of nutritional supplements of any kind of 19.01%, of which 56.0% (10.64% of the total) corresponded to adolescents that consumed protein supplements for a mean protein intake of 0.26 g/kg/day (SD, 0.18). The profile of consumers of any type of supplements differed from that of nonconsumers in age, use of long-term medication and weight loss or high-protein diets. The comparison of adolescents who consumed protein supplements versus nonprotein supplements only evinced a significant difference in the control of supplement consumption. Although most of these adolescents were not subject to external control, 25.92% of those who consumed protein supplements were monitored by a professional, compared to 7.38% of consumers of nonprotein supplements. In the group that consumed protein supplements, 85.18% of adolescents achieved the desired effect and 18.51% reported some form of negative effect. CONCLUSIONS The prevalence of protein supplement consumption among adolescents in our area is 10.64%, with consumption of amounts corresponding to 25% of the recommended daily allowance of protein. The profile of protein supplement consumers is very similar to that of nonprotein supplement consumers.
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Affiliation(s)
- Antonio Millán-Jiménez
- Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain; Grupo de Investigación Transhumancias HUM-965, Universidad de Sevilla, Spain
| | | | | | - Bartolomé Fernández-Torres
- Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain; Grupo de Investigación Transhumancias HUM-965, Universidad de Sevilla, Spain.
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11
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Mol T, Thompson JK, Fuller-Tyszkiewicz M. A meta-analytic review of impact of measurement choice on RCTs to reduce appearance internalization. Int J Eat Disord 2023; 56:1480-1501. [PMID: 37237436 DOI: 10.1002/eat.23990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Prior reviews have shown that interventions targeting internalization of appearance standards are generally efficacious, though there is considerable heterogeneity in estimates across studies. This updated review of the literature evaluates whether efficacy estimates from RCTs systematically vary as a function of three related outcome measures (internalization, awareness, and perceived pressure regarding appearance standards). METHODS Seven electronic databases were systematically searched from inception to February 8, 2023. The Cochrane Risk of Bias tool assessed each study's risk of bias. Studies included were randomized-controlled trials evaluating body image/eating disorder prevention or intervention programs targeting internalization as a focal point of treatment. Effect sizes were meta-analyzed and meta-regression analyses were conducted investigating the impact of outcome measure choice on study effect size at post-intervention and follow-up. RESULTS Thirty-seven studies (N = 4809 participants) were included. The meta-analytic findings as expected found interventions efficacious at reducing internalization post-intervention (d = -0.47, 95% CI [-0.60 to -0.34], k = 44), and at follow-up (d = -0.28, 95% CI [-0.39 to -0.17], k = 43), but also highly heterogenous (I2 = 52-67%). Operationalization of internalization moderated results at follow-up but not post-intervention timepoints, with awareness measures (compared with internalization measures) producing weaker effect sizes. Exploratory analyses found bigger effects when internalization was compared with all other measurement categories combined, suggesting possible issues with statistical power in main analyses. DISCUSSION Mixed present findings suggest need for further evaluation of measurement effects on efficacy, and possible caution in choice of outcome measure for internalization-based interventions. PUBLIC SIGNIFICANCE STATEMENT This review provides some preliminary evidence that choice of survey measures used in randomized controlled trials can impact our judgments about whether a trial reduces the extent to which participants endorse unrealistic appearance standards. Accuracy in measurement of this efficacy of trials is crucial, given the role that internalized appearance standards play in onset and maintenance of eating disorders.
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Affiliation(s)
- Tess Mol
- School of Psychology, Deakin University, Geelong, Victoria, Australia
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Garbett KM, Craddock N, Saraswati LA, Diedrichs PC. Body Image among Girls in Indonesia: Associations with Disordered Eating Behaviors, Life Engagement, Desire for Cosmetic Surgery and Psychosocial Influences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6394. [PMID: 37510625 PMCID: PMC10378758 DOI: 10.3390/ijerph20146394] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
Body image is an important risk factor for mental and physical health during adolescence. Nonetheless, few studies have empirically investigated body image among girls in Southeast Asia. This cross-sectional study examined the prevalence of body esteem (a holistic measure of body image assessing the degree of satisfaction with one's appearance, weight, and shape), associated behavioral outcomes, and potential psychosocial influences on body image among Indonesian girls to inform future intervention efforts. Girls across Indonesia with internet access (N = 318, Mage = 13.59 years) completed a questionnaire that assessed body image, disordered eating behaviors, appearance-related life engagement, desire for cosmetic surgery, appearance ideal internalization, media literacy, appearance-related teasing, and self-esteem. The younger girls' (10-13 years) responses were analyzed separately from those of the older girls (14-17 years). Over half of the girls did not have high body esteem. Approximately a quarter of the girls across both age groups reported restricting their food intake, emotionally eating, and/or engaging in excessive exercise, and over half desired cosmetic surgery. Disordered eating behaviors and a desire for cosmetic surgery were negatively correlated with body esteem. Hierarchical regression analyses found BMI, internalization, appearance-related teasing, and self-esteem were uniquely associated with body esteem among younger girls. Appearance-related teasing and self-esteem were positively associated with body esteem among older girls. These findings suggest body image interventions may be important for this population, with appearance-related teasing and self-esteem potentially useful targets for intervention efforts. Further prospective research to investigate these findings would be beneficial for a deeper understanding of body image risk factors for girls across Indonesia.
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Affiliation(s)
- Kirsty May Garbett
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
| | - Nadia Craddock
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
| | - L Ayu Saraswati
- Department of Women, Gender, and Sexuality Studies, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
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13
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Trompeter N, Austen E, Bussey K, Reilly EE, Cunningham ML, Mond J, Lonergan A, Tame J, Mitchison D. Examination of bidirectional relationships between fear of negative evaluation and weight/shape concerns over 3 years: A longitudinal cohort study of Australian adolescents. Int J Eat Disord 2023; 56:646-653. [PMID: 36609864 PMCID: PMC10357886 DOI: 10.1002/eat.23881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Adolescents commonly experience both fear of negative evaluation and weight/shape concerns. However, evidence concerning the prospective associations between these constructs during adolescence is limited. The current study examined the bidirectional relationships between fear of negative evaluation and weight/shape concerns over a 3-year period in adolescents. METHOD Australian high school students (n = 2073; 55% girls) completed self-report measures at three timepoints, each 1 year apart. RESULTS Findings showed a bidirectional relationship, whereby increases in fear of negative evaluation predicted exacerbated weight/shape concerns, and vice versa. Results point towards a vicious maintenance cycle between fear of negative evaluation and weight/shape concerns. DISCUSSION Findings from the current study highlight the importance of considering both fear of negative evaluation and weight/shape concerns in the development of health promotion and prevention programs designed to reduce the occurrence and adverse effects of body dissatisfaction or improve general mental health. PUBLIC SIGNIFICANCE Many adolescents experience some level of fear of negative evaluation (i.e., worry about being judged by others) and worry about their weight and/or shape. This study examined the prospective relationship between both constructs. Findings showed a bidirectional relationship, whereby higher fear of negative evaluation predicted increased weight/shape concerns, and vice versa. Programs designed to reduce body dissatisfaction might be improved by targeting both fear of negative evaluation and weight/shape concerns.
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Affiliation(s)
- Nora Trompeter
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
- Department of Psychological Medicine, King's College London, London, UK
| | - Emma Austen
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Kay Bussey
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Erin E Reilly
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA
| | | | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Alexandra Lonergan
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Jack Tame
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
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Yager Z, Doley JR, McLean SA, Griffiths S. Goodform: A cluster randomised controlled trial of a school-based program to prevent body dissatisfaction and muscle building supplement use among adolescent boys. Body Image 2023; 44:24-35. [PMID: 36434957 DOI: 10.1016/j.bodyim.2022.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 11/27/2022]
Abstract
Although body dissatisfaction is common among adolescent boys, few intervention programs specifically developed for boys have been shown to be effective for reducing body dissatisfaction. Our study aim was to evaluate Goodform, a 4-session, teacher delivered intervention program specifically developed for boys to reduce body dissatisfaction and muscle building supplement use. The Goodform program was based on cognitive dissonance, social learning theory, and a social norms approach, and drew from two existing body image intervention programs that have shown promise among males: The Body Project- More than Muscles, and the Athletes Training and Learning to Avoid Steroids Program (ATLAS). A sample of 488 boys in grades 9 and 10 (Mage = 14.81, SDage = 0.51) at nine secondary schools in Australia were randomly assigned to Goodform (n = 244) or control (n = 244) at the school level. Self-reported body image, supplement use, anabolic androgenic steroid (AAS) use, and attitudes around using AAS and muscle building supplements were measured at baseline, post-intervention, and eight-week follow-up. Analyses with multi-level, mixed-effect regression models revealed no changes over time attributable to the intervention. Our results have implications for researchers in the body image and eating disorder prevention fields. Lessons learned in this study can inform future school-based efforts for reducing muscle building supplement use.
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Affiliation(s)
- Zali Yager
- Institute for Health and Sport, Victoria University, Footscray Park, Australia; Body Confident Collective, Australia.
| | - Jo R Doley
- Institute for Health and Sport, Victoria University, Footscray Park, Australia
| | - Siân A McLean
- The Bouverie Centre and Department of Psychology, Counselling, and Therapy, La Trobe University, Melbourne, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
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15
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Garbett KM, Haywood S, Craddock N, Gentili C, Nasution K, Saraswati LA, Medise BE, White P, Diedrichs PC, Williamson H. Evaluating the Efficacy of a Social Media-Based Intervention (Warna-Warni Waktu) to Improve Body Image Among Young Indonesian Women: Parallel Randomized Controlled Trial (Preprint). J Med Internet Res 2022; 25:e42499. [PMID: 37010911 PMCID: PMC10131926 DOI: 10.2196/42499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/09/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Body dissatisfaction is a global issue, particularly among adolescent girls and young women. Effective body image interventions exist but face barriers to scaling up, particularly in lower- and middle-income countries, such as Indonesia, where a need exists. OBJECTIVE We aimed to evaluate the acceptability and efficacy of Warna-Warni Waktu, a social media-based, fictional 6-episode video series with self-guided web-based activities for improving body image among young Indonesian adolescent girls and young women. We hypothesized that Warna-Warni Waktu would increase trait body satisfaction and mood and decrease internalization of appearance ideals and skin shade dissatisfaction relative to the waitlist control condition. We also anticipated improvements in state body satisfaction and mood immediately following each video. METHODS We conducted a web-based, 2-arm randomized controlled trial among 2000 adolescent girls and young women, aged 15 to 19 years, recruited via telephone by an Indonesian research agency. Block randomization (1:1 allocation) was performed. Participants and researchers were not concealed from the randomized arm. Participants completed self-report assessments of trait body satisfaction (primary outcome) and the internalization of appearance ideals, mood, and skin shade dissatisfaction at baseline (before randomization), time 2 (1 day after the intervention [T2]), and time 3 (1 month after the intervention [T3]). Participants also completed state body satisfaction and mood measures immediately before and after each video. Data were evaluated using linear mixed models with an intent-to-treat analysis. Intervention adherence was tracked. Acceptability data were collected. RESULTS There were 1847 participants. Relative to the control condition (n=923), the intervention group (n=924) showed reduced internalization of appearance ideals at T2 (F1,1758=40.56, P<.001, partial η2=0.022) and T3 (F1,1782=54.03, P<.001, partial η2=0.03) and reduced skin shade dissatisfaction at T2 (F1,1744=8.05, P=.005, partial η2=0.005). Trait body satisfaction improvements occurred in the intervention group at T3 (F1, 1781=9.02, P=.005, partial η2=0.005), which was completely mediated by the internalization change scores between baseline and T2 (indirect effect: β=.03, 95% CI 0.017-0.041; direct effect: β=.03, P=.13), consistent with the Tripartite Influence Model of body dissatisfaction. Trait mood showed no significant effects. Dependent sample t tests (2-tailed) found each video improved state body satisfaction and mood. Cumulative analyses found significant and progressive improvements in pre- and poststate body satisfaction and mood. Intervention adherence was good; participants watched an average of 5.2 (SD 1.66) videos. Acceptability scores were high for understandability, enjoyment, age appropriateness, usefulness, and likelihood to recommend. CONCLUSIONS Warna-Warni Waktu is an effective eHealth intervention to reduce body dissatisfaction among Indonesian adolescent girls and young women. Although the effects were small, Warna-Warni Waktu is a scalable, cost-effective alternative to more intense interventions. Initially, dissemination through paid social media advertising will reach thousands of young Indonesian women. TRIAL REGISTRATION ClinicalTrials.gov NCT05383807, https://clinicaltrials.gov/ct2/show/NCT05383807 ; ISRCTN Registry ISRCTN35483207, https://www.isrctn.com/ISRCTN35483207. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/33596.
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Affiliation(s)
- Kirsty M Garbett
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Sharon Haywood
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Nadia Craddock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Caterina Gentili
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | | | - L Ayu Saraswati
- Department of Women, Gender, and Sexuality Studies, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | | | - Paul White
- Faculty of Environment and Technology, University of the West of England, Bristol, United Kingdom
| | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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16
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Lewis-Smith H, Hasan F, Ahuja L, White P, Diedrichs PC. A comic-based body image intervention for adolescents in semi-rural Indian schools: Study protocol for a randomized controlled trial. Body Image 2022; 42:183-196. [PMID: 35750013 DOI: 10.1016/j.bodyim.2022.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
Adolescents in India experience body dissatisfaction, however, empirically supported interventions are lacking. This paper describes the protocol for the development, acceptability testing, and cluster randomized controlled trial (RCT) of a six-session comic-based intervention, which aims to improve body image and related outcomes among adolescents in semi-rural Indian schools. If found to be acceptable and effective, UNICEF will disseminate the intervention across schools in eight states of India. The acceptability study will be conducted with 24 students in Classes 6-8 (age 11-14) and nine teachers from Hindi-medium government schools using interviews and focus groups. The subsequent RCT will be conducted with 2400 students, with schools randomized to either the comic-based intervention or lessons-as-usual (control) groups. The primary outcome is body esteem, and secondary outcomes are disordered eating, appearance ideal internalization, body-image-related life disengagement, self-esteem, negative affect, and positive affect. Additional exploratory outcome measures are skin colour dissatisfaction, body hair dissatisfaction, appearance-based teasing, and endorsement of traditional gender roles. These outcomes will be examined at three timepoints: baseline (T1), 1 week-post-intervention (T2), and 12-weeks follow-up (T3). Analyses will compare outcomes in the intervention with the control group. This will be the first study to evaluate a body image intervention for adolescents in semi-rural Indian schools.
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Affiliation(s)
| | - Farheen Hasan
- Centre for Appearance Research, University of the West of England, UK
| | - Latika Ahuja
- Centre for Appearance Research, University of the West of England, UK
| | - Paul White
- Applied Statistics Group, University of the West of England, UK
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17
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Functional Imaging in Improving Children’s Mental Health Based on Behavior. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4774771. [PMID: 35880091 PMCID: PMC9308513 DOI: 10.1155/2022/4774771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 01/08/2023]
Abstract
At present, children’s psychological and behavioral health care is mainly based on the doctor’s observation and diagnosis. On the whole, it is inefficient, and the effect of health care cannot meet the current needs of children’s behavior. Therefore, this paper uses the method of functional imaging to study the key factors of children’s behavioral health care. In this paper, the structure and function of children’s brain are associated with children’s psychological behavior. The brain structure of 64 children in our city is detected by functional image processing, and 64 children are divided into groups according to the detection results. According to the children’s performance, the children were divided into physical disorder (11 cases), emotional disorder (14 cases), cognitive disorder (12 cases), and normal group (42 cases). Among them, 3 cases had three kinds of disorders, 6 cases had both emotional and cognitive disorders, 7 cases had physical and emotional disorders, and 5 cases had physical and cognitive disorders. In this paper, according to the research data of functional imaging on different levels of children’s brain, we use computer to model and simulate through digital conversion technology, draw the neural network Atlas of children’s psychological behavior, compare the children’s representation and image characteristics according to functional imaging, and then, study the relationship between children’s signs and images, to make a plan for improving children’s psychological behavior health care. The study shows that in the above different groups, the linear correlation between the functional imaging results and the representation of 22 abnormal children is 98%, and the fuzzy deviation is only 3.52%, which indicates that functional imaging can be used as the basic judgment basis in improving children’s psychological and behavioral health care and can predict and reasonably prevent children’s potential psychological behavior according to the images.
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18
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Mahon C, Seekis V. Systematic Review of Digital Interventions for Adolescent and Young Adult Women's Body Image. Front Glob Womens Health 2022; 3:832805. [PMID: 35392118 PMCID: PMC8982933 DOI: 10.3389/fgwh.2022.832805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/11/2022] [Indexed: 11/20/2022] Open
Abstract
Background A growing number of digital interventions have been developed to address a range of mental health issues including body image. Identifying effective interventions for body image is important given the prevalence of body image concerns and their associated negative outcomes among young women. This review aimed to critically evaluate current evidence on the use of digital interventions for adolescent and young adult women's body image. Methods A literature search was performed in November 2021 across three databases, PsychINFO, Web of Science and Pubmed to identify studies published with keywords and synonyms of "body image" and "digital interventions" that have been conducted with girls/women aged 10-25 years. Studies were included if they assessed a universal body image intervention delivered through a digital platform (e.g., web-based, mobile phone) and if they reported body image outcomes using validated measures. Two authors independently screened studies extracted data and assessed the quality of studies. Results Eight of 15 interventions were effective in improving at least one body image outcome from pre-post intervention; however, effect sizes were mostly small-medium, and few effects were maintained at follow-up. Studies were heterogeneous in terms of delivery format, duration, sample characteristics, quality, and outcomes. Discussion Findings suggest that digitally delivered interventions can effectively improve some body image outcomes in young women. Characteristics of effective studies are discussed and suggestions for future work on intervention development in this field are provided. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021281435, identifier CRD42021281435.
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Affiliation(s)
- Ciara Mahon
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Veya Seekis
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
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19
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Guimond FA, Laursen B. Low Body Image Satisfaction Predicts Declining Academic Engagement in Primary School Children. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-022-09503-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Garbett KM, Craddock N, Haywood S, Nasution K, White P, Saraswati LA, Medise BE, Diedrichs PC, Williamson H. A Novel, Scalable Social Media-Based Intervention ("Warna-Warni Waktu") to Reduce Body Dissatisfaction Among Young Indonesian Women: Protocol for a Parallel Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e33596. [PMID: 35089154 PMCID: PMC8838567 DOI: 10.2196/33596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/08/2021] [Accepted: 11/30/2021] [Indexed: 01/14/2023] Open
Abstract
Background Despite the prevalence of body dissatisfaction among young Indonesian women and its consequential negative impacts, there are currently no evidence-based, culturally appropriate interventions to tackle this issue. Therefore, there is a need to develop scalable, cost-effective, and accessible interventions to improve body image among this population. Objective This paper describes the study protocol of a parallel randomized controlled trial to evaluate the effectiveness of Warna-Warni Waktu, a social media–based intervention that aims to reduce state and trait body dissatisfaction and improve mood among young Indonesian women aged 15-19 years. Methods The trial will take place online. Approximately 1800 young women from 10 cities in Indonesia, evenly split across the ages of 15-19 years, will be recruited via a local research agency’s established research panel. Participants will be randomly allocated to the intervention condition or a waitlist control condition. The intervention consists of six 5-minute videos, with each video supplemented with up to five brief interactive activities. The videos (and associated activities) will be delivered at a rate of one per day across 6 days. All participants will complete three self-report assessments: at baseline (Day 1), 1 day following the intervention (Day 9), and 1 month following the intervention (Day 36). The primary outcome will be change in trait body dissatisfaction. Secondary outcomes include change in internalization of appearance ideals, trait mood, and skin shade satisfaction. Intervention effectiveness on these outcomes will be analyzed using linear mixed models by a statistician blinded to the randomized condition. Intervention participants will also complete state measures of body satisfaction and mood before and after watching each video to assess the immediate impact of each video. This secondary analysis of state measures will be conducted at the within-group level. Results Recruitment began in October 2021, with baseline assessments underway shortly thereafter. The results of the study will be submitted for publication in 2022. Conclusions This is the first study to evaluate an eHealth intervention aimed at reducing body dissatisfaction among young Indonesian women. If effective, the intervention will be disseminated to over half a million young women in Indonesia via Facebook, Instagram, and YouTube. Trial Registration ClinicalTrials.gov NCT05023213; https://clinicaltrials.gov/ct2/show/NCT05023213 International Registered Report Identifier (IRRID) PRR1-10.2196/33596
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Affiliation(s)
- Kirsty May Garbett
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Nadia Craddock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Sharon Haywood
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | | | - Paul White
- Applied Statistics Group, University of the West of England, Bristol, United Kingdom
| | - L Ayu Saraswati
- Department of Women, Gender, and Sexuality Studies, University of Hawaii, Manoa, HI, United States
| | | | | | | | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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21
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Prevention of eating disorders in primary education. NUTR HOSP 2022; 39:81-85. [DOI: 10.20960/nh.04182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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22
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Comics as a body image intervention among adolescents in Indian Hindi medium schools: insights from an acceptability study. Glob Ment Health (Camb) 2022; 9:460-469. [PMID: 36618749 PMCID: PMC9807003 DOI: 10.1017/gmh.2022.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/27/2022] [Accepted: 08/26/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Indian adolescents experience body dissatisfaction. However, empirically supported interventions are lacking, particularly in lower socio-economic regions of India. This paper describes the acceptability testing of a six-session teacher-led comics-based intervention, aiming to improve body image and related outcomes among adolescents in Indian Hindi medium schools. METHODS Thirty-five students (50% girls; M age, girls = 12.3 years; M age, boys = 13 years) and nine teachers (11% women) from Hindi medium schools in Rajasthan, India, completed a quantitative acceptability questionnaire regarding comics that target body dissatisfaction and associated risk factors. They also participated in online or telephone semi-structured interviews to share in-depth feedback, with teachers providing additional feedback on an accompanying teacher guide. The quantitative data were analysed descriptively, with the interviews analysed using qualitative codebook thematic analysis. RESULTS Quantitative analyses revealed that 73% of students felt the comics made them feel good about themselves. Qualitative analyses revealed four themes: (1) body dissatisfaction is a concern; (2) the comics are powerful; (3) increasing ease of understanding; (4) a teacher guide to aid delivery. CONCLUSION This study demonstrates acceptability of a novel teacher-led comics-based body image intervention for adolescents in Indian Hindi medium schools from lower socio-economic settings. These findings are currently informing intervention optimizations, which will be evaluated in a randomized controlled effectiveness trial. If found to be effective, this intervention will be disseminated across eight Indian states by UNICEF. Trial registration. This trial has been registered with ClinicalTrials.gov; a database of privately and publicly funded studies conducted around the world. Registration date: 2nd May 2020; Registration ID: (NCT04317755). https://clinicaltrials.gov/ct2/show/NCT04317755?term=NCT04317755&draw=2&rank=1.
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23
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Kurz M, Rosendahl J, Rodeck J, Muehleck J, Berger U. School-Based Interventions Improve Body Image and Media Literacy in Youth: A Systematic Review and Meta-Analysis. J Prim Prev 2021; 43:5-23. [PMID: 34962632 DOI: 10.1007/s10935-021-00660-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 10/19/2022]
Abstract
Body ideals conveyed by the media and by body comparisons often result in body dissatisfaction, which can cause risky health behaviours and eating disorders, especially in adolescents. We conducted a meta-analytic review of existing school-based interventions designed to enhance media literacy in order to reduce body dissatisfaction and to promote a positive body image. We included controlled trials examining children and adolescents from grade five to nine (age 10-15 years) after a manual search and a comprehensive literature search using PsycINFO, Medline, Web of Science, and CENTRAL. We computed average weighted effect sizes (Hedges' g) with the help of a random effects model and identified seventeen different programme evaluations with 7392 participants. We found a significantly larger effect on positive body image and media literacy in the intervention compared to control groups. However, heterogeneity was substantial for both outcomes. Results suggest that media literacy interventions have the potential to improve media literacy and reduce body dissatisfaction. Interventions that worked with the principle of induction of cognitive dissonance were the most effective.
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Affiliation(s)
- Martina Kurz
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena of the Friedrich-Schiller-University Jena, Stoystr. 3, 07740, Jena, Germany
| | - Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena of the Friedrich-Schiller-University Jena, Stoystr. 3, 07740, Jena, Germany
| | - Johanna Rodeck
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena of the Friedrich-Schiller-University Jena, Stoystr. 3, 07740, Jena, Germany
| | - Julia Muehleck
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena of the Friedrich-Schiller-University Jena, Stoystr. 3, 07740, Jena, Germany
| | - Uwe Berger
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena of the Friedrich-Schiller-University Jena, Stoystr. 3, 07740, Jena, Germany.
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Craddock N, Garbett KM, Haywood S, Nasution K, White P, Saraswati LA, Rizkiah C, Medise BE, Diedrichs PC. 'Dove Confident Me Indonesia: Single Session': study protocol for a randomised controlled trial to evaluate a school-based body image intervention among Indonesian adolescents. BMC Public Health 2021; 21:2102. [PMID: 34784916 PMCID: PMC8593637 DOI: 10.1186/s12889-021-11770-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 09/10/2021] [Indexed: 01/08/2023] Open
Abstract
Background Due to the prevalence and associated adverse health consequences of negative body image among adolescents globally, there is a need to develop acceptable, effective, and scalable interventions. School-based body image interventions delivered by trained teachers show promise in reducing negative body image in adolescents. However, there is currently a lack of evidenced-based body image interventions for use in low- and middle-income countries (LMICs). This paper outlines a protocol for the development and evaluation of Dove Confident Me Indonesia: Single Session, a single-session, teacher-led body image intervention for Indonesian adolescents. Method The effectiveness of the intervention will be evaluated using a cluster randomised controlled trial design. Due to the COVID-19 pandemic, the trial will be conducted online. Trained teachers or school guidance counsellors will deliver the intervention. Self-report questionnaires will be collected at three time points: baseline, post-intervention, and two-month follow-up. The primary outcome is body esteem. Secondary outcomes are internalisation of appearance ideals, mood, engagement in life activities, tendency to engage in appearance comparisons, and skin shade satisfaction. A minimum of 1000 participants will provide 95% power to detect small-to-medium intervention effects. To account for attrition and potential internet issues, the sample will comprise of 2000 Indonesian adolescents in grades 7–9, attending state junior high schools in Surabaya, East Java. Quantitative and qualitative data on acceptability of the intervention will also be collected from teachers and students. Additionally, fidelity of lesson implementation will be assessed. This project received ethical approval from the Universitas Indonesia and the University of the West of England. The intervention will be disseminated in junior high schools throughout Indonesia via UNICEF’s Life Skills Education (LSE) programme, which will be freely available for teachers to download. Discussion This paper presents Dove Confident Me Indonesia: Single Session, a culturally adapted school-based intervention designed to improve Indonesian adolescents’ body image. It details the plan for evaluation, highlighting the strengths and limitations of the proposed study design. It will be informative for others aiming to adapt evidence-based school curricula to promote well-being among adolescents in LMICs. Trial registration NCT04665557. Registered 11th December 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11770-0.
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Affiliation(s)
- Nadia Craddock
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK.
| | - Kirsty M Garbett
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
| | - Sharon Haywood
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
| | | | - Paul White
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
| | | | | | - Bernie E Medise
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
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Outcomes of a Cluster Randomized Controlled Trial of the SoMe Social Media Literacy Program for Improving Body Image-Related Outcomes in Adolescent Boys and Girls. Nutrients 2021; 13:nu13113825. [PMID: 34836084 PMCID: PMC8674763 DOI: 10.3390/nu13113825] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/24/2022] Open
Abstract
Although the negative effect of social media use among youth on body image and eating concerns has been established, few classroom-based resources that can decrease these effects through targeting social media literacy skills have been developed. This study aimed to test the efficacy of SoMe, a social media literacy body image, dieting, and wellbeing program for adolescents, through a cluster randomized controlled trial. Participants (n = 892; Mage = 12.77, SD = 0.74; range 11–15; 49.5% male) were randomized by school (n = 8) to receive either weekly SoMe (n = 483) or control sessions (lessons as usual; n = 409) over 4 weeks in their classroom. Participants completed surveys at four timepoints (baseline, 1-week post-intervention, and 6- and 12-month follow-up) assessing body dissatisfaction, dietary restraint, strategies to increase muscles (primary outcomes), self-esteem and depressive symptoms (secondary outcomes), and internalization of appearance ideals and appearance comparison (exploratory outcomes). Modest positive intervention effects were found in dietary restraint and depressive symptoms at 6-month follow-up in girls but few positive effects emerged for boys. The findings provide only preliminary support for a social media literacy intervention, but suggest the usefulness of both identifying those who benefit most from a universally delivered intervention and the need to refine the intervention to maximize intervention effects.
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Pursey KM, Burrows TL, Barker D, Hart M, Paxton SJ. Disordered eating, body image concerns, and weight control behaviors in primary school aged children: A systematic review and meta-analysis of universal-selective prevention interventions. Int J Eat Disord 2021; 54:1730-1765. [PMID: 34245459 DOI: 10.1002/eat.23571] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Body image concerns and extreme weight control behaviors frequently develop in childhood indicating an important age group for the implementation of universal-selective prevention approaches. This systematic review aimed to evaluate the effect of universal-selective prevention interventions addressing disordered eating, body image concerns, and/or extreme weight control behaviors in children aged 6-12 years. METHOD Nine databases were searched up to April 2021. Studies were included if they delivered a universal-selective prevention intervention to children aged 6-12 years and reported outcomes relating to body image, disordered eating, or weight control behaviors. The review was conducted in line with the PRISMA Guidelines. RESULTS A total of 42 articles describing 39 studies included in the review, with most (n = 24; 57%) classified as neutral quality. Thirty studies implemented an eating disorder specific universal-selective program and nine implemented lifestyle interventions plus content to address disordered eating risk factors. Meta-analysis (n = 16 studies) revealed an improvement in body image-related outcomes across all studies (standardized mean difference [SMD] 0.26 [95%CI 0.01, 0.51]); with a high level of heterogeneity (Î2 = 89.9%; p < .01). Meta-analysis according to gender revealed a general improvement in body image-related outcomes for girls (SMD 0.40 [95%CI 0.07, 0.73]), but not boys (SMD 0.23 [95%CI -0.24, 0.70]). DISCUSSION By investigating child, parental and teaching interventions and including outcomes such as weight control and disordered eating behaviors, a trend toward a reduction in eating disorder risk factors was observed, particularly body image-related outomes in girls. Future directions include embedded disordered eating prevention materials within existing lifestyle interventions and inclusion of more diverse samples.
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Affiliation(s)
- Kirrilly M Pursey
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Daniel Barker
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Melissa Hart
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,Hunter New England Mental Health, Waratah, New South Wales, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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Bell BT, Taylor C, Paddock D, Bates A. Digital Bodies: A controlled evaluation of a brief classroom-based intervention for reducing negative body image among adolescents in the digital age. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2021; 92:280-298. [PMID: 34350594 DOI: 10.1111/bjep.12449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND A growing body of research has linked social media use to negative body image. AIMS The present research aimed to evaluate the efficacy of Digital Bodies, a brief classroom-based intervention that aims to improve adolescents' body image. METHODS British adolescents (N = 290; Age M = 12.81; SD = 0.40; Range = 12-13; Female = 151) were cluster randomized to intervention or waiting list control groups. Measures of body satisfaction, appearance ideal internalization (thin and athletic ideal internalization) and self-objectification were completed at baseline (T1), 1-week post-intervention (T2) and 8-week follow-up (T3). RESULTS Multi-level modelling showed adolescents in the intervention group reported improved body satisfaction at T2, in comparison to the control, and crucially this effect was sustained at T3. Additionally, girls reported less thin ideal internalization at T2 relative to the control, but this effect was not sustained at T3. No other intervention effects were found. CONCLUSIONS Overall, the findings provide initial support for the efficacy of Digital Bodies as an intervention for improving adolescents' body satisfaction.
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Affiliation(s)
- Beth T Bell
- School of Education, Languages and Psychology, York St John University, UK
| | - Caitlin Taylor
- School of Education, Languages and Psychology, York St John University, UK
| | - Danielle Paddock
- School of Education, Languages and Psychology, York St John University, UK
| | - Adam Bates
- College of Social Sciences and Arts, Sheffield Hallam University, UK
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Selbstwertförderung in der universellen Prävention von Essstörungen. PSYCHOTHERAPEUT 2021. [DOI: 10.1007/s00278-021-00515-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bell BT, Taylor C, Paddock DL, Bates A, Orange ST. Body talk in the digital age: A controlled evaluation of a classroom-based intervention to reduce appearance commentary and improve body image. Health Psychol Open 2021; 8:20551029211018920. [PMID: 34104461 PMCID: PMC8165851 DOI: 10.1177/20551029211018920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research evaluates the efficacy of a classroom-based intervention - Body Talk in the Digital Age (BTIDA) - in reducing adolescents' appearance commentary and improving body image. British adolescents (N = 314; Age Range = 12-14) were cluster randomised to intervention or waiting-list control groups. Measures of appearance commentary, appearance ideal internalisation, self-objectification and body satisfaction were completed at baseline (T1), then one-week (T2) and eight-week (T3) post-intervention. Multi-level modelling showed girls who received BTIDA reported less appearance commentary engagement and thin ideal internalisation at T2 and T3, than the control, supporting the partial efficacy of BTIDA for girls. No intervention effects were found among boys.
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Wilson E. Where next for youth mental health? Reflections on current research and considerations for the future. J Ment Health 2020; 29:371-375. [DOI: 10.1080/09638237.2020.1766001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Emma Wilson
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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