Disturbances in eating behavior and body image: The role of attachment, media internalization, and self-objectification

OBJECTIVE

Research has increasingly demonstrated the need to conceptualize the etiology of eating disorders beyond a sole focus on body image disturbance. Attachment patterns, media internalization, and self-objectification have been previously found to play a potential role in the development and maintenance of eating psychopathology.

METHOD

This study 1) examined the associations between eating behavior, body dissatisfaction, attachment, media internalization, and self-objectification, 2) evaluated media internalization and self-objectification as mediators of the relationship between insecure attachment patterns and both eating disorder symptomatology and body dissatisfaction, and 3) explored predictors of eating behavior in a sample of 252 Lebanese individuals between the ages of 18 and 25.

RESULTS

Eating disorder symptomatology was positively correlated with body dissatisfaction, insecure attachment patterns, media internalization, and self-objectification. Positive associations between attachment anxiety and avoidance and eating disorder symptomatology were mediated by media internalization and self-objectification. Positive associations between attachment anxiety and avoidance and body dissatisfaction were also mediated by media internalization and self-objectification. Body dissatisfaction, media internalization, attachment anxiety and avoidance, and self-objectification were identified as predictors of eating behavior, with media internalization accounting for the highest variance in eating behavior.

CONCLUSIONS

Insecure attachment, heightened susceptibility to internalizing unrealistic media portrayals, and an objectifying self-concept were found to be associated with eating disorder symptomatology and body image dissatisfaction. Findings were interpreted in light of suggested directions and considerations for the design of prevention and intervention programs.

Childhood emotional maltreatment and emerging adults' body dissatisfaction: Self-compassion and body surveillance as explanatory mechanisms

The association between childhood emotional maltreatment and body dissatisfaction has been widely identified. However, the explanatory mechanisms for this association remain unclear. Guided by the Stress Process Model, the present study tested the potential mediating roles of self-compassion and body surveillance in the associations between emotional maltreatment (i.e., emotional abuse and neglect) and body dissatisfaction. Three-wave, self-report survey data were collected from 668 Chinese young adults (66.8 % female, Mage = 19.96 years old, SD = 1.25) with a 6-month between-wave interval. Results demonstrated that childhood emotional neglect (recalled at Time 1) was positively associated with body dissatisfaction (at Time 3) through a serial mediating pathway from self-compassion (at Time 1) to body surveillance (at Time 2). In contrast, no links involving childhood emotional abuse were identified. Findings suggest that the compromised emotion regulation capacity related to self-care and the subsequent self-objectification could be key processes through which childhood emotional deprivation would be positively associated with later body dissatisfaction. Accordingly, prevention and intervention efforts aimed at combating young adults' body image issues with early adversity of emotional deprivation could integrate emotion regulation training (that can enhance self-care) and cognitive-behavioral techniques (that may reduce body surveillance) into extant programs to enhance effectiveness.

Advocacy through storytelling: challenging eating disorders and eating disorders stigma

BACKGROUND

Although eating disorders (EDs) are among the most stigmatised mental illnesses, a number of individuals break past this stigma and engage in ED advocacy by sharing their recovery stories. Little is known, however, about the role of such advocacy in their healing journeys.

METHODS

To bridge this gap, the authors examined the role of autobiographical oral storytelling in the ED recovery of adult advocates. Autobiographical oral history interviews were carried out with adult advocates (n = 16) recovering from EDs. The data were analysed using a mixture of actantial and thematic analyses. Authors also used activity theory to categorise how storytelling was translated into concrete social actions. Results were then interpreted through frameworks of embodiment and the intersectionality of identity.

RESULTS

Advocates chose to share their ED stories as a way to embody resilience and make meaning from their ED experiences. Beyond personal gains, the social benefits of sharing their stories included raising hope and openness to converse further with audiences, advocating for greater ED resources (e.g., ED literacy among school staff), and offering new training initiatives for healthcare professionals. The ties between storytelling and the unique aspects of one's identity are also discussed.

CONCLUSIONS

Engaging in advocacy through storytelling can positively affect both the advocates and the audiences with whom they connect. Future studies, informed by feminist biopsychosocial frameworks, can examine storytelling as a therapeutic intervention. Such frameworks serve as alternatives to biomedical models of EDs and mental illnesses. They also emphasise the need for broader changes that destabilise oppressive body cultures and display how storytelling can help mobilise change.

Sexual Harassment and Binge Eating Among Chinese Female Undergraduates: A Mediation Model of Self-Objectification and Self-Control

Sexual harassment is a serious health issue prevalent on campuses worldwide, with significant implications for individuals' well-being. Past research has highlighted the close association between sexual harassment and eating disorders, yet little is known about the mechanisms underlying this relationship. This study aimed to investigate the potential mediating roles of self-objectification and self-control in linking sexual harassment to binge eating, drawing upon objectification theory and self-control resource theory. A sample of 801 Chinese female undergraduates, with a mean age of 19.60 years (SD = 1.42), participated in the study by completing questionnaires on sexual harassment experience, self-objectification, self-control, and binge eating. The results indicated that sexual harassment experience exhibited a significant positive correlation with binge eating and self-objectification, while showing a negative correlation with self-control. And an increased frequency of sexual harassment experiences and self-objectification were associated with lower levels of self-control. Furthermore, mediation analyses utilizing Hayes' PROCESS macro (2013) for SPSS (Model 6) demonstrated that both self-objectification and self-control independently and sequentially mediated the relationship between sexual harassment and young women's binge eating. In other words, young women who had experienced sexual harassment were more likely to exhibit increased self-objectification, leading to decreased self-control and ultimately culminating in binge eating behaviors. This study provides valuable insights into how sexual harassment affects young women's binge eating by elucidating the mediating roles of self-objectification and self-control, thus enhancing our understanding of developing strategies to mitigate the negative consequences of experiencing sexual harassment.

Body Image and High-Risk Weight and Shape Control Behaviors Among Transgender and Nonbinary Young Adults: The Role of Sexual Assault

Purpose: Transgender and nonbinary (TNB) populations experience disproportionate rates of sexual assault. Despite evidence from cisgender samples linking sexual assault exposure to body image concerns and disordered eating behaviors, such as weight and shape control behaviors (WSCBs), little is known about these relationships in TNB people. The purpose of this study was to assess associations among past-year sexual assault exposure, body areas satisfaction, body weight esteem, and high-risk WSCBs in a sample of TNB young adults. Methods: A sample of 714 participants completed a cross-sectional online survey. Multivariable linear and logistic models were fit to determine associations between constructs of interest. Natural effects mediation analyses assessed for potential mediation of the relationship between sexual assault and WSCBs by body areas satisfaction and body weight esteem. Analyses were stratified by three gender identity categories. Results: Past-year sexual assault exposure was associated with significantly decreased body areas satisfaction, but only for nonbinary participants. No significant association was found between sexual assault and body weight esteem. Sexual assault was associated with significantly increased risk for WSCBs across gender identity categories. No mediation of these relationships by body areas satisfaction and body weight esteem was observed. Conclusion: Findings support clinical consideration of WSCBs in TNB survivors of sexual assault. Results suggest that multiple factors, including body image and sexual assault, may contribute separately to disordered eating behaviors in TNB young adults.

The Effect of Sexual Objectification on Dishonesty

In daily life, women often experience various forms of sexual objectification such as being stared at in public settings and receiving unsolicited sexual remarks on social media. These incidents could have damaging effects on women's physical and mental health, necessitating ways to respond to the experience. Researchers have provided burgeoning evidence demonstrating the effects of sexual objectification on various psychological, emotional, and cognitive outcomes. However, relatively few researchers have tested how sexually objectified people behaviorally react to the objectification experience. To address this knowledge gap, we aimed to test whether sexual objectification increases dishonesty among women and reveal one potential underlying psychological mechanism. We predicted that sexual objectification increases dishonesty serially through higher levels of relative deprivation and lower levels of self-regulation. We conducted two experiments (valid N = 150 and 279, respectively) to test the predictions and found that participants who experienced sexual objectification reported greater dishonest tendencies than those who did not (Experiments 1 and 2). Moreover, relative deprivation and self-regulation serially mediated the effect of sexual objectification on dishonesty (Experiment 2). In the current experiments, we highlight the essential role of relative deprivation and self-regulation in explaining how sexual objectification increases dishonesty and various related forms of antisocial behavior.

Pathways from sociocultural and objectification constructs to body satisfaction among women: The U.S. Body Project I

Objectification theory proposes that widespread sexualization causes women to engage in surveillance of their appearance. We integrated this concept into a model with constructs from the tripartite influence model, which proposes that body dissatisfaction is a result of internalizing cultural notions of thin ideal beauty that stem from family, peer, and media appearance-related pressures. We tested this model with an online sample of 6327 adult women. Specifically, we tested whether these pressures predicted increased thin-ideal and muscular-ideal internalization, leading to greater body surveillance, and in turn lower appearance evaluation and body image quality of life. Structural equation modeling supported many aspects of the model. Family, peer, and media pressures related to higher thin-ideal internalization, which related to higher body surveillance and lower appearance evaluation. Peer and media pressures related to higher muscular-ideal internalization, which related to lower appearance evaluation. However, muscular-ideal internalization was not related to body image quality of life. An indirect relationship emerged between thin-ideal internalization and body image outcomes via body surveillance. Body mass index (BMI) moderated several of these model paths. Findings highlight the value of this integrated sociocultural model, and of BMI as an important moderating factor when examining objectification and tripartite influence models.

A Test of Objectification Theory with Sexual Minority Women

With this study, we aimed to advance objectification theory research with sexual minority women by examining the understudied roles of appearance anxiety and interoceptive awareness concomitantly with other key variables, including sexual objectification experiences, internalization of cultural appearance standards, body surveillance, and body shame. We also examined depressive symptoms as a criterion variable in addition to eating disorder symptoms. Survey data from 201 sexual minority women were analyzed. Manifest variable path analysis of the hypothesized model explained 35% and 27% of the variance in eating disorder and depressive symptoms, respectively. Results revealed a distinct pattern of cross-sectional direct and indirect relations for eating disorder and depressive symptoms. Specifically, body shame was a key unique correlate of eating disorder symptoms and linked internalization of cultural appearance standards and body surveillance with eating disorder symptoms. Appearance anxiety was a key unique correlate of depressive symptoms and linked internalization of cultural appearance standards and body surveillance with depressive symptoms. Sexual objectification experiences and interoceptive awareness generally did not yield significant unique direct or indirect relations in the model. These findings suggest distinct and complementary points of intervention to mitigate eating disorder and depressive symptoms for sexual minority women.

The Relationship Between Sexual Assault, Intimate Partner Violence, and Eating Disorder Symptomatology Among College Students

This study examined the interrelationship of intimate partner violence (IPV), sexual assault (SA), and eating disorder (ED) symptomatology among a sample of college students (n = 1,580). Students reporting a history of SA were 2.5 times more likely to screen positively for further ED assessment. A history of IPV also increased odds of having a positive ED screener. The model showed that 6% of the variance in ED symptomatology was explained by IPV and SA. Results did not differ based on gender. This study furthers our understanding of the relationship between IPV, SA, and ED to guide future prevention and treatment efforts. Specifically, the use of trauma-informed ED treatment could assist with full ED recovery and other comorbid mental health conditions.

Shame and eating disorders symptoms: A meta-analysis

OBJECTIVE

Numerous empirical studies and theoretical models posit that shame is a common experience among individuals across the eating disorder spectrum. In this study we aim to investigate the association between shame and eating disorders symptoms using a meta-analytical approach.

METHOD

In this meta-analysis, we synthesized findings from 195 studies to examine the proposed association between shame and eating disorders symptoms. We looked at the associations with both general eating disorders symptoms and with specific eating disorders symptoms (i.e., anorexic, bulimic, and binge-eating symptoms). Moderation analyses testing for the effect of type of shame, type of eating symptoms, clinical status, quality of the study, age, and gender were conducted.

RESULTS

Shame was significantly associated with a medium to large effect size with all types of eating disorders symptoms (rs between .40 and .52). Body shame (r = .55) and shame around eating (r = .59) were more strongly related with eating disorders pathology. Type of eating disorders symptoms did not moderate the relationship between shame and disturbed eating.

DISCUSSION

Overall, the magnitude of the effect size of the association between shame and eating disorders symptoms is a medium to large one. Body shame and shame around eating seem to be the types of shame most closely tied with eating disorders symptoms, suggesting that directly targeting them in interventions might be highly beneficial. Findings highlight current gaps in the literature (e.g., mostly correlational studies, low quality studies) with implications for future research.

Analysis of a Modification to the Sexual Experiences Survey to Assess Intimate Partner Sexual Violence

Greater accuracy is needed in the assessment of sexual victimization that occurs in intimate relationships. Existing assessment strategies in the literature often represent two distinct approaches - intimate partner violence specific strategies vs. sexual violence specific strategies. The current study compared multiple distinct strategies for assessing intimate partner sexual victimization (IPSV) and evaluated a modification that optimizes intimate partner and sexual violence specific strategies. Two samples of undergraduate women were recruited. Sample 1 (N = 236) completed the Severity of Violence Against Women Scales (SVAWS) and a modified version Sexual Experiences Survey-Short Form Victimization (SES-SFV) in which participants were cued to respond both for romantic partners and non-partners (referred to as the SES-RP/NP). Sample 2 (N = 206) completed the SVAWS and was randomized to either the traditional SES-SFV or the SES-RP/NP. Across samples, the prevalence of IPSV varied based on the measure used (SVAWS = 11.7%; SES-SFV = 17.0%; SES-RP/NP = 25.4%). The SES-RP/NP identified significantly more IPSV than the SES-SFV, SVAWS, and prior studies. Both the SES-SFV and the SES-RP/NP were positively and significantly associated with the SVAWS. The results suggested that optimal measurement of IPSV would consider both intimate partner and sexual violence strategies.

Objectification limits authenticity: Exploring the relations between objectification, perceived authenticity, and subjective well-being

Five studies (total valid N = 834) examined whether objectification (i.e., being treated as a tool or an object to achieve others' goals) reduces people's perceived authenticity and subjective well-being. Participants who experienced more objectification (Studies 1a and 1b), imagined being objectified (Study 2), or recalled a past objectification experience (Study 3) felt less authentic and reported lower levels of subjective well-being than their counterparts. Moreover, perceived authenticity mediated the link between objectification and subjective well-being (Studies 1a-3). In addition, offering objectified participants an opportunity to restore authenticity could enhance their well-being (Study 4). Taken together, our findings highlight the crucial role of authenticity in understanding when and why objectification decreases subjective well-being and how to ameliorate this relationship. Our findings also imply the effect of authenticity in understanding various psychological outcomes following objectification.

Sexual Victimization and Disordered Eating in Bisexual Women: A Test of Objectification Theory

The current study (a) ascertained whether there is a relationship between sexual victimization (SV) and disordered eating (DE) among bisexual women, (b) assessed whether objectification theory explains the relationship, and (c) tested for group differences between bisexual and heterosexual women on SV, DE, and other objectification theory variables. Utilizing a sample of 164 undergraduate bisexual women, there was a significant positive relationship between SV and DE that was serially mediated by self-surveillance and body shame. In addition, bisexual participants endorsed more SV, DE, body shame, and interoceptive deficits than a comparison sample of 335 undergraduate heterosexual women. Implications are discussed.

Understanding the relationship between sexual harassment and eating disorder psychopathology: A systematic review and meta-analysis

OBJECTIVE

The experience of sexual harassment (SH) may exacerbate the drive toward an ideal and often unattainable physical appearance, creating the foundation of unhealthy eating, and greater shape and weight concerns. This systematic review aimed to synthesize evidence on the relationship between SH and eating disorder psychopathology, as well as mediating and moderating factors that contribute to this relationship.

METHOD

Six key databases were searched from inception to August 2020; including CINAHL, PsycInfo, PubMed, Medline, Scopus, and Web of Science.

RESULTS

Overall, 15 studies meeting inclusion criteria were found, with 14 reporting a statistically significant relationship between SH and eating disorder psychopathology. A meta-analysis with 12 cross-sectional studies confirmed a small but significant effect for this concurrent association. Moderators of this relationship included gender, posttraumatic stress, and anxiety. No studies in this review conducted true mediation.

DISCUSSION

Conclusions about causal and mediating relationship between SH and eating disorder psychopathology are constrained by the preponderance of cross-sectional design (14 of the 15 studies). Therefore, it is recommended that future studies focus on the use of longitudinal design, and also on adolescent populations, where first experiences of SH are usually reported, and which is also the peak age of onset for eating disorders.

Sexual Objectification, Internalization, and College Women’s Depression: The Role of Shame

This study examined potential mediators, a moderator, and a moderated mediation of the link between sexual objectification experiences and depression among 489 young adult college women. Findings from the mediation analyses revealed that sexual objectification was directly and indirectly related to depression via greater body surveillance and self-blame. Shame moderated the direct effect of sexual objectification on body surveillance. Sexual objectification predicted body surveillance for women with low but not high or moderate levels of shame. Shame also moderated the direct effect of sexual objectification on self-blame and provided support for moderated mediation via conditional process analyses. Sexual objectification predicted self-blame for women with high and moderate but not low levels of shame. The findings underscore the importance of attending to experiences of objectification when working with women clients presenting with depression and to help them lessen habitual body monitoring, blaming themselves for being sexually objectified, and feelings of shame.

Peer sexual harassment predicts African American girls’ psychological distress and sexual experimentation

Peer sexual harassment (PSH) occurs frequently and across contexts during adolescence. The current study examined the relations among PSH in school, psychological distress, sexual experimentation, and sexual risk-taking in a sample of African American middle and high school girls. Results indicate that negative body appraisals mediated the relationship between PSH and psychological distress, suggesting that PSH is one way to operationalize interpersonal sexualization and sexual objectification. PSH was directly associated with sexual experimentation, but the association between PSH and sexual experimentation was not mediated by negative body appraisals. Neither PSH nor negative body appraisals were related to sexual risk-taking. This suggests that frequent exposure to high levels of sexualization and sexual objectification, in the form of PSH, is associated with more psychological distress and sexual experimentation, but not with sexual risk-taking, regardless of how girls feel about their bodies.