Is my body better than yours? Validation of the German version of the Upward and Downward Physical Appearance Comparison Scales in individuals with and without eating disorders

Introduction

This study examines the psychometric properties of a German version of the Upward and Downward Physical Appearance Comparison Scales (UPACS and DACS).

Methods

A total of 2,114 participants, consisting of 1,360 women without eating disorders (M age = 25.73, SD age = 6.84), 304 men without eating disorders (M age = 24.48, SD age = 6.34), and 450 women with eating disorders (M age = 27.11, SD age = 7.21), completed the UPACS and DACS as well as further questionnaires on appearance comparisons, eating disorder pathology, and self-esteem.

Results

Structural equation modeling confirmed the proposed one-factor structure of the original English-language version of the DACS but not of the UPACS. Both scales showed good internal consistency and test-retest reliability. The UPACS and DACS showed the expected correlations with related constructs, indicating acceptable construct validity, with some limitations for women with eating disorders.

Discussion

Overall, this study indicates that the German versions of the UPACS and DACS are psychometrically suitable for assessing upward and downward physical appearance comparisons in women and men without eating disorders and women with eating disorders in research and clinical practice.

Body dissatisfaction and disordered eating symptoms in children's daily life: Can parents protect against appearance comparison on social media?

Research suggests that body dissatisfaction is common among children. However, it remains largely unknown how body dissatisfaction occurs on a daily basis and which environmental factors are linked to this. The purpose of this study was to examine (1) state body dissatisfaction, dietary restraint, compensatory exercise and loss of control eating among children and its association with upward comparisons via social media and (2) whether trust in parents may attenuate this association. Children from 10 to 12 years old (N = 50) were assessed three times a day during a two-week period. Trust was examined via a baseline questionnaire. State body dissatisfaction, dietary restraint, compensatory exercise, loss of control eating and upward comparisons were examined via Ecological Momentary Assessment (EMA). Multilevel analyses indicated that an a higher level of upward comparison is associated with a higher level of state body dissatisfaction, compensatory exercise and loss of control eating. Trust in father significantly moderated the association between appearance comparison and body dissatisfaction. No evidence was found for the protective role of trust in mother. Future research is necessary to enhance our understanding of state body dissatisfaction among children and of environmental factors that may protect children from the adverse effects of social media.

Effects of videoconferencing use on momentary changes in disordered eating urges, body dissatisfaction, and mood

The coronavirus disease 2019 (COVID-19) pandemic led to a global surge in videoconferencing use for work/study-related reasons. Although these platforms heighten exposure to one's image, the implications of videoconferencing use on body image and eating concerns remain scantly examined. This study sought to investigate, in an Australian sample, whether videoconferencing for work/study-related reasons predicted increases in body dissatisfaction (BD), urge to engage in disordered eating (DE; restrictive eating, exercise, overeating/purging), and negative mood at the state level. Participants (N = 482, 78.8% women, Mage  = 20.5 years [SD = 5.3]) completed baseline demographic measures, accompanied by an ecological momentary assessment (EMA) of videoconferencing for work/study-related reasons, BD, DE urges, and negative mood six times a day for 7 days via a smartphone application. Most participants (n = 429; 89.0%) reported state-based videoconferencing use during the EMA phase. Consistent with expectations, state-based videoconferencing use was associated with an increase in state-level urges to engage in exercise. However, contrary to predictions, state-based videoconferencing use was linked to a decrease in state-level BD at the next assessment point and failed to predict negative mood and urges to engage in restrictive eating or overeating/purging at the state level. Given the simplified measure of videoconferencing use, the current research is considered preliminary and future replication and extension, using more nuanced measures, is warranted.

Do appearance comparisons mediate the effects of thinspiration and fitspiration on body dissatisfaction, happiness, and disordered eating urges in women's daily lives?

We examined whether thinspo and fitspo exposure predicted women's body dissatisfaction (BD), happiness, and disordered eating (DE) urges (binge-eating/purging, restrictive eating, and exercise) in daily life. A further aim was to assess whether these effects were stronger for thinspo versus fitspo exposure and whether upward appearance comparisons mediated the effect of thinspo-fitspo exposure on BD, happiness, and DE urges. Participants (N = 380 women) completed baseline measures and a 7-day ecological momentary assessment (EMA) investigating state-based experiences of thinspo-fitspo exposure, appearance comparisons, BD, happiness, and DE urges. Multilevel analyses revealed that thinspo-fitspo exposure was associated with greater BD and DE urges (but unrelated to happiness) at the same EMA time point. However, there was no association between thinspo-fitspo exposure and BD, happiness, and DE urges at the next EMA time-point. Thinspo relative to fitspo exposure was associated with greater BD (but unrelated to happiness and DE urges) at the same EMA time-point. The proposed mediation models were not supported in time-lagged analyses; such that upward appearance comparisons did not mediate the effects of thinspo-fitspo exposure on BD, happiness, and DE urges. Current findings provide novel micro-longitudinal data on the potentially direct detrimental effects of thinspo-fitspo exposure on women's daily lives.

Examining the individual and relational impacts of varying responses to negative body talk within college women's female friendships

Many college women make self-disparaging comments about their appearance to others. This "fat talk" (negative body talk) is a causal risk factor for body image disturbance, which in turn predicts eating disorders and depression. Research is needed to identify effective responses to negative body talk; namely, those that reduce negative body talk without shaming its initiator or damaging the relationship. The current study examined the impact of different responses to negative body talk on the likelihood of future negative body talk and on individual and relationship factors. College women (N = 160) recalled a situation using negative body talk with a female friend. Participants listened to audio recordings of four responses (Deny/Reassure, Challenge, Empathize/Reciprocate, Ignore) and rated appearance satisfaction, shame, friendship support, and likelihood of future negative body talk after each. Linear mixed models indicated that the Deny/Reassure response followed closely by the Challenge response were most beneficial for individual and relationship factors; however, participants reported being least likely to use future negative body talk after the Ignore response. Recommendations for developing promising responses to negative body talk include combining responses to balance validation (Deny/Reassure) and change (Challenge), and studying the contribution of other relationships and varying body dissatisfaction levels.

Tonight, I'm disordered eating: The effects of food delivery app use, loneliness, and mood on daily body dissatisfaction and disordered eating urges

With the recent proliferation of food delivery applications ('apps'; FDAs), accessing a meal is more convenient and immediate than ever. However, these apps may foster dysregulated eating behaviours, including maladaptive eating to cope with negative emotional states. Using ecological momentary assessment (EMA), the current study assessed whether FDA use at baseline predicted levels of EMA-assessed disordered eating urges and body dissatisfaction, whether negative mood and loneliness impacted disordered eating urges and body dissatisfaction at the state level, and whether the latter relationships were moderated by FDA usage frequency. Participants (N = 483; 78.7% women; 20.1% men; 1.2% other) completed a baseline questionnaire and were characterised as current FDA users (49.3%) or non-users (50.7%). Participants then completed a smartphone-facilitated investigation into their experiences of loneliness, negative mood, body dissatisfaction, and disordered eating urges, six times per day for 7-days. Across the entire sample, current FDA users at baseline reported greater EMA-assessed urges to overeat. At the state level, loneliness and negative mood predicted greater body dissatisfaction, with the latter also predicting greater urges for restrictive eating and overeating. Among current FDA users at baseline, at the state level, loneliness predicted greater body dissatisfaction, and negative mood predicted greater body dissatisfaction and urges for overeating. No moderating effects were observed for baseline FDA usage frequency. These results elucidate FDA use and daily experiences of loneliness and negative mood as factors elevating eating disorder (ED)-related risk. Further extensions of this research with nuanced measures of state FDA use are required.

Love me Tinder: The effects of women's lifetime dating app use on daily body dissatisfaction, disordered eating urges, and negative mood

Dating apps may potentially serve as an environment that subjects young women to the harmful effects of appearance-related pressure. The current study assessed for the first time whether women's dating app use predicted body dissatisfaction (BD), urges to engage in disordered eating (DE), and negative mood in daily life. We also examined the unique effects of women's dating app partner preferences (i.e., seeking idealised versus non-idealised physical characteristics) on the aforementioned outcomes, and whether appearance-based rejection sensitivity (appearance-RS) moderated the effects of dating app use. Participants (N = 296; 100% women) first completed a baseline survey assessing lifetime dating app usage (i.e., current or former usage), partner preferences, and appearance-RS, followed by a 7-day smartphone-facilitated ecological investigation into momentary experiences of BD, DE urges (i.e., binge-eating/purging, dietary restraint, and exercise), and negative mood. Ninety-four women (32%) reported lifetime dating app usage, which, relative to non-use, predicted greater daily urges for binge-eating/purging and negative mood. However, appearance-RS failed to moderate these effects. Among dating app users, partner preferences were not a significant predictor of the central outcomes. These findings extend previous research by examining the unique effects of dating app use on everyday BD, DE urges, and negative mood. Replication and extension are encouraged.

The impact of different responses to negative body talk on body satisfaction, shame, and future negative body talk likelihood: A UK sample

A recent online experiment found that, following a negative body talk induction task, receiving a response of ignoring the comment, compared with reassuring, reciprocating, and challenging, led to worse body satisfaction and socio-emotional outcomes for Australian women. The current online study aimed to replicate and extend this study by examining the effects of these four negative body talk responses on body satisfaction, shame, and future negative body talk likelihood in UK-based women. Participants (N = 156, M_age = 25.29, SD_age = 5.64, range_age = 18-40) recalled a scenario in which they engaged in negative body talk and were randomly assigned to receive one of four responses. Contrary to hypotheses, there were no significant differences in body satisfaction, shame, or future negative body talk likelihood across the four groups. Preferred negative body talk response data were mixed, with challenge and reassurance responses preferred at comparable rates, and just under a quarter of participants preferring a response outside of the original four. Possible explanations, including that the responses used in the original Australasian study may not perfectly correspond with UK women's experiences of social interactions and heterogeneous motivations for engaging in negative body talk necessitate more nuanced and sophisticated responses, are explored.

Relations between social comparisons and physical activity among women in midlife with elevated risk for cardiovascular disease: an ecological momentary assessment study

Women in midlife (ages 40–60) show decreases in physical activity (PA) that exacerbate risk for cardiovascular disease. Social comparisons (i.e., self-evaluations relative to others) are known to influence PA in other groups, but their association in this population is unknown. The present study used ecological momentary assessment to examine this relation among women in midlife with hypertension or another CVD risk condition (N = 75, M_BMI = 34.0 kg/m²). Participants completed 5 surveys per day and wore tri-axial accelerometers for 10 days. PA engagement was lower after women reported more comparisons than were typical for them (7–14% reductions in PA for each additional comparison). These relations varied across days of observation and relations were positive on 34–58% of days. Findings call for careful consideration of how best to harness any potential benefits of social comparison for promoting PA in this and other groups.

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

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

The effects of fitspiration images on body attributes, mood and eating behaviors: An experimental Ecological Momentary Assessment study in females

Through an experimental Ecological Momentary Assessment (EMA) design, we assessed the effects of fitspiration images (relative to neutral) on body image, mood and disordered eating and whether trait body dissatisfaction, thin-ideal internalization and pressures from the media, family and peers moderated these effects. After completing trait-based measures, 85 women were prompted via a mobile application 6 times daily for 7 days to view an image (fitspiration or neutral) and report on state levels of perceived pressures to attain an idealized physique, satisfaction with various body attributes, mood and eating behavior. When participants were exposed to fitspiration images, their perceived pressure to attain an idealized physique was significantly higher than after exposure to the control images. This effect was most pronounced for women experiencing pressure from the media. Furthermore, fitspiration images lowered the extent to which women felt that idealized physiques were attainable, and decreased satisfaction with current fitness. There were no significant effects on mood and disordered eating. Exposure to fitspiration content predicted only a few adverse outcomes in terms of negative body attributes and perceived pressures to attain a similar physique, suggesting that its content is not as detrimental as initially believed, but further research is needed.

State-Based Markers of Disordered Eating Symptom Severity

Recent work using naturalistic, repeated, ambulatory assessment approaches have uncovered a range of within-person mood- and body image-related dynamics (such as fluctuation of mood and body dissatisfaction) that can prospectively predict eating disorder behaviors (e.g., a binge episode following an increase in negative mood). The prognostic significance of these state-based dynamics for predicting trait-level eating disorder severity, however, remains largely unexplored. The present study uses within-person relationships among state levels of negative mood, body image, and dieting as predictors of baseline, trait-level eating pathology, captured prior to a period of state-based data capture. Two-hundred and sixty women from the general population completed baseline measures of trait eating pathology and demographics, followed by a 7 to 10-day ecological momentary assessment phase comprising items measuring state body dissatisfaction, negative mood, upward appearance comparisons, and dietary restraint administered 6 times daily. Regression-based analyses showed that, in combination, state-based dynamics accounted for 34-43% variance explained in trait eating pathology, contingent on eating disorder symptom severity. Present findings highlight the viability of within-person, state-based dynamics as predictors of baseline trait-level disordered eating severity. Longitudinal testing is needed to determine whether these dynamics account for changes in disordered eating over time.

Methods to Assess Social Comparison Processes Within Persons in Daily Life: A Scoping Review

Self-evaluations relative to others (i.e., social comparisons) have well-established implications for health and well-being, and are typically assessed via global, retrospective self-report. Yet, comparison is inherently a dynamic, within-person process; comparisons occur at different times, on a range of dimensions, with consequences that can vary by context. Global, retrospective assessment forces aggregation across contexts and reduces ecological validity, limiting its utility for informing a nuanced understanding of comparisons in daily life. Research across social and clinical psychology has implemented methods to assess comparisons naturalistically, involving intensive, repeated assessments of comparison occurrence, characteristics, and consequences in everyday life (via ecological momentary assessment or daily diaries). Although promising, this work to date lacks an overarching conceptual framework for guiding decisions about assessment design and implementation. To address this gap, the aims of this scoping review were: (1) to summarize available literature on within-person naturalistic assessment of social comparison, and (2) to provide a set of key considerations to inform future social comparison research using within-person naturalistic assessment. Searches in PubMed, PsycInfo, and CINAHL identified relevant articles published before June 2019. Articles were included if they described at least 3 comparison assessments within each participant, taken in the natural environment, and spaced no more than ~24 h apart (i.e., repeated momentary or daily assessment). In articles meeting these criteria (33 unique studies across 36 published papers), we summarized aspects of the comparison assessment, including recording methods, direction (e.g., upward, downward), target (e.g., friend, stranger), and dimension (e.g., status, appearance). Most studies assessed appearance comparisons (vs. other comparison dimensions) and collected information in response to signals (rather than initiated by participants). However, there was considerable heterogeneity in the number of assessments, assessment periods, recording modalities, and comparison predictors and outcomes assessed. Findings broadly establish heterogeneity in the aspects of comparison considered critical for within-person naturalistic assessment. We describe key decision points for future work to help advance within-person naturalistic assessment methods and improve the utility of such approaches to inform research, theory, and intervention.

Body image states in everyday life: Evidence from ecological momentary assessment methodology

This review highlights the contributions of Professor Thomas Cash to the scholarship of body image experiences in daily life, including his influence on subsequent research in this field. Cash's arguments for capturing a broad range of state-based body image experiences have been heeded, with recent studies exploring positive body image constructs as well as the more studied negative body image experiences. Appearance comparisons are the most commonly studied contextual influence on body image, and they seem to have a consistent effect. However, the experiences of body image in sexual contexts, and among adolescents, those who are pregnant, or have other physical characteristics that may increase the salience of appearance warrant further attention. Findings generally support Cash's contention that trait body image relates to likelihood and level of experience of body image in daily life, though the moderating effects of trait aspects on state-based relationships remains unclear. The discussion concludes with consideration of the impact of assessment schedules on obtained results. It is also discussed how accumulated knowledge regarding state-based body image experiences may be leveraged in treatment contexts, particularly in light of clear evidence that repeated assessment of body image in daily life increases self-awareness of one's body image characteristics.

Effect of digital alteration information and disclaimer labels attached to fashion magazine advertisements on women's body dissatisfaction

The present study aimed to investigate whether the provision of prior information about digital alteration would enhance the effectiveness of disclaimer labels attached to fashion images in protecting against body dissatisfaction. Participants were 363 female undergraduate students who viewed fashion magazine advertisements with either no label or a digital alteration disclaimer label. Prior to viewing the advertisements, participants read one of three news stories containing digital alteration information that focused on either the unrealistic nature of the images or on social comparison, or a control news story (on magazine circulation figures). Irrespective of the preceding information, disclaimer labels offered no benefit for body satisfaction. However, reading the news articles containing information about digital alteration led to higher levels of body dissatisfaction than reading the control article. It was concluded that information in the form of news stories or disclaimer labels cannot be assumed to be useful or to offer positive benefit. Accordingly, more extensive and thorough evaluation is required and policy makers might better direct their attention to other forms of cost-effective universal intervention.

The impact of different responses to fat talk on body image and socioemotional outcomes

Fat talk, the act of making disparaging comments about one's own appearance, has been associated with an extensive range of negative body image outcomes. Despite this well-established body of literature highlighting the prevalence and consequences, scant research exists on the impact of different responses to fat talk in situ. The current online experiment aimed to explore four different responses to fat talk and their impact on body satisfaction, shame, and feelings of support. Female participants (N = 191, M_age = 23.52, SD_age = 4.54, range_age = 18-40) recalled or imagined an experience of engaging in fat talk before being randomly assigned to receive a set response (where their fat talk was either challenged, ignored, reassured, or reciprocated). Largely in line with hypotheses, the Ignore condition led to the lowest level of body satisfaction and perceived support, and the highest level of shame. The Challenge condition resulted in positive outcomes for both perceived support and feelings of shame. The findings demonstrate that ignoring fat talk is associated with negative outcomes, providing evidence to inform practical guidelines aimed at tackling the social phenomenon.

Body-, Eating-, and Exercise-Related Comparisons During Eating Disorder Recovery and Validation of the BEECOM-R

Social comparison tendencies are strongly associated with body dissatisfaction and disordered eating. In the current study, we quantitatively examined the structure and predictive value of these constructs during eating disorder recovery. We revised an existing measure of body-, eating-, and exercise-related social comparisons, the Body, Eating, and Exercise Comparison Orientation Measure (BEECOM), to improve psychometric properties. We also assessed the psychometric properties of the shortened Body, Eating, and Exercise Comparison Orientation Measure-Revised (BEECOM-R) in a comparison sample, resulting in an abbreviated measure suitable for recovering, clinical, and non-clinical samples. Finally, we used the revised measure to examine the additive influence of body-, eating-, and exercise-related comparisons on shape and weight dissatisfaction and disordered eating cognitions among 150 women (ages of 18–35 years) in self-identified recovery. Results suggest that body-, eating-, and exercise-related social comparisons all continue to correlate with body dissatisfaction and disordered eating during recovery. A minority of participants reported these comparisons to be helpful during the recovery process. We recommend social comparison as a clinical target for most women seeking support for eating pathology. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/ 10.1177/0361684319851718

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

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

Nature and consequences of positively-intended fat talk in daily life

The current study used ecological momentary assessment to explore the frequency, trait predictors, and momentary consequences of positively-intended fat talk, a specific sub-type of fat talk that involves making negative comments about one's own appearance with the view to making someone else feel better. A total of 135 women aged 18-40 completed trait measures of appearance-based comparisons, thin-ideal internalisation, body shame, and body surveillance, before completing a state-based component, involving six short surveys delivered via a smartphone app at random points during the day for seven days. Findings indicate that both self- and other-fat talk are common in daily social interactions, and that individuals with higher levels of trait negative body image were more likely to engage in fat talk. Self-fat talk negatively impacted state body satisfaction levels. Possible theoretical and practical implications are outlined.