The meaning of body image for women with eating disorders

Body image and eating disorders in older adults: a review

Researchers have shown body image to be an important part of a person's self-concept and have linked body dissatisfaction to various psychopathologies, most frequently eating disorders. However, the majority of the literature to date has focused on adolescents and college-aged samples, with little attention paid to the course of body image and eating disorders throughout the life span. The present article reviews the available literature on body image and eating disorders in older adults to understand more fully the unique presentation of body concerns and disordered eating across the life span. The authors address unique factors affecting body dissatisfaction and the development of eating disorders among older adults and offer directions for future research.

Self-esteem threat combined with exposure to thin media images leads to body image compensatory self-enhancement

This study examined the effect of a self-esteem threat combined with exposure to thin images on body image (BI) satisfaction and investment. Female participants (N=94) received a self-esteem threat consisting of false failure feedback or received false success feedback on an intellectual task allegedly highly predictive of academic and professional success. They then viewed media images featuring thin models or products. After viewing thin models, women who had received failure feedback declared themselves more satisfied about their appearance and less invested in it than did women who had received success feedback. These results suggest that exposure to the thin ideal may inspire women experiencing self-esteem threats to use appearance as an alternative source of worth, thus maintaining their global esteem through BI compensatory self-enhancement. Potential long-term implications of this strategy, such as a paradoxical increase in BI investment and the development of eating pathology, are discussed.

The effectiveness of stand-alone cognitive-behavioural therapy for body image: a meta-analysis

This meta-analysis examined the effectiveness of stand-alone body image (BI) cognitive-behavioural therapy (CBT). Nineteen studies met inclusion criteria. The behavioural dimension of BI improves most after BI CBT while the investment dimension improves the least. Individuals with clinical BI disturbances improve more than do college student samples. Treatments addressing the attitudinal, behavioural, and perceptual components of BI are more effective than treatments addressing attitude and behaviour only. Therapist-assisted therapy is more effective than is self-directed therapy. BI variables improve somewhat more than do general psychological variables, while the latter show equivalent improvement. Finally, treatment gains are maintained at follow-up. More research is needed to better understand and treat the investment dimension of BI.

Baseline personality characteristics of responders to 6-month psychotherapy in eating disorders: preliminary data

OBJECTIVE

The Karolinska Psychodynamic Profile (KAPP) was used for the assessment of the six-month outcome of Brief Adlerian Psychodynamic Psychotherapy (B-APP).

METHOD

Fifty-seven eating disordered women (28 with anorexia nervosa, 29 with bulimia nervosa), were included in the study. The sample was evaluated at baseline (time 0) and after six months (T6) with a clinical assessment and with Temperament and Character Inventory (TCI), Eating Disorder Inventory (EDI-2), State-Trait Anger Expression Inventory (STAXI), and KAPP.

RESULTS

Based on symptomatologic improvement, two sub-groups were obtained: responders (66.6%) and non-responders (33.3%). Significantly higher baseline scores emerged in the responders group on Ineffectiveness and Impulsivity (EDI-2) and on Harm Avoidance (TCI). Several KAPP items and areas improved in both groups at T6.

CONCLUSION

Multimodal treatment centered on B-APP lead to both a global clinical improvement and an improvement in several psychological and psychopathological features as assessed by EDI-2, STAXI and KAPP. The results suggest interesting clinical implications, though outcome predictors are quite weak.

Eating Disorders

HEALTH ISSUE: Eating disorders are an increasing public health problem among young women. Anorexia and bulimia may give rise to serious physical conditions such as hypothermia, hypotension, electrolyte imbalance, endocrine disorders, and kidney failure. KEY ISSUES: Eating disorders are primarily a problem among women. In Ontario in 1995, over 90% of reported hospitalized cases of anorexia and bulimia were women. In addition to eating disorders, preoccupation with weight, body image and self-concept disturbances, are more prevalent among women than men.Women with eating disorders are also at risk for long-term psychological and social problems, including depression, anxiety, substance abuse and suicide. For instance, in 2000, the prevalence of depression among women who were hospitalized with a diagnosis of anorexia (11.5%) or bulimia (15.4 %) was more than twice the rate of depression (5.7 %) among the general population of Canadian women. The highest incidence of depression was found in women aged 25 to 39 years for both anorexia and bulimia. DATA GAPS AND RECOMMENDATIONS: Hospitalization data are the most recent and accessible information available. However, this data captures only the more severe cases. It does not include the individuals with eating disorders who may visit clinics or family doctors, or use hospital outpatient services or no services at all. Currently, there is no process for collecting this information systematically across Canada; consequently, the number of cases obtained from hospitalization data is underestimated. Other limitations noted during the literature review include the overuse of clinical samples, lack of longitudinal data, appropriate comparison groups, large samples, and ethnic group analysis.

Bulimic symptomatology, body-image, and personality characteristics of university men

This study examined the relationships, using regression analysis, among bulimic symptomatology, body-image characteristics, and personality factors in a nonclinical sample of 46 undergraduate university men. They completed the Bulimia Test-Revised (a measure of bulimic symptomatology), the Eysenck Personality Questionnaire-Revised (a measure of personality characteristics), and the Multidimensional Body-Self Relations Questionnaire (a multidimensional measure of body-image parameters). Statistically significant relationships were identified among Appearance Evaluation, Neuroticism, and Psychoticism, and the BULIT-R scores.

Adult psychopathology: issues and controversies

This review discusses issues and controversies with respect to the construct of a mental disorder, models of etiology and pathology, and domains of psychopathology. Fundamental to the science of psychopathology is a conceptualization of mental disorder, yet inadequate attention is being given to the differentiation of normal and abnormal psychological functioning in current research. The boundaries between mental and physical disorders are equally problematic. Neurophysiological models are receiving particular emphasis in large part because of the substantial progress being made in documenting and clarifying the important role of neurophysiological structures and mechanisms in etiology and pathology. However, this attention might be at the expense of the recognition of equally valid psychological models. Problematic diagnostic boundaries are also considered, including those within and between different classes of disorder. Dimensional models may offer a more precise and comprehensive classification of psychopathology.

Body image preferences of self and others: A comparison of spanish and american male and female college students

To study cross-cultural differences in various aspects of body image, we examined body size ratings of self, ideal, and ideal opposite sex, and predictions regarding the opposite sex, for men and women in two different cultures, one in which there is a high incidence of eating disorders (the United States) and one in which there is believed to be a lower incidence (Spain). Participants were 240 college students from universities in Spain or the southwest United States. A group-format version of the Body Image Assessment with both female and male silhouettes was administered to all participants. Women's ratings of current and ideal body sizes were very similar across countries, although there was a tendency for American women to be more dissatisfied with their body size. Greater differences were found for men in that, on average, American men wanted to be larger and Spanish men wanted to be smaller. Across countries, men's ratings of their ideal body size were consistent with what they predicted that women found attractive whereas women in both countries wanted to be thinner than what they predicted that men found attractive.