Concerns about fertility, social appearance, and relationships in young adults with polycystic ovary syndrome

BACKGROUND

Polycystic Ovary Syndrome (PCOS), affecting 1-11% of reproductive-age women, is characterised by many symptoms that cause important concerns especially in young adults.

OBJECTIVE

This study aimed to evaluate the concerns about fertility, social appearance, and relationships in young adults with PCOS.

METHODOLOGY

This descriptive study included 140 young female adults aged 18-26, who were diagnosed with PCOS, agreed to participate in the onlineresearch through social media between July and December 2022 in Turkey. Data were collected using the 'Participant Interview Form' and the "Social Appearance Anxiety Scale (SAAS).

RESULTS

The mean age of the participants was 22.1 ± 2.1. As the most common symptoms, 78.6% experienced menstrual irregularities, 16.4% were overweight, 7.1% were obese, 67.1% had hirsutism and 65.7% had acne. Most of the participants expressed concerns about future infertility (72.9%), and worried about being unable to conceive due to PCOS in the future (sometimes = 61.4%). Over eighty percent of the participants expressed some level of dissatisfaction with their physical appearance. They commonly believe that their self-esteem, emotionalstate, social relationships and partner relationships could be negatively affected by PCOS. SAAS scores were significantly increased by low income, high BMI, hirsutism, dissatisfaction with physicalappearance, low self-esteem, emotional problems and concerns related to social and partner relationships (p < 0.05).

CONCLUSION

Young adults have common concerns about the potential negative impacts of PCOS on fertility, social appearance, and relationships. Health professionals should be aware of their counselling needs about the possible physical and psycho-social effects of PCOS and provide continuous care and support.

Effects of exposure to plus-size fashion models on weight-related attitudes in bulimia nervosa: Findings from an exploratory study

BACKGROUND AND OBJECTIVES

Eating disorders are often linked to the internalization of the thin-ideal and weight stigma. The present exploratory study investigates the effects of plus-sized fashion media on weight-related attitudes in bulimia nervosa (BN).

METHODS

Women with BN (n=27) and without an eating disorder (n=28) were exposed to 17 pictures of plus-size fashion models. Participants rated the attractiveness of the models. Before and after the exposure task, participants completed questionnaires on their attitudes towards people with higher weight as well as thin-ideal media.

RESULTS

The BN group rated the bodies of the plus-size fashion models as less attractive than controls, whereas no group differences were found in attractiveness ratings for the models' faces or full images. In both groups, negative attitudes about people with higher weight significantly decreased after viewing plus-size model pictures. Attitudes toward thin-ideal media remained unchanged, with scores higher for BN than controls.

LIMITATIONS

This exploratory study has several limitations, such as the lack of a control condition, small sample size, and reliance on only self-report data.

CONCLUSIONS

These exploratory results imply that the positive effects of plus-sized model images on reducing negative assumptions about people with high weight may not be limited to healthy individuals but also seem to extend to women with BN. Further controlled studies with larger samples and long-term assessments are needed to confirm these findings.

Body image and social appearance anxiety in patients with cancer undergoing radiotherapy: Across-sectional study

BACKGROUND

The body image of patients with cancer can be negatively affected due to treatment toxicities. Changes in body image may cause patients to experience social appearance anxiety. This study aimed to evaluate the body image and social appearance anxiety of patients with cancer undergoing radiotherapy.

METHODS

The cross-sectional study was conducted with 153 patients with cancer undergoing radiotherapy in a university hospital. The data were collected with a Patient Information Form, the Body Image Scale, and the Social Appearance Anxiety Scale and the Radiation Therapy Oncology Group Skin Toxicity Criteria.

RESULTS

Patients' mean body image score was 15.18 ± 8.26 (min = 0, max = 30), mean social appearance anxiety score was 45.29 ± 14.50 (min = 16, max = 80). Patients with low education levels and low-income levels had higher body image and social appearance anxiety scores (p < 0.01). Body image and social appearance anxiety scores were found to be higher in patients with advanced cancer, grade III-IV skin toxicity, pain, fatigue, and constipation (p < 0.05).

CONCLUSIONS

Radiotherapy may negatively affect body image and social appearance anxiety. Assessments of body image and social appearance anxiety regularly before, during, and after treatment are essential. Psychosocial support should be provided to patients to reduce body image and social appearance anxiety and increase their well-being. Patients with cancer especially those who have low income and education levels, advanced cancer stage and skin toxicity, and suffer from pain, fatigue, constipation, etc. should be supported by methods such as counseling and social support groups.

Reduced Tolerance for Risky Play in Primary Caregivers of Children With Hearing Loss

PURPOSE

It is known that taking appropriate risks during play is crucial for the development of a child's creativity, problem-solving abilities, resilience, self-confidence, and skills in evaluating risky situations. However, communication problems resulting from hearing loss (HL) can affect a child's ability to hear danger and warning signals during play, potentially leading to injury. This study investigates the attitudes of parents or caregivers with children with HL toward risky play.

METHOD

The study included 170 caregivers of children with normal hearing (NH; n = 103) and cochlear implant and/or hearing aids users (n = 67) aged 3-13 years. The primary caregiver completed the Tolerance for Risk in Play Scale (TRIPS), and the caregivers of children with HL also completed the Auditory Behavior in Everyday Life (ABEL) questionnaire.

RESULTS

TRIPS total scores were significantly higher in the NH group (p < .05). Mothers of children with HL had lower TRIPS scores than mothers of children with NH (p < .05). Similarly, lower TRIPS scores were found in the lower income group with HL (p < .05). A weak positive correlation was observed between TRIPS and both the ABEL total score (p < .05, r = .207) and ABEL auditory awareness score (p < .05, r = .204) in the hard of hearing group.

CONCLUSIONS

The study found that caregivers of children with HL have less tolerance for risky play. Additionally, caregivers of children with better auditory skills were more tolerant of risky play. Therefore, it is suggested that caregivers of children using appropriate hearing devices should be informed that they do not need to be overly restrictive during play, and these children should be encouraged to engage in risky play.

The effect of social appearance anxiety and loneliness on nomophobia levels of young adults

BACKGROUND

Nomophobia can be defined as a disorder in which people fear being away from their smartphone. Studies on the determinants of nomophobia in young adults seem to be limited.

AIM

This study aims to determine the levels of nomophobia, social appearance anxiety and loneliness in young adults and to examine the effects of social appearance anxiety and the level of social and emotional loneliness on nomophobia levels.

DESIGN

This is a descriptive and correlational study. Data were collected from 687 young adults. Data were collected using the Information Form, the Nomophobia Scale, the Social Appearance Anxiety Scale, and the Social and Emotional Loneliness Scale for Adults. Descriptive and multiple linear regression statistics were used.

RESULTS

The mean Nomophobia Scale score of the participants was 73.76 ± 27.46, which points to moderate nomophobia levels. The findings revealed those with a high level of social appearance anxiety have higher nomophobia levels. It was revealed that social appearance anxiety, social and emotional loneliness explain 8 % (Adjusted R2 = 0.082) of the variance in the nomophobia.

CONCLUSION

A sample of 687 participants showed that young adults were relatively moderately nomophobic. In this study, social appearance anxiety, social and emotional loneliness was determined as predictor of nomophobia.

Differentiation between atypical anorexia nervosa and anorexia nervosa using machine learning

OBJECTIVE

Body mass index (BMI) is the primary criterion differentiating anorexia nervosa (AN) and atypical anorexia nervosa despite prior literature indicating few differences between disorders. Machine learning (ML) classification provides us an efficient means of accurately distinguishing between two meaningful classes given any number of features. The aim of the present study was to determine if ML algorithms can accurately distinguish AN and atypical AN given an ensemble of features excluding BMI, and if not, if the inclusion of BMI enables ML to accurately classify between the two.

METHODS

Using an aggregate sample from seven studies consisting of individuals with AN and atypical AN who completed baseline questionnaires (N = 448), we used logistic regression, decision tree, and random forest ML classification models each trained on two datasets, one containing demographic, eating disorder, and comorbid features without BMI, and one retaining all features and BMI.

RESULTS

Model performance for all algorithms trained with BMI as a feature was deemed acceptable (mean accuracy = 74.98%, mean area under the receiving operating characteristics curve [AUC] = 74.75%), whereas model performance diminished without BMI (mean accuracy = 59.37%, mean AUC = 59.98%).

DISCUSSION

Model performance was acceptable, but not strong, if BMI was included as a feature; no other features meaningfully improved classification. When BMI was excluded, ML algorithms performed poorly at classifying cases of AN and atypical AN when considering other demographic and clinical characteristics. Results suggest a reconceptualization of atypical AN should be considered.

PUBLIC SIGNIFICANCE

There is a growing debate about the differences between anorexia nervosa and atypical anorexia nervosa as their diagnostic differentiation relies on BMI despite being similar otherwise. We aimed to see if machine learning could distinguish between the two disorders and found accurate classification only if BMI was used as a feature. This finding calls into question the need to differentiate between the two disorders.

Perfectionistic Self-Presentation and Psychopathology: A Systematic Review and Meta-Analysis

Decades of research implicate perfectionism as a risk factor for psychopathology. Most research has focused on trait perfectionism (i.e., needing to be perfect), but there is a growing focus on perfectionistic self-presentation (PSP) (i.e., the need to seem perfect). The current article reports the results of a meta-analysis of previous research on the facets of PSP and psychopathology outcomes (either clinical diagnoses of psychiatric disorders or symptoms of these disorders). A systematic literature search retrieved 30 relevant studies (37 samples; N = 15,072), resulting in 192 individual effect-size indexes that were analysed with random-effect meta-analysis. Findings support the notion of PSP as a transdiagnostic factor by showing that PSP facets are associated with various forms of psychopathology, especially social anxiety, depression, vulnerable narcissism and-to lesser extent-grandiose narcissism and anorexia nervosa. The results indicated that there both commonalities across the three PSP and some unique findings highlighting the need to distinguish among appearing perfect, avoiding seeming imperfect and avoiding disclosures of imperfections. Additional analyses yielded little evidence in the results across studies including undergraduates, community samples and clinical samples. Our discussion includes a focus on factors and processes that contribute to the association between PSP and psychopathology.

Social appearance anxiety among the dark tetrad and self-concealment

This study analyzed the effects of the Dark Tetrad (narcissism, Machiavellianism, psychopathy, sadism) and self-concealment on social appearance anxiety. Empirical investigations on which personality traits influence social appearance anxiety are yet missing. In this study, a sample of N = 1186 Chinese students performed a questionnaire-based survey assessing different personality facets and social appearance anxiety tendencies. Measures included the Narcissistic Personality Inventory, the Levenson Self-Report Psychopathy Scale, the Machiavellian Personality Scale, the Short Sadistic Impulse Scale, the Self-concealment Scale, and the Social Appearance Anxiety Scale. The results of the multiple regression analysis showed that psychopathy, Machiavellianism, sadism, and self-concealment positively predicted social appearance anxiety and narcissism negatively predicted social appearance anxiety. Machiavellianism, psychopathy, sadism, and self-concealment were positive predictors of social appearance anxiety, whereas narcissism was a negative predictor. These findings provide insight into the complex nature of the Dark Tetrad and their influence on social appearance anxiety.

Unravelling the veil of appearance anxiety: exploring social media use among Chinese young people

The purpose of this study is to explore the relationship between appearance anxiety and social media use among Chinese adolescents. Using a grounded theory approach, the study conducted two-round online interviews with ten Chinese university students and subsequently constructed a theoretical model of social media appearance anxiety among Chinese young people. The results of the study indicate that social media has a dual impact on appearance anxiety. On one hand, increased social media engagement amplifies appearance anxiety by shaping aesthetic standards and fostering comparative environments. On the other hand, diverse aesthetic perspectives and authentic presentations on social media partially alleviate appearance anxiety by promoting acceptance of unique appearances and boosting self-confidence. It is emphasized in this study that there should be an in-depth understanding of the dual impact and complicated relationship of social media on the daily lives of Chinese adolescents to further develop relevant strategies that promote healthy social media behavior among youth. Furthermore, this study calls for efforts to actively promote the healthy image and psychological well-being of adolescents while alleviating the negative impact of appearance anxiety and overall mental health. Such efforts are needed to ensure a positive and healthy development for the younger generation.

The Unique and Moderating Role of Social and Self-Evaluative Factors on Perinatal Eating Disorder and Depression Symptoms

Pregnancy and postpartum represent a critical transition period for changes in eating disorder (ED) symptoms and depression. Past research has established a relationship between ED and depressive symptoms during pregnancy. However, changes in depression and ED symptom across stages of pregnancy and postpartum, and factors that influence this relationship, remain understudied. Social factors and self-evaluative factors may be important given rapidly changing social pressures and expectations during this transitional time. The current study (N = 454 pregnant women) examined (1) differences in ED and depressive symptoms across pregnancy and postpartum and (2) whether social factors (social appearance anxiety; social support) and self-evaluative factors (maladaptive perfectionism; self-compassion) moderate the relationship between depression and ED symptoms cross-sectionally and prospectively. Study aims, hypotheses, and data analysis were preregistered on the Open Science Foundation (osf.io). This study did not identify differences in ED or depression symptoms across women at different stages of pregnancy; however, depression symptoms significantly improved within individuals from pregnancy to postpartum. ED symptoms and all social and self-evaluative factors were uniquely associated with depression during pregnancy. ED symptoms, maladaptive perfectionism, social appearance anxiety, and self-compassion during pregnancy significantly predicted postpartum depression, when accounting for prenatal depression. During pregnancy, but not postpartum, when social support and self-compassion were low, and when maladaptive perfectionism was high, there was a stronger relationship between ED and depression symptoms. ED symptoms and social and self-evaluative factors could be targeted in routine medical care and stepped-care interventions to improve maternal mental healthcare and prevent postpartum depression.

Clinical and psychological impact of lip repositioning surgery in the management of excessive gingival display

Background

Excessive gingival display (EGD), also known as a gummy smile, is characterized by overexposure of the maxillary gingiva on smiling. EGD can cause embarrassment and reduce patient satisfaction. This study aimed to evaluate the clinical and psychological effects of lip repositioning surgery on the management of EGD.

Methodology

This experimental study enrolled 14 patients with EGD who had undergone a modified lip repositioning technique, which comprised moving two strips of mucosa bilaterally to the maxillary labial frenum and repositioning the new mucosal margin coronally. The extent of gingival display (GD), lip mobility (LM), total lip length (TLL), lip length (LL), and internal lip length (ILL) was measured at baseline and 6 months postoperatively. The pre-operative psychological assessment was conducted using the social appearance anxiety scale (SAAS) scores, whereas the postoperative assessment was conducted using SAAS and visual analog scale (VAS) scores at 1 week, 3 months, and 6 months postoperatively.

Results

Among the clinical parameters, TLL increased by 2.0 ± 1.038, LL increased by 2.28 ± 0.99, ILL reduced by 2.78 ± 1.36, LM reduced by 3.21 ± 1.12, and GD reduced by 3.14 ± 0.77 at 6 months postoperatively. Among the psychological parameters, SAAS reduced by 31.42 ± 1.907 from the baseline to 6 months, whereas the VAS score reduced to 3.14 ± 0.27 at 6 months postoperatively.

Conclusion

A significant reduction in GD, which is largely dependent on strict case selection, pain, and social anxiety was observed in this study, indicating that lip repositioning surgery is effective in managing EGD.

Social Appearance Anxiety Scale: a psychometric investigation and evaluation of the influence of individual characteristics on social appearance anxiety in Brazilian adults who practice physical exercise

Introduction

Evaluating signs of anxiety related to body appearance is becoming increasingly important in contemporary society and, in this sense, the Social Appearance Anxiety Scale (SAAS) seems an interesting alternative of measurement.

Objectives

To evaluate the psychometric properties of the Portuguese version of the SAAS when applied to Brazilian adults who practice physical exercise and verify the influence of individual characteristics on participants' social appearance anxiety.

Methods

This was a cross-sectional study conducted online. The participants completed the SAAS and a demographic questionnaire. The psychometric properties of the SAAS one-factor model were evaluated using confirmatory factor analysis. A structural model was built for men and women to verify the influence of individual characteristics of the participants on social appearance anxiety.

Results

1,495 individuals participated in the study (70.8% women; mean age = 29.5, SD = 8.9 years). The data obtained with the SAAS presented good indicators of validity and reliability for both genders (CFI > 0.97, TLI > 0.97, SRMR = 0.04, α > 0.97, ω > 0.85). For both men and women, greater levels of social appearance anxiety were observed among younger participants, who had a higher body mass index, self-reported an eating disorder, and perceived a change in their body after the onset of the COVID-19 pandemic. For women specifically, higher income and having started physical exercise more recently were associated with greater levels of social appearance anxiety.

Conclusion

The findings supported the validity and reliability of the data obtained with the SAAS and revealed that when investigating social appearance anxiety in future research and clinical protocols, specific individual characteristics should be considered.

The Relationship between Anxious-Ambivalent Attachment and Social Appearance Anxiety in Adolescents: The Serial Mediation of Positive Youth Development and Instagram Addiction

The prevalence of social appearance anxiety among adolescents has increased in recent years. It can be said that one of the reasons for this situation is appearance-oriented social media applications. Attachment styles in adolescents may play a role in social appearance anxiety, as in many types of anxiety. However, adolescents' positive youth development levels may have a protective role against social appearance anxiety. Therefore, this study investigated the serial mediator roles of Instagram addiction and positive youth development in the relationship between anxious-avoidant attachment style and social appearance anxiety in adolescents. The research was carried out with 508 high school students. As a result of the research, it was determined that anxious-avoidant attachment and Instagram addiction predicted social appearance anxiety positively. It was determined that positive youth development predicted social appearance anxiety negatively. In addition, mediating roles in the relationship between positive youth development and Instagram addiction, anxious-avoidant attachment and social appearance anxiety were found significant in the study.

Examination of Social Appearance Anxiety through Psychological Theories

Social appearance anxiety, which is expressed as a type of social anxiety, is defined as the state of tension and anxiety experienced by people when their physical appearance is evaluated by others. In the literature, there are studies examining the factors that increase or decrease social appearance anxiety and the negative effects of social appearance anxiety. However, it is noteworthy that psychological theories are not included in the examination of social appearance anxiety, which is a common problem experienced by almost everyone at certain periods of their lives. Addressing the concept of social appearance anxiety from a theoretical perspective will contribute to the understanding of the concept, better planning of future research, and will also fill the gap in the literature. In this context, in this review study, the concept of social appearance anxiety is explained, and then the concepts related to its analysis in terms of psychological theories are discussed.

The Effect of Appearance Anxiety on Social Anxiety among College Students: Sequential Mediating Effects of Self-Efficacy and Self-Esteem

Social anxiety is a serious psychological problem prevalent among Chinese college students, and appearance anxiety plays an important role in its development. Although some studies have explored the relationship between the two, the mediating mechanism is unclear. This study constructed a sequential mediation model based on the cognitive-behavioral theory of body image disorder and social phobia to explore the mediating role of self-efficacy and self-esteem. A total of 234 college students were recruited using the convenience sampling method, including 68 males (29.10%) and 166 females (70.90%), with an average age of 21.25 years (SD = 1.75). Data were collected using the Social Appearance Anxiety Scale, the General Self-Efficacy Scale, the Self-Esteem Scale, and the Interaction Anxiety Scale. The study's results demonstrated a significant and positive predictive relationship between appearance anxiety and social anxiety (effect = 0.21, SE = 0.04, 95% CI = [0.13, 0.29], p < 0.001). Appearance anxiety not only directly affects social anxiety but also has three indirect paths affecting social anxiety: the independent mediating effect of self-efficacy (effect = 0.03, SE = 0.01, 95% CI = [0.00, 0.06], p < 0.001), the independent mediating effect of self-esteem (effect = 0.03, SE = 0.02, 95% CI = [0.01, 0.07], p < 0.001), and the serial mediation effect of self-efficacy and self-esteem (effect = 0.01, SE = 0.01, 95% CI = [0.00, 0.03], p < 0.001). Direct and indirect effects accounted for 73.81% and 26.19% of the total effect, respectively. These findings provide new perspectives on the intervention with and treatment of social anxiety in college students.

Profiles of experienced and internalized weight-based stigma in college students across the weight spectrum: Associations with eating disorder, depression, and anxiety symptoms

OBJECTIVE

Weight stigma comprises negative attitudes and weight-related stereotypes that result in rejection, discrimination, and prejudice against individuals in larger bodies. Both internalized and experienced weight stigma are associated with negative mental health outcomes, yet it remains unknown how types of stigmatizing experiences (e.g., systemic vs. intraindividual), internalized stigma, and weight status relate, or how profiles of weight stigma differentially impact mental health.

METHOD

The current study (N = 1001 undergraduates) used latent profile analysis to identify weight stigma risk profiles and test whether profiles were cross-sectionally associated with eating disorder symptoms, depression, and social appearance anxiety.

RESULTS

The best-fitting solution indicated a class high on all facets of weight stigma, a class low on all facets of weight stigma, and three groups with intermediate levels of weight, weight bias internalization, and experienced weight stigma. Gender, but not ethnicity, was associated with class membership. Classes with higher experienced and internalized stigma had higher eating disorder symptoms, depression, and social appearance anxiety.

CONCLUSION

Findings support the utility of weight stigma profiles in identifying risk for negative mental health outcomes. These findings can inform initiatives to reduce weight stigma among college students, especially among high-risk groups.

Systematic Review and Meta-Analysis of the Correlation Coefficients between Nomophobia and Anxiety, Smartphone Addiction, and Insomnia Symptoms

Nomophobia is an emerging phenomenon in the 21st century. Consequently, it results in various health problems, both physical and psychological. The following systematic review and meta-analysis aimed to establish the relationship between nomophobia with anxiety, smartphone addiction, and insomnia. To identify the relevant studies, we searched through several databases. Out of the 1523 studies identified, 16 studies met the inclusion criteria. After conducting the statistical analysis, the results revealed that anxiety r = 0.31 (95% CI: 0.25 to 0.38), smartphone addiction r = 0.39 (95% CI: 0.04 to 0.75), and insomnia r = 0.56 (95% CI: 0.38 to 0.75) are positively associated with nomophobia. Mobile phone usage has become inevitable, even for individuals who use it to a lesser degree than others, to perform simple tasks, such as communicating with others or for educational purposes. It is crucial to raise awareness about the consequences of overusing these devices, including the physical and psychological complications in both the short and long terms.

Comparison of Social-Evaluative Anxiety and Theory of Mind Functions in Social Anxiety Disorder, Schizophrenia, and Healthy Controls

INTRODUCTION

Despite the similarities in poor social competence and clinical manifestations of poor social behavior, no study has compared the theory of mind performance between social anxiety disorder (SAD) and schizophrenia, considering the effect of social-evaluative anxiety and neurocognitive functions. In our study, we aimed to compare the theory of mind functions and social-evaluative anxiety between patients with SAD and schizophrenia and healthy controls and to examine the relationship between the theory of mind, neurocognitive skills, and social-evaluative anxiety.

METHODS

Thirty-four consecutive patients with schizophrenia, 29 patients with SAD, and 30 controls matched by age, education level, and sex were enrolled in the study. Structured Clinical Interview for DSM, Beck Depression Inventory, Liebowitz Social Anxiety Scale, Theory of Mind measures (Reading the Mind in the Eyes Test, Hinting Task, Faux Pas Test), Social Appearance Anxiety Scale, Fear of Positive Evaluation Scale, Fear of Negative Evaluation Scale-Short Form, and neuropsychological tests were administered to all participants.

RESULTS

A greater significant deterioration in theory of mind and neurocognitive functions was found in patients with schizophrenia compared to those with SAD and healthy controls. Social evaluation anxiety was highest in patients with SAD. Although social-evaluative anxiety was associated with the theory of mind function in schizophrenia, only fear of positive evaluation was associated with SAD. In all groups, neither theory of mind nor neurocognitive ability measures were correlated with social anxiety levels and related symptoms.

CONCLUSIONS

The impaired theory of mind functioning detected in our study is more prominent in the schizophrenia group and largely independent of anxiety in schizophrenia and SAD. Although social evaluation anxiety, as a transdiagnostic concept, seems to be independent of theory of mind function in general, fear of positive evaluation seems to be associated with hinting in both disorders.

Deconstructing the components model of addiction: an illustration through "addictive" use of social media

The components model of addiction posits that all addictions share six components, namely salience, tolerance, mood modification, relapse, withdrawal, and conflict. This highly influential model has resulted in the development of numerous psychometric instruments that measure addictive behaviors according to these criteria. However, recent research suggests that, in the context of behavioral addictions, certain components constitute peripheral features that do not distinguish non-pathological from pathological behavior. Using "addictive" use of social media as a representative example, we examined this perspective by testing whether these six components actually assess central features of addiction, or whether some of them constitute peripheral features that are not indicative of a disorder. Four independent samples totaling 4,256 participants from the general population completed the Bergen Social Media Addiction Scale, a six-item psychometric instrument derived from the components model of addiction to assess social media "addiction". By performing structural equation modeling and network analyses, we showed that the six components did not form a unitary construct and, crucially, that some components (i.e., salience, tolerance) were not associated with measures assessing psychopathological symptoms. Taken together, these results suggest that psychometric instruments based on the components model conflate central and peripheral features of addiction when applied to behavioral addictions. This implies that such instruments pathologize involvement in appetitive behaviors. Our findings thus call for renewing the conceptualization and assessment of behavioral addictions.

Social physical anxiety and eating disorders: A systematic review and meta-analysis

The present study's aim was to summarize existing quantitative evidence linking social physique anxiety (SPA) and eating disorders (ED). Eligible studies were searched for up to June 2, 2022 in six databases: MEDLINE, Current Contents Connect, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global. Studies were considered eligible if they included information derived from self-report instruments that allowed for computing the relationship between SPA and ED. Pooled effect sizes (r) were computed using three-level meta-analytic models. Potential sources of heterogeneity were examined using univariable and multivariable meta-regressions. Influence analyses and a three-parameter selection model (3PSM) were used for the purpose of examining the robustness of the results and publication bias, respectively. Results summarizing 170 effect sizes from 69 studies (N = 41,257) showed two main groups of findings. Firstly, that SPA and ED were very largely related (i.e., r = .51). Secondly, that this relationship was stronger (i) among individuals from Western countries, and (ii) when ED scores concerned the diagnostic feature of bulimia/anorexia nervosa involving body image disturbances. The present study adds to the current understanding of ED by suggesting that SPA is a maladaptive emotion with a potential role in the onset and maintenance of these group of pathologies.

Attention bias modification add-on to inpatient treatment for young women with anorexia nervosa-A randomized controlled trial

Patients with anorexia nervosa (AN) display elevated anxiety and attention biases (ABs) in threat processing. Attention bias modification treatment (ABMT) is considered promising for anxiety disorders, but its potential for AN is limited. In this study, 154 young women hospitalised because of AN were assigned to ED-related and anxiety-related threat stimuli, or to a non-ABMT intervention control condition in a randomized control trial. Hundred-and-ten patients completed the study. ABMT was an add-on to the regular inpatient treatment. Research participants completed two pretreatment training sessions and eight biweekly sessions of ABMT. AB, ED-related symptoms, depression, anxiety and stress were assessed before and after ABMT in the research groups, and, similarly, 5 weeks apart, in the controls. We found that despite the different patterns of change in AB between the three groups following ABMT, the reduction in AB, or the between-group differences in AB-reduction, were not significant. While the severity of ED-symptoms, depression, anxiety and stress was reduced following ABMT, or control condition, in all groups, there were no between-group differences in these changes. Changes in AB were not correlated with baseline and pre-post-treatment changes in ED-related and comorbid symptomatology. Methodological and inpatient treatment-related considerations may explain our negative ABMT-related results.

Strong Correlations between Social Appearance Anxiety, Use of Social Media, and Feelings of Loneliness in Adolescents and Young Adults

Social appearance anxiety is a type of social anxiety that is associated with body image perception and exacerbated by the use of social media, leading to feelings of loneliness. The purpose of this cross-sectional study was to examine the relations between social appearance anxiety, use of social media, and feelings of loneliness in Greek adolescents and young adults. The sample of the research consisted of 632 participants, 439 women (69.5%) and 193 men (30.5%), aged 18-35 years. The Social Appearance Anxiety Scale (SAAS), the Social Media Disorder Scale (SMDS), and the UCLA Loneliness Scale were the instruments used. Data collection was performed online, via Google forms. Multiple regression analyses were performed and demonstrated a significant positive correlation between the Social Appearance Anxiety Scale and the UCLA Loneliness Scale scores. The feeling of loneliness was predicted by the social appearance anxiety score (p < 0.0001). On the other hand, there was a significant negative correlation between the Social Appearance Anxiety Scale and the Social Media Disorder Scale scores (p = 0.002), suggesting that social media use may exacerbate appearance anxiety and, hence, loneliness. The findings suggest that there may be a complex, vicious reverberatory cycle between appearance anxiety, use of social media, and feelings of loneliness in some young people.

The Effect of Social Appearance Anxiety on the Online Impulse Purchases of Fashionable Outfits Among Female College Students During Pandemic Periods: The Mediating Role of Self-Control and the Moderating Role of Subjective Socioeconomic Status

Purpose

With the rise of social media, an increasing number of young females have focused more attention on their body image, leading to social appearance anxiety. Thus, the current study aimed to investigate a moderated mediation model of social appearance anxiety and online impulse purchases of fashionable outfits through self-control moderated by subjective socioeconomic status during the pandemic.

Methods

A total of 1651 female college students (Age = 17-24, M_age = 19.30, SD = 1.14) with more than one month of closed-off management experience completed self-report questionnaires concerning social appearance anxiety, self-control, online impulse purchases of fashionable outfits, and subjective socioeconomic status.

Results

After controlling for the potential influence of coronavirus stress, the results indicated that social appearance anxiety was positively related to online impulse purchases of fashionable outfits among female college students during the pandemic, mediated by self-control. Furthermore, subjective socioeconomic status moderated the indirect link between social appearance anxiety and the online impulse purchase of fashionable outfits. Specifically, subjective socioeconomic status buffers the negative effect of social appearance anxiety on self-control and the risk effect of low self-control on the online impulse purchases of fashionable outfits.

Implications

The current study deepens the research on the relationship between social appearance anxiety and online impulse purchases during pandemic periods; meanwhile, it provides evidence for preventing excessive online impulse purchases of fashionable outfits among young females.

'Everybody is watching me': A closer look at anxiety in people with facial palsy

OBJECTIVES

Objectives were to evaluate the sociodemographic and disease-related factors, and coping style associated with social interaction and social appearance anxiety in people with unilateral facial palsy.

METHODS

Medical data were extracted from electronic health records, and participants completed the Social Interaction Anxiety Scale (SIAS), Social Appearance Anxiety Scale (SAAS), and Coping Orientation to Problems Experienced inventory. Associations of SIAS and SAAS scores with sociodemographic and disease variables, and coping were assessed with multiple linear regression.

RESULTS

Among 111 participants (mean age 58.6 years; 59% women), higher age and greater use of emotion-focused coping were associated with lower SIAS scores, whereas greater use of avoidant coping was associated with higher SIAS scores. Higher age, male sex, and greater use of emotion-focused coping were associated with lower SAAS scores, whereas greater use of avoidant coping was associated with higher SAAS scores.

CONCLUSIONS

Healthcare providers should understand that women and younger people are more likely to have social appearance concerns and that this is not predicted by the objective severity of facial palsy.

Farklı Yaşam Dönemlerindeki Kadınların Sosyal Görünüş Kaygısı ve Sağlıklı Yaşam Biçimi Davranışlarının Değerlendirilmesi

Giriş: Kadınların farklı yaşam dönemlerine göre sosyal görünüş kaygılarının ve sağlıklı yaşam biçimi davranışlarının belirlenmesi önemlidir. Amaç: Farklı yaşam dönemlerindeki kadınların sosyodemografik ve obstetrik özelliklerini değerlendirmek ve sosyal görünüş kaygısı ile sağlıklı yaşam biçimi davranışları arasındaki ilişkiyi belirlemek amacıyla yapılmıştır. Yöntem: Çalışma tanımlayıcı ve ilişki arayıcı tiptedir. Çalışmanın örneklemini farklı yaşam dönemlerinden 404 kadın oluşturmuştur. Veriler kişisel bilgi formu, Sosyal Görünüş Kaygısı Ölçeği (SGKÖ) ve Sağlıklı Yaşam Biçimi Davranışları Ölçeği-II (SYBÖ-II) kullanılarak toplanmıştır. Veriler tanımlayıcı istatistiklerin yanı sıra Kruskal Wallis testi, One Way Anova test, Mann Whitney U testi ve korelasyon analizi ile değerlendirilmiştir. Bulgular: Kadınların sosyal görünüş kaygılarının ve sağlıklı yaşam biçimi davranışlarının yaşam dönemlerine göre anlamlı farklılık göstermediği belirlenmiştir (p>.05). Kadınların medeni durum, bki, gelir düzeyi, gebelik sayısı değişkenleri ile SGKÖ medyan puanları arasında; gelir düzeyi ile SYBDÖ-II arasında anlamlı bir farklılık olduğu belirlenmiştir. Kadınların SGKÖ ve SYBDÖ-II toplam puan ortalamaları arasında negatif yönde anlamlı ilişki saptanmıştır (r=-.247; p

The Psychosocial Impact of Chronic Facial Dermatoses in Adults

INTRODUCTION

Skin diseases have negative psychological and social consequences, especially when they are chronic and affect a visible area of the body, such as the face.

OBJECTIVES

The purpose of this study is to investigate and compare the psychosocial impact of three common chronic dermatoses of the face: acne, rosacea, and seborrheic dermatitis.

METHODS

The Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and Social Appearance Anxiety Scale (SAAS) were used to compare acne, rosacea, and seborrheic dermatitis patients and healthy controls. The relationships between DLQI, HADS, and SAAS results were investigated, as well as their associations with disease duration and severity.

RESULTS

The study included 166 acne patients, 134 rosacea patients, 120 seborrheic dermatitis patients, and 124 controls. The patient groups had significantly higher DLQI, HADS, and SAAS scores than the control group. Rosacea patients had the highest DLQI and SAAS scores, as well as the highest anxiety prevalence. Patients with seborrheic dermatitis had the highest rate of depression. The DLQI, HADS, and SAAS results were moderately correlated with each other, but their relationship with disease duration and severity was insignificant or weak at best.

CONCLUSIONS

Chronic facial dermatoses have a detrimental impact on mood and quality of life. Although patients with acne, rosacea, and seborrheic dermatitis have distinct lesions, the outcomes in terms of quality of life, anxiety, and depression are largely similar. Furthermore, these patients report similar levels of social anxiety as a result of their overall appearance.

Stigma, social appearance anxiety and coping in men and women living with skin conditions: A mixed methods analysis

BACKGROUND

The psychological impact of living with a skin condition can have a profound impact on quality of life and could cause appearance-related social anxiety. Existing research suggests ambiguous findings in relation to whether the impact of living with a skin condition differs between males and females.

OBJECTIVES

The present study aimed to explore the association between stigma, coping styles and social appearance anxiety in men and women living with a skin condition in the United Kingdom.

METHODS

231 participants (n = 199 females, n = 30 males, n = 2 non-binary) completed a cross-sectional online questionnaire, capturing quantitative data with the social appearance anxiety scale (SAAS), the shortened version of the coping inventory for stressful situations (CISS-21), and qualitative data from free-text comments and thematic content analysis. Respondents were also asked to provide additional free text comments in relation to the challenges faced and how these were managed.

RESULTS

Content analysis revealed that males and females faced daily practical, social and emotional challenges and coped with them in several ways; with higher levels of social appearance anxiety associated with both higher perceived severity of skin condition and younger age. Males and females appeared equally as emotionally affected by living with a skin condition, with the only significant gender difference being females as significantly more likely to engage in avoidant coping behaviours than males.

CONCLUSIONS

Living with a skin condition presents daily practical, social, and psychological challenges for males and females that have the potential to impact on quality of life. Findings highlight the need for dermatological care to routinely address these issues, and psychosocial interventions must be made available to promote healthy coping with skin conditions.

Predictors of Orthorexia Nervosa behavior in women within the framework of the theory of planned behavior

PURPOSE

This study aims to examine the predictors of Orthorexia Nervosa behavior in women.

DESIGN AND METHODS

This cross-sectional study was conducted with 418 women of reproductive age in Turkey.

FINDINGS

More positive attitudes towards healthy eating and higher levels of control were significantly associated with more positive intentions. High Orthorexia Nervosa and low control were significantly associated with high body mass index.

PRACTICE IMPLICATIONS

Within the framework of the Theory of Planned Behavior, predictors of Orthorexia Nervosa behavior in women were determined as an attitude towards healthy eating, perceived behavioral control, intention, and body mass index.

Men have eating disorders too: an analysis of online narratives posted by men with eating disorders on YouTube

Eating Disorders (ED) among men are still surrounded by stigma and gender stereotypes, with a common misconception that ED are an exclusively female condition. This study employed a gender-sensitive approach to uncover males' critical needs for effective treatment and recovery. We qualitatively analyzed a sample of twenty-five videos posted on YouTube by men with ED, presenting personal stories of recovery and recovery in-progress. Through thematic analysis of the narratives, we identified three common factors increasing disordered eating behaviors in men: 1) bullying, 2) drive for muscularity, and 3) self-regulation. In addition, we found three major themes related to barriers preventing men from help-seeking: 1) shame and stigma, 2) lack of knowledge and information, and 3) low level of perceived doctor-patient communication. The findings of this study can contribute to the conceptualization of future interventions and recovery programs designed to prevent and treat ED in men.

The contribution of social media addiction to adolescent LIFE: Social appearance anxiety

The use of social media by adolescents, who spend about 3 hours a day on social media, is dominated by visual communication. Nowadays, appearance ideals are presented through social media platforms. Exposure to these popular ideals of appearance could cause appearance-based anxiety and adolescents to develop binge-eating behavior. This cross-sectional study was conducted to determine social appearance anxiety, social media addictions, and emotional eating behaviors of adolescents. 1363 adolescents, living in the Central Anatolian Region of Turkey, were included in the study. Data were collected with a Questionnaire form, the Social Appearance Anxiety Scale (SAAS), Social Media Addiction Scale (SMAS), and Emotional Eating Scale (EES-C). 24.4% of adolescents are social media addicts. No relationship was found between adolescents' social appearance anxiety, social media addictions, and emotional eating behaviors. However, social appearance anxiety and social media addictions of girls, those who perceive their family income as low and who think that they are influenced by social media influencers have higher anxiety. The value of this study is that it shows that gender, low income perception, time spent on social media, being influenced by influencers, following influencers who share diet and nutrition content, and social media addiction are associated with social appearance anxiety. As a result, it is thought that social media addiction and being affected by social media influencers increase social appearance anxiety in adolescents and pose a risk in terms of adolescents' mental health.

Investigation of the relationship between social appearance anxiety and perceived social support in patients with burns

INTRODUCTION

Since burns affect body image, they cause appearance anxiety. Interventions designed to reduce appearance anxiety that can cause psychological problems such as depression are important. This study aimed to determine the social appearance anxiety of individuals following burns and the factors affecting it and to examine the relationship between social appearance anxiety and perceived social support.

METHODS

This descriptive study was conducted between November 2018 and November 2019 with 106 adult patients with burns. Data were collected using a Personal Information Form, the Social Appearance Anxiety Scale, and the Multidimensional Scale of Perceived Social Support. Shapiro-Wilk test, Independent Two Samples T-Test, One Way Analysis of Variance, Duncan's test, Pearson's correlation analysis, multiple linear regression analysis, the Q-Q plot, and the Durbin-Watson statistics were used in data analysis.

RESULTS

The social appearance anxiety scores were moderate (39.38 ± 17.71). Being single; having a high level of education; burns on the face, head, or neck; burn-related amputation; and passing the one-week after injury period were found to significantly increase social appearance anxiety (p < 0.05). Although the perceived social support scores of the individuals with burns were high (68.34 ± 18.08), they were found to have no correlation with social appearance anxiety (p > 0.05).

CONCLUSIONS

The results of this study show that social support does not affect social appearance anxiety. In this respect, we recommend that interventions such as reconstruction and professional psychological support initiatives be prioritized for individuals with burn trauma who are evaluated to have high social appearance anxiety by the appearance anxiety scales.

Effect of resilience on social appearance anxiety in Turkish early adolescents

PROBLEM

Preventive and supportive nursing care interventions of school nurses are very important in the early adolescence period, in which the significant physical and sexual changes occur. One ramification of these changes may be social appearance anxiety. This study was carried out to investigate the effects of resilience on social appearance anxiety among early adolescents.

METHODS

The study was a cross-sectional design. The study data were collected between February and June 2018. Study sample consists of 495 early adolescents studying at a state secondary school in Turkey. The data were gathered using personal information form, Social Appearance Anxiety Scale (SAAS), and Child and Young Resilience Measure (CYRM-12). The data were analyzed using the independent-sample t test, one-way analysis of variance, and multiple linear regression methods.

FINDINGS

In the present study, the mean age of early adolescents was found to be 11.90 (1.07) years. The mean scores of students in SAAS and CYRM-12 were 31.79 (13.30) and 52.96 (5.86), respectively. Social appearance anxiety scores of early adolescents were found to have a negative effect on the resilience levels (β = -0.294).

CONCLUSIONS

It can be suggested to teach adolescents, the interventions about the use of active coping skills aiming to decrease social appearance anxiety and to increase the resilience.

The efficacy of change in limb volume on functional mobility, health-related quality of life, social appearance anxiety, and depression in patients with lower extremity lymphedema

Objectives

This study aims to investigate the impact of change in limb volume on the levels of functional mobility, health-related quality of life, social appearance anxiety, and depression before and after complex decongestive physiotherapy in patients with lower extremity lymphedema.

Method

Twenty-seven patients with unilateral lower extremity lymphedema were included. The treatment period was 20 sessions. The outcome measures were the limb volume, the Timed Up and Go test, the Short Form-36, the Social Appearance Anxiety Scale, and the Beck Depression Inventory.

Results

A statistically significant decrease in the limb volume ( p < 0.001) and statistically significant improvements in the Timed Up and Go test performance ( p < 0.001), the Short Form-36 Physical Component Summary score ( p < 0.01), the Social Appearance Anxiety Scale score ( p < 0.001), and the Beck Depression Inventory score ( p < 0.001) were found. No statistically significant difference was found on the Short Form-36 Mental Component Summary score ( p > 0.05).

Conclusion

The decrease in the limb volume improves the functional mobility, physical health-related quality of life, social appearance anxiety, and depression in patients with lower extremity lymphedema, but not the mental health-related quality of life.

Predictors of Embarrassment in Daily Social Interactions in Social Phobia, Major Depression and Healthy Controls

Introduction: Embarrassment is a social affect. Once experienced in social interactions (SIs), it can be a precursor of clinical symptoms like depersonalization and ruminative thinking. This experience sampling study investigated predictors of embarrassment in social phobia (SP), major depressive disorder (MDD), and controls. Methods: For seven days, a total of n = 165 patients (n = 47 SP, n = 118 MDD) and n = 119 controls completed five surveys per day on their smartphones. The effect of social anxiety and depression facets on embarrassment was examined in contemporaneous and time-lagged models. Results: Individuals with SP or MDD experienced more embarrassing SIs than controls. Among facets of depression, feelings of guilt, and low self-worth significantly predicted embarrassment in contemporaneous, but not in time-lagged models. Among facets of social anxiety, worries about other people's opinion and worries of saying or doing something wrong during a social interaction significantly predicted embarrassment (contemporaneous and time-lagged; all p < .05). Discussion: The study reveals important cognitive factors that accompany embarrassment in SIs and that connect social experience and clinical symptoms. Targeting these putative dysfunctions could be an important strategy in therapy. The differential patterns in SP and MDD are discussed.

Further support for the validity of the social appearance anxiety scale (SAAS) in a variety of German-speaking samples

PURPOSE

Eating disorders (ED) and social anxiety disorder are highly comorbid with potentially shared symptoms like social appearance anxiety (SAA) referring to a fear of being negatively evaluated by others' because of overall appearance. SAA constitutes a risk factor for eating psychopathology and bridges between EDs and social anxiety disorder.

METHODS

The present studies examined internal consistency, factor structure, test-retest reliability, gender and age invariance, convergent validity and differences between individuals with and without an ED of a German version of the social appearance anxiety scale (SAAS) in four independent samples (n₁ = 473; n₂ = 712; n₃ = 79; n₄ = 33) including adolescents and patients with EDs.

RESULTS

Consistently, the SAAS showed excellent internal consistency (ωs ≥ 0.947) and a one-factorial structure. Convergent validity was shown via high correlations of the SAAS with social anxiety (e.g., social interaction anxiety r = 0.642; fear of negative evaluation rs ≥ 0.694), body image disturbance measures (e.g., shape concerns rs ≥ 0.654; weight concerns rs ≥ 0.607; body avoidance rs ≥ 0.612; body checking rs ≥ 0.651) and self-esteem (r = -0.557) as well as moderate correlations with general eating psychopathology (e.g., restrained rs ≥ 0.372; emotional r = 0.439; external eating r = 0.149). Additionally, the SAAS showed gender and age invariance and test-retest reliability after 4 weeks with r = 0.905 in Study 2 and was able to discriminate between individuals with and without an ED in Study 4.

CONCLUSION

Hence, the German version of the SAAS can reliably and validly assess SAA in female and male adolescents or adults with or without an ED. Additionally, the SAAS might be used in a therapeutic context to especially target patient groups suffering from EDs with comorbid social anxiety.

LEVEL OF EVIDENCE

Level III: Evidence obtained from cohort or case-control analytic studies.

Systematic Review of Digital Interventions for Adolescent and Young Adult Women's Body Image

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.

Eating attitudes and depressive symptoms in a LGBTIQ sample in Turkey

BACKGROUND

Lesbian, gay, bisexual, transgender, intersexual and queer (LGBTIQ) individuals are often stigmatized due to their minority status. Sexual-minority stress is often discussed as a risk factor for the increased mental health problems reported in this population.

OBJECTIVE

The current study (1) investigated eating attitudes and depressive symptoms in a sexual minority sample from Turkey who identify themselves as LGBTIQ and (2) explored the role of sexual minority stressors beyond the potential predictors of eating attitudes and depressive symptoms in this population.

METHODS

Recruitment was supported and streamlined by several Turkish NGOs and LGBTIQ community networks. Sociodemographic measures, eating attitudes, depressive symptoms, sexual minority stressors (e.g., heterosexist experiences, internalized homophobia), and the potential predictors of eating attitudes and depressive symptoms were assessed with an anonymous online survey between February 2022 and June 2022. The sample consisted of 440 participants. The mean age was 31.92 (SD = 11.82). The majority of the participants reported their current gender identity as male (64.3%; n = 440) and their sexual orientation as attracted to men (62.8%; n = 439). For 79.7% of the participants, the assigned sex at birth was man (n = 439).

RESULTS

Two separate three-stage multiple hierarchical regression analyses were conducted, controlling for sociodemographic characteristics and the risk and protective factors of eating attitudes and depressive symptoms. Disturbed eating attitudes were predicted by assigned female sex at birth, higher scores for depression, social isolation, and the total number of heterosexist experiences, and lower distress related to heterosexist experiences. Depressive symptoms were predicted by assigned female sex at birth, lesbian sexual orientation, disturbance in eating attitudes, increases in generalized anxiety, and distress related to daily heterosexist experiences.

CONCLUSION

The current study demonstrated the significant role of sexual minority stressors in the prediction of disturbed eating attitudes and depressive symptomatology beyond the general psychosocial vulnerability factors. These findings emphasize the need for developing strategies to reduce prejudicial attitudes at the societal level and to enhance the skills of LGBTIQ individuals in coping with sexual minority stressors in Turkey.

#childhoodobesity - A brief literature review of the role of social media in body image shaping and eating patterns among children and adolescents

Children's food preferences are closely related to their parents' food preferences and knowledge of food is linked to what their parents share with them. Parents, however, are not the only people who model such behavior. Paradoxically, the ubiquitous technological development can also pose a huge threat. In developed countries, 94% of teenagers use social media platforms such as: Instagram, Snapchat, Facebook, or TikTok, and this also applies to children. It can therefore be argued that parents' nutritional preferences and behavior are related to the same behaviors of children and there is an extensive literature on this subject. It is therefore important to check how other factors - new technology (and social media in particular) - can influence changes in this area. A literature search was conducted in the following databases: Google Scholar, PubMed, EBSCO in December 2021. After applying all the filters and verification of relevance in terms of the research on the topic of interest to us, 4 articles related to research on body image and social media and 4 articles related to research on food choices and social media among children and adolescents were obtained. The conducted analysis showed that various studies so far indicate that social media can have a very strong influence on the development of eating patterns and body image in children and adolescents, which in turn may be one of the risk factors for developing obesity when promoted behaviors are not associated with a healthy lifestyle. It is also worth pointing out that social media can be used as a resource in the prevention and treatment of obesity. A closer look at this topic seems to be particularly important due to the fact that, among adults, social media is not only a very important source of information about lifestyle, but also a source of social support when people attempting to lose weight. Therefore, by increasing preventive activity in social media and using modern solutions related to social media (including the use of hashtag signs), we can have a greater impact on the health awareness of children and adolescents around the world.

The unique and moderated relationships across repetitive negative thinking and disordered eating behaviors in adolescent girls

OBJECTIVE

Repetitive negative thinking (RNT) is associated with eating disorder (ED) symptoms, but few studies have evaluated how RNT may relate to specific ED behaviors (e.g., fasting, binge eating). Furthermore, little research has examined RNT in adolescent girls, a critical population for ED development. Concern over mistakes perfectionism (i.e., preoccupation with and overvaluation of errors) and social appearance anxiety are transdiagnostic risk factors for EDs that may be amplified by RNT, contributing to the development of ED behaviors.

METHOD

The current study (N = 332 female high school students) explored RNT in an adolescent sample and tested whether RNT was uniquely associated with fasting/binge eating and moderated the relationships between social appearance anxiety/perfectionism and fasting/binge eating.

RESULTS

RNT was not associated with fasting and did not significantly moderate the relationship between social appearance anxiety/perfectionism and fasting. RNT was positively associated with binge eating but did not moderate the relationship between social appearance anxiety/perfectionism and binge eating.

CONCLUSIONS

RNT may contribute differentially to specific ED behaviors such as fasting and binge eating during ED development. If replicated in prospective data, these findings suggest targeting RNT in adolescence may decrease binge eating.

The Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program: protocol for a two-arm parallel partially nested randomized controlled feasibility trial with progression to full-scale trial

BACKGROUND

Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. We completed an initial feasibility trial of an online self-administered version of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program using the cohort multiple randomized controlled trial (RCT) design. Due to low intervention offer uptake, we will conduct a new feasibility trial with progression to full-scale trial, using a two-arm parallel, partially nested RCT design. The SPIN-SELF Program has also been revised to include facilitator-led videoconference group sessions in addition to online material. We will test the group-based intervention delivery format, then evaluate the effect of the SPIN-SELF Program on disease management self-efficacy (primary) and patient activation, social appearance anxiety, and functional health outcomes (secondary).

METHODS

This study is a feasibility trial with progression to full-scale RCT, pending meeting pre-defined criteria, of the SPIN-SELF Program. Participants will be recruited from the ongoing SPIN Cohort ( http://www.spinsclero.com/en/cohort ) and via social media and partner patient organizations. Eligible participants must have SSc and low to moderate disease management self-efficacy (Self-Efficacy for Managing Chronic Disease (SEMCD) Scale score ≤ 7.0). Participants will be randomized (1:1 allocation) to the group-based SPIN-SELF Program or usual care for 3 months. The primary outcome in the full-scale trial will be disease management self-efficacy based on SEMCD Scale scores at 3 months post-randomization. Secondary outcomes include SEMCD scores 6 months post-randomization plus patient activation, social appearance anxiety, and functional health outcomes at 3 and 6 months post-randomization. We will include 40 participants to assess feasibility. At the end of the feasibility portion, stoppage criteria will be used to determine if the trial procedures or SPIN-SELF Program need important modifications, thereby requiring a re-set for the full-scale trial. Otherwise, the full-scale RCT will proceed, and outcome data from the feasibility portion will be utilized in the full-scale trial. In the full-scale RCT, 524 participants will be recruited.

DISCUSSION

The SPIN-SELF Program may improve disease management self-efficacy, patient activation, social appearance anxiety, and functional health outcomes in people with SSc. SPIN works with partner patient organizations around the world to disseminate its programs free-of-charge.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04246528 . Registered on 27 January 2020.

The KOALA-study: study protocol for a comprehensive study of cognitive biases in adolescent anorexia nervosa patients compared to healthy and clinical controls

BACKGROUND

Anorexia nervosa (AN) is characterized by dysfunctional cognitions including cognitive biases at various levels of information processing. However, less is known about the specificity of these biases, i.e., if they occur for eating-disorder-related information alone or also for non-eating-disorder-related emotional information in AN patients (content-specificity) and if they are unique to individuals with AN or are also shown by individuals with other mental disorders (disorder-specificity).

METHODS

The present study systematically assesses cognitive biases in 12-18-year-old female adolescents with AN on three levels of information processing (attention, interpretation, and memory) and with regard to two types of information content (eating-disorder-related, i.e., stimuli related to body weight and shape, and non-eating-disorder-related). To address not only content- but also disorder-specificity, adolescents with AN will be compared not only to a healthy control group but also to a clinical control group (adolescents with major depression or particular anxiety disorders). Cognitive biases are assessed within a single experimental paradigm based on the Scrambled Sentences Task. During the task eye movements are recorded in order to assess attention biases while interpretation biases are derived from the behavioural outcome. An incidental free recall test afterwards assesses memory biases. We expect adolescents with AN to show more pronounced negative cognitive biases on all three levels of information processing and for both types of content compared to healthy adolescents. In addition, we expect the specificity of biases to translate into differential results for the two types of content: AN patients are expected to show stronger biases for disorder-related stimuli but similar or less pronounced biases for non-disorder-related stimuli compared to the clinical control group.

DISCUSSION

This is the first study to comprehensively assess cognitive biases in adolescents with AN. It will have essential implications not only for cognitive-behavioural models of AN but also for subsequent studies aiming to modify cognitive biases in this population, thereby addressing important maintaining factors already at an early stage of the disorder.

The Medium is the Message: Effects of Mediums of Communication on Perceptions and Emotions in Social Anxiety Disorder

We examined the use of voice/text and visual mediums and their effects on perceptions and emotions in social anxiety disorder (SAD). Our sample included 88 individuals: 44 individuals with SAD and 44 non-socially-anxious (NSA) individuals. We used an experience sampling methodology (ESM) in which participants received daily links to online measures at random times during the day, for 21 days and reported on social interactions, emotions and perceptions. Results indicated that individuals with SAD used voice/text mediums to a greater extent and used visual mediums to a lesser extent compared to NSA individuals. However, despite preferring voice/text mediums, use of visual mediums resulted in immediate increases in positive perceptions and emotions for individuals with SAD. These findings were above and beyond the effect of depressive symptoms and remained when social anxiety was represented as a continuum of severity. This has important implications for exposure interventions in the treatment of SAD.

Cross-cultural adaptation of the Social Appearance Anxiety Scale to the Portuguese language

ABSTRACT Objectives To perform the cross-cultural adaptation of the Social Appearance Anxiety Scale (SAAS) to the Portuguese language and estimate its internal consistency in a sample of Brazilian young adults. Methods The cross-cultural adaptation process followed international references based on five stages (translation, synthesis, back-translation, expert assessment, and pretest) to assess idiomatic, semantic, conceptual, and cultural equivalence. The internal consistency was estimated by the ordinal alpha coefficient (α). Results The new Portuguese version is presented in this study with minor changes from the original that did not violate the meaning of the items. This version was tested in 30 adults (women = 56.7%, M age = 26.0 [SD = 6.2] years) who understood the content. The participants completed the scale in an average time of 4.6 (SD = .6) minutes. The internal consistency of the scale was good (α = .95) when applied in a sample of 80 adults (women = 51.2%, M age = 28.0 [SD = 5.7] years). Conclusions The new Portuguese version of the SAAS was equivalent to the original in the idiomatic, semantic, and conceptual area. As the Brazilian participants understood the Portuguese version, cultural equivalence was found. The instrument’s internal consistency was adequate to the sample. The findings of this study may help researchers and clinicians interested in using the SAAS in Brazilian context for tracking characteristic symptoms of social anxiety due to physical appearance. However, before using SAAS in any protocol, it is important to evaluate its psychometric properties, especially the construct validity.

Mask-Wearing Behavior During the COVID-19 Pandemic: A Cross-Cultural Comparison Between the United States and South Korea

This study identified and compared factors that directly and indirectly influenced face mask-wearing in the United States and South Korea during the COVID-19 pandemic by applying the theory of reasoned action. The overall levels of attitudes and future mask-wearing behavioral intention were lower for United States than Korean participants (N _US = 150 and N _{South Korea} = 150). Differences between the groups were noted in the impact of norms and background characteristics on attitudes and behavioral intention. Messages communicating the importance of wearing masks should be tailored to different cultures. Americans should be encouraged to try wearing masks on their own while Koreans should hear about the social benefits of mask-wearing.

The Positive Body Image among Adolescents Scale (PBIAS): Conceptualization, development, and psychometric evaluation among adolescents from Belgium

In this study, we aimed to offer a conceptualization of positive body image during adolescence and psychometrically examine a new scale developed to measure this conceptualization. A literature review on positive body image and adolescence was conducted, which shaped the development of the Positive Body Image among Adolescents Scale (PBIAS). In Study 1, four focus groups (totaling 14 adolescents) from Belgium explored the content, clarity, and applicability of the PBIAS items. In Study 2, an exploratory factor analysis (N = 565; M_age = 14.9, 63.8 % girls) revealed 4 factors: body self-appreciation, body other-appreciation, resilience against media body ideals, and resilience against negative appearance feedback. This 4-factor structure was confirmed in Study 3 (N = 718; M_age = 15.2, 50.4 % girls), and gender invariance was upheld. The test-retest reliability of the PBIAS scores was partially supported in Study 4 (N = 309, M_age = 15.3, 66.3 % girls). Across studies, internal consistency was supported and construct validity (convergent and incremental) evidence was garnered. Further, the PBIAS was translated from Dutch to English to offer researchers an option for collecting data in English-speaking countries. Overall, the PBIAS is a brief measure with psychometric support that assesses four dimensions of adolescent positive body image.