1
|
Donofre GS, Campos JADB, dos Santos PC, Marôco J, Campos LA, da Silva WR. 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. Front Psychol 2023; 14:1261605. [PMID: 38106390 PMCID: PMC10723900 DOI: 10.3389/fpsyg.2023.1261605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Giovanna Soler Donofre
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), São Paulo, Brazil
| | | | - Priscila Carvalho dos Santos
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), São Paulo, Brazil
| | - João Marôco
- William James Center for Research (WJCR), University Institute of Psychological, Social, and Life Sciences (ISPA), Lisbon, Portugal
- Flu Pedagogy, Nord University, Bodø, Norway
| | - Lucas Arrais Campos
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
- School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - Wanderson Roberto da Silva
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), São Paulo, Brazil
- Postgraduate Program in Food, Nutrition, and Food Engineering, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| |
Collapse
|
2
|
Lampe EW, Presseller EK, Abber SR, Sonnenblick RM, Juarascio AS, Manasse SM. Affective profiles of exercise episodes are associated with maladaptive and adaptive motivations for exercise. EUROPEAN EATING DISORDERS REVIEW 2023; 31:863-873. [PMID: 37436089 PMCID: PMC11256205 DOI: 10.1002/erv.3012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/26/2023] [Accepted: 07/01/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE Maladaptive exercise (i.e., driven and/or compensatory exercise) is common in binge-spectrum eating disorders (EDs; e.g., bulimia nervosa, binge ED) and associated with adverse treatment outcomes. Alternatively, individuals with EDs are often also engaging in adaptive exercise (e.g., for enjoyment or health improvement), and increasing adaptive exercise may decrease ED symptoms. The current study aimed to understand which exercise episodes are likely to be maladaptive/adaptive so that interventions can appropriately decrease/increase maladaptive and adaptive exercise. METHOD We used latent profile analysis (LPA) to identify pre-exercise affective profiles of 661 exercise episodes among 84 individuals with binge-spectrum EDs and examined associations between LPA-identified profiles and subsequent exercise motivations using ecological momentary assessment. RESULTS A two-profile solution best fit our data: Profile 1 (n = 174), 'positive affectivity,' and Profile 2 (n = 487), 'negative affectivity.' Episodes in the 'negative affectivity' profile were more likely to be endorsed as both driven and intended to influence body shape/weight. Episodes in the 'positive affectivity' profile were more likely to be endorsed as exercising for enjoyment. CONCLUSIONS Results support two phenotypes of exercise episodes, and differential associations of these phenotypes with adaptive and maladaptive motivations for exercise.
Collapse
Affiliation(s)
- Elizabeth W. Lampe
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Emily K. Presseller
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Sophie R. Abber
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Ross M. Sonnenblick
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S. Juarascio
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M. Manasse
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
3
|
Lampe EW, Trainor C, Presseller EK, Michael ML, Payne-Reichert A, Juarascio AS, Manasse SM. Characterizing reasons for exercise in binge-spectrum eating disorders. Eat Behav 2021; 43:101558. [PMID: 34454172 PMCID: PMC8629836 DOI: 10.1016/j.eatbeh.2021.101558] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022]
Abstract
Although 40-60% of individuals with eating disorders (EDs) report engaging in maladaptive exercise, self-reported reasons for engaging in exercise vary. Further, no studies have examined momentary reasons for exercise and whether reasons for exercising could be both adaptive and maladaptive for any episode. Examining reasons for exercise can inform interventions which more effectively target maladaptive exercise. The current study recruited adults with binge-spectrum EDs (N = 58, 89.2% Female) and assessed self-reported reasons for exercise using ecological momentary assessment over 7-14 days. Exercise episodes were categorized as maladaptive if the participant endorsed exercising to compensate for eating or feeling driven to exercise. On average, participants reported exercising 8 times (SD = 8) over the 7-14 days. On average, 73% of exercise episodes were maladaptive. Participants most frequently stated exercising to control shape or weight (67.2% of episodes), feeling driven (62.9%), and exercising as part of a routine (52.9%). Participants least endorsed exercising so that they could eat more later (9.8%). Participants reported a mean of 3.6 reasons for exercising at each episode (SD = 1.85, mode = 1.0). As hypothesized, individuals with EDs were exercising for several reasons at each exercise episode. Further, the extent to which each exercise episode is maladaptive varied between participants and even within a single participant's exercise episodes. These findings underscore the importance of research evaluating when, and for whom, exercise becomes maladaptive, as well as research examining other characteristic features of maladaptive and adaptive exercise in EDs.
Collapse
Affiliation(s)
- Elizabeth W Lampe
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychology, Drexel University, Philadelphia, PA, United States.
| | - Claire Trainor
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Emily K Presseller
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Megan L Michael
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Adam Payne-Reichert
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States
| | - Adrienne S Juarascio
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Stephanie M Manasse
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States
| |
Collapse
|
4
|
Lampe EW, Forman EM, Juarascio AS, Manasse SM. Feasibility, Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 29:598-613. [PMID: 36171804 PMCID: PMC9512260 DOI: 10.1016/j.cbpra.2021.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Bulimia nervosa (BN) is characterized by a pattern of binge eating and compensatory behaviors as well as an overemphasis on body weight and shape in self-evaluation. Although cognitive behavioral therapy (CBT) is efficacious, recent reviews suggest that only 30% of patients reach abstinence at posttreatment. One potential reason for these poor outcomes is that CBT fails to adequately reduce elevated negative affect (NA) and shape and weight concern, which have been shown to be correlated with poorer treatment outcomes in BN. Therefore, novel treatment components that focus on improving NA and shape and weight concern are needed in order to enhance outcomes. Promoting physical activity (PA) is a promising avenue through which to reduce NA and improve body image in healthy individuals, other clinical populations (e.g., individuals with depression or anxiety), and individuals with eating disorders. While prescribing PA for individuals with BN has been controversial (due to concerns that exercise maybe be used to compensate for binge episodes or become driven or compulsive), this approach may have many benefits, including promoting healthy lifetime exercise habits that reduce likelihood of relapse through the improvement of emotion regulation skills and weight regulation. Given the promise of PA for targeting key maintenance factors of BN, we developed a 12-session healthy PA promotion intervention for BN and tested initial feasibility, acceptability, and preliminary target engagement in an iterative case series design (n = 3). The treatment provided cognitive-behavioral skills designed to identify, practice, and achieve behavioral goals while asking patients to engage in up to 150 minutes of moderate-to-vigorous PA per week, which was preplanned during each session with the client's therapist. Results suggested that the healthy PA promotion intervention was both feasible and acceptable to deliver. In addition, the intervention resulted in a clinically significant decrease in BN symptom frequency in each participant. Further, participants showed clinically significant decreases in NA and shape and weight concern. The current study demonstrates that healthy PA interventions can have beneficial effects on BN symptoms, NA, and shape and weight concern. However, due to the small sample size, conclusions must be treated with caution. Future research should investigate additional approaches for promoting healthy PA and include a larger sample in order to further test initial efficacy of this treatment approach.
Collapse
|
5
|
van Mierlo LA, Scheffers M, Koning I. The relative relation between body satisfaction, body investment, and depression among dutch emerging adults. J Affect Disord 2021; 278:252-258. [PMID: 32971318 DOI: 10.1016/j.jad.2020.09.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/29/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Depression is one of the biggest global health problems, especially among emerging adults (18 to 25). A negative body image is a well-known risk factor for the development of depressive symptoms. However, little is known about how different aspects of body image relate to depressive symptoms. Therefore, the current study explores the relation between body satisfaction, body investment, and depressive symptoms, moderated by sex and physical activity, among a non-clinical sample of emerging adults. METHODS Cross-sectional data from 410 Dutch emerging adults (Mage = 21.95 years, SD = 1.98, 80.60% women) within a convenience sample was used within a hierarchical multiple regression analysis. RESULTS Results showed that a higher body satisfaction and more body investment were related to fewer depressive symptoms. This relation was somewhat stronger for body investment than for body satisfaction. Furthermore, the relation between lower body satisfaction and more depressive symptoms was stronger for participants with a lower level of physical activity. No other moderation effects were found. LIMITATIONS This results should be seen within the light of their limitations. This study used cross-sectional data and therefore no causal relations can be determined. Also, the sample was biased in which mostly highly educated females participated. CONCLUSIONS However, this research is unique for adding different concepts of body image in one model. The findings propose that interventions regarding depressive symptoms among emerging adults should focus, next to body satisfaction, on the emotional investment in the body and the enhancement of physical activity.
Collapse
Affiliation(s)
- Lieselot A van Mierlo
- Windesheim University of Applied Sciences, Campus 2, 8017 CA Zwolle, the Netherlands.
| | - Mia Scheffers
- Windesheim University of Applied Sciences, Campus 2, 8017 CA Zwolle, the Netherlands
| | - Ina Koning
- Utrecht University, Padualaan 14, 3584 CH Utrecht, the Netherlands
| |
Collapse
|