Review of Body Image and some of Contributing Factors in Iranian Population

Association between lifestyle-related risk behaviors, chronic diseases, and body image distortion: gender differences in follow-up 1 of the ELSA-Brasil cohort

Aim

To determine the prevalence of body image accuracy/distortion in Brazilian men and women and to investigate sociodemographic and lifestyle-related factors, and the presence of chronic diseases associated with body image distortion.

Methods

Data from 6,357 men and 7,657 women participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were collected using a multidimensional questionnaire covering sociodemographic characteristics, health behaviors, heath conditions and body image perception.

Results

Most participants (53.5% of the women and 54.7% of the men) were found to have an accurate self-perception of their body. When the factors associated with the perception of being heavier than reality were investigated, adopting weight loss measures and not being hypertensive proved protective against this distortion, both in women and men. Conversely, the perception of being lighter than reality was associated, in both women and men, with better education, being black or of mixed race, adopting weight loss measures and not being hypertensive or diabetic. Additional factors associated with underestimating weight were not consuming alcohol (only in women) and belonging to a lower social class (only in men).

Conclusion

These findings may contribute to the implementation of public health policies and interventions to promote health and well-being in the Brazilian population.

Role of family communication patterns as predictors of behavioral health among students of public universities in north of Iran

BACKGROUND

Communication is one of the oldest and greatest human achievements and the basis of social life. The aim of this study was to evaluate the role of family communication patterns as predictors of behavioral health among students of public universities in the north of Iran.

MATERIALS AND METHODS

In this cross-sectional study, a total of 461 students from all the public universities of Babol, Iran, were selected in 2019. A stratified sampling random method was used to select the samples. The demographic characteristics, Depression Anxiety Stress Scale, Acceptance and Action Questionnaire, Rosenberg self-esteem questionnaire, and Communication Skills Interpersonal Test were used to collect data. Simple and multi-variate linear regressions as well as Pearson's correlation coefficient were utilized for data analysis.

RESULTS

The mean and standard deviation scores of conversation orientation and conformity orientation were 35.61 ± 0.55 and 19.31 ± 0.41, respectively. Family conversation orientation was a significant predictor of behavioral health scales of students (except for acceptance and action), predicting negatively and significantly depression, anxiety, stress, and positively self-esteem and inter-personal communication skills of students. Family conformity orientation was also a significant predictor of behavioral health scales (except for inter-personal communication skills) of students, which predicted positively and significantly depression, anxiety, stress, and negatively acceptance, action, and students' self-esteem.

CONCLUSION

To prevent behavioral health problems, it is necessary to observe conformity orientation and rely on conversation orientation.

The Moderating Effect of Body Appreciation on the Relationship between Self-Esteem and Life Satisfaction

BACKGROUND

Although positive associations between life satisfaction, self-esteem, and body image have previously been established, differences in these variables by gender and age have yielded mixed results. Moreover, little is known about the interplay between self-esteem and body appreciation on life satisfaction. This study aims to investigate the moderating effect of body appreciation on the relationship between self-esteem and life satisfaction, considering disparities between females and males and also between emerging adults (before the age of thirty) and older adults.

METHODS

A cross-sectional online survey was performed in Poland with a sample of 449 adults aged between 18 and 75 (M = 30.41, SD = 12.72), including 68% of women. The survey included the Satisfaction With Life Scale (SWLS), Rosenberg Self-Esteem Scale (RSES), and Body Appreciation Scale (BAS-2).

RESULTS

Men scored higher than women in terms of life satisfaction and self-esteem, while older participants (age > 30) scored higher than younger individuals (age ≤ 30) in terms of life satisfaction, self-esteem, and body appreciation. The study confirmed positive and moderate correlations between life satisfaction, self-esteem, and body appreciation. The interactive effect of self-esteem and body appreciation on life satisfaction was also found by controlling for age and gender.

CONCLUSIONS

Some intervention programs focused on increasing levels of self-esteem and body appreciation should be implemented, especially among women and emerging adults, to improve their well-being.

The Persian version of the body esteem scale among Iranian adolescents: a translation, psychometrics, and network analysis

Introduction

The psychometric properties of the body esteem scale have not been assessed in Iran. Therefore, the aim of this study was to translate and determine the validity and reliability of the Persian version of the body esteem scale among Iranian adolescents.

Methods

The sample of this methodological study consisted of 504 adolescents [mean age: 16.55 (SD = 1.54) years] living in Tehran City, Iran. After translation of the scale, its content validity (quantitative and qualitative) and structural (exploratory and confirmatory factor analysis), convergent, and discriminant validity were evaluated. Exploratory graph analysis was performed to determine the number of factors. Cronbach's alpha, composite reliability, and maximal reliability were calculated.

Results

In the content validity evaluation step, all items had acceptable scores and were retained. The results of exploratory factor analysis with Promax rotation and exploratory graph analysis extracted three factors accounting for 49.49% of the variance, comprising 18 items. Furthermore, after necessary modifications during CFA, the final model was approved. Convergent and discriminant validity were confirmed. Cronbach's alpha, CR, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability.

Conclusion

According to the results, the Persian version of the body esteem scale has a valid structure and acceptable reliability. Health professionals, in many ways, can use this scale.

The effect of sexual education on the postpartum women's sexual self-confidence and self-efficacy: a theory-based intervention

INTRODUCTION

Pregnancy, childbirth, and the postpartum period cause significant physical and psychological changes in mothers, leading to changes in their sexual self-concept and adverse effects on their sexual self-confidence and self-efficacy. Therefore, this study aimed to determine the effect of sexual education on postpartum women's sexual self-efficacy and self-confidence.

METHOD

This randomized interventional study was conducted on 115 women who had given birth at least six weeks ago and attended healthcare centers. Using convenience sampling, the researchers randomly allocated the participants into two intervention and control groups through a block size of six. The intervention group received six 90-minute online training sessions based on the sexual self-concept model over one month, while the control group received routine care. To collect data, the self-efficacy and sexual confidence questionnaires by Buzwell and Rosenthal were used before the intervention, immediately after the intervention, and one month later.

RESULTS

The study findings demonstrated no significant differences in demographic characteristics, sexual self-confidence, and sexual self-efficacy scores between the two groups before the intervention. However, the repeated measures ANOVA results revealed a substantial increase in sexual self-confidence and self-efficacy scores over time in the intervention group immediately after participating in the training sessions and one month later.

CONCLUSION

Considering the effect of training based on the sexual self-concept model on postpartum women, the researchers recommend using this model to improve their sexual self-efficacy and self-confidence after childbirth.

CLINICAL TRIAL REGISTRATION

This study is registered at the Iranian Registry Clinical Trial (IRCT20220530055025N1).

Exploring Body Image Dissatisfaction and Psychiatric Co-morbidities in Rural India: A Comprehensive Review

This comprehensive review examines the intricate landscape of body image dissatisfaction (BID) in rural India, shedding light on the multifaceted factors influencing individual perceptions and societal expectations. Delving into cultural nuances, economic disparities, and gender-specific experiences, the study highlights the pervasive nature of BID across diverse age groups. Unveiling the complex interplay between BID and psychiatric co-morbidities, such as depression and anxiety, underscores the urgency of integrated mental health interventions. The review concludes with a resounding call to action for policymakers, healthcare professionals, and communities. It advocates for culturally sensitive mental health policies, targeted healthcare training, and community-driven initiatives to foster environments conducive to positive body image and mental well-being. By acknowledging these challenges and committing to collaborative solutions, this review aims to contribute to developing comprehensive strategies that address BID in rural India and pave the way for healthier and more resilient communities.

The Effect of Sociocultural Attitudes on Developing Eating Disorders Among Young Females in Almadinah Almunawarah, Saudi Arabia

BACKGROUND

Eating disorders (ED) are believed to be more susceptible in women due to varied factors involving dissatisfaction with their body and appearance. The exact cause of ED isn't known. But it may be triggered by biological, psychological, environmental, and social factors.

OBJECTIVES

The current literature aims to explore the body dissatisfaction of women from Almadinah Almunawarah and factors that may contribute to developing risk of ED and assess the discrepancies between desired and healthy BMI.

METHODS

The Sociocultural Attitudes Toward Appearance Questionnaire-4 (SATAQ-4) questionnaire surveyed 384 females to explore family, peer, and media pressure, followed by the Eating Attitudes Test-26 (EAT-26) questionnaire to recognize those at risk of developing ED. The body dissatisfaction of the sample was measured by the difference between the healthy BMI and the desired BMI.

RESULTS

A total of 127 of the participants, who were reported to have a high probability of developing an ED, had the highest factor scored in the SATAQ-4 questionnaire being media exposure with a p-value less than 0.001. The study showed a difference in the ideal body and what is considered a healthy BMI. Results showed no correlation between BMI and developing ED.

DISCUSSION

Women of younger age groups are more vulnerable to being under the influence of sociocultural attitudes, thus they are more susceptible to developing risky eating behaviors. This can be affected by family, peers, and media factors.

CONCLUSION

The findings of this study show a high prevalence of risky eating behaviors, particularly among those who experience family and media pressure toward body shape and weight. Peer pressure was also identified as a significant risk factor. These findings emphasize the need for interventions that target sociocultural attitudes and provide support for vulnerable individuals.

Exploring the tripartite influence model of body image and disordered eating among adolescent girls living in Australia, China, India, and Iran

The aim of this study was to evaluate the tripartite influence model of body image and disordered eating among 12-18-year-old girls (N = 900) living in Australia (n = 184), China (n = 293), India (n = 223), and Iran (n = 200). Participants completed measures about appearance pressures from family, peers, and media, thin-ideal internalization, appearance comparisons, appearance satisfaction, and disordered eating. Results indicated that media- pressures were most salient in Australia, whereas Iranians perceived family pressures to be the strongest. Indians felt the most pressure to look attractive from their family and peers, whereas Chinese felt similar levels of pressure from family, peers, and media. Path analyses suggested direct associations from one or more sociocultural factors to appearance satisfaction or disordered eating, with indirect paths via thin-ideal internalization and appearance comparisons emerging in all countries. Certain sociocultural factors contributed more strongly to the internalization of ideals and appearance comparisons within some countries. Multigroup path analyses demonstrated some cross-cultural variations in the strength of the pathways. Findings extend cross-cultural support for a modified tripartite influence model emphasizing culture-based specificities that can further guide preventative efforts to improve body image and eating attitudes among young girls in these four countries.

The effect of counseling with cognitive behavior approach on self-esteem and body image in lactating mothers: randomized clinical trial

BACKGROUND

Some of the women experience low self-esteem and negative body image in pregnancy and postpartum. These two factors along with other factors can reduce the rate of exclusive breastfeeding among women. Cognitive-behavior therapy (CBT) is one of the psychological approaches that is effective on the betterment of many of the psychological and personality disorders such as body image disorders as well as improvement of self-esteem. The aim of this randomized control trial is to recognize the effects of CBT during pregnancy period on self-esteem, body image (primary outcome) and exclusive breastfeeding (secondary outcome).

METHOD

In this randomized controlled trial, 70 eligible pregnant women referring to health centers of Tabriz- Iran were assigned to two groups of 35 as intervention and control groups using randomized blocking method. For intervention group, 8 sessions of CBT based on Cash and Strachan's body image protocol and Michael Free's for self-esteem were performed. Control group was received routine pregnancy care by their health provider. Rosenberg self-esteem scale and multidimensional body self-relation questionnaire (MBSRQ) were completed before intervention, immediately after intervention and 4 weeks after delivery. Likewise, exclusive breastfeeding questionnaire was completed 4 weeks after childbirth. Independent t-test, chi square and repeated measures ANOVA tests were used to analyze the data.

RESULTS

According to repeated measures ANOVA test and with controlling baseline score, the mean scores on self-esteem (AMD): 7.18; 95%confidence interval (CI): 4.43 to 9.94; p < 0.001)) and body image (AMD: 49.74; 95%CI = 28.57 to 70.91; p < 0.001) in the intervention group were significantly higher than the control group. Also, after intervention, the mean score of body image subscales including appearance evaluation (p = 0.010), appearance orientation (p = 0.001), fitness evaluation (p = 0.004), fitness orientation (p = 0.001), health evaluation (p = 0.001), health orientation (p = 0.018), and illness orientation (p = 0.002) was significantly higher in the intervention group than the control group.

CONCLUSIONS

CBT was effective on the improvement of self-esteem and body image and through which might lead to the increase of exclusive breastfeeding among women.

TRIAL REGISTRATION NUMBER

IRCT20110524006582N33. First Date of registration: 17/10/2022. Submission ID 4ca86cd4-8459-4b86-9fe5-63f6a8184956.

The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions

Anorexia nervosa is a psychiatric disorder with an unknown etiology that is characterized by an individual's preoccupation with their weight and body structure while denying the severity of their low body weight. Due to the fact that anorexia nervosa is multifaceted and may indicate the coexistence of genetic, social, hormonal, and psychiatric disorders, a description of non-pharmacological interventions can be used to ameliorate or reduce the symptoms of this condition. Consequently, the purpose of the present narrative review is to describe the profile's context in the anorexic person as well as the support they would require from their family and environment. In addition, it is aimed at examining preventative and non-pharmacological interventions, such as nutritional interventions, physical activity interventions, psychological interventions, psychosocial interventions, and physical therapy interventions. To reach the narrative review aims, a critical review was conducted utilizing both primary sources, such as scientific publications, and secondary sources, such as bibliographic indexes, web pages, and databases. Nutritional interventions include nutritional education and an individualized treatment for each patient, physical activity interventions include allowing patients to perform controlled physical activity, psychological interventions include family therapy and evaluation of the existence of other psychological disorders, psychosocial interventions include management of the relationship between the patient and social media and physical therapy interventions include relaxation massages and exercises to relieve pain. All these non-pharmacological interventions need to be individualized based on each patient's needs.

Effects of maternal pre-pregnancy body mass index and gestational weight gain on antenatal mental disorders in China: a prospective study

BACKGROUND

Maternal obesity is the most common medical condition among women of reproductive age worldwide. The pre-pregnancy body mass index and gestational weight gain have been suggested to be associated with maternal mental disorders. This study aimed to investigate the effects of the pre-pregnancy body mass index and gestational weight gain on antenatal depression, stress, and anxiety.

METHODS

In total, 4,890 pregnant women were enrolled in the present study, which is based on an ongoing prospective cohort study. We used self-reported pre-pregnancy weights and the last weights measured prior to delivery (using professional instruments) to calculate the pre-pregnancy body mass index and gestational weight gain. The questionnaires used included the Center for Epidemiologic Studies Depression Scale (CES-D), Self-Rating Anxiety Scale (SAS), and 10-item version of the Perceived Stress Scale (PSS-10). We used Pearson product-moment correlation and multivariable logistic regression models to examine the impact of the pre-pregnancy body mass index and gestational weight gain on different maternal mental disorders.

RESULTS

After adjusting for conception, annual household income, occupation, education, smoking status, and drinking status, excessive gestational weight gain during pregnancy was associated with a greater chance of anxiety symptoms in the entire sample (adjusted model: odds ratio = 1.479, 95% confidence interval = 1.128, 1.938) and especially in women with a normal body mass index (adjusted model: odds ratio = 1.668, 95% confidence interval = 1.209, 2.302). However, the relationship between the maternal pre-pregnancy body mass index and mental health was not significant.

CONCLUSION

Pregnant women with a normal pre-pregnancy body mass index had a greater chance of experiencing anxiety symptoms before delivery if gestational weight gain was excessive; however, its effects on depression or stress symptoms were not observed. The maternal pre-pregnancy body mass index may not be independently associated with maternal mental disorders.

Neural and behavioral effects of modification of visual attention in body dysmorphic disorder

In individuals with body dysmorphic disorder (BDD), perceptual appearance distortions may be related to selective attention biases and aberrant visual scanning, contributing to imbalances in global vs. detailed visual processing. Treatments for the core symptom of perceptual distortions are underexplored in BDD; yet understanding their mechanistic effects on brain function is critical for rational treatment development. This study tested a behavioral strategy of visual-attention modification on visual system brain connectivity and eye behaviors. We acquired fMRI data in 37 unmedicated adults with BDD and 30 healthy controls. Participants viewed their faces naturalistically (naturalistic viewing), and holding their gaze on the image center (modulated viewing), monitored with an eye-tracking camera. We analyzed dynamic effective connectivity and visual fixation duration. Modulated viewing resulted in longer mean visual fixation duration compared to during naturalistic viewing, across groups. Further, modulated viewing resulted in stronger connectivity from occipital to parietal dorsal visual stream regions, also evident during the subsequent naturalistic viewing, compared with the initial naturalistic viewing, in BDD. Longer fixation duration was associated with a trend for stronger connectivity during modulated viewing. Those with more severe BDD symptoms had weaker dorsal visual stream connectivity during naturalistic viewing, and those with more negative appearance evaluations had weaker connectivity during modulated viewing. In sum, holding a constant gaze on a non-concerning area of one's face may confer increased communication in the occipital/parietal dorsal visual stream, facilitating global/holistic visual processing. This effect shows persistence during subsequent naturalistic viewing. Results have implications for perceptual retraining treatment designs.

Psychometric properties of a Farsi translation of the Functionality Appreciation Scale (FAS) in Iranian adolescents

The 7-item Functionality Appreciation Scale (FAS; Alleva et al., 2017) measures an individual's appreciation of their body for what it can do and is capable of doing (i.e., functionality appreciation). However, few studies have assessed the psychometric properties of the FAS in non-English speaking populations and in younger age groups. Here, we examined the psychometric properties of a novel Farsi translation of the FAS in Iranian adolescent girls and boys. A sample of 828 Iranian adolescents completed the FAS alongside the Rosenberg Self-Esteem Scale and the Beck Depression Inventory-II. Participants were randomly split into a first split-half for exploratory factor analysis (EFA) or a second split-half for confirmatory factor analysis (CFA). The EFA broadly supported a 1-dimensional model of FAS scores, although one item had low item-factor loadings. The CFA indicated that both the 6- and 7-item models had adequate fit. In further analyses, we found that the 7-item unidimensional model was invariant across gender and that higher FAS scores were significantly associated with higher self-esteem and lower depressive symptoms, indicative of convergent validity. These results provide evidence that the Farsi translation of the FAS is reliable and valid for use in Iranian adolescent girls and boys.

Associations between Body Image and Self-Perceived Physical Fitness in Future Spanish Teachers

Body image is a complex construct related to how each person perceives their own body and how they value it. Physical fitness and physical activity are factors that can influence the perception of a better or worse body image. This study aimed to identify the potential associations between body image and physical fitness self-perception in future Spanish teachers, analysing possible sex-related differences. A total of 278 Spanish university students answered the Multidimensional Body Self Relations Questionnaire and the International Fitness Scale, having an average age of 22 years, of which 40% were men and 60% were women. Nonparametric techniques (Spearman's Rho test) were used as the data did not fit normality. The findings showed associations between body image and perceived physical fitness, confirming differences between the sexes. Correlations were found between the first three dimensions of the Multidimensional Body Self Relations and the International Fitness Scale, with sex-related differences being more significant in women than in men, and between the physical abilities self-assessed by the International Fitness Scale (except flexibility) and the dimensions of the Multidimensional Body Self Relations (except Dimension 4). Since body image influences well-being and conditions the time spent exercising, public health organisations and universities should design supports to improve master students' body image through physical activity programmes, education and sex-specific individualised attention.

Factors of body dissatisfaction among lebanese adolescents: the indirect effect of self-esteem between mental health and body dissatisfaction

Background

Body dissatisfaction (BD) rates are alarmingly high, especially among adolescents, thus. Having a better understanding of correlates associated with BD seems to be an important issue in this developmental context. Furthermore, as adolescence is an essential time in the development of self-perception and self-esteem the current study assesses factors associated with BD among Lebanese adolescents and evaluates the indirect effect of self-esteem between depression/anxiety/stress and BD.

Methods

This is a cross-sectional study among 555 Lebanese adolescents, ages 15–18, who completed an online survey incorporating BD, socioeconomic status, weight and height, physical activity index, Rosenberg Self Esteem Scale, Beirut Distress Scale, Hamilton Anxiety Rating Scale, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index and Global Physical Activity Questionnaire.

Results

The results of a stepwise linear regression, taking the body dissatisfaction score as the dependent variable, showed that higher BMI (B = 0.47), feeling pressured by media/TV to lose weight (Beta = 2.80), higher depression (Beta = 0.39), exercising to lose weight (Beta = 1.84) and following a diet to lose weight (Beta = 1.58) were significantly associated with more body dissatisfaction, whereas higher self-esteem (Beta=-0.11) and more psychological distress (Beta=-0.21) were significantly associated with less body dissatisfaction. Self-esteem played an indirect role in the associations between anxiety and body dissatisfaction and stress and body dissatisfaction.

Conclusions

BD is common among young Lebanese adolescents. Treating adolescents with low self-esteem and psychological issues is crucial in preventing anticipated BD and future eating disorders.

Factors Associated with Likelihood to Undergo Cosmetic Surgical Procedures Among Young Adults in the United States: A Narrative Review

Introduction/Goals

Over the past decade, cosmetic surgical procedures have become increasingly popular. This trend has been driven by procedural innovations as well as access to Internet and social media. Consequently, patients have been seeking cosmetic surgical procedures at younger ages. In this narrative review, studies assessing attitudes towards cosmetic surgical procedures among college-aged young adults were evaluated.

Methods

A search identified 20 studies published from 2002 to 2021 that focused on cosmetic surgical procedures among young adults. Each study used survey-based data to determine attitudes, acceptance, interests, perceptions, and beliefs about cosmetic surgical procedures among college-aged students in the United States.

Results

The proportion of college-aged participants who had undergone cosmetic surgical procedures ranged from 1.3% to 6.4% with surveys reporting that between 21 and 43% were interested in procedures in the future. In general, young women were more likely to express interest in cosmetic surgical procedures than young men. Studies consistently demonstrated an inverse relationship between body satisfaction and use of aesthetic procedures among this patient population. Other factors associated with acceptance and approval of cosmetic surgical procedures included importance of appearance to self-worth, concern with social standing and attractiveness, investment in appearance, media influence on body image, and positive attitudes towards celebrities. Exposure to cosmetic surgery advertising was correlated with increased approval of cosmetic surgical procedures, especially the perception that advertising influences "others" more than survey respondents themselves.

Conclusion

Interest in cosmetic surgical procedures continues to grow among young adults in the United States. In the future, this cohort is likely to become an increasingly important demographic to target for education, advertising, and research regarding cosmetic surgical procedures.

Confirmatory factor analysis and psychometric properties of the Persian version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS) in women with polycystic ovary syndrome

PURPOSE

Body image is a multidimensional and complex psychological construct. Since the Multidimensional Body Self-Relation Questionnaire-Appearance Scale (MBSRQ-AS) is a questionnaire that measures body image as a multidimensional construct. This study aimed to translate and evaluate the psychometric properties of the Persian version of MBSRQ-AS.

METHODS

This methodological study was conducted on 251 women with polycystic ovary syndrome referring to polyclinics of hospitals that were covered by Iran University of Medical Sciences, with age ranging from 18 to 46 years old (M = 27.35; SD = 6.32). The mean body mass index (BMI) was 25.59 kg/m² (SD = 4.9). A forward-backward translation procedure was applied. Then face and content validity was inducted.

RESULTS

Face and content validity of the Persian MBSRQ-AS was established. Confirmatory factor analyses showed good fit indices for the five-factor structure (appearance evaluation, appearance orientation, body areas satisfaction, overweight preoccupation, and self-classified weight). The internal consistency (Cronbach's alpha ranged from 0.71 to 0.85) and test-retest reliability by calculating the intraclass correlation coefficient ranged from 0.75 to 0.91 was adequate.

CONCLUSION

This study confirms the factor structure of the MBSRQ-AS. The Persian version of MBSRQ-AS has acceptable psychometric properties.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Body Schema Self-Awareness and Related Dream Content Modifications in Amputees Due to Cancer

PURPOSE

the evaluation of body image perception, pain coping strategies, and dream content, together with phantom limb and telescoping phenomena in patients with sarcoma who underwent surgery for limb amputation.

MATERIAL AND METHODS

consecutive outpatients were evaluated at T0 (within 3 weeks after surgery) and T1 (4-6 months after surgery) as follows: demographic and clinical data collection; the Groningen Questionnaire Problems after Arm Amputation; the West Haven-Yale Multidimensional Pain Inventory; the Body Image Concern Inventory, a clinical trial to identify telescoping; and a weekly diary of dreams. Dream contents were coded according to the Hall and Van de Castle coding system.

RESULTS

Twenty patients completed the study (15 males and 5 females, mean age: 53.9 ± 24.6, education: 7.8 ± 3.4). All subjects experienced phantom limb and 35% of them experienced telescoping soon after surgery, and 25% still after 4-6 months. Both at T0 and T1, that half of the subjects reported dreams about still having their missing limbs. At T1 the patients' perceptions of being able to deal with problems were lower, and pain and its interference in everyday life were higher yet associated with significant engagement in everyday activities and an overall good mood. The dream content analysis highlighted that males were less worried about health problems soon after amputation, and women showed more initial difficulties that seemed to be resolved after 4-6 months after surgery.

CONCLUSIONS

The dream content analysis may improve clinicians' ability to support their patients during their therapeutic course.

The psychometric properties and validity of the Turkish version of the Body Image in Pregnancy Scale (BIPS-Turkish)

In our study, we aimed to assess the validity and reliability of the Turkish version of the Body Image in Pregnancy Scale (BIPS). A total of 220 pregnant women participated in the study. The content validity of the scale was evaluated by the content validity index (CVI) and its construct validity was evaluated by confirmatory factor analysis (CFA). The reliability of the scale was assessed with internal consistency analysis, item analysis, test-retest reliability, and parallel forms reliability. After the modification, the t values, factor loadings and fit indices of the scale items were at a good and acceptable level (χ2 = 1114.57, df = 505, χ2/df = 2.20, RMSEA = 0.07, SRMR = 0.07, CFI = 0.95, GFI = 0.90). Hence, a 34-item, 7-factor construct was confirmed for the Turkish version of the BIPS. Cronbach's alpha internal consistency coefficient of the overall scale was 0.90 and Cronbach's alpha internal consistency coefficients of the subscales were within the range of 0.65-0.94. Test-retest and parallel forms reliability of the scale were at a sufficient level. In conclusion, it was determined that BIPS can be used as a valid and reliable measurement tool to evaluate body image perceptions of Turkish pregnant women.

Novel anthropometric predictors of subjective weight among women

The main aim of the current study was to examine novel anthropometric predictors of subjective weight among women. In this cross-sectional study, 229 women were selected through simple random sampling method. The participants completed the Multidimensional Body Self-Relation Questionnaire. Pearson correlation coefficient and linear regression were used to analyze the data. The mean subjective weight score was 4.05 ± 1.01. There was a significant relationship between anthropometric indices and subjective weight (Pearson r correlation range: 0.62-0.81, p < .01). Beta coefficients for predictor variables indicated that weight (ß = -2.774, t (229) = -2.868, p = .005), hip circumference (ß = 3.454, t (229) = 5.999, p < .001), waist to hip ratio (ß = 4.218, t (229) = 4.953, p < .001), waist to height ratio (ß = -3.284, t (229) = -2.067, p = .04), and conicity index (ß = -0.708, t (229) = -2.518, p = .013) significantly predicted the subjective weight. The waist to hip ratio was the most important predictor of the subjective weight. This study suggests using the waist to hip ratio as an anthropometric index in subjective weight studies in women. Considering the negative impact of subjective weight on women's health, these results indicate the need for interventions designed to control body weight and unsuitable anthropometric indices in women.

Composition and Factorial Invariance for the Assessment of Body Image Dissatisfaction Questionnaire in Mexican Adolescents

Body image is a mental representation that a person has, which could become a body dissatisfaction due to the pressure exerted by the culture, affecting several life stages specially in adolescents. The aim of this study was to analyze the psychometric properties and factorial invariance of the questionnaire to assess body image dissatisfaction. The sample consisted of 552 Mexican teenagers, 259 female, and 293 male, with a mean age of 12.91 ± 0.96 years. Confirmatory Factor Analyses show that a five-factor structure is viable and adequate. The five-factor structure (perceptual, emotional distress, behavioral, proposal to change, and fear of gaining weight) show adequate fit indices and validity, even though the obtained model does not completely correspond to that proposed by the authors of the scale, it continues to endorse the multifactorial component of body dissatisfaction. On the other hand, the factorial structure, the factor loadings, and the intercepts are considered invariant in both populations; however, there are differences between the populations for the means of the perceptual, emotional distress, and fear of gaining weight factors. This study serves as a premise for future research on the study of instruments for measuring body image in populations with different personal and cultural factors.

Dance practice modifies functional fitness, lipid profile, and self-image in postmenopausal women

OBJECTIVE

The aim of the present study was to analyze the effects of dance practice on body composition, metabolic profile, functional fitness, and self-image/self-esteem in postmenopausal women.

METHODS

A total of 36 postmenopausal participants (mean age 57 years) danced three times per week for 90 minutes each day and were evaluated before and after 16 weeks. The parameters evaluated were body composition (body fat and lean mass), blood lipids, functional fitness, self-image, and self-esteem.

RESULTS

Statistical analysis was done using Student t test for paired samples and the Wilcoxon test with P values less than 0.05 considered statistically significant. Lower triglycerides (baseline = 156.5 ± 17.0 mg/dL; after 16-weeks = 131.5 ± 12.9 mg/dL; P < 0.01), higher high-density lipoprotein cholesterol (baseline = 55.4 ± 15.9 mg/dL; after 16 weeks = 60.0 ± 15.4 mg/dL; P < 0.001), and higher total cholesterol (baseline = 199.5 ± 26.8 mg/dL; after 16 weeks = 211.8 ± 35.7 mg/dL; P < 0.01) levels were observed in postmenopausal women. Dance intervention improved coordination (baseline = 8.6 ± 2.6; after 16 weeks = 6.7 ± 1.6; P < 0.001), agility (baseline = 55.9 ± 8.8; after 16 weeks = 64.1 ± 8.3; P < 0.001), and aerobic capability (baseline = 446.8 ± 63.4; after 16 weeks = 377.4 ± 53.8; P < 0.001). Classification of general function fitness index (GFFI) was considered regular at baseline (GFFI of 200-299), but improved after 16 weeks of dance practice (GFFI of 300-399, P < 0.001).

CONCLUSION

The 16-week dance intervention was effective in improving not only the lipid profile and functional fitness of postmenopausal women, but also self-image and self-esteem.

The effect of cognitive behavior therapy on body image and self-esteem in female adolescents: a systematic review and meta-analysis

Low self-esteem and negative body image expose girls to many risks and damages. Cognitive-behavior counseling is one of the ways of improving body image and self-esteem. The aim of this systematic review was to determine the effects of cognitive-behavior therapy on body image and self-esteem of adolescent girls. The English (Cochrane library, Web of sciences, EBSCO, PubMed, Google Scholar) and Persian (SID, MagIran) databases were searched without any time limit. The quality of included studies in terms of risk of bias was assessed using Cochran handbook and the quality of evidence was evaluated through Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analysis was performed using RevMan software. Heterogeneity of studies was analyzed by index I ². Subgroup analysis was performed on the basis of outcome evaluation intervals (after intervention, one month and two months later). A total of 2,664 articles were accessed in different databases of which 2,655 articles were excluded and finally nine studies were systematically reviewed. Meta-analysis results on seven studies (228 participants) showed that the group receiving cognitive-behavior counseling was significantly better than the control group regarding body image (Standardized Mean Difference [SMD]: 13.01; 95% CI: 10.68 to 15.34; I²=26.1%). Likewise, meta-analysis results on two studies (50 participants) showed that self-esteem was not significantly different between the group receiving cognitive-behavior counseling and the control group (SMD: 1.13; 95% CI: -0.7 to 2.32, I²=73%). Meta-analysis results of this study represent effectiveness of cognitive-behavior therapy on body image of adolescent girls; however, since the number of studies in the field of self-esteem is low, more trials in this field with stronger designs are suggested.

The main physical components of body image from the perspectives of Iranian adolescents: a qualitative study

Background

Although different aspects of body image have been extensively studied in Western societies, there is little evidence regarding the main physical components that contribute to perceptions of body image from the perspective of adolescents, especially in Eastern-Mediterranean regions. This study aims to investigate main physical components of body image from the perspectives of Iranian boys and girls.

Methods

This qualitative study has been conducted using a grounded theory approach. The focus of the current study was on identifying the main physical characteristics of body image as perceived by participants. A total of 13 semi-structured focus group discussions were conducted with 84 adolescents (42 girls and 42 boys), aged 15–18 years. All focus group discussions were audio recorded and transcribed verbatim. Data collection continued until saturation was reached.

Results

The mean age and BMI of participants were 16.2±0.9 years and 24.3±8.0 kg/m² respectively. Regarding main physical components of body image, three main themes emerged from the data: 1) perceived face/hair, which included three subthemes-facial features, facial shape/form and hair, 2) perceived body, which included three subthemes-body size, body shape and bone structure and 3) perceived physical functioning which included three subthemes-physical ability, physical health and voice tone. Among mentioned themes, perceived body was the concept which was most frequently addressed by both adolescent boys and girls. Additionally, in terms of the other remaining two themes, when adolescents were talking about their bodies, girls more frequently mentioned their faces and its features, while boys tended to talk more about their physical functioning.

Conclusion

This qualitative study provide further insight into the physical components of body image as perceived by Iranian boys and girls. Current findings indicated that besides those features that focused on body appearance and its aesthetic aspects, physical functioning was another main component of perceived body image by participants. These findings can contribute to the design and implementation of effective interventions aiming at improving body image and its related disorders in Iranian adolescents.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-10096-7.

Body-, eating-, and exercise-related social comparison behavior and disordered eating in college women in the U.S. and Iran: A cross-cultural comparison

Wearing of the hijab is associated with lower eating disorder (ED) attitudes and behaviors in women. However, this potential buffering role of the hijab has been questioned in countries, such as Iran, where its wearing is compulsory. Further, cross-cultural comparisons between disordered eating behaviors and correlates in Iranian and U.S. women are lacking. This study examines social-cognitive correlates of disordered eating in U.S. and Iranian women, comparing rates of ED- related social comparison and eating pathology. College women in the U.S. (n = 180) and Iran (n = 384) completed the Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) and the Eating Disorder Examination-Questionnaire (EDE-Q) in one session. One-way analyses of covariance and partial correlations were used to test the mean differences and inter-correlations between the variables among U.S. and Iranian women. U.S. women endorsed higher BEECOM scores and higher levels of overvaluation of weight and shape and dietary restraint compared to Iranians. Most BEECOM subscales and disordered eating symptoms were inter-correlated in each culture. The tendency to engage in exercise comparison was not significantly correlated with excessive exercise for U.S. women. Correlations between variables were stronger for U.S. women compared to Iranian women. While the ED-related social comparison levels were higher for U.S. women, the typical Western patterns of social comparison and disordered eating extend to Iranian women. Eating disorder-related social comparison is a recommended clinical target in both Eastern and Western cultures.

Validation of a Farsi version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (F-SATAQ-4) in Iranian men and women

Understanding sociocultural factors (i.e., thin-ideal internalization and pressures for thinness) is a key step in managing disordered eating risk. Although sociocultural factors may vary across cultures and nations, studies on populations outside of Europe and North America are sparse, and psychometric data are often lacking. The purpose of this study was to validate a Farsi version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (F-SATAQ-4) in Iranian college students. Participants (age 18-30) were recruited from Iranian universities, resulting in two separate convenience samples for Study 1 (n = 328 men, n = 342 women) and Study 2 (n = 336 men, n = 331 women). In Study 1, which followed back-translation procedure, exploratory factor analyses supported a 5-factor structure of the F-SATAQ-4 for men and women (i.e., thin-ideal internalization, athletic-ideal internalization, family pressure, media pressure, and peers pressure). In Study 2, confirmatory factor analyses confirmed the same structure for men and women. The F-SATAQ-4 subscales scores demonstrated excellent reliability, internal consistency, and weak convergent validity for men and women, as evidenced by significant Pearson's correlations with shape/weight concerns (EDE-Q), appearance evaluation (MBSRQ-AE), social comparison (PACS-R), perceived pressures for thinness (PSPS), BMI, as well as a partial discriminant validity with self-esteem (RSES) in women. Women scored higher on thin-ideal internalization, while men scored higher on athletic-ideal internalization. Participants with higher weights had higher scores on thin-ideal internalization and on family and peers pressures. The Farsi SATAQ-4 is a useful measure of internalization and pressures for thinness among Iranian college men and women.

Correlations between Excessive Body Mass Index, Body Perception, Physical Activity, and Respiratory Functions among Youths in an Urban Setting of Vietnam

Young adults are susceptible to overweight and obesity and their adverse outcomes. However, limited studies have been conducted to understand this health problem in Vietnamese youths. This study was conducted to examine the rate of overweight and obesity, as well as the relationship between this condition on body perception, physical activity, and respiratory function among young adults in Hanoi, Vietnam. We performed a cross-sectional survey with 367 students aged 18-25 years at the Hanoi University of Pharmacy from June 2017 to June 2018. The result showed that the rate of overweight and obesity in our sample was 16.6%. There were 55.7% of overweight/obese students having the misperception of their body image. Results of multivariate regression analysis showed that overweight/obesity increased nearly three times (OR = 2.8, 95% CI: 1.5-5.0) the ability to be active. Overweight/obese students with physical activity had a better respiratory function. To conclude, this study underlined the associations between overweight and obesity with physical activity, body image, and respiratory function in our young sample. Further longitudinal studies should be warranted to examine their causal relationships.

The validity and reliability of the Farsi version of the Body, Eating, and Exercise Comparison Orientation Measure (F-BEECOM) among Iranian male and female students

Body-, eating-, and exercise-related social comparison tendencies are implicated in body dissatisfaction and disordered eating among Western women. To date, no published study examines eating- and exercise-related comparisons in a male or non-Western sample. The current series of studies fills these gaps in the literature by translating and validating the existing measure of these comparisons (the 18-item Body, Eating, and Exercise Comparison Orientation Measure [BEECOM]) in samples of Iranian men and women. In Studies 1 and 2, female (n = 284) and male (n = 302) participants completed the translated Farsi BEECOM. Scores were analyzed by exploratory factor analyses (EFA) revealing two different three factor, 15-item scale structures for men and women. In Studies 3 and 4, participants (female n = 384; male n = 253) completed measures of social comparison and psychological functioning in one session. These data were analyzed using confirmatory factor analyses (CFA) and Pearson correlations. Each CFA yielded adequately fitting models. Results support the use of two different 15-item Farsi BEECOM measures with women and men and highlight unique gender differences in social comparison tendencies. The resulting F-BEECOM demonstrates strong psychometric properties and will be a useful research tool in Iranian women and men.

Self-Esteem and Symptoms of Eating-Disordered Behavior Among Female Adolescents

BACKGROUND

Compared to males, female adolescents show greater concerns about their appearance, concerns related to their self-esteem. We explored the associations between self-esteem, body image and BMI as proxies for appearance, and eating-disordered behavior among adolescent females.

METHODS

A total of 263 females (mean age:15.78 years) took part in this study. They completed questionnaires covering anthropometric characteristics, self-esteem, eating-disordered behavior, subjective physical activity levels, and body image.

RESULTS

Higher scores for self-esteem were associated with higher scores for eating-disordered behavior, indices of physical activity, and slimmer body image. Body image was not associated with eating-disordered behavior. Multiple regression analyses showed that self-esteem, but not physical activity, or body image predicted eating-disordered behavior.

CONCLUSIONS

Among a non-clinical sample of female adolescents, self-esteem and eating-disordered behavior were positively associated. Body image was associated in a complex and contradictory fashion. It is possible that cognitive-emotional mastering of the vital impulse to eat may enhance self-esteem.

Body image among Muslim women in Israel: exploring religion and sociocultural pressures

The study aimed to investigate the association of the Muslim religion, as a multidimensional factor, with social pressures related to body image concerns, among Muslim women in Israel. Four hundred and Seventy-five Israeli Muslim women ages between 18 and 30 years completed questionnaire measures of strength of religious faith, wearing a traditional head cover (the Hijab), positive and negative body image, media exposure, societal pressures to conform to Western body ideals and its internalization, from 2016 to 2018. Strength of religious faith and wearing the Hijab were positively associated with positive aspects of body image, while only strength of religious faith negatively correlated with body dissatisfaction. Further, mediation analyses revealed that the relationship between the strength of religious faith and both positive body image and body dissatisfaction was mediated by media pressures. Notably, reduced peer pressures had more influence on positive body image, while reduced family pressures were more influential for negative body image. These results are discussed with regard to promoting a more intricate and multicultural understanding of body image concepts.

Body image before and after coronary artery bypass graft surgery: comparison and its contributing factors

BACKGROUND

Cardiovascular diseases are the leading cause of death in the world. Coronary artery bypass graft (CABG) surgery is among the treatment options for coronary artery disease. However, it is associated with significant physical and psychological problems. This study sought to compare body image before and after the surgery and to determine its contributing factors.

METHODS

This comparative study was conducted in 2017 on a sample of 140 patients consecutively recruited from Shahid Beheshti hospital, Kashan, Iran. Body image was assessed before and 4 weeks after the surgery (T1 and T2) using Multidimensional Body-Self Relations Questionnaire. The independent-sample and paired t tests, one-way analysis of variance, Pearson correlation test, and multiple regression were conducted for data analysis.

RESULTS

Participants' mean score of body image was 139.60 ± 13.21 at T1 and 160.25 ± 7.75 at T2 and the variation was statistically significant (p = < 0.001). At T1, only the three factors of age (p = 0.005), education at high school diploma and higher levels (p < 0.001), and being housekeeper (P = 0.048) could significantly explain BI (R² = 0.231). However, at T2, none of the factors were significant predictors for BI (P > 0.05).

CONCLUSIONS

Candidates for CABG have poor body image. After the surgery, their body image improves significantly. Healthcare providers need to employ programs to improve body image among these patients.

Association of Health Status and Health Behaviors with Weight Satisfaction vs. Body Image Concern: Analysis of 5888 Undergraduates in Egypt, Palestine, and Finland

Little is known about the relationships between weight satisfaction, body image concern, healthy nutrition, health awareness, and physical activity among college students across culturally different countries. We assessed country and sex-specific associations between health status (self-rated health, depression, BMI), healthy behavior (healthy nutrition, physical activity, health awareness), weight satisfaction, and body image concern via a cross-sectional survey (5888 undergraduates) in Egypt, Palestine, and Finland. This health and wellbeing survey employed identical self-administered paper questionnaires administered at several Universities in two Eastern Mediterranean countries (Egypt, Palestine—Gaza Strip), and an online-survey comprising the same questions in Finland. Regression analyses were employed. Health status variables exhibited the strongest associations; high BMI and more depressive symptoms were more often among students satisfied with their weight (except in Palestine), but they were positively associated with body image concern irrespective of country or gender. Self-rated health was not associated with body image concern or weight satisfaction. Healthy behaviors were not associated with body image concern or weight satisfaction. Depressive symptoms and BMI were the most prominent predictors for body image concern. There were country-specific consistent results when using the body image concern score. Further research is necessary to compare body image across different cultures and countries.