Testing mediators hypothesized to account for the effects of a dissonance-based eating disorder prevention program over longer term follow-up.

Objective: Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method: Data were drawn from a randomized effectiveness trial in which 306 female high school students (mean age = 15.7 years, SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Results: Dissonance-intervention participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Conclusions: Findings provided support for the intervention theory of this eating disorder prevention program over longer term follow-up, extending the evidence base for this effective intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Body dissatisfaction, ethnic identity, and disordered eating among African American women.

Initial research suggested that only European American women developed eating disorders (Garner, 1993), yet recent studies have shown that African American women do experience them (e.g., Lester & Petrie, 1998b; Mulholland & Mintz, 2001) and also may be negatively affected by similar sociocultural variables. In this study, we examined a sociocultural model of eating disorders for African American women but included the influences of ethnic identity (e.g., Hall, 1995; Helms, 1990). Participants (N = 322) were drawn from 5 different universities. They completed measures representing ethnic identity, societal pressures regarding thinness, internalization of societal beauty ideals, body image concerns, and disordered eating. Structural equation modeling revealed that ethnic identity was inversely, and societal pressures regarding thinness directly, related to internalization of societal beauty ideals. Societal pressures regarding thinness was also related to greater body image concerns. Both internalization of societal beauty ideals and body image concerns were positively associated with disordered eating (R2 = .79). Overall, the final model fit the data well, supporting its generalizability and the importance of ethnic identity in determining risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body image across the life span in adult women: The role of self-objectification.

This study aimed to investigate women's body image across the entire life span from within the theoretical perspective provided by objectification theory (B. L. Fredrickson & T.-A. Roberts, 1997). In a cross-sectional study, a sample of 322 women ranging in age from 20 to 84 years completed a questionnaire measuring body dissatisfaction, self-objectification, and its proposed consequences. Although body dissatisfaction remained stable across the age range, self-objectification, habitual body monitoring, appearance anxiety, and disordered eating symptomatology all significantly decreased with age. Self-objectification was found to mediate the relationship between age and disordered eating symptomatology. It was concluded that objectification theory helps clarify the processes involved in the changes in body image that occur with age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dissonance and healthy weight eating disorder prevention programs: Long-term effects from a randomized efficacy trial.

Adolescent girls with body dissatisfaction (N = 481, SD = 1.4) were randomized to a dissonance-based thin-ideal internalization reduction program, healthy weight control program, expressive writing control condition, or assessment-only control condition. Dissonance participants showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment and lower risk for eating pathology onset through 2- to 3-year follow-up than did assessment-only controls. Dissonance participants showed greater decreases in thin-ideal internalization, body dissatisfaction, and psychosocial impairment than did expressive writing controls. Healthy weight participants showed greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment; less increases in weight; and lower risk for eating pathology and obesity onset through 2- to 3-year follow-up than did assessment-only controls. Healthy weight participants showed greater decreases in thin-ideal internalization and weight than did expressive writing controls. Dissonance participants showed a 60% reduction in risk for eating pathology onset, and healthy weight participants showed a 61% reduction in risk for eating pathology onset and a 55% reduction in risk for obesity onset relative to assessment-only controls through 3-year follow-up, implying that the effects are clinically important and enduring. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The thin ideal and body image: An experimental study of implicit attitudes.

Thin-ideal internalization is a core construct in body dissatisfaction, central to eating disorders and generally assessed with explicit measures. To compare implicit and explicit measures of thin-ideal internalization and their relationship to body image, the authors developed a thin-ideal implicit association test (IAT). Although the IAT revealed a strong cognitive bias toward fat as negative (differences in response latencies: t[85]=9.829, p     

A 10-year longitudinal study of body weight, dieting, and eating disorder symptoms.

This article describes a 10-year longitudinal study of eating attitudes and behaviors. A sample of 509 women and 206 men completed a detailed survey in 1982 while they were in college. The authors contacted participants 10 years later and administered a 2nd questionnaire to assess stability and change in eating behaviors that occurred during the transition to early adulthood. Women in the study had substantial declines in disordered eating behavior as well as increased body satisfaction. However, body dissatisfaction and desires to lose weight remained at relatively high levels. Men, who rarely dieted or had eating problems in college, were prone to weight gain following college, and many of them reported increased dieting or disordered eating. The authors conclude that disordered eating generally tends to decline during the transition to early adulthood. However, body dissatisfaction remains a problem for a substantial segment of the adult population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Magazine exposure: Internalization, self-objectification, eating attitudes, and body satisfaction in male and female university students.

Investigated the relationships among magazine exposure, self-objectification, body shape dissatisfaction, and eating disorder symptomatology in 150 men and women (aged 18-42 yrs). Women reading beauty magazines and men reading fitness magazines internalized societal ideals (internalization). For women, beauty magazines predicted self-objectification, mediated by internalization. For men, only internalization predicted self-objectification. For men, fitness magazines predicted body shape dissatisfaction, mediated by internalization. For women, only internalization predicted body shape dissatisfaction. Reading magazines also predicted eating problems for men and women, for women this was mediated by internalization. Findings suggest that magazine reading is related to concerns with physical appearance and eating behaviors. Many of the relationships previously found for women are similar for men. A sociocultural model is used to explain these results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Roles of Sexual Objectification Experiences and Internalization of Standards of Beauty in Eating Disorder Symptomatology: A Test and Extension of Objectification Theory.

This study extends the literature on eating disorder symptomatology by testing, based on extant literature on objectification theory (B. L. Fredrickson & T. Roberts, 1997) and the role of sociocultural standards of beauty (e.g., L. J. Heinberg, J. K. Thompson, & S. Stormer, 1995), a model that examines (a) links of reported sexual objectification experiences to eating disorder-related variables and (b) the mediating roles of body surveillance, body shame, and internalization of sociocultural standards of beauty. Consistent with hypotheses, with a sample of 221 young women, support was found for a model in which (a) internalization of sociocultural standards of beauty mediated the links of sexual objectification experiences to body surveillance, body shame, and eating disorder symptoms, (b) body surveillance was an additional mediator of the link of reported sexual objectification experiences to body shame, and (c) body shame mediated the links of internalization and body surveillance to disordered eating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body-image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: A growth curve analysis.

Using data from a longitudinal community study (N?=?231), the authors tested whether body-image and eating disturbances might partially explain the increase in depression observed in adolescent girls. Initial pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and bulimic symptoms, but not body mass, predicted subsequent increases in depressive symptoms, as did increases in these risk factors over the study. There was also prospective support for each of the hypothesized mediational relations linking these risk factors to increases in depressive symptoms. Effects remained significant when other established gender-nonspecific risk factors for depression (social support and emotionality) were statistically controlled. Results provide support for the assertion that body-image and eating disturbances, operating above and beyond gender-nonspecific risk factors, contribute to the elevated depression in adolescent girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk factors for body dissatisfaction in adolescent girls: A longitudinal investigation.

Because few prospective studies have examined predictors of body dissatisfaction--an established risk factor for eating disorders--the authors tested whether a set of sociocultural, biological, interpersonal, and affective factors predicted increases in body dissatisfaction using longitudinal data from adolescent girls (N=496). Elevated adiposity, perceived pressure to be thin, thin-ideal internalization, and social support deficits predicted increases in body dissatisfaction, but early menarche, weight-related teasing, and depression did not. There was evidence of 2 distinct pathways to body dissatisfaction--1 involving pressure to be thin and 1 involving adiposity. Results support the contention that certain sociocultural, biological, and interpersonal factors increase the risk for body dissatisfaction, but suggest that other accepted risk factors are not related to this outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An effectiveness trial of a dissonance-based eating disorder prevention program for high-risk adolescent girls.

Efficacy trials indicate that an eating disorder prevention program involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program produced effects when school staff recruit participants and deliver the intervention. Adolescent girls with body image concerns (N = 306; M age = 15.7, SD = 1.1) randomized to the dissonance intervention showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, dieting attempts, and eating disorder symptoms from pretest to posttest than did those assigned to a psychoeducational brochure control condition, with the effects for body dissatisfaction, dieting, and eating disorder symptoms persisting through 1-year follow-up. Effects were slightly smaller than those observed in a prior efficacy trial, suggesting that this program is effective under real-world conditions, but that facilitator selection, training, and supervision could be improved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modification of an existing measure of body image preoccupation and its relationship to disordered eating in female college students.

Body image disturbance is both positively associated with the development of eating disorders and negatively associated with recovery. However, the aspects of body image most relevant to eating disorders have not been clearly established. Body image preoccupation may be particularly relevant to disordered eating. Yet, its measurement has proven problematic. In Study 1, a modification of the Body Shape Questionnaire (BSQ), a measure of body image preoccupation (P. J. Cooper, M. J. Taylor, Z. Cooper, & C. G. Fairburn, 1987), was developed in a sample of female undergraduates. The BSQ–R–10 yielded reliable and valid scores, and was more strongly related to disordered eating than measures of body image attitudes. In Study 2, the BSQ–R–10 was cross-validated in another sample of female undergraduates, and its psychometric properties further supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing risk factors for eating disorders: Comparison of an Internet- and a classroom-delivered psychoeducational program.

This controlled trial compared Internet- (Student Bodies [SB]) and classroom-delivered (Body Traps [BT]) psychoeducational interventions for the reduction of body dissatisfaction and disordered eating behaviors/attitudes with a control condition. Participants were 76 women at a private university who were randomly assigned to SB, BT, or a wait-list control (WLC) condition. Measures of body image and eating attitudes and behaviors were measured at baseline, posttreatment, and 4-month follow-up. At posttreatment, participants in SB had significant reductions in weight/shape concerns and disordered eating attitudes compared with those in the WLC condition. At follow-up, disordered behaviors were also reduced. No significant effects were found between the BT and WLC conditions. An Internet-delivered intervention had a significant impact on reducing risk factors for eating disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of the media in body image concerns among women: A meta-analysis of experimental and correlational studies.

Research suggests that exposure to mass media depicting the thin-ideal body may be linked to body image disturbance in women. This meta-analysis examined experimental and correlational studies testing the links between media exposure to women's body dissatisfaction, internalization of the thin ideal, and eating behaviors and beliefs with a sample of 77 studies that yielded 141 effect sizes. The mean effect sizes were small to moderate (ds = -.28, -.39, and -.30, respectively). Effects for some outcome variables were moderated by publication year and study design. The findings support the notion that exposure to media images depicting the thin-ideal body is related to body image concerns for women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent male athletes: body image, diet, and exercise

The purpose of this study was to investigate and compare body image concerns, attitudes toward eating/weight control, and reasons for exercising between two groups of adolescent male athletes--football players (N = 44) and cross-country runners (N = 30). Subjects responded to surveys covering eating attitudes, weight concerns, physical traits, perceived and ideal body shape/size, and reasons for exercising. Significant differences were noted: Football players reported a more positive body image; cross-country runners indicated a greater degree of body dissatisfaction, more disordered eating patterns, and a greater degree of concern for weight control which identified this group as one in need of increased health education.     

Moderators of the body dissatisfaction-eating disorder symptomatology relationship: Replication and extension.

In this study, research conducted by T. L. Tylka (2004) was replicated and extended by examining perfectionism (self-oriented and socially prescribed), ego goal orientation, body surveillance, and neuroticism as moderators of the relationship between body dissatisfaction and bulimic and anorexic symptomatology among female undergraduates (N = 398). Hierarchical moderated regression was used to test the main and interactive effects of the models and to control for physical size and social desirability. As expected, body dissatisfaction was strongly related to the measures of disordered eating, accounting for 16% to 26% of the variance. Two variables (neuroticism and body surveillance) received support as moderators of the relationships between body dissatisfaction and bulimic and anorexic symptoms. Ego goal orientation and socially prescribed perfectionism moderated the effects of body dissatisfaction on bulimic symptoms, whereas self-oriented perfectionism served as a moderator only for anorexic symptoms. In all instances, higher levels of body dissatisfaction paired with higher levels of the moderator were associated with more disturbed eating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing mediators of intervention effects in randomized controlled trials: An evaluation of two eating disorder prevention programs.

The authors investigated mediators hypothesized to account for the effects of 2 eating disorder prevention programs using data from 355 adolescent girls who were randomized to a dissonance or a healthy weight intervention or an active control condition. The dissonance intervention produced significant reductions in outcomes (body dissatisfaction, dieting, negative affect, bulimic symptoms) and the mediator (thin-ideal internalization), change in the mediator correlated with change in outcomes and usually occurred before change in outcomes, and intervention effects became significantly weaker when change in the mediator was partialed, providing support for the hypothesized mediators and this new approach to testing mediation in randomized trials. Findings provide somewhat less support for the hypothesis that change in healthy eating and exercise would mediate the healthy weight intervention effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body image and strategies to lose weight and increase muscle among boys and girls.

This study examined factors that influence body image and strategies to either lose weight or increase muscle among children. Participants were 237 boys and 270 girls. Body mass index (BMI), body dissatisfaction, cognitions and behaviors to both lose weight and increase muscles, as well as self-esteem and positive and negative affect, were evaluated. Self-esteem was associated with body satisfaction, positive affect predicted strategies to lose weight and increase muscles, and negative affect predicted body dissatisfaction and cognitions to lose weight and increase muscles. Boys were more likely to focus on changing muscles. Respondents with higher BMIs were more focused on losing weight but not muscle. The discussion focuses on health risk behaviors related to eating and exercise among children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Support for the continuity hypothesis of bulimic pathology.

There has been debate as to whether bulimia represents the endpoint of an eating disorder continuum (the continuity hypothesis) or is categorically different from subthreshold bulimia or an absence of eating disorders (the discontinuity hypothesis). The present study tested whether differences among bulimic, subthreshold bulimic, and control women on weight-concern and psychopathology variables better accord with the continuity or discontinuity hypothesis. These 3 groups were compared on body mass, thin-ideal internalization, body dissatisfaction, dietary restraint, depressive symptoms, anxiety symptoms, and temperamental emotionality. Discriminant function analysis and follow-up pairwise contrasts indicated that the continuity hypothesis was supported for measures of both weight concern and psychopathology. Research and treatment implications of the continuity perspective are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic and environmental influences on disordered eating: An adoption study.

Twin studies indicate significant genetic, but little shared environmental, influences on eating disorders. However, critics argue that study limitations constrain the conclusions that can be drawn. Adoption studies avoid many of these limitations, but to date, no adoption studies of eating pathology have been conducted. The current study was the first adoption study to examine genetic/environmental effects for disordered eating. Participants included 123 adopted and 56 biological female sibling pairs. Disordered eating (i.e., overall eating pathology, body dissatisfaction, weight preoccupation, binge eating) was assessed with the Minnesota Eating Behaviors Survey (Klump, McGue, & Iacono, 2000; von Ranson, Klump, Iacono, & McGue, 2005). Biometric model fitting indicated significant genetic influences (59%–82%) on all forms of disordered eating, with nonshared environmental factors accounting for the remaining variance. Shared environmental factors did not contribute significantly to any disordered eating symptom. Our findings bolster those from twin studies and provide critical evidence of significant genetic effects on disordered eating symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)