Preliminary test of two hypotheses of body image disturbance

The present study compared the ability of two hypotheses of body image disturbance, social comparison and negative verbal commentary (teasing), to explain variance associated with body dissatisfaction and eating disturbance. Female undergraduates (n = 146) completed measures of eating disturbance, body dissatisfaction, self-esteem, depression, history of being teased about physical appearance, frequency of appearance comparison, and importance of various individuals as appearance comparison targets. Utilizing multiple regression analyses, levels of self-esteem and depression were first entered to remove a general distress/ negative affectivity variable from the analyses. The results indicated that specific teasing about weight/size, but not general appearance, was a significant and consistent predictor of body dissatisfaction and eating disturbance. In addition, the importance of others as comparison targets, but not general comparison frequency, also predicted unique variance after the removal of the general distress factor. The findings are discussed with regard to the need for longitudinal analyses of predictors of body image and eating disturbance, particularly the possible importance of negative verbal commentary as a developmental precursor to adult levels of dysfunction. © 1993 by John Wiley & Sons, Inc.     

The nature of body image disturbance in patients with binge eating disorder

OBJECTIVE: This study examined the distinction between body dissatisfaction and self-evaluation unduly influenced by body shape and weight, and their longitudinal relationships to depressive symptomatology and self-esteem in patients with binge eating disorder (BED). METHOD: Ninety-seven patients with BED completed measures tapping these constructs at baseline and again 4 weeks later. RESULTS: Change in body dissatisfaction was significantly correlated with both change in depressive symptomatology and change in self-esteem over time, whereas change in self-evaluation was significantly correlated only with change in self-esteem. In addition, change in shape concern, but not change in weight concern, was significantly correlated with change in self-esteem only. DISCUSSION: These findings suggest that self-evaluation unduly influenced by body shape is a more useful indicator for BED than body dissatisfaction or self-evaluation unduly influenced by weight.     

Mirror exposure for the treatment of body image disturbance

OBJECTIVE: Body image disturbance is a risk factor for the development and persistence of eating disorders. Limitations of current treatments for body image disturbance prompted the development of a mirror exposure (ME) treatment. METHOD: ME involves deliberate, planned, and systematic exposure to body image. The approach is nonjudgmental, holistic in focus, and mindful of present emotional experience. Complementary behavioral assignments aim to reduce avoidance and excessive checking. The current study evaluated the effectiveness of ME therapy (in a three-session format) compared with a nondirective (ND) therapy for 45 women with extreme weight and shape concerns. RESULTS: ME resulted in significant improvements at termination and follow-up in body checking and avoidance, weight and shape concerns, body dissatisfaction, dieting, depression, and self-esteem. As hypothesized, ME was significantly better than ND on many of the outcome measures. CONCLUSION: ME is an effective treatment for body image disturbance and should be evaluated in the context of treatments for eating disorders.     

Eating disturbance,emotional separation,and body image

The present study explored the interrelationship of eating disturbance, emotional separation from mother and father, body satisfaction, and body boundary definiteness. Subjects for the study were undergraduate women recruited from an introductory psychology subject pool on the basis of self-reports of eating behavior. The results indicate that eating disturbance is associated with less emotional separation from parents, greater body dissatisfaction, and less definite body boundaries.     

Interrelationships among multiple aspects of body image and eating disturbance

The relationships among several indices of body size estimation and eating disturbance were examined in 72 college females. Measures of absolute size and estimated size had stronger correlations with eating disturbance than degree of perceptual size overestimation. Overestimation of self was highly related to estimates of the size of inanimate objects, suggesting the presence of a general perceptual deficit. Actual size was negatively correlated with degree of overestimation, indicating that small-sized individuals overestimate to a greater degree than large subjects. The necessity of a multifaceted assessment approach for body image research is discussed.     

Cross-cultural explanations of body image disturbance in Western cultural samples

OBJECTIVE: We replicated and extended the findings of S. M. Stormer and J. K. Thompson (1996), by comparing the relationships among body image disturbance (BID) and teasing history, age of pubertal onset, societal pressures to be thin, and appearance comparison, across three Western cultures. METHODS: College females from the United States, Italy, and England completed several BID measures, as well as measures of the four predictors. Body mass levels and self-esteem, two known correlates of BID, were also examined. Data were analyzed using first standard, then hierarchical regression procedures. RESULTS: This investigation essentially found no cultural differences in the relationships among BID and its correlates for six of the seven criteria (BID) measures. Only one of the measures, the Figure Rating Scale (FRS), distinguished across groups. DISCUSSION: A lack of true cultural differences, or general similarities among university students, might explain these results. Nevertheless, these findings support the use of a Western cross-cultural research model.     

Comorbidity of body dysmorphic disorder and eating disorders: severity of psychopathology and body image disturbance

OBJECTIVE: The current study examined comorbidity and clinical correlates of eating disorders in a large sample of individuals with body dysmorphic disorder (BDD). METHOD: Two hundred individuals with DSM-IV (4th ed. of the Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1994) BDD completed reliable interviewer-administered and self-report measures, including diagnostic assessments and measures of body image, symptom severity, delusionality, psychosocial functioning, quality of life (QOL), and history of psychiatric treatment. RESULTS: A total of 32.5% of BDD subjects had a comorbid lifetime eating disorder: 9.0% had anorexia nervosa, 6.5% had bulimia nervosa, and 17.5% had an eating disorder not otherwise specified. Comparisons of subjects with a comorbid lifetime eating disorder (n = 65) and subjects without an eating disorder (n = 135) indicated that the comorbid group was more likely to be female, less likely to be African American, had more comorbidity, and had significantly greater body image disturbance and dissatisfaction. There were no significant group differences in BDD symptom severity, degree of delusionality, or suicidal ideation or attempts. Functioning and QOL were notably poor in both groups, with no significant between-group differences. However, a higher proportion of the comorbid eating disorder group had been hospitalized for psychiatric problems. This group had also received a greater number of psychotherapy sessions and psychotropic medications. CONCLUSION: Eating disorders appear relatively common in individuals with BDD. BDD subjects with a comorbid eating disorder differed on several demographic variables, had greater comorbidity and body image disturbance, and had received more mental health treatment than subjects without a comorbid eating disorder. These findings have important implications for the assessment and treatment of these comorbid body image disorders.     

女大学生自我客体化和体育锻炼与体像烦恼的关系

探讨女大学生自我客体化和体育锻炼与体像烦恼的关系,为预防大学生体像烦恼的发生提供理论参考.方法 方便抽取青岛科技大学、山东理工大学、中国海洋大学、长春大学4所高校2 201名女大学生,完成青少年体像烦恼问卷、自我客体化问卷、体育活动等级量表.结果 女生体像烦恼检出率为28.7%,大四年级得分低于其他年级,无恋爱经历者低于有恋爱经历者;形体烦恼检出率为41.4%,大四年级得分低于其他年级,无恋爱经历者低于有恋爱经历者;容貌烦恼检出率为19.6%,大四年级得分低于其他年级;性别烦恼检出率为13.1%;性器官烦恼检出率为4.3%.女大学生存在自我客体化现象.自我客体化能正向预测体像烦恼(β=0.37,P<0.01);自我客体化和体育锻炼交互项解释了体像烦恼变异的2.8%,回归系数有统计学意义(β=-0.20,P<0.01).锻炼量低时,自我客体化对体像烦恼的预测作用有统计学意义(t=11.88,P<0.01);锻炼量高时,自我客体化对体像烦恼的预测作用无统计学意义(t=1.87,P>0.05).结论 大学生自我客体化影响体像烦恼的过程受到体育锻炼的调节.     

Size estimation versus figural ratings of body image disturbance: Relation to body dissatisfaction and eating dysfunction

The current investigation compared several different measures of body image disturbance in college males and females. Measures of perceptual size overestimation, figure rating preferences, and questionnaire indices of body dissatisfaction and eating disturbance were collected. Subjects also rated body sizes based on ideal, affective, and cognitive/rational rating protocols. The results revealed little connection between indices of perceptual overestimation and body dissatisfaction or eating dysfunction. Alternatively, figural ratings were strongly associated with these measures. Regression analyses revealed that body dissatisfaction and figural discrepancy measures were highly related to eating disturbance for both males and females. In addition, discrepancies based on affective versus cognitive/rational rating protocols explained unique variance associated with eating disturbance. The findings are discussed with regard to the need to conduct a multifaceted assessment of body image disturbance.     

The tripartite influence model of body image and eating disturbance: a replication with a Japanese sample

OBJECTIVE: To examine the tripartite influence model of body image and eating disturbance as a viable sociocultural explanation for the development of eating and body image problems with young Japanese females. METHOD: A sample of 289 Japanese female undergraduates completed a variety of measures designed to index family, peer, and media influences, as well as levels of body dissatisfaction, eating disturbances, and self-esteem. RESULTS: The data were evaluated with structural equation modeling to test the tripartite model. Fit indices indicated a moderate fit to the overall tripartite model, replicating previous findings. CONCLUSION: This study suggests that the sociocultural variables found to influence body image and eating disturbances in Japan are similar to those observed with US samples. The implications for prevention and intervention programs are discussed.     

A method for the assessment of body image disturbance in patients with eating disorders

This paper describes a new method for assessing body image disturbances in eating disordered patients. Fifteen bulimic, 25 anorexic, and 24 normal controls served as subjects. All subjects were matched for age and height, and bulimics and controls were matched lor weight as well. All subjects completed the Perceived Body Image Scale (PBIS), which required subjects to report on how they see themselves when they look in the mirror, how they think they look, and how they feel themselves to be, reflecting the perceptual, cognitive, and affective aspects of body image, respectively. Subjects also selected their ideal. An objective rating was made. Objective ratings had a high correlation with the subject's weight. Results showed that both eating disorder groups demonstrated more apparent body image disturbance than controls, and that the bulimics showed significantly greater body image dissatisfaction than anorexics or controls. The potential use of the PBIS as a research and clinical instrument is discussed.     

A translational neuroscience approach to body image disturbance and its remediation in anorexia nervosa

Deviant perception of the body is a fundamental component of anorexia nervosa. Here we offer a potential mechanistic explanation that involves perturbations within the visual system and the brain circuits that modulate perceptual organization. Based on the model proposed, we also suggest a mechanistic strategy for altering neuronal activity in the visual system to normalize perception of the body, and set out a strategy for empirically testing its clinical application.     

Body checking and body image avoidance: Construct validity and norms for college women

The current study explored the prevalence of body checking and body image avoidance behaviors in a large sample of undergraduate women (N = 1011). The factor structures of two relevant measures, the Body Checking Questionnaire and the Body Image Avoidance Questionnaire, were compared with factor structures proposed by the development studies. Subscales are described, and the influence of race on responses examined. Results suggest these scales are valid in White and African American samples with a modified factor structure. Findings can inform clinical and research use of these measures, although additional experimental research is needed.     

The validity of subjective quality of life measures in psychotic patients with severe psychopathology and cognitive deficits: an item response model analysis

Purpose  

Subjective quality of life (SQOL) is an established patient-reported outcome in the evaluation of treatments for psychosis. The use of SQOL measures in the presence of psychiatric symptoms and cognitive deficits has been questioned. However, there is little evidence on whether items function differently as indicators of SQOL in psychotic patients with different levels of symptoms and deficits. Substantial differential item functioning (DIF) would, indeed, challenge the validity of established measures. We aimed to investigate the validity of a widely used measure of subjective quality of life (SQOL), i.e., the Lancashire Quality of Life Profile (LQOLP), in the presence of cognitive deficits and psychiatric symptoms in patients with severe and enduring psychosis.     

The validity of self-reported diabetes quality of care measures.

OBJECTIVE: First, to test the validity of self-reported quality of care and treatment measures compared with medical records and administrative data for: eye examinations, hemoglobin A1C tests, and use of insulin and oral agents for adult patients with diabetes; and secondly to assess the consistency between medical record information and administrative data for the same measures plus microalbumin testing. DESIGN: Cross-sectional study using data from telephone survey, primary care medical and eye records, and administrative claims. SETTING: Statewide health maintenance organization in Minnesota, USA, 1995. STUDY PARTICIPANTS: Four hundred and forty adults with diabetes, aged 31-64 years. MAIN OUTCOME MEASURES: Validity++ of self-reported diabetes quality of care measures compared with a criterion standard combining information from primary care and eye records with information from administrative data; and reliability of medical record information compared with administrative data. RESULTS: Although the sensitivity of self-reported eye examination was high (89%), the specificity was low (65%). Self-report of hemoglobin A1C also had high sensitivity (99%) and a lower specificity than that of eye examination (28%). The two information sources (medical records and claims) used in the criterion standard each contained complementary and non-overlapping information. Reliability was highest for microalbumin testing (kappa, 0.75) and lowest for eye examination (kappa, 0.37). CONCLUSIONS: Quality of care measures for diabetes are often drawn from a variety of sources. To the extent that data sources are biased, the measures can be misleading. Self-report is likely to lead to an overestimate of eye screening and the measurement of hemoglobin A1C. Reported rates of quality of care should be inspected carefully. The 'same' rate taken from different sources may vary.     

Exercise status and sexual orientation as moderators of body image disturbance and eating disorders in males

OBJECTIVE: This study evaluated the moderating effects of sexual orientation and exercise status on measures of body image and eating disturbance in a sample of men. METHOD: One hundred and thirty-four men completed measures designed to index a range of body image facets (ideals, actual, partner's preference, overall dissatisfaction), eating disturbance (restrictive and bulimic levels), and overall self-esteem. RESULTS: There were few significant effects as a function of exercise status or sexual orientation. Bodybuilders were more satisfied on a global measure of body image and had a higher ideal and actual upper torso size rating. Gay men had a smaller actual upper torso rating than heterosexual men, but ideal size upper torso did not differ as a function of sexual orientation. DISCUSSION: Findings are discussed in terms of methodological limits of previous work and future examinations of moderating factors for body image and eating disturbance in men.     

The impact of body image experiences: development of the body image quality of life inventory

OBJECTIVE: Substantial research confirms that body image affects multiple aspects of psychosocial functioning, yet there is no direct assessment to quantify its impact on an individual's quality of life. METHOD: In the present study, the Body Image Quality of Life Inventory was developed and empirically evaluated with 116 college women. RESULTS AND DISCUSSION: This 19-item assessment was internally consistent and stable over a 2- to 3 week period. It converged significantly with multiple measures of body image evaluation and investment and with body mass. The results further revealed that women in the sample reported more positive than negative consequences of their body image for various domains of life. The implications of these findings and directions for continued validation of this unique measure are considered.