Development and validation of the sociocultural attitudes towards appearance questionnaire

The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) was developed to assess women's recognition and acceptance of societally sanctioned standards of appearance. In Study 1, factor analyses revealed two clearcut factors: awareness/acknowledgment of a societal emphasis on appearance and an internalization/acceptance of these standards. These findings were cross-validated in Study 2, resulting in a six-item Awareness subscale (alpha = .71) and an eight-item Internalization subscale (alpha = .88). Study 3 obtained good convergence between both scales and multiple indices of body image and eating disturbance. Regression analyses indicated that both factors accounted for unique variance associated with body image and eating dysfunction, however, internalization of standards was a stronger predictor of disturbance. The SATAQ should prove useful for researchers and clinicians interested in body image and eating disorders. © 1995 by John Wiley & Sons, Inc.     

Association of thin-ideal media exposure,body dissatisfaction and disordered eating behaviors among adolescents in Taiwan

ObjectiveThe present study examined the relationships between thin-ideal media exposure, body dissatisfaction, and disordered eating behaviors among adolescents in Taiwan.MethodA total of 2992 students in the 10th grade were recruited from 26 high schools in Taipei, Taiwan to complete a questionnaire in 2010.ResultsThe results showed that the adolescents were exposed to thin-ideal messages a few times a week. Females had higher levels of thin-ideal media exposure, media pressure to be thin, thin-ideal internalization, body dissatisfaction, and disordered eating behaviors than males. Multivariate logistic regression results indicated that media pressure and thin-deal internalization significantly increased the likelihood of body dissatisfaction, while media pressure and body dissatisfaction contributed to both restrained eating and unhealthy weight control behaviors, when all other variables were controlled for.     

Predictors of body image dissatisfaction and disturbed eating attitudes and behaviors in African American and Hispanic girls

Disturbed eating attitudes and behaviors are widespread among girls in the United States. Because obesity is one of the leading risk factors for eating disorder development, African American and Hispanic girls may be at heightened risk due to their greater prevalence and degree of overweight. The present study examined the associations among disturbed eating attitudes and behaviors, body image dissatisfaction, weight classification, fears of negative evaluation, and coping skills among 139 African American and Hispanic girls in Grades 4 and 5 from a low-income urban area. African American girls had significantly lower body image dissatisfaction than Hispanic girls. Significant predictors of body image dissatisfaction included fear of negative evaluation and weight classification. Fear of negative evaluation was also a significant predictor of disturbed eating attitudes and behaviors. Overall, 10.1% of the African American girls and 12.7% of the Hispanic girls qualified for a diagnosis of a probable eating disorder. Girls with eating disorders had greater fears of negative evaluation and engaged in more cognitive avoidance. Both groups are at risk of eating disorder development.     

Does perfectionism mediate or moderate the relation between body dissatisfaction and disordered eating attitudes and behaviors?

A link between perfectionism and disordered eating has been documented in previous studies. The purpose of the current study was to expand our knowledge of the specific role of perfectionism in disordered eating by examining perfectionism as a mediator or a moderator in the relation between body dissatisfaction and disordered eating (assessed using the EAT-26 and its subscales, and the Binge Scale). We sampled a large ethnically diverse sample of university women (N = 520) using two measures of perfectionism: the Eating Disorder Inventory Perfectionism subscale (EDI-P) and the Multidimensional Perfectionism Scale (H-MPS). In general, socially prescribed and self-oriented perfectionism, but not other-oriented perfectionism, were correlated with disordered eating attitudes and behaviors, except binge eating. Furthermore, perfectionism was found to partially mediate and moderate the relation between body dissatisfaction and disordered eating, however the strength of these associations differed depending on both the particular measure of perfectionism (EDI-P versus H-MPS) and the specific dimension of perfectionism (self-oriented, socially prescribed, other-oriented) used in the analyses. The findings are discussed in relation to the need for more informed and theoretically sound models of the development and maintenance of disordered eating.     

The use of the sociocultural attitudes towards appearance questionnaire with middle school boys and girls.

OBJECTIVE: To assess the psychometric validity of versions of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) designed for use with middle school girls and boys. METHOD: As part of a larger study, the SATAQ was administered to 505 middle school children. To assess concurrent validity, scales concerning the use of Weight Control and Muscle Building Techniques as well as the Body Esteem Scale (BES) were also administered. Body mass index (BMI) was also calculated. RESULTS: Both the girls and boys versions of the SATAQ showed adequate validity. Two SATAQ subscales, Internalization and Awareness of societal ideals of thinness, were identified for girls. For boys, three SATAQ subscales were identified: Internalization and Awareness of a muscular, non-fat ideal and a scale tapping the the importance of a Muscular Look. The subscales and total score showed acceptable concurrent validity. Even after controlling for BMI, they contributed significant explained variance for the use of Weight Control Techniques in both boys and girls and use of Muscle Building Techniques in boys. Patterns of relationships among variables differed by gender. DISCUSSION: The results suggest that sociocultural influences play a role in the use of Weight Control and Muscle Building Techniques for middle school boys although their influence is not as strong as it is for the use of Weight Control Techniques by middle school girls. The SATAQ seems to be an adequate measure of the nature of some of these influences.     

Factors associated with body dissatisfaction in non-clinical adolescents at risk of eating disorders

Aim To examine factors (individual, familiar and socio-cultural) associated with body dissatisfaction (BD) by gender in non-clinical adolescents at risk of eating disorders (rED) and in a control group (CG). Subjects and methods A total of 2,967 adolescent students was screened using the Eating Attitudes Test-40 and the Youth’s Inventory-4. Of these, 217 students (161 girls and 56 boys) identified as being at rED were chosen for the study, and 208 students (168 girls and 40 boys) were chosen as the CG. The subjects were given the Body Areas Satisfaction Test, the Youth’s Inventory-4, a questionnaire to evaluate social influences on the “model of thinness” (SI-MT), the Family Environment Scale, and their body mass index (BMI) was determined. Results BD frequency in at-risk girls (44.6%) was significantly higher than in boys (27.3%). Girls at rED were most dissatisfied with their weight. BMIs were significantly higher and energy intake was significantly lower in dissatisfied girls than in satisfied girls at rED. In girls at rED, multiple linear regression analyses showed that SI-MT factors and dysthymia were associated with BD. In the CG, higher BMI were associated with BD. These relationships were not found in adolescent boys. Conclusion Within the at-risk group, adolescents with BD had higher BMIs, consumed fewer calories, were more influenced by socio-cultural factors and had more emotional issues than those who were satisfied. We suggest that although high BMIs are associated with BD, the interaction with other social and psychopathological characteristics increases the risk of the development of eating disorders.     

Body dissatisfaction among Chinese undergraduates and its implications for eating disorders in Hong Kong

Objectives: To study the body dissatisfaction of Chinese undergraduates and its implications for eating disorders in Hong Kong. Method: A large sample of 1,581 subjects completed a “Body Dissatisfaction Questionnaire” (BDQ) which included 25 items about various body parts and questions on body indices, body shape dissatisfaction, and dieting. Results: Whereas male subjects wanted to be taller and stronger in their upper body, the majority of female subjects felt fat in their lower body and were cognitively inclined to weigh less even though they were not obese. They desired a slimming of the stomach, thighs, waist and hip, but not the breasts. Body dissatisfaction was substantially intensified in females who reported a history of dieting in the previous year. Factor analysis of the BDQ affirmed the gender specificity and multidimensionality of body dissatisfaction. Discussion: The typically “Western” pattern of body dissatisfaction has overshadowed the traditional Chinese notions of female beauty based on the face and other nontruncal features. In the context of a rapidly urbanizing Chinese society, this will predispose more females to weight control behavior and eating disorders. © 1996 by John Wiley & Sons, Inc.     

The sociocultural attitudes towards appearance scale-3 (SATAQ-3): development and validation

OBJECTIVE: The goal of this investigation was to develop and validate a revision of a widely used measure of societal influences on body image and eating disturbances-the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ). METHOD: Two independent samples of college females completed a revision and extension of the SATAQ and factor analyses were conducted to determine the underlying structure of the revised scale. RESULTS: Factor analyses indicated two distinct internalization factors: one appeared to reflect a generic media influence related to TV, magazines, and movies. A second factor clearly reflected internalization of athletic and sports figures. Two other factors, reflecting media pressures and media as an informational source, also emerged. Another widely used measure of thin-ideal internalization, the Ideal Body Internalization Scale-Revised (IBIS-R), was included in factor analyses to determine its empirical relationship with the revised SATAQ. None of the IBIS-R items loaded with any of the internalization items or items reflective of media pressures or information. Instead, the IBIS-R appeared to tap into an awareness of appearance norms dimension. The SATAQ-3 subscales had excellent convergent validity with measures of body image and eating disturbance. Eating-disturbed and eating-disordered samples had higher scores on SATAQ-3 subscales than a control sample. DISCUSSION: The SATAQ-3 measures multiple aspects of a societal influence and should prove useful for basic risk factor work as well as for gauging the efficacy of prevention and treatment programs.     

Self-weighing among adolescents: associations with body mass index, body satisfaction, weight control behaviors, and binge eating

Among adolescent girls, the health effects of frequent self-weighing are unclear. This study examines cross-sectional and longitudinal associations between frequency of self-weighing and body mass index (BMI), body satisfaction, weight control behaviors, and binge eating among a diverse population of adolescent girls. The study was conducted in the Minneapolis/St Paul, MN, metropolitan area between 2007 and 2009. The study population included 356 adolescent girls (mean age 15.7 years); 46.2% of the girls were overweight or obese and >75% were from a racial/ethnic minority group. Anthropometric and survey data were collected at baseline and at follow-up 9 months later. Hierarchical linear regression models were developed to test associations. Cross-sectionally, frequent self-weighing was associated with lower body satisfaction (P=0.034) and higher rates of healthy (P=0.002), unhealthy (P=0.016), and extreme (P=0.038) weight control behaviors. A quadratic association was found between frequency of self-weighing and binge eating, with girls who weighed themselves least and most frequently reporting the highest prevalences of binge eating (P=0.014). No association was observed between frequency of self-weighing and girls' BMI (P=0.111). Short-term longitudinal associations between baseline frequency of self-weighing and changes in body satisfaction, weight control behaviors, binge eating, or BMI were not observed. Findings suggest that among adolescent girls, frequent self-weighing is cross-sectionally associated with both healthy and potentially harmful unhealthy weight control behaviors, and does not contribute to weight loss over time. Adolescents should not be encouraged to engage in frequent self-weighing.     

Prevalence and correlates of problem behaviors among adolescents in Hong Kong

The aims of this study were to examine the frequency and correlates of problem behaviors among Hong Kong adolescents. It is a cross-sectional survey targeting secondary forms 1 to 3 (equivalent to grades 7-9 in the United States) students (N = 1029). A self-administered questionnaire was used as the measurement tool. The study found that there are intercorrelations of problem behaviors in adolescence, such as tobacco use, alcohol use, drug abuse, and having connections with triad society. Given the intercorrelations among problem behaviors, identification of a single type of problem behavior in adolescents can help discover the likelihood of the occurrence of other problem behaviors. It can facilitate identification and intervention at an early stage. The results provide some insights for the concerned authorities to develop a syndrome approach addressing problem behaviors.     

Exposure to suicide and suicidal behaviors among Hong Kong adolescents

Suicidal behaviors (deliberate self-injury with the intent to hurt or kill oneself) have been little examined outside the West. The aims of this study were to (a) determine the correlates of suicidal behaviors, and (b) examine whether depression and suicide ideation moderated the effects of exposure to completed and attempted suicide on suicidal behaviors among a community sample of Hong Kong youth ages 12-17. Adolescents responded to questions regarding self-injurious behaviors, and also indicated presence of intention to hurt or kill themselves in the past 12 months. Based on their responses, two groups of interest were formed: 96 youths reported both self-injurious behaviors and the intent to hurt or kill themselves, and formed the "suicidal behaviors" group; and, 1213 adolescents reported neither self-injurious behaviors nor intent to hurt self or die, and formed the control group. The participants also responded to questions about depressive symptoms, anxiety, suicidal ideation and attempt, alcohol/drug use, stressful life events, and family relationships. They indicated whether anyone they knew had attempted or completed suicide in the previous 12 months. Logistic regression indicated that depressive symptoms, stressful life events, suicidal ideation and exposure to suicide attempt (but not completed suicide) contributed unique variance to the presence of suicidal behaviors, after controlling for demographic variables. Depression (and at trend levels, suicidal ideation) moderated the effect of exposure to suicide attempt by others on suicidal behaviors. Our results indicate that completed suicide in the social network increases risk for suicidal behaviors, but not when other risk factors are controlled. By contrast, a suicide attempt independently increases risk for suicidal behaviors. Furthermore, those youths who experience depressive symptoms or suicidal ideation are at particularly high risk for engaging in suicidal behaviors when an exposure to suicide attempt occurs.     

Hong Kong Chinese parental attitudes towards vaccination and associated socio-demographic disparities

BackgroundMost previous studies on parental attitudes towards vaccination focused on a disease-specific vaccine. In this study we describe general attitudes towards vaccination in Chinese parents and associated socio-demographic disparities.MethodsData were collected from a random sample of 1996 Hong Kong Chinese parents by telephone interviews (response rate 60%). Multiple linear regression analysis was performed.ResultsMost parents believed vaccination to be effective (91.6%) and beneficial (78.7%), though many considered optional vaccines unimportant (39.5%) and unnecessary (62.1%). Demographic characteristics associated with parental negative attitudes to vaccination included being female, born in Hong Kong, married, having fewer children, and children ever experienced vaccination side effects. Lower personal income and religious affiliation were associated with more hesitant attitudes towards optional vaccines.ConclusionSegments of the population hold significantly negative attitudes towards vaccination and optional vaccines, suggesting a need for targeted efforts on vaccination communication in these groups.     

Validation of the eating disorder diagnostic scale for use with Hong Kong adolescents

OBJECTIVE: We examined the psychometric properties of the Eating Disorder Diagnostic Scale (EDDS) in a community sample of Hong Kong school children. METHOD: Participants (359 boys and 387 girls), aged 12 to 19 years, were assessed on the EDDS on two occasions, one month apart. Factor structure, internal consistency, test-retest reliability, and validity against the Eating Disorders Examination-Questionnaire (EDE-Q) and Center for Epidemiological Studies-Depression (CES-D) were investigated. RESULTS: Four groupings emerged on exploratory factor analysis: body dissatisfaction, bingeing behaviors, bingeing frequency, and frequency of compensatory behaviors. Items loaded on the same factors for boys and girls. Internal consistency for these factors was acceptable. Test-retest reliability was high for body dissatisfaction factor but weak to moderate for other factors and for diagnoses. High concurrent validity with the EDE-Q, and correlation with the CES-D was shown. CONCLUSION: We offer preliminary reliability and validity evidence to support the further development of the EDDS as a screening instrument to assess eating disturbances in Hong Kong youth.