Clinically significant body dissatisfaction: prevalence and association with depressive symptoms in adolescent boys and girls

A pre-post evaluation of the impact of the Embrace Kids film on children's and adults' body image and self-compassion

Given the prevalence of body dissatisfaction among young people, which tends to persist into adulthood, a need exists for large-scale interventions that address this problem. Film has been identified as a resource that is well-suited to large-scale dissemination, which can achieve broad impact and reach. Embrace Kids, a film aimed at improving young people's body image, is one such resource. To evaluate the film's impact on body image, 55 children (M = 10.59, SD = 1.49) and 47 adults (M = 43.75, SD = 8.54) were recruited from the Australian general public to complete a brief survey before and after viewing the film. After viewing the film, significant increases in state body appreciation, state functionality appreciation and state self-compassion were reported for children (d = 0.46 - 0.61) and adults (d = 0.88 - 1.08). They supported the safety of the film by indicating that it did not make them more concerned about their appearance. Findings provide initial support for the film as a scalable intervention that can be safely task-shifted to non-professional audiences. Future research directions include comparing the effect of Embrace Kids against a control film, and testing the longitudinal impact of the film on trait body image.

Childhood obesity and adolescent follow-up depressive symptoms: exploring a moderated mediation model of body esteem and gender

Obesity is a well-recognized risk factor for adolescent depressive symptoms, but mediating mechanisms of this association have scarcely been studied. This study is unique in examining an indirect pathway of this link via body esteem (BE) prospectively from childhood (8-12 years) to adolescence (13-18 years). In addition, potential gender moderation was examined. This study utilized data from a case-control study comparing 100 children with and without obesity matched on important confounders (age, gender, and socioeconomic status). Our findings provide support for the mediating role of BE in the link between childhood weight status and adolescent depressive symptoms at a 5-year follow-up. This mediation effect did not differ between boys and girls. The findings suggest the relevance of specifically targeting children's BE in preventive intervention programs among children with obesity to prevent future mental health problems.

[Bullying victimization and associated factors among schoolchildren in a city in the south of Brazil]

The objective was to assess the prevalence of bullying victimization and associated factors among adolescents in the city of Pelotas, Rio Grande do Sul. A cross-sectional school-based study was conducted with 795 ninth grade students from 25 urban municipal schools linked to the School Health Program. Bullying was assessed using questions that addressed the occurrence, frequency, location, type of violence suffered and how much it bothers the victims. Gross and adjusted analyses were performed by Poisson regression. Approximately 71% of the students reported having suffered bullying, and school was the location of greatest occurrence (86.7%). Among the types of aggression suffered, "nicknames" was the most recurrent complaint (88.4%), followed by exclusion or isolation (26.6%). Victimization was more frequent among girls (PR 1.13; 95%CI 1.02-1.27), students with non-white skin color/race (PR 1.16; 95%CI 1.05-1.29), who have already tried tobacco (PR 1.14; 95%CI 1.03-1.27), dissatisfied (PR 1.42; 95%CI 1.27-1.58) or indifferent (PR 1.21; 95%CI 1.02-1.43) about their bodies, and who were overweight (PR 1.15; 95%CI 1.04-1.27). The results show that bullying is a frequent practice in the school environment, pointing to the need for educational practices aimed at reducing and preventing this type of violence.

Psychological correlates of body dissatisfaction in Swiss youth over a one-year study-period

Introduction

It is well known that young individuals often report pronounced negative perceptions and attitudes towards their own body or intense fear of being not muscular enough. There is much less data available, however, on the role of psychological mechanisms on these perceptions and attitudes, such as emotion regulation difficulties, correlates of alexithymia, and appearance-related rejection sensitivity.

Methods

We therefore set out to assess associations between these psychological mechanisms, and body image as well as muscle dysmorphic symptoms. Our sample was recruited as part of a larger-scale study aiming at assessing correlates of mental health (with a focus on eating disorder symptoms) in German speaking Switzerland. The first wave (T1), starting in April 2021, included 605 participants (80% female, 19.6 ± 2.5 years) who completed the online-questionnaire and were reassessed in a second wave (T2), one year later.

Results

Results indicated that at both waves, emotion regulation difficulties [DERS-SF] and appearance-based rejection sensitivity [ARS-D] were both positively cross-sectionally associated with body dissatisfaction [BSQ-8C] and muscle dysmorphic symptoms [MDDI] at the first assessment time-point and one year later at follow-up assessment. Moreover, alexithymia [TAS-20] was positively cross-sectionally associated with muscle dysmorphic symptoms at both waves. We further observed high absolute and relative level stabilities for all variables involved across the one-year study period.

Discussion/Conclusion

Even though the effects for some associations were rather small, our findings underline the relevance of such mechanisms in the development of body dissatisfaction and to a lesser extent of muscle dysmorphia symptoms over the period of one year. Additional research is necessary to replicate these findings in other youth samples.

Health Consequences of Familial Negative Weight Talk Across the Spectrum of Gender Diversity

PURPOSE OF REVIEW

To synthesize differences in familial negative weight talk and health-related correlates across gender identities and to highlight gaps relevant to the unique experiences and health correlates of boys and transgender and gender diverse youth.

RECENT FINDINGS

Most of the studies included in this review observed no difference by gender in familial negative weight talk health correlates. Gender biases in existing measures, however, may have contributed to underreporting of health correlates in boys. Moreover, transgender and gender diverse youth are severely underrepresented in this research. Future research should consistently examine effect modification across gender identities and include measures that are specific to the weight-based concerns and experiences of boys and transgender and gender diverse youth.

Association between childhood trauma and affective lability among adolescents: A moderated mediation model

BACKGROUND

Affective lability is an important feature of psychopathology. However, there is limited relevant research involving adolescents. To fill this research gap, the present study assessed the relationship between childhood trauma and affective lability among adolescents using a moderated mediation model.

METHODS

A total of 3738 students were recruited from four high schools in Shenzhen, China, between September and December 2019. The participants completed self-reported questionnaires measuring childhood trauma, affective lability, body image dissatisfaction, and the experience of being bullied. Linear regression and moderated mediation analyses were used in this study.

RESULTS

Linear regression analysis showed that emotional abuse and body image dissatisfaction positively predicted affective lability in boys and girls (all p < 0.001). Body image dissatisfaction mediated the relationship between emotional abuse and affective lability. In the moderated mediation model, being bullied moderated the direct path from emotional abuse to affective lability (p = 0.0236, p = 0.0188), and gender did not have a significant moderating effect on any direct or indirect path (all p > 0.05).

LIMITATIONS

A causal relationship could not be ascertained due to the cross-sectional design, and the results cannot be generalized to other populations.

CONCLUSIONS

The findings support that childhood trauma has an impact on affective lability in adolescents. Specifically, body image dissatisfaction and being bullied affect the relationship between emotional abuse and affective lability.

A randomized controlled trial to evaluate the acceptability and effectiveness of two eating disorders prevention interventions: the HEIDI BP-HW project

BACKGROUND

Eating disorders (ED) are common in Switzerland, as in other Western countries, with a prevalence of any ED of 3.5%. However, no specific prevention intervention has been evaluated in the French-speaking part of the country. In this study, we assessed the acceptability and effectiveness of two well-validated eating disorders prevention interventions: the Body Project intervention (BP), based on cognitive dissonance techniques, and the Healthy Weight intervention (HW), based on the implementation of a healthy lifestyle.

METHODS

Forty female students, aged 18-28, with body dissatisfaction, were randomized into three arms: a BP group, an HW group, and a waiting-list control group (WLCG). The primary outcome measure was body dissatisfaction. Secondary outcomes were thin-ideal internalization, dietary restraint, negative affect, and ED psychopathology. Thirty-three participants completed the assessments before and after the one-month interventions or waiting period. A follow-up measurement was conducted one month after the interventions to assess the stability of the results.

RESULTS

Both interventions, delivered via a virtual web platform, were considered acceptable. The reduction in body dissatisfaction was greater in the BP group (r = 0.7; p < 0.01) or the HW group (r = 0.6; p < 0.01) than in the WLCG, with large effect sizes. Dietary restraint and shape concern were also significantly reduced in the BP group (r = 0.6 and r = 0.7, respectively; p < 0.01) and HW group (r = 0.5 and r = 0.5, respectively; p < 0.05) compared to the WLCG, with moderate to large effect sizes. The results obtained in each intervention group were stable at the one-month follow-up.

CONCLUSIONS

This study showed encouraging results in young women with body dissatisfaction, arguing in favor of the French adaptations of the BP and HW interventions. However, the feasibility of recruitment was difficult, partly due to the pandemic situation at the time of the study, and should be further considered to improve dissemination.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04558073, 22/09/2020 and Swiss National Clinical Trial Portal (SNCTP000003978).

Delivering a media literacy intervention for body dissatisfaction using an app-based intervention: A feasibility and pilot trial

Body dissatisfaction rates continue to remain high, and the consequences remain dire, especially among young women. Traditional media literacy interventions have found success in addressing body image-related constructs, though they are limited in their reach and are often quickly outdated. This study was designed to examine the feasibility and acceptability of delivering a media literacy intervention via ecological momentary intervention. This pilot study tested a media literacy intervention delivered via a smartphone app designed to disrupt the connection between media use and body dissatisfaction. Thirty-seven undergraduate women (Mage = 21.17; SD = 2.20) received a 15-day media literacy intervention through a smartphone application. The primary outcomes were completion rates, retention rates, percentage of data points lost to technological errors, and participant feedback. The secondary outcome was change in body dissatisfaction. The retention and percentage of data points lost to technological errors, alongside participants' ratings, indicated that this intervention is feasible and acceptable. Several targets were identified to increase participant acceptance and potential efficacy of the intervention. Trait body dissatisfaction decreased, though not significantly, following the intervention. State body image satisfaction improved significantly from the first day to the last day of engagement with the app. Overall, the intervention was deemed feasible and acceptable, opening the door for future research in which the intervention and its delivery system are improved, and its efficacy is reexamined. Future digital media literacy interventions should focus on building a user-centered app, further reducing participant burden, and testing efficacy in large and diverse samples.

Profiles and Transitions of Non-Suicidal Self-Injury and Depressive Symptoms among Adolescent Boys and Girls: Predictive Role of Bullying Victimization

Although non-suicidal self-injury (NSSI) and depressive symptoms often co-occur, as well as display distinct profiles in different genders, few studies examined the gender-specific profiles and transitions of NSSI and depressive symptoms among adolescents and the role of bullying victimization on their profiles and transitions. This study examined the profiles and transitions of NSSI and depressive symptoms for Chinese adolescent boys and girls separately, along with the predictive role of bullying victimization in subgroup memberships and transitions. A total of 3510 adolescents (52.9% boy, M age = 13.36, SD = 0.50) participated in two waves of the study over six months. The results indicated that four and three profiles identified for girls and boys separately. Adolescents in at-risk profiles showed varying degrees of transition. Adolescents with more bullying victimization were more likely to belong or transition to at-risk profiles for both genders, and bullying victimization exacerbated girls transitioning into co-occurring high profile but not in boys. The findings indicate distinct profile and transition patterns of NSSI and depressive symptoms, as well as different risk role of bullying victimization on their profiles and transitions in boys and girls, highlighting the importance of gender differences in understanding co-occurring and transitional nature of NSSI and depressive symptoms and the risk role of bullying victimization, informing effective strategies for prevention and intervention.

Eating disorders in 11–17 year old schoolgirls: Prevalence, features of clinical manifestations, psychosomatic comorbidity

Background. Eating disorders are an urgent public health problem due to their high prevalence and mortality. The disease prognosis depends on timely diagnosis; however, these conditions are sure to be underestimated.

The aim. To study the prevalence, features of clinical manifestations and psychosomatic comorbidity of eating disorder (ED) and subthreshold eating disorder (SED) in schoolgirls aged 11–17 years.

Materials and methods. We examined 917 schoolgirls aged 11–17 years. The screening questionnaire including 11questions combined into three pools named “Thoughts about one’s own body” was used. The first pool (A) – assessed body dissatisfaction, the second one (B) – eating disorders, the third one (C) – food intake disorders. The answers were encoded as “1”, “2”, “3” (“false”, “rather true”, “true”). Schoolgirls who scored the maximum number of points (12) in the pool A were regarded as dissatisfied with their body and were further divided into two groups: the first group (ED) included girls who scored more than 10 points in the pool B; girls who scored less than 10 points were in the second group (SED), respectively. Body mass index (BMI) was determined by the weight-height coefficient correlated with centile tables. Psychosomatic comorbidity was assessed by the presence of recurrent headache and abdominal pain in the last six months.

Results. The overall prevalence of eating disorders was 11.7 %, where ED made 2.1 %, SED – 9.6 %. All schoolgirls had abnormal eating behavior; however, those with SED used less aggressive weight-loss methods. BMI ˂ 5th percentile was observed in 10 % of girls with ED and 4.5 % – with SED. 60 % of girls with ED and 40.9 % with SED complained about frequent headaches; 30 % of girls with ED and 20.4 % with SED were suffering from frequent abdominal pain.

Conclusion. In schoolgirls, subthreshold eating disorder is 4.6 times more common than threshold eating disorder. Characteristics of clinical manifestations are the absence of underweight for most schoolgirls and comorbidity with pain syndrome. 

Popularity Status Insecurity as a Risk Factor for Adolescents' Maladaptive Weight-Related Cognitions and Behaviors: Examining a Moderated Mediation Model

Previous studies have identified popularity as a risk factor for adolescents' body image concerns and disordered eating behaviors, yet little is known about how adolescents' insecure feelings about their popularity status may be associated with these outcomes. To address this gap, this study examined whether popularity status insecurity was linked to weight-related cognitions and behaviors one year later and whether these links were mediated by body dissatisfaction and moderated by popularity status. A total of 233 Chinese 10th and 11th grade adolescents (41% girls; M_age = 15.81 years, SD = 0.68) participated in the study. The results showed that adolescents' popularity status insecurity was positively and indirectly related to greater future drive for thinness and restrained eating through the mediation of dissatisfied feelings about their own body shape only among those with average and low popularity, and these indirect effects were strengthened as adolescents' popularity decreased. Implications for prevention and intervention of eating disturbances for adolescents are discussed.

Black adolescents' appearance concerns, depressive symptoms, and self-objectification: Exploring the roles of gender and ethnic-racial identity commitment

There is a dearth of research examining Black adolescents' body image, with even less work examining gender differences or the influence of ethnic-racial identity (ERI) commitment. It is critical to understand how culturally relevant aspects of appearance-beyond commonly measured ideals such as thinness and muscularity-are particularly relevant to Black adolescents. The present study of Black youth (n = 252; 55% girls, 45% boys, ages 13-18, M_age = 15.5) explored the roles of gender and ERI commitment in the associations between skin tone, hair, and facial satisfaction and appearance esteem, depressive symptomatology, and self-objectification. With a few exceptions, satisfaction with skin tone, hair, and face were significantly associated with higher appearance esteem and lower self-objectification and depressive symptoms, even when controlling for weight and muscle tone satisfaction. Findings were similar across genders, with some associations stronger among Black girls relative to boys. Among youth with higher ERI commitment, associations were stronger between skin tone, hair, and facial satisfaction and some indicators of wellbeing. Findings elucidate the role of culturally relevant appearance concerns of Black adolescents and the potential benefits of ERI commitment. This work can inform culturally sensitive research practices and therapeutic interventions related to Black youth's body image experiences.

Childhood trauma and body dissatisfaction among young adult women: the mediating role of self-criticism

The present study examined the relationship between childhood trauma and body dissatisfaction among young women. The mechanisms through which childhood trauma are related to body dissatisfaction have not been sufficiently examined previously. The aims of the present study were to analyze the (i) relationships between childhood trauma, self-criticism, and body dissatisfaction and (ii) mediating role of self-criticism in the relationship between childhood trauma and body dissatisfaction. A total of 754 young adult women aged 18 to 30 years participated (M = 20.49 years; SD = 2.28). The findings showed positive correlations between childhood trauma, self-criticism, and body dissatisfaction. The mediation model indicated that (i) greater childhood trauma was associated with greater self-criticism, and (ii) greater self-criticism was significantly associated with greater body dissatisfaction. Therefore, childhood trauma was indirectly associated with increased body dissatisfaction and explained by the positive relationship with increased self-criticism. These results highlight the importance of childhood trauma in body dissatisfaction among young adult women and demonstrates self-criticism coping style as a key factor in this relationship. Early detection of self-criticism-based coping styles and childhood trauma could improve (i) quality of life and prevent the onset of body dissatisfaction, and (ii) treatment planning and prevent body dissatisfaction from escalating into major problems (e.g., eating disorders, body dysmorphic disorder, morbid exercise and/or depressive symptomatology).

Outcomes of a Cluster Randomized Controlled Trial of the SoMe Social Media Literacy Program for Improving Body Image-Related Outcomes in Adolescent Boys and Girls

Although the negative effect of social media use among youth on body image and eating concerns has been established, few classroom-based resources that can decrease these effects through targeting social media literacy skills have been developed. This study aimed to test the efficacy of SoMe, a social media literacy body image, dieting, and wellbeing program for adolescents, through a cluster randomized controlled trial. Participants (n = 892; M_age = 12.77, SD = 0.74; range 11–15; 49.5% male) were randomized by school (n = 8) to receive either weekly SoMe (n = 483) or control sessions (lessons as usual; n = 409) over 4 weeks in their classroom. Participants completed surveys at four timepoints (baseline, 1-week post-intervention, and 6- and 12-month follow-up) assessing body dissatisfaction, dietary restraint, strategies to increase muscles (primary outcomes), self-esteem and depressive symptoms (secondary outcomes), and internalization of appearance ideals and appearance comparison (exploratory outcomes). Modest positive intervention effects were found in dietary restraint and depressive symptoms at 6-month follow-up in girls but few positive effects emerged for boys. The findings provide only preliminary support for a social media literacy intervention, but suggest the usefulness of both identifying those who benefit most from a universally delivered intervention and the need to refine the intervention to maximize intervention effects.