Accounting for fluctuations in body dissatisfaction

Daily instability in body dissatisfaction in individuals with and without eating disorders

Body dissatisfaction (BD) includes negative thoughts and feelings about one's body shape. Although typically assessed as a trait, BD has been found to fluctuate within a day. The present study examined whether daily instability in BD differs according to trait BD, eating disorder (ED) diagnosis, and engagement in maladaptive exercise. Participants with EDs (n = 166) and controls (n = 44) completed a self-report measure of trait BD and reported BD and engagement in maladaptive exercise five times daily for 14 days as part of an ecological momentary assessment protocol. BD instability was calculated as adjusted mean squared successive difference. On average across assessments, participants with EDs reported a 16% change in their BD ratings between consecutive assessments, which was significantly higher than the 12% change in controls. Trait BD was significantly inversely associated with BD instability in individuals with EDs, but not in controls. BD instability did not differ across ED diagnoses or between days with versus without maladaptive exercise. Findings suggest that BD is a dynamic state that varies within a day, especially in participants with EDs. Further research is needed to clarify whether this heightened instability in BD is a clinically relevant factor underlying ED symptoms.

Comorbidity between body dissatisfaction and nicotine vaping among young adults in college: a daily diary study

Objective: The purpose of this study was to elucidate comorbidity between body dissatisfaction and nicotine vaping. Participants: Participants were 121 college students (M age = 20.51 years; 75.0% female; 75.2% White) who participated in a 14-day daily diary study. Methods: Logistic regression was used to test links between baseline trait body dissatisfaction and vaping frequency across 14 days. Multilevel logistic regression was used to test within-person, daily links between body dissatisfaction and nicotine vaping. Results: Each additional unit of trait body dissatisfaction increased the odds of frequent vaping by 33% (95% CI [1.00, 1.77]) and daily vaping by 54% (95% CI [1.10, 2.15]). Within-person, daily associations between body dissatisfaction and vaping were nonsignificant. Conclusions: Body dissatisfaction may increase college students' risk for engaging in frequent nicotine vaping. However, daily changes in body dissatisfaction may not predict same- or next-day vaping. College students with body dissatisfaction may benefit from nicotine interventions.

Body image disturbance, interoceptive sensibility and the body schema across female adulthood: a pre-registered study

Introduction

Body image disturbance (BID) typically involves explicit negative attitudes toward one's shape and weight and is associated with altered interoceptive sensibility (the subjective perception of internal bodily states). This association is a known risk factor for the development and maintenance of eating disorders. However, while research has centred on younger women with eating disorders, diverse facets of BID appear in women without eating disorders across adulthood. Research shows that in the general population, young women (ages 18-25) with high BID exhibit disturbances in the body schema: an implicit sensorimotor representation of the body in space which includes mental simulation of a movement such as motor imagery. Given that body image is subject to age-related influences, it is important to investigate how age-related variation in BID can influence the body schema beyond young adulthood alone. Here, we examine the relationship between BID, interoceptive sensibility and the body schema across female adulthood.

Methods

Cross-sectional data was collected online from 1,214 women across four age groups: Young adults (18-24), Adults (25-39), Middle-aged adults (40-59), and Older aged adults (60-75). BID was indexed by questionnaires measuring body objectification, state, and trait body dissatisfaction. Interoceptive sensibility (IS) was measured using the MAIA-2 questionnaire. The body schema was evaluated through the Own Body Transformation task: a mental rotation task which assesses the capacity to make an embodied mental transformation.

Results

Analyses revealed that while body objectification and trait body dissatisfaction decreased from young to older adulthood, state body dissatisfaction showed a marked increase. A negative relationship between IS and BID across all age groups was also evidenced. Finally, age, BID and orientation of the presented body were significant predictors of the time taken to make an embodied transformation.

Discussion

These findings highlight the consistent relationship of BID and IS across age groups beyond young adulthood and demonstrate the varying importance of different aspects of BID as individuals age. We also evidence for the first time that disruptions in body image have the potential to impact implicit sensorimotor representations of the body even in women without eating disorders across female adulthood.

Demographic predictors of body image satisfaction: The U.S. Body Project I

We examined how gender, body mass, race, age, and sexual orientation were linked to appearance evaluation, overweight preoccupation, and body image-related quality of life among 11,620 adults recruited via Mechanical Turk. Men were less likely than women to report low appearance evaluation, high overweight preoccupation, negative effects of body image on their quality of life, being on a weight-loss diet, and trying to lose weight with crash diets/fasting. Racial differences were generally small, but greater appearance evaluation was reported by Black men versus other groups and Black women versus White women. Across all measures, gay and bisexual men reported poorer body image than heterosexual men, with only small effect sizes observed for sexual orientation differences among women. Body mass, but not age, was strongly associated with body image. The prevalence of poor body image highlights the need for interventions. On the positive side, half of men and women reported high appearance evaluation. Examination of this group could identify factors promoting positive body image.

Real-time predictors of body dissatisfaction in females with binge eating: an ecological momentary assessment study

PURPOSE

Body dissatisfaction (BD) is supported as a maintenance factor for eating disorders (EDs) characterized by binge eating (BE). Although it is traditionally conceptualized as a trait construct, ecological momentary assessment (EMA) studies have shown that it fluctuates within-day and that momentary elevations in BD prospectively predict near-time ED behaviors. However, less is known about the contextual factors that precipitate these fluctuations in BD.

METHODS

The current study thus sought to examine whether certain internal (i.e., negative affect, shape/weight-related cognitions) and environmental (i.e., attending social events, being exposed to thin-ideal media, spending time on social media) factors prospectively predict momentary elevations in BD in females with BE. Participants (n = 25) completed an EMA protocol over 14 days.

RESULTS

Data on BD and internal and environmental factors were analyzed using generalized estimating equations. Results showed that (1) greater than one's usual negative affect and shape/weight-related cognitions, and (2) spending time on social media prospectively predicted momentary elevations in BD. Interestingly, attending social events prospectively predicted momentary reductions in BD.

CONCLUSION

These findings may have important implications for conceptualizing and managing BD to prevent ED behaviors.

LEVEL OF EVIDENCE

Level II, controlled trial without randomization.

The impact of nature exposure on body image and happiness: an experience sampling study

Exposure to nature is associated with improved psychological well-being and positive body image. Here, we examined whether everyday exposure to natural environments is associated with state body image outcomes (and, for comparative reasons, state happiness) using an experience sampling method. One-hundred-and-seven participants completed a 30-day experience sampling phase in which they reported their state body image (body weight, body shape, and physical appearance satisfaction), state happiness, and features of the surrounding environment (total = 6,025 responses) at three random time-points each day. Results indicated that being outdoors was associated with significantly higher state body image on all three indicators, but effect sizes were lower compared to effects on state happiness. Specific environment type was also important, with blue-spaces and wood- and grasslands, respectively, having stronger effects than other environments. These results provide evidence that everyday exposure to natural environments is associated with more positive state body image and greater happiness.

Demographic predictors of objectification theory and tripartite influence model constructs: The U.S. Body Project I

We examined how demographic factors (gender, sexual orientation, racial group, age, body mass) were linked to measures of sociocultural appearance concerns derived from objectification theory and the tripartite influence model (McKinley & Hyde, 1996; Schaefer et al., 2015) among 11,620 adults. Men were less likely than women to report high body surveillance, thin-ideal internalization, appearance-related media pressures, and family pressures; did not differ in peer pressures; and reported greater muscle/athletic internalization. Both men and women expressed greater desire for their bodies to look "very lean" than to look "very thin". Compared to gay men, heterosexual men reported lower body surveillance, thin-ideal internalization, peer pressures, and media pressures. Black women reported lower thin-ideal internalization than White, Hispanic, and Asian women, whereas Asian women reported greater family pressures. Being younger and having higher BMIs were associated with greater sociocultural appearance concerns across most measures. The variation in prevalence of sociocultural appearance concerns across these demographic groups highlights the need for interventions.

Translation and Validation of a State-Measure of Body Image Satisfaction: The Body Image State Scale

The aim of the present study is to test the validity and reliability of the French Body Image State Scale (F-BISS). The scale was translated using a back-translation technique, with discrepancies being settled through consensus. Three hundred and twelve female participants were recruited. Convergent validity was assessed using eating disorder evaluation and social comparison. Exploratory and confirmatory factor analyses were also conducted. The translated Body Image State Scale (BISS) demonstrated good psychometric properties, with good internal consistency (α = 0.83), and adequate goodness-of-fit. The translated BISS presented a unifactorial structure, with one factor explaining 56% of the variance. The exploratory factor analysis led to the removal of a single item due to insufficient factor loading (<0.45). Its convergent validity seems consistent with previous literature. Discriminant analyses showed a significant difference in F-BISS score between participants relative to eating disorder symptomatology (t = 11.65; p < 0.001). This translation could prove useful in both research and clinical settings to assess state body satisfaction in French populations.

"eLoriCorps Immersive Body Rating Scale": Exploring the Assessment of Body Image Disturbances from Allocentric and Egocentric Perspectives

The first objective of this study was to test the convergent and discriminant validity between the “eLoriCorps Immersive Body Rating Scale” and the traditional paper-based figure rating scale (FRS). The second objective was to explore the contribution of the egocentric virtual reality (VR) perspective of eLoriCorps to understanding body image disturbances (BIDs). The sample consisted of 53 female and 13 male adults. Body size dissatisfaction, body size distortion, perceived body size, and ideal body size were assessed. Overall, outcomes showed good agreement between allocentric perspectives as measured via VR and the FRS. The egocentric VR perspective produced different results compared to both the allocentric VR perspective and the FRS. This difference revealed discriminant validity and suggested that eLoricorps’ egocentric VR perspective might assess something different from the traditional conception of body dissatisfaction, which an allocentric VR perspective generally assesses. Finally, the egocentric VR perspective in assessing BIDs deserves to be studied more extensively to explore the possibility of finding two types of body image distortion: (a) an egocentric perceptual body distortion, referring to internal body sensation affected by intra-individual changes, and (b) an allocentric perceptual body distortion, referring to external body benchmarks constructed by inter-individual comparison occurring in a given cultural context.

The Happy American Body 2.0: Predictors of affective body satisfaction in two U.S. national internet panel surveys

The first national study of body image was reported four decades ago in the article The Happy American Body (Berscheid et al., 1973). To provide a modern follow-up to this study, we used two Internet panel surveys of U.S. adults to examine feelings about appearance (Survey 1: Married N = 1095; Single N = 5481) and weight, appearance, body, and muscle size/tone (Survey 2: N = 1601). Mean ages across samples for men and women ranged from 42-53. On the positive side, many men and women were somewhat-to-very satisfied with their appearance (67 %; 57 %), overall body (61 %; 46 %), weight (54 %; 42 %), and muscle tone/size (56 %; 41 %). Mean gender differences were small (Cohen's ds = 0.18-0.32), as were sexual orientation differences within each gender (ds = |0.00-0.25|). Looking at negative body image, fewer men than women were somewhat-to-very unhappy with their appearance among married (19 %; 29 %) and single participants (29 %; 35 %), and fewer men were somewhat-to-extremely dissatisfied with their appearance (18 %; 24 %), body (27 %; 39 %), weight (36 %; 49 %), muscle tone/size (27 %; 41 %). Nearly one-fifth of men (18 %) and one-fourth of women (27 %) were very-to-extremely dissatisfied with at least one of these traits, highlighting the importance of body image interventions.

Reciprocal longitudinal relations between weight/shape concern and comorbid pathology among women at very high risk for eating disorder onset

PURPOSE

Understanding how known eating disorder (ED) risk factors change in relating to one another over time may inform efficient intervention targets. We examined short-term (i.e., 1 month) reciprocal longitudinal relations between weight/shape concern and comorbid symptoms (i.e., depressed mood, anxiety) and behaviors (i.e., binge drinking) over the course of 24 months using cross-lagged panel models.

METHODS

Participants were 185 women aged 18-25 years at very high risk for ED onset, randomized to an online ED preventive intervention or waitlist control. We also tested whether relations differed based on intervention receipt.

RESULTS

Weight/shape concern in 1 month significantly predicted depressed mood the following month; depressed mood in 1 month also predicted weight/shape concern the following month, but the effect size was smaller. Likewise, weight/shape concern in 1 month significantly predicted anxiety the following month, but the reverse was not true. Results showed no temporal relations between weight/shape concern and binge drinking in either direction. Relations between weight/shape concern, and comorbid symptoms and behaviors did not differ based on intervention receipt.

CONCLUSIONS

Results support focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change.

LEVEL OF EVIDENCE

Level I, evidence obtained from a properly designed randomized controlled trial.

Body image states in everyday life: Evidence from ecological momentary assessment methodology

This review highlights the contributions of Professor Thomas Cash to the scholarship of body image experiences in daily life, including his influence on subsequent research in this field. Cash's arguments for capturing a broad range of state-based body image experiences have been heeded, with recent studies exploring positive body image constructs as well as the more studied negative body image experiences. Appearance comparisons are the most commonly studied contextual influence on body image, and they seem to have a consistent effect. However, the experiences of body image in sexual contexts, and among adolescents, those who are pregnant, or have other physical characteristics that may increase the salience of appearance warrant further attention. Findings generally support Cash's contention that trait body image relates to likelihood and level of experience of body image in daily life, though the moderating effects of trait aspects on state-based relationships remains unclear. The discussion concludes with consideration of the impact of assessment schedules on obtained results. It is also discussed how accumulated knowledge regarding state-based body image experiences may be leveraged in treatment contexts, particularly in light of clear evidence that repeated assessment of body image in daily life increases self-awareness of one's body image characteristics.

Nature and consequences of positively-intended fat talk in daily life

The current study used ecological momentary assessment to explore the frequency, trait predictors, and momentary consequences of positively-intended fat talk, a specific sub-type of fat talk that involves making negative comments about one's own appearance with the view to making someone else feel better. A total of 135 women aged 18-40 completed trait measures of appearance-based comparisons, thin-ideal internalisation, body shame, and body surveillance, before completing a state-based component, involving six short surveys delivered via a smartphone app at random points during the day for seven days. Findings indicate that both self- and other-fat talk are common in daily social interactions, and that individuals with higher levels of trait negative body image were more likely to engage in fat talk. Self-fat talk negatively impacted state body satisfaction levels. Possible theoretical and practical implications are outlined.

Do women with greater trait body dissatisfaction experience body dissatisfaction states differently? An experience sampling study

The present study evaluated the relation of key features of state body dissatisfaction experiences - inertia, instability from moment-to-moment, and average level across time-points - to trait body dissatisfaction and/or eating disorder risk. Participants included 161 women who completed measures of trait body dissatisfaction and disordered eating pathology, and then completed reported state body dissatisfaction and contextual influences (binge eating, dietary restraint, exercise, and appearance comparison behaviors) 6 times daily for 7 days. Results indicated that individuals with elevated trait body dissatisfaction were reliably different from those with healthier body image in terms of average state body dissatisfaction ratings, but not for inertia or instability. State mean and trait body dissatisfaction uniquely predicted eating pathology, although their predictive accuracy for clinical caseness was comparable. Cost vs. benefit of using state body image data for understanding trait body image and eating pathology is discussed.

The Daily Frequency, Type, and Effects of Appearance Comparisons on Disordered Eating

Using experience sampling methodology, we examined the effects of frequency and occurrence of appearance-based comparisons on disordered eating behaviors (binge eating, restrictive behaviors, and weight-related exercise). A total of 161 Australian women (aged 18–48) completed a baseline measure of eating pathology. An iPhone application prompted participants 6 times daily for 7 days to self-report on appearance comparisons and disordered eating behaviors since the last assessment. We hypothesized that contemporaneously reported occurrences of both upward and downward appearance comparisons, when compared to noncomparison situations, and frequency of upward comparisons would predict disordered eating behaviors. In prospective (lagged) analyses, only upward comparisons (relative to noncomparison situations) significantly predicted the likelihood of disordered eating outcomes. Trait eating pathology had a direct effect on each disordered eating variable and also moderated the influence of upward appearance comparisons (relative to noncomparison assessments) on binge-eating episodes. The lack of a differentiated effect between contemporaneously reported occurrences of upward and downward comparisons suggests that both forms of comparison increase the likelihood of disordered eating. Women may benefit from preventive programs that focus on the detrimental consequences of appearance comparisons on disordered eating; such programs may equip women with strategies to help reduce the frequency of these comparisons.

When does behavior follow intent? Relationships between trait level dietary restraint and daily eating behaviors

BACKGROUND

The relationship between self-report trait level restriction and daily engagement in restriction behaviors is not well understood, and as a result the usefulness of such trait level measures is unclear. The present study aimed both to examine the validity of self-reported trait dietary restraint behaviors, and to examine the respective relationships among self-reported trait dietary restraint intentions and behaviors and both restrained and disinhibited eating at the daily level.

METHODS

A sample of 109 women (M_age = 24.72, SD = 4.15) completed a self-report trait level measure of dietary restraint before providing EMA data on their daily engagement in dietary restraint and disinhibited eating behaviors, as well as mood, over a period of 7 days. Multilevel hurdle models were used to test the relationship between trait levels of dietary restraint, and daily level reports of restraint and disinhibited eating behaviors.

RESULTS

Trait restraint behavior was a consistent predictor of daily presence and frequency of restraint behaviors. In contrast, trait restraint intentions was not a predictor of daily restraint behaviors, however it did predict daily frequency of overeating. In addition, daily negative affect emerged as a predictor of comfort eating, but was not predictive of restraint behaviors.

CONCLUSIONS

Findings confirm the usefulness of assessments of self-reported trait dietary restraint behaviors as a method of capturing dieting behaviors. In contrast, trait level dietary restraint intentions was a poor predictor of eating outcomes and more research on the way that restraint intentions affect eating behaviors is warranted.

Regression tree analysis of ecological momentary assessment data

An increasingly popular form of data collection in health psychology research is Ecological Momentary Assessment (EMA); that is, using diaries or smartphones to collect intensive longitudinal data. This method is increasingly applied to the study of relationships between state-based aspects of individuals' functioning and health outcomes (e.g., binge eating, alcohol use). Analysis of such data is challenging and regression tree modelling (RTM) may be a useful alternative to multilevel modelling for investigating the association between a set of explanatory variables and a continuous outcome. Furthermore, RTM outputs 'decision trees' that could be used by health practitioners to guide assessment and tailor intervention. In contrast to regression, RTM is able to easily accommodate many complex, higher-order interactions between predictor variables (without the need to create explicit interaction terms). These benefits make the technique useful for those interested in monitoring and intervening upon health and psychological outcomes (e.g., mood, eating behaviour, risky alcohol use, and treatment adherence). Using real data, this paper demonstrates both the benefits and limitations of RTM and how to extend these models to accommodate analysis of nested data; that is, data that arise from EMA where repeated observations are nested within individuals.

A Person-by-Situation Account of Why Some People More Frequently Engage in Upward Appearance Comparison Behaviors in Everyday Life

Although the influence of stable, trait-like factors (such as trait body dissatisfaction and appearance internalization) on instances of appearance comparison has been well documented, the additive and interactive influence of contextual factors (such as one's current body satisfaction) on comparison behaviors is unknown. Therefore, the present study tested a Person×Situation model in which both state and trait body image variables interacted to predict engagement in various forms of comparison (upward, downward, and lateral). Participants included 161 women who completed a baseline measure of trait body dissatisfaction and internalization, and then completed, via an iPhone app, an ecological momentary assessment phase in which they reported momentary experiences of mood and comparison behaviors at up to 6 random times per day for 7days. Multilevel analyses revealed that upward comparisons (comparisons against more attractive people) were more likely for individuals with heightened trait and/or state negative body image, but these predictive effects of state and trait on appearance comparisons appear largely independent of each other. Furthermore, neither state nor trait body image variables were related to the other forms of comparison, and time lag at the state-level between predictor and outcome did not seem to influence the strength of these associations. Present findings are consistent with the notion that how an individual feels in the moment about their appearance may influence engagement in deleterious appearance behaviors. However, further testing is needed to confirm these causal hypotheses.

Mediators of the relationship between thin-ideal internalization and body dissatisfaction in the natural environment

Social comparisons (i.e., body, eating, exercise) and body surveillance were tested as mediators of the thin-ideal internalization-body dissatisfaction relationship using ecological momentary assessment (EMA). Participants were 232 college women who completed a 2-week EMA protocol, responding to questions three times per day. Multilevel path analysis was used to examine a 2-1-1 mediation model (thin-ideal internalization assessed as trait; between-person effects examined) and a 1-1-1 model (component of thin-ideal internalization [thin-ideal importance] assessed momentarily; within- and between-person effects examined). For the 2-1-1 model, only body comparison and body surveillance were significant specific mediators of the between-person effect. For the 1-1-1 model, all four variables were significant specific mediators of the within-person effect. Only body comparison was a significant specific mediator of the between-person effect. At the state level, many processes explain the thin-ideal internalization-body dissatisfaction relationship. However, at the trait level, body comparison and body surveillance are more important explanatory factors.

A daily diary study of self-compassion, body image, and eating behavior in female college students

Although self-compassion is associated with healthier body image and eating behavior, these findings have generally emerged at the between-persons level only. The present study investigated the unique contributions of within-person variability in self-compassion, and between-persons differences in self-compassion, to body image and eating behavior. Over seven days, 92 female college students completed nightly measures of self-compassion, self-esteem, dietary restraint, intuitive eating, body appreciation, body satisfaction, and state body image. Multilevel modeling revealed that within-persons, day-to-day fluctuations in self-compassion contributed to day-to-day fluctuations in body image and eating. Between-persons, participants' average levels of self-compassion across days contributed to their average levels of body image and eating over the week. Results generally held when controlling for within- and between-persons self-esteem. Evidently, the eating and body image benefits of self-compassion may come not only from being a generally self-compassionate person, but also from treating oneself more self-compassionately than usual on a given day.

Use of weekly assessment data to enhance evaluation of a subjective wellbeing intervention

PURPOSE

While intervention effects in target outcomes have typically been tested based on change from baseline to post-intervention, such approaches typically ignore individual differences in change, including time taken to see improvement. The present study demonstrates how weekly patient-reported data may be used to augment traditional pre-post intervention evaluations in order to gain greater insights into treatment efficacy.

METHODS

Two hundred and fifty-two adolescent boys and girls (M age = 13.6 years, SD = 0.6 years) from four secondary schools in Victoria, Australia, were assigned by school into control (n = 88) or intervention (n = 164) groups. The intervention group participated in a 6-week course designed to improve subjective wellbeing (SWB) by fostering resilience, coping skills, and self-esteem. In addition to baseline, post-intervention, and 3-month follow-up assessments of SWB, intervention group participants also completed weekly summarise of affective experiences for the duration of the intervention phase.

RESULTS

While standard pre-post data showed significant improvement in SWB for the intervention group relative to controls, weekly data showed individual differences in the trajectory of change during this intervention phase; low SWB individuals experienced initial worsening of symptoms followed by improvement in the second half of the intervention phase, whereas high SWB individuals experienced initial gains, followed by a plateau from Week 4 onwards.

CONCLUSIONS

Addition of weekly data provided greater insights into intervention effects by: (1) contradicting the notion that early responsiveness to treatment is predictive of level of improvement by post-intervention, and (2) providing data-based insights into ways to enhance the intervention.

Does body satisfaction influence self-esteem in adolescents' daily lives? An experience sampling study

This study examined, within the context of the Contingencies of Self-Worth model, state-based associations between self-esteem and body satisfaction using the experience sampling method. One hundred and forty-four adolescent girls (mean age = 14.28 years) completed up to 6 assessments per day for one week using Palm Digital Assistants, in addition to baseline measures of trait body satisfaction and self-esteem. Results showed considerable variation in both state-based constructs within days, and evidence of effects of body satisfaction on self-esteem, but not vice versa. Although these state-based associations were small in size and weakened as the time lag between assessments increased for the sample as a whole, individual differences in the magnitude of these effects were observed and predicted by trait self-esteem and body satisfaction. Collectively, these findings offer support for key tenets of the Contingencies of Self-Worth model.

Understanding the link between body image and binge eating: a model comparison approach

PURPOSE

The present study tests several competing, explanatory models-dual pathways, escape from awareness, and objectification theory-for the established link between body dissatisfaction and binge eating.

METHODS

408 women aged between 18 and 40 years completed a survey designed to assess contributions of proposed mediators (dietary restraint and negative affect from the dual pathway model, self-distraction from the escape from awareness model, and interoceptive deficits from objectification theory) for the body dissatisfaction-binge eating relationship.

RESULTS

Although mediation analyses supported the dual pathway model and objectification theory when tested separately, the dual pathway model most strongly predicted the body dissatisfaction-binge eating relationship. Both model-implied mediators (dietary restraint and negative affect) made significant unique contributions, accounting for roughly one-quarter of the shared variance between body dissatisfaction and binge eating when tested separately from other mediators. Improvements in variance explained were negligible once other proposed mediators were included in a test of models combined.

CONCLUSIONS

Collectively, these findings suggest the superiority of the dual pathway model over objectification theory and the escape model, but the remaining unaccounted for covariance suggests need to consider alternative mechanisms that may also account for the relationship between body dissatisfaction and binge eating.

Optimizing prediction of binge eating episodes: a comparison approach to test alternative conceptualizations of the affect regulation model

BACKGROUND

Although a wealth of studies have tested the link between negative mood states and likelihood of a subsequent binge eating episode, the assumption that this relationship follows a typical linear dose-response pattern (i.e., that risk of a binge episode increases in proportion to level of negative mood) has not been challenged. The present study demonstrates the applicability of an alternative, non-linear conceptualization of this relationship, in which the strength of association between negative mood and probability of a binge episode increases above a threshold value for the mood variable relative to the slope below this threshold value (threshold dose response model).

METHODS

A sample of 93 women aged 18 to 40 completed an online survey at random intervals seven times per day for a period of one week. Participants self-reported their current mood state and whether they had recently engaged in an eating episode symptomatic of a binge.

RESULTS

As hypothesized, the threshold approach was a better predictor than the linear dose-response modeling of likelihood of a binge episode. The superiority of the threshold approach was found even at low levels of negative mood (3 out of 10, with higher scores reflecting more negative mood). Additionally, severity of negative mood beyond this threshold value appears to be useful for predicting time to onset of a binge episode.

CONCLUSIONS

Present findings suggest that simple dose-response formulations for the association between negative mood and onset of binge episodes miss vital aspects of this relationship. Most notably, the impact of mood on binge eating appears to depend on whether a threshold value of negative mood has been breached, and elevation in mood beyond this point may be useful for clinicians and researchers to identify time to onset.

A naturalistic study of fat talk and its behavioral and affective consequences

Fat talk is a style of verbal expression among young women involving negative self-statements, complaints about physical appearance, and weight management. This research used ecological momentary assessment to examine the impact of naturalistic fat talk experiences on body dissatisfaction, body checking, negative affect, and disordered eating behaviors. We examined trait self-objectification as a moderator. Sixty-five female college students completed a baseline questionnaire and responded to questions when randomly prompted by palm pilot devices for five days. Results indicated fat talk is common and associated with greater body dissatisfaction, body checking, negative affect, and disordered eating behaviors. Fat talk participation was associated with greater body checking than overhearing fat talk. Greater trait self-objectification was associated with greater body dissatisfaction and body checking following fat talk. These results suggest that fat talk negatively impacts the cognitions, affect, and behavior of young women and has increased negative effects for women higher in self-objectification.

Tests of an extension of the dual pathway model of bulimic symptoms to the state-based level

The dual pathway model proposes that trait body dissatisfaction leads to bulimic symptoms via two distinct pathways: dieting and trait negative affect. As many of these modelled variables have state-based equivalents, the present study evaluated the generalisability of this model to predict associations between state body dissatisfaction and instances of disordered eating. 124 women aged 18 to 40 years completed an online survey (accessed via a mobile phone device with web access) over a 7-day period. The mobile phone device prompted participants at random intervals seven times daily to self-report their state body dissatisfaction, current mood experiences, dieting attempts, and disordered eating practices. Multi-level mediation modelling revealed that both negative mood states and dieting significantly mediated the state body dissatisfaction-disordered eating relationships, although the strength of these associations depended on the aspect of disordered eating measured and individual differences in trait body dissatisfaction, internalization of appearance standards, tendency towards dieting, and BMI. Collectively, these results not only support adapting the dual pathway model to the state-level, but also suggest that several of the model implied pathways may be more relevant for individuals with more pathological eating- and body-related concerns and behaviours.

State Body Dissatisfaction and Social Interactions

To date, there has been limited empirical scrutiny of the correlates and consequences of day-to-day state body dissatisfaction fluctuations within naturalistic contexts. We used ecological momentary assessment (a form of naturalistic observation) to evaluate whether state body dissatisfaction was concurrently and/or prospectively associated with occurrence and quality of social interactions. Women ( N = 121), aged 18 to 40, completed a brief trait-based survey and then nominated a 7-day period within which to receive seven text messages daily, at random intervals, prompting them to complete measures of body dissatisfaction at that moment. If they were currently or had recently engaged in social interactions, they were also asked to fill out questions rating the quality of these interactions (operationalized in terms of enjoyment of, and control in, the interaction). Findings suggest that the relationship between state body dissatisfaction and aspects of social interactions is complex and may vary over time. Cross-sectionally, state body dissatisfaction and social interaction quality were negatively associated. Prospectively, however, body dissatisfaction predicted subsequent avoidance of social interactions. Interestingly, when women chose to avoid social interactions, their body dissatisfaction worsened, yet when they did engage in social interactions, they reported improved body satisfaction. Importantly, the links between state body dissatisfaction and social interactions may be moderated by body mass index and trait body satisfaction levels. Potential mechanisms underlying the association between state body dissatisfaction and quality and quantity of social interactions are discussed, and future research avenues are proposed to further understand their inter-relation.

Does the burden of the experience sampling method undermine data quality in state body image research?

Despite growing popularity of experience sampling methodology (ESM) for evaluations of state-based components of body image, there have been concerns that the frequent repeated measurement might encourage problematic responding resulting in low data quantity and/or quality. Using a sample of 105 women (mean age=24.84), this study used multilevel modelling to investigate whether (a) there were changes in compliance or response variability across a 7-day period, and (b) whether such changes are explained by participant characteristics. Present findings suggest that demands of ESM protocol undermine quantity more so than quality of obtained data. Decline in procedural compliance across the testing period correlated with BMI and body shame, whereas reduced variability in state-based assessments did not adversely impact the strength of association between state body satisfaction ratings and other variables in the dataset. The authors make several recommendations for ensuring the quality of ESM-based data in future studies.

Psychometric properties of a French version of a Dutch scale for assessing breast and body image (BBIS) in healthy women

Background

Genetic testing among women for BRCA1/2 mutation can have various psychological effects, such as those focusing on body image. The aim of this study was to examine the psychometric properties of a generic scale assessing breast and body image (BBIS) in healthy women tested for BRCA1/2 mutations.

Methods

A Dutch body image scale focusing on both general and breast-related body image was translated into French. It was presented to a French cohort of female cancer-free BRCA1/2 mutation carriers and non-carriers (N = 568). The psychometric properties of the scale were studied by assessing its dimensional and factorial structure, internal consistency, construct-related validity, and external validity.

Results

The scale was found to be a satisfactory psychometric tool for assessing both body image and breast image. The three main dimensions which emerged were classified under the headings “values attached to body image”, “satisfaction with body image and perceived attractiveness”, and “satisfaction with breasts”. The BBIS scores were not significantly associated with the participants’ socio-demographic characteristics or their BRCA1/2 mutation carrier status, but significant associations were observed between these scores and the women’s medical and behavioural characteristics.

Conclusions

The BBIS is a generic tool which can be used to assess body image in either affected or unaffected women. The scale will have to be administered to other populations in order to confirm its validity.

Is intensive measurement of body image reactive? A two-study evaluation using Ecological Momentary Assessment suggests not

Intensive assessment methods (e.g., Ecological Momentary Assessment [EMA]) are increasingly used to capture body image experiences in daily life. One concern with EMA is multiple assessments may increase reactivity to internal or external cues, potentially biasing measurement. Reactivity to EMA was evaluated in two studies (Study 1: N=63 female undergraduates, Study 2: N=131 women with high body dissatisfaction/disordered eating). Participants completed five daily surveys on handheld computers for 1-2 weeks and body image-related questionnaires at the start and end of each study. Results showed no systematic changes in pre- and post-EMA measures or momentary EMA reports, suggesting women were not reactive to the EMA protocols. Completing 1-2 weeks of EMA does not appear to affect body dissatisfaction, mood, or attitudes in non-clinical or at-risk samples of women. These studies provide evidence that EMA methods can be used to assess real-world body image experiences without undue concern about measurement reactivity.

A re-examination of the benefits of exercise for state body satisfaction: consideration of individual difference factors

Although the link between exercise and body image is well documented, the considerable inter-individual variability in this relationship has been largely ignored. Therefore, the aim of the present study was to test the contributions of key body image and exercise-related moderators (age, body mass index (BMI), exercise frequency, trait body dissatisfaction, internalisation of appearance standards, and body surveillance tendencies) in predicting variability in the exercise-body satisfaction relationship. Thirty-seven undergraduate women completed a questionnaire containing the above trait-based measures and then carried a Personal Digital Assistant (PDA) for a 7-day period. Participants were instructed to use the PDA to self-report their state body satisfaction immediately following an exercise session and also when the PDA signalled at each of six random intervals throughout the day. Multilevel modelling revealed a bi-directional relationship between exercise and state body satisfaction. Moreover, post-exercise increases in state body satisfaction were strongest for individuals who were younger and engaged in regular exercise, and weakest for individuals with high BMI and/or the tendency to compare their appearance with others. These findings highlight potential limits on the efficacy of exercise-based therapy for body image disturbances.