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Alcaraz-Ibáñez M, Paterna A, Griffiths MD. Exploring the differentiated relationship between body-, eating-, and exercise-related social comparisons and depressive symptoms among adolescents. J Affect Disord 2024; 344:389-396. [PMID: 37839470 DOI: 10.1016/j.jad.2023.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND The present study examined (i) the potential differentiated relationship between three forms of social comparison previously identified as particularly relevant within the context of eating disorders (EDs) (i.e., those related to body, eating, and exercise) and depressive symptomatology among adolescents, and (ii) whether this relationship may differ according to gender and ED risk status. METHODS A sample comprising 689 adolescents (46.15 % females) aged 12-19 years (M = 15.06, SD = 2.04) were recruited using non-probabilistic techniques from nine schools in southern Spain. Cross-sectional data derived from a self-report survey which included the variables of interest were analysed using the PROCESS macro for SPSS. RESULTS Bootstrapped regression/moderation analysis with 5000 resamples demonstrated two key sets of findings. Firstly, that having low self-esteem, being a girl, being at risk for ED, having social-physique anxiety, and social comparisons referring to body and exercise accounted for unique variance in depressive symptomatology. Secondly, the relationship between both eating-related and exercise-related comparisons and depressive symptomatology tended to be stronger in the group of females at risk for EDs. LIMITATIONS The study was mainly limited by the use of self-reported cross-sectional data. CONCLUSIONS Prevention and treatment efforts aimed at reducing depressive symptomatology among adolescents could benefit from incorporating content alluding to body comparison and, particularly in the case of females at risk for EDs, content alluding to eating and exercise comparisons.
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Affiliation(s)
| | - Adrian Paterna
- Health Research Centre and Department of Education, University of Almería, Spain.
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Thompson KA, White JP, Bardone-Cone AM. Associations between pressure to breastfeed and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum women. Psychiatry Res 2023; 328:115432. [PMID: 37669578 DOI: 10.1016/j.psychres.2023.115432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Data from qualitative interviews indicate postpartum individuals feel pressure from their healthcare providers, the media, and their partners to breastfeed their infant(s). However, the link between pressure to breastfeed and maternal mental health symptoms has not been evaluated quantitatively. The goal of the current study was to evaluate the associations between perceived pressure to breastfeed from various sources and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum individuals. METHODS Participants were 306 women, ages 18-39, who gave birth in the past 12 months in the United States (primarily in North Carolina). They completed an online survey about their health history (including mental health symptoms) and breastfeeding experiences. RESULTS Results found postpartum women perceived more pressure to breastfeed from healthcare providers and from the media compared to pressure to breastfeed from their partners. Pressure from healthcare providers was associated with depressive, obsessive-compulsive, and eating disorder symptoms, but not with anxiety symptoms. Pressure from the media was associated with only depressive and eating disorder symptoms. Pressure from partners was not significantly associated with mental health symptoms. Above and beyond the other sources of pressure, pressure from healthcare providers explained a unique proportion of variance of obsessive-compulsive and eating disorder symptoms. LIMITATIONS Limitations include the cross-sectional design (which limits causal interpretations), and the homogenous sample (87% identified as White). CONCLUSIONS Messaging and information about breastfeeding (particularly from healthcare providers) should be reviewed to determine if there is language which could be perceived as "pressure." It is important to screen for a variety of mental health symptoms, including eating disorders, in perinatal populations when discussing breastfeeding.
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Affiliation(s)
- Katherine A Thompson
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States; Department of Psychology and Neurosciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Jennifer P White
- Department of Psychiatry, UNC School of Medicine, Chapel Hill, NC, United States
| | - Anna M Bardone-Cone
- Department of Psychology and Neurosciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Bailey-Straebler SM, Susser LC, Cooper Z. Breastfeeding and pumping as maladaptive weight control behaviors. Int J Eat Disord 2023; 56:1683-1687. [PMID: 37260319 DOI: 10.1002/eat.24006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
It is well recognized by the general public that breastfeeding expends calories. In our clinical practice, a number of postpartum women with a history of or a current eating disorder (ED) report using breastfeeding and/or pumping breast milk to influence their body shape and weight. This appears to be either a form of weight control behavior or, in some cases, a compensation for perceived overeating or binge eating. Breastfeeding and pumping have not generally been identified as maladaptive weight control behaviors, nor have they been a subject of research to date. We suggest that this practice should be investigated to determine how common it is, its potential role in maintaining EDs or contributing to relapse in the postpartum period, and to better understand other potential harms it may cause to both the mother and infant/child. PUBLIC SIGNIFICANCE: Breastfeeding and pumping may be used as maladaptive methods of weight control by women with EDs. This behavior is under-recognized in clinical practice and has received little research attention. We argue that maladaptive breastfeeding and pumping warrant further investigation, as the behaviors may play an important role in maintaining an ED or in contributing to relapse during the postpartum period and may also indirectly harm the infant/child.
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Affiliation(s)
- Suzanne M Bailey-Straebler
- Weill Cornell Medicine - New York Presbyterian Hospital, White Plains, New York, USA
- Columbia University Medical Center, New York, New York, USA
| | - Leah C Susser
- Weill Cornell Medicine - New York Presbyterian Hospital, White Plains, New York, USA
| | - Zafra Cooper
- Yale School of Medicine - New Haven, New Haven, Connecticut, USA
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Tarchi L, Merola GP, Selvi G, Caprara E, Pecoraro V, Cassioli E, Rossi E, Petraglia F, Ricca V, Castellini G. Pregorexia: a systematic review and meta-analysis on the constructs of body image dissatisfaction and eating disturbances by gestational age in the peripartum. Eat Weight Disord 2023; 28:64. [PMID: 37526698 PMCID: PMC10393903 DOI: 10.1007/s40519-023-01595-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced calorie intake or increased physical activity. METHODS In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake. RESULTS Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy. DISCUSSION The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies. LEVEL OF EVIDENCE Level I-Evidence obtained from: systematic reviews and meta-analyses.
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Affiliation(s)
- Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giuseppe Pierpaolo Merola
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giulia Selvi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Eleonora Caprara
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Vincenzo Pecoraro
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Felice Petraglia
- Obstetrics and Gynecology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy.
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Tavares IM, Nobre PJ, Heiman JR, Rosen NO. Longitudinal associations between mindfulness and changes to body image in first-time parent couples. Body Image 2023; 44:187-196. [PMID: 36706673 DOI: 10.1016/j.bodyim.2023.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/16/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023]
Abstract
Pregnancy and postpartum are associated with declines in body image. Research on postpartum body image focuses almost exclusively on the person who gave birth and studies examining protective factors for postpartum body image are scarce. We assessed 257 new-parent couples from mid-pregnancy to 6-months postpartum to examine whether mindfulness-a recognized contributor to psychological well-being-buffered against declines in both partners' perceptions of mothers' body. Mothers' positive body image and partners' perception of mothers' body were collected at four time-points (second and third trimester; 3- and 6-months postpartum); both partners' mindfulness facets-observing, describing, awareness acting, non-judgement, and non-reactivity-were assessed in the second trimester. Dyadic latent growth curve modeling revealed that both partners' perceptions of mothers' body were positively correlated at all moments; however, mothers' positive body image worsened over time, whereas partners' perception of mothers' body remained stable. Mindfulness facets were positively associated with mothers' positive body image (observe, describe, and non-judging) and fathers' (non-judging) perceptions of mothers' body in pregnancy. Mothers' mindfulness facets (acting with awareness, non-judging) were associated with subsequent trajectories of their own body image. By identifying mindfulness facets as targetable protective factors during pregnancy, these findings have implications for future research and interventions focused on perinatal body image.
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Affiliation(s)
- Inês M Tavares
- Department of Psychology and Neuroscience, Dalhousie University, Canada
| | - Pedro J Nobre
- Center for Psychology at the University of Porto, Portugal
| | - Julia R Heiman
- Department of Psychological and Brain Sciences, Indiana University Bloomington, USA
| | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Canada; Department of Obstetrics and Gynaecology, Dalhousie University, Canada.
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Psychometric Examination of the Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) among Spanish Adolescents and Young Adults. Nutrients 2023; 15:nu15030626. [PMID: 36771333 PMCID: PMC9921885 DOI: 10.3390/nu15030626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/19/2023] [Accepted: 01/22/2023] [Indexed: 01/28/2023] Open
Abstract
The Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) has been frequently used within the context of research on eating disorders (ED). Although both long (BEECOM-L) and short (BEECOM-S) versions of the instrument exist, their psychometric properties have not yet been concurrently investigated across different populations in terms of age and gender. The present study aimed to compare the psychometric properties of both the BEECOM-L and the BEECOM-S among Spanish male and female non-clinical adolescents and young adults. Data from 4 samples including 1213 middle school and college students enrolled in 10 education centers from southern Spain (age ranging from 12 to 35 years, Mage = 17.796, SDage = 4.796, 53% females) were analyzed using factorial, correlation, and regression analysis techniques. Results provided evidence that support the reliability, measurement invariance according to age and gender, and convergent/incremental validity for the scores from both the BEECOM-L and BEECOM-S. Concerning factorial validity, marginally acceptable and adequate goodness-of-fit indices were obtained for the BEECOM-L and BEECOM-S, respectively. The BEECOM-S proves to be a psychometrically sound instrument with potential value for assessing social comparisons focused on body, eating, and exercise in non-clinical adolescents and young adults from Spain.
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