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Zhao YF, Yin MXC, Huang MY, Chen XY. The effectiveness of randomized controlled psychosocial interventions on body image among nonclinical women: A systematic review and meta-analysis. Body Image 2025; 52:101843. [PMID: 39756142 DOI: 10.1016/j.bodyim.2024.101843] [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: 06/03/2024] [Revised: 12/15/2024] [Accepted: 12/17/2024] [Indexed: 01/07/2025]
Abstract
Women are vulnerable to body image disturbances, prompting numerous interventions to improve their body image. However, a systematic review and meta-analysis of such interventions is lacking. This study reviewed interventions designed to enhance body image among nonclinical women and quantified their effectiveness. Seven English databases were searched up to 6 September 2024. Studies included were psychosocial, randomized controlled, high-quality according to the Newcastle-Ottawa Quality Assessment Scale, and evaluating nonclinical women's body image as outcomes. Effect sizes on body image components were meta-analyzed; subgroup analyses and sensitivity tests were conducted to determine the sources of heterogeneity. Forty-eight high-quality studies with 7,182 participants (3,669 subjects and 3,513 controls) were included. Most interventions targeted body dissatisfaction (n = 36) and thin-ideal internalization (n = 34). Weight and shape concerns (n = 15), body satisfaction (n = 14), and behavioral avoidance (n = 10) were commonly measured. Interventions produced reductions in body dissatisfaction (d = -0.45), thin-ideal internalization (d = -0.59), weight and shape concerns (d = -1.08), and behavioral avoidance (d = -1.14), and improvements in body satisfaction (d = 0.42). The long-term effects were examined. High heterogeneity among studies was attributed to countries, scales, therapies, and delivery modes. Results supported that existing interventions effectively relieved body image disturbances in nonclinical women. Additionally, face-to-face interventions led by facilitators are needed to achieve greater improvements in body image.
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Affiliation(s)
- Yi-Fei Zhao
- School of Humanities, Southeast University, Nanjing 211189, China
| | | | - Meng-Yi Huang
- School of Humanities, Southeast University, Nanjing 211189, China
| | - Xuan-Yu Chen
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
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2
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Naraindas AM, Moreno M, Cooney SM. Beyond Gender: Interoceptive Sensibility as a Key Predictor of Body Image Disturbances. Behav Sci (Basel) 2023; 14:25. [PMID: 38247677 PMCID: PMC10812832 DOI: 10.3390/bs14010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Body image disturbance (BID) involves negative attitudes towards shape and weight and is associated with lower levels of interoceptive sensibility (IS) (the subjective perceptions of internal bodily states). This association is considered a risk factor for developing eating disorders (EDs) and is linked to altered sensorimotor representations of the body (i.e., body schema). BIDs manifest across genders and are currently understudied in men. This study investigated gender-related differences in BID and its relationship to the body schema and IS. Data were collected from 86 men and 86 women. BID was assessed using questionnaires measuring self-objectification, state, and trait body dissatisfaction. IS was measured via the MAIA-2. The body schema was indexed via an embodied mental rotation task. Results showed that women reported higher BID than men across all scales. Gender differences in sub-components of interoceptive sensibility were found. Overall, both gender and interoceptive sensibility predicted BID. However, interoceptive sensibility exhibited its own unique association with BID beyond the influence of gender. BID, IS and gender were not significant predictors of performance in the body schema task. Therefore, while gender predicts differences in BID and interoceptive sensibility, there was no evidence of gender-related differences in body schema.
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Affiliation(s)
| | | | - Sarah M. Cooney
- School of Psychology, University College Dublin, D04 F6X4 Dublin, Ireland;
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3
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Zhao Z, Serier KN, Smith BN, Vogt D, Kehle-Forbes S, Mitchell KS. Gender similarities and differences in associations between weight discrimination, shape/weight concerns, and eating disorder symptoms among post-9/11 veterans. Eat Behav 2023; 51:101818. [PMID: 37741082 DOI: 10.1016/j.eatbeh.2023.101818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE Weight discrimination, defined as mistreatment of people based on body weight, is associated with body image concerns and eating disorder (ED) symptoms. Military veterans are particularly vulnerable to developing ED symptoms, which may be due to experiences of weight discrimination resulting from the military's strict weight and fitness requirements. However, no previous study has examined these associations among veterans. We investigated relationships between weight discrimination during and after military service and shape/weight concerns and ED symptoms in post-9/11 veterans. Based on evidence for gender differences in weight discrimination, body image, and ED symptoms, we also examined whether gender moderated these associations. METHOD Participants were randomly selected from the population of post-9/11 U.S. veterans who had been discharged from the military within the previous 18 months. A total of 1494 veterans completed the Everyday Discrimination Scale, Eating Disorders Examination-Questionnaire, and the Eating Disorder Diagnostic Scale-5. RESULT Women were more likely to report weight discrimination and had higher levels of ED symptoms and shape/weight concerns than men. Weight discrimination in and after leaving the military were positively associated with shape/weight concerns and ED symptoms in the full sample and among men and women. Gender moderated the association between weight discrimination after leaving the military and shape/weight concerns such that the association was stronger among men. DISCUSSION Both male and female veterans may be vulnerable to developing ED symptoms, in part due to weight discrimination experienced during and after military service. Our findings emphasize the need to address weight discrimination and its consequences in veterans.
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Affiliation(s)
- Ziyu Zhao
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychological & Brain Science, Boston University, United States of America
| | - Kelsey N Serier
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States of America
| | - Brian N Smith
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States of America
| | - Dawne Vogt
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States of America
| | - Shannon Kehle-Forbes
- National Center for PTSD at VA Boston Healthcare System, United States of America; Minneapolis VA Healthcare System, United States of America; Department of Medicine, University of Minnesota, United States of America
| | - Karen S Mitchell
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States of America.
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4
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Modica CA, DiLillo V. A structural invariance analysis of the acceptance model of intuitive eating across black, hispanic, and white young-adult women. Body Image 2023; 44:157-169. [PMID: 36638751 DOI: 10.1016/j.bodyim.2022.12.009] [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: 07/28/2022] [Revised: 11/22/2022] [Accepted: 12/23/2022] [Indexed: 01/13/2023]
Abstract
In this cross-sectional study, structural invariance of the acceptance model of intuitive eating was examined between a sample of Black (n = 420), Hispanic (n = 420), and White (n = 435) cisgender women between the ages of 18-30 years old residing in the United States. Mean age for the total sample (n = 1275) was 24.17 years old (SD = 3.65). Women were recruited via Qualtrics Sampling, and self-report measures were administered online. Multigroup analyses were employed within a structural equation modeling framework, and measurement invariance at the configural, metric, scalar, and strict/residual levels was investigated first. After uncovering and accounting for several error variances that were non-invariant, multigroup structural invariance analyses indicated that paths within the model were invariant across the three ethnicities of women. BMI was also incorporated into the model, which, likewise, showed invariance in its associations with specific constructs. With due cautions related to the impact of cultural ideals regarding appearance and the interplay of ethnicity and body-related experiences among women, these results provide preliminary evidence that the model may apply to Black, White, and Hispanic women in the U.S.
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Affiliation(s)
- Christopher A Modica
- Department of Psychology, Ohio Wesleyan University, Delaware, OH, United States.
| | - Vicki DiLillo
- Department of Psychology, Ohio Wesleyan University, Delaware, OH, United States
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5
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Pritchard M, Brasil K, McDermott R, Holdiman A. Untangling the associations between generalized anxiety and body dissatisfaction: The mediating effects of social physique anxiety among collegiate men and women. Body Image 2021; 39:266-275. [PMID: 34695680 DOI: 10.1016/j.bodyim.2021.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
Researchers disagree on which types of anxiety influence body dissatisfaction and how gender (cisgender men vs. cisgender women) may impact these associations. Specifically, little is known about how generalized anxiety and social physique anxiety combine to predict body dissatisfaction in men and women. The purpose of the present study was to explore a moderated mediation model in which the relationships between generalized anxiety and body dissatisfaction (drive for thinness and drive for muscularity) were mediated by social physique anxiety and moderated by gender. Data from 423 U.S. college students (n = 259 women) were analyzed using multigroup structural equation modeling. Generalized anxiety was positively associated with social physique anxiety, and this association was significantly stronger for men than for women. Neither social physique anxiety nor generalized anxiety were associated with drive for muscularity. Social physique anxiety was positively and significantly associated with drive for thinness equally for men and women and emerged as a significant mediator. These results highlight gender differences/similarities in body image and suggest drive for thinness and social physique anxiety may have a common factor of generalized anxiety. When helping clients who suffer with body dissatisfaction, clinicians and researchers may wish to focus on generalized anxiety (and not just social physique anxiety).
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Affiliation(s)
- Mary Pritchard
- Boise State University, Department of Psychological Science, 1910 University Dr. Boise, ID83725-1715, USA.
| | - Kyle Brasil
- University of South Alabama, Department of Counseling and Instructional Sciences, University Commons 3600, Mobile, AL 36688, USA
| | - Ryon McDermott
- University of South Alabama, Department of Counseling and Instructional Sciences, University Commons 3600, Mobile, AL 36688, USA
| | - Anna Holdiman
- Boise State University, Department of Psychological Science, 1910 University Dr. Boise, ID83725-1715, USA
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Zarychta K, Horodyska K, Chan CKY. Body areas satisfaction and body mass in adolescents: mediating effects of actual-ideal body weight discrepancies. Eat Weight Disord 2020; 25:1011-1019. [PMID: 31175619 PMCID: PMC7399669 DOI: 10.1007/s40519-019-00722-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/27/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study aims at investigating prospective associations between body areas satisfaction (BAS), actual (objectively measured)-ideal body weight discrepancy, actual (self-reported)-ideal body weight discrepancy and BMI among adolescents from the general population. METHODS Data were collected at three measurement points: baseline (T1), 2-month follow-up (T2), 13-month follow-up (T3) among 1011 adolescents (59.3% girls) aged 13-19 years (M = 16.30, SD = 0.82) with BMIs ranging from 15.20 to 38.78 (M = 20.01, SD = 3.33). Adolescents completed questionnaires regarding BAS (T1), actual and ideal body weight (T2). Body weight and height were measured objectively (T1 and T3). RESULTS Adolescents satisfied with most areas of their bodies had lower levels of actual (objectively measured)-ideal body weight discrepancy, which in turn predicted higher BMI, while lower levels of actual (self-reported)-ideal body weight discrepancy predicted lower BMI. No moderating effect of gender was found. CONCLUSIONS Actual-ideal weight discrepancies may operate in complex manner prompting opposite effects on BMI. LEVEL OF EVIDENCE Level III, longitudinal study without control group.
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Affiliation(s)
- Karolina Zarychta
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities in Wroclaw, 30b Ostrowskiego Street, 53-238, Wroclaw, Poland.
| | - Karolina Horodyska
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities in Wroclaw, 30b Ostrowskiego Street, 53-238, Wroclaw, Poland
| | - Carina K Y Chan
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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7
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Zarychta K, Chan CKY, Kruk M, Luszczynska A. Gender-Specific Body Areas Satisfaction and Body Weight Status in Adolescents: Mediating Effects of Physical Activity, Fruit and Vegetable Intake, and Energy-Dense Food Intake. Appl Psychol Health Well Being 2018; 11:80-101. [PMID: 30288920 PMCID: PMC7379245 DOI: 10.1111/aphw.12145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Body satisfaction is one of the key modifiable cognitive determinants of eating behaviours, physical activity, and body mass index (BMI). As the sociocultural models suggest, low body satisfaction may explain unhealthy eating and exercise behaviours. Importantly, body satisfaction levels and body areas that individuals focus on vary across genders. This study aims at investigating links between the global index of body areas satisfaction (BAS), gender‐specific BAS, fruit and vegetable (F&V) intake, energy‐dense foods intake, moderate‐to‐vigorous physical activity (MVPA), and BMI. Methods In all, 1,254 adolescents completed questionnaires and had their weight and height objectively measured with 2‐ and 13‐month follow‐ups. Indirect effects of three indices of BAS were tested in three models (male‐specific BAS amongst boys; female‐specific BAS amongst girls; the global BAS index in the total sample). Results Higher levels of all three BAS indices indirectly predicted lower BMI, with higher MVPA mediating this effect. In addition, higher energy‐dense foods intake mediated higher global BAS–higher BMI relationship in the total sample. Thus, the global index of BAS acts as double‐edged sword, predicting both higher MVPA and energy‐dense foods intake. Conclusion BAS may operate in a complex manner, predicting behaviours which may have opposite effects on BMI.
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Affiliation(s)
- Karolina Zarychta
- SWPS University of Social Sciences and Humanities in Wroclaw, Poland
| | | | - Magdalena Kruk
- SWPS University of Social Sciences and Humanities in Wroclaw, Poland
| | - Aleksandra Luszczynska
- SWPS University of Social Sciences and Humanities in Wroclaw, Poland.,University of Colorado at Colorado Springs, Colorado Springs, USA
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8
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Duncan MJ, Al-Nakeeb Y, Nevill AM. Establishing the optimal body mass index - body esteem relationship in young adolescents. BMC Public Health 2013; 13:662. [PMID: 23866083 PMCID: PMC3720562 DOI: 10.1186/1471-2458-13-662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 07/15/2013] [Indexed: 11/10/2022] Open
Abstract
Background This study sought to compare the utility of either inverted body mass index or body mass index to optimise the relationship with body esteem in young adolescents Design: The study was cross sectional in design and assessed body esteem and weight status in756 young adolescents (394 boys, 362 girls, mean age ± S.D. 11.4 ± 1.6 years). Methods Body esteem was determined using the body esteem scale for children. Height and body mass were measured directly. Body mass index was determined as kg/m2 and iBMI as cm2/kg. Results Results indicated that the association between iBMI and body esteem was curvilinear in nature and iBMI was the better predictor of body esteem (P = .001) predicting 21.3% of the variance in body esteem scores compared to 20.5% using BMI (P = .001). When split by gender, the curvilinear relationship was still evident but significantly different between boys and girls although iBMI remained a better predictor of body esteem compared to BMI in both boys and girls. The peak differed between gender groups with the association between iBMI and body esteem peaking at 642 cm2/kg for boys and 800.64 cm2/kg for girls. Conclusion This study suggests that iBMI is a better predictor of body esteem in young adolescents, and that the association between body esteem and iBMI is curvilinear in nature. However, the peak of body esteem scores occured at a lower degree of leanness for boys compared to girls and indicated that the point at which body esteem scores are highest for girls is at a point of extreme leanness whereas the peak for boys was within the values considered as ‘normal’ on the leanness to obesity continuum. iBMI may therefore be a useful measure of leanness for future studies examining the association between overweight/obesity and body esteem in young adolescents.
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Affiliation(s)
- Michael J Duncan
- Department of Biomolecular and Sports Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK.
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9
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Nemiary D, Shim R, Mattox G, Holden K. The Relationship Between Obesity and Depression Among Adolescents. Psychiatr Ann 2012; 42:305-308. [PMID: 23976799 DOI: 10.3928/00485713-20120806-09] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Deina Nemiary
- Assistant Professor, Department of Psychiatry and Neurobiology, University of Alabama at Birmingham
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10
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Bully P, Elosua P. Changes in body dissatisfaction relative to gender and age: the modulating character of BMI. SPANISH JOURNAL OF PSYCHOLOGY 2011; 14:313-22. [PMID: 21568188 DOI: 10.5209/rev_sjop.2011.v14.n1.28] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study examines the level of body satisfaction in adolescents, and its association with age, sex and body mass index. A non-clinical group was made up of 935 adolescents (484 boys and 451 girls), aged between 10 and 18 years. The body image was assessed by the Body Dissatisfaction scale within the Eating Disorder Inventory (Garner, 1998, 2004) and by the indirect indicator Ideal Body Mass Index. The results showed that the Body Mass Index is an important covariable in the study of body dissatisfaction. Body dissatisfaction mean values increased in the female sample. The males' values did not change throughout adolescence.
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Affiliation(s)
- Paola Bully
- Facultad de Psicología, Universidad del País Vasco, Avda. Tolosa, no 70, 20009 San Sebastián, Guipúzcoa, Spain.
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11
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Sherry SB, Vriend JL, Hewitt PL, Sherry DL, Flett GL, Wardrop AA. Perfectionism dimensions, appearance schemas, and body image disturbance in community members and university students. Body Image 2009; 6:83-9. [PMID: 19200791 DOI: 10.1016/j.bodyim.2008.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2008] [Revised: 12/10/2008] [Accepted: 12/17/2008] [Indexed: 11/30/2022]
Abstract
The present study examined the relationship between a self-presentational style involving an extreme need to conceal perceived imperfections from others and body image disturbance (BID). Findings from both a community and a university sample indicated that nondisplay of imperfection (i.e., concerns over behavioral displays of imperfections to others) predicted BID beyond self-imposed perfectionistic expectations and other contributors to BID. Mediational analyses suggested that dysfunctional appearance schemas represent one possible mechanism through which nondisplay of imperfection influences BID. In contrast to earlier work on perfectionism and BID, which emphasized the role of self-imposed perfectionistic expectations, the current study offers a novel view of the connection between perfectionism and BID. That is, rather than striving to achieve perfection, the present study suggests that individuals with BID are characterized by a strong need to avoid appearing imperfect to others.
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Affiliation(s)
- Simon B Sherry
- Department of Psychology, Dalhousie University, Life Sciences Centre, 1355 Oxford Street, Halifax, Nova Scotia, Canada B3H 4J1.
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12
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Bardone-Cone AM, Cass KM, Ford JA. Examining body dissatisfaction in young men within a biopsychosocial framework. Body Image 2008; 5:183-94. [PMID: 18463012 DOI: 10.1016/j.bodyim.2007.12.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 12/27/2007] [Accepted: 12/28/2007] [Indexed: 10/22/2022]
Abstract
This study examined biopsychosocial factors related to body dissatisfaction in young men within multivariate and moderator contexts. A female sample was included as a gender comparison. Male (n=111) and female (n=236) undergraduates filled out self-report questionnaires assessing body mass index (BMI), media influence, a history of weight-related teasing, and socially prescribed perfectionism, along with various indices of body dissatisfaction. Perceived pressure from the media was consistently related to body dissatisfaction in men whereas multiple biopsychosocial variables accounted for body dissatisfaction in women. Socially prescribed perfectionism and a history of weight teasing each moderated the relationship between BMI and male body dissatisfaction, identifying men low in body dissatisfaction. Findings indicate that applying a biopsychosocial framework to the study of body dissatisfaction in men is useful and suggest the need for including other factors, such as male peers and sports involvement, in understanding contributors to male body image.
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Affiliation(s)
- Anna M Bardone-Cone
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA.
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