Limiting the effects of the media on body image: does the length of a media literacy intervention make a difference?

Randomized control trial of a single-session intervention targeting sociocultural pressures of body image in college sorority women

Objective: To assess the effectiveness of a peer-led single-session intervention targeting the sociocultural pressures of body image. Participants: New members of 13 sororities at one university. Methods: Participants were randomized by sorority into the intervention (n = 207) or wait list control (n = 264). Online surveys were administered at baseline and one month to assess social determinants of body image, body image dissatisfaction (BID), and body appreciation. Multiple logistic and linear regression analyses compared changes over time between groups. Results: We observed significant improvements in overall sociocultural pressures of body image (p = .001) and the subscales of Norms (p < .001) and Perceived Norms (p = .009) of eating and exercise behaviors. Change in BID and body appreciation did not differ between groups. Conclusion: A one-hour peer-led community-level intervention can lead to positive changes in sociocultural pressures in new initiates to a sorority.

An Exploratory Content Analysis of the Use of Health Communication Strategies and Presence of Objectification in Fitness Influencer Social Media Posts

Health and fitness content intended to inspire people to live healthy lives (e.g. "fitspiration") has been linked to negative body image among girls and young women. Fitness influencers purport wanting to motivate healthy behaviors. This study seeks to examine the presence of strategies known to positively influence health behaviors (e.g. attitudes, self-efficacy) as well as of content known to have a negative influence (e.g. objectification) among fitness influencers. We conducted a content analysis (N = 441) of a random sample of one year of posts from four Instagram fitness influencers popular with girls and young women in the United States. The main analysis consisted of codes related to objectification, health promotion strategies, health-related content, and social engagement (i.e., likes). We found that fitness influencers included content that conveyed constructs previously found to positively influence health behaviors (e.g., attitudes and self-efficacy), but objectification was frequently present, in more than half of the posts. Additionally, we found that the presence of objectification in posts was negatively associated with likes, a form of social endorsement. We suggest health communicators aim to work in tandem with fitness influencers to include content that may motivate positive health behaviors and improve media literacy and that influencers aim to reduce the amount of objectifying content included in their posts. Our findings shed light on content being conveyed and possible insights into the negative effects associated with viewing such content.

Social comparisons on social media: online appearance-related activity and body dissatisfaction in adolescent girls

INTRODUCTION

Adolescents' engagement with online social networking platforms is advancing at an exponential rate and research is needed to investigate any impact on young users' mental health. This study examined appearance-related activity (e.g. looking at photos of friends) on social media and body dissatisfaction among adolescent girls.

METHODS

Self-report measures of online appearance-related activity, social comparisons to female target groups, internalization of the thin ideal, body dissatisfaction, and self-esteem were administered to 210 girls (mean age = 15.16 years).

RESULTS

Body dissatisfaction was significantly related to (i) time spent engaged in social comparisons and (ii) upward social comparisons with various female targets while online. Evaluating oneself less favorably than the target group of close friends was most strongly associated with poorer body image appraisals. Serial multiple mediation analysis revealed that even after controlling for age and self-esteem, time spent engaged in social comparisons significantly mediated the relationship between online appearance-related activity and body dissatisfaction. This association was then further partially mediated by internalization of the thin ideal, which significantly mediated the relationship between time engaged in social comparisons and body dissatisfaction.

DISCUSSION

Results are discussed in terms of online social media platforms representing an additional appearance culture environment for adolescent girls. The effects of this on the mental health of vulnerable users and how future research should investigate protective factors that may buffer young girls from the adverse effects of social media are considered.

Conservative Media Use and COVID-19 Related Behavior: The Moderating Role of Media Literacy Variables

At the start of the COVID-19 pandemic, there was no vaccine to cure or slow its impact due to the novelty of the virus, nor were there were any other standardized measures to handle its spread. Yet, despite the detrimental consequences of the pandemic and its impact on people's lives, the behavior of individuals to combat the pandemic was not necessarily consistent with official guidelines. To make things worse, the pandemic was highly politicized in countries such as the U.S. With a help of a national survey from the U.S., we examine the associations between media literacy variables and willingness to perform recommended COVID-19 related health behavior. Moreover, we also examine the moderating role of conservative media use in this relationship. Our findings show that conservative media use was negatively associated with these protective behaviors, and that both media literacy variables were positively related with willingness to perform recommended COVID-19 related health behavior. Our results show that media literacy can mitigate some of the impact of conservative media use on individuals. Our findings help understand the complexity of protective behavior against the virus during a highly politicized pandemic.

Media Exposure and Health Behavior during Pandemics: The Mediating Effect of Perceived Knowledge and Fear on Compliance with COVID-19 Prevention Measures

Emerging research has examined the role of media coverage of diseases in influencing people's health behavior, particularly their compliance with prevention measures. This study examines whether increased media exposure to COVID-19 news and interpersonal communication about the disease positively relate to people's abidance by prevention measures, and whether perceived knowledge and fear mediate this relationship. The study focuses on Lebanon, whose government and media responses led to a successful containment of COVID-19 in its first phase, although the country was experiencing a severe economic crisis, widespread political unrest, and a massive influx of refugees. It examines both legacy media (Television) and social media, as well as interpersonal communication, through a cross-sectional researcher-administered phone survey of 1,536 adults and a nationally representative probability sample. The fieldwork was conducted between March 27 and April 23, 2020, and resulted in a 51.6% response rate. The findings support the hypotheses that increased media exposure to COVID-19 news positively relates to people's abidance by prevention measures and that perceived knowledge and fear mediate this relationship. However, the same hypotheses for interpersonal communication were not supported.

Last Word: Ending the intergenerational transmission of body dissatisfaction and disordered eating: a call to investigate the mother-daughter relationship

The ubiquity and gravity of female body dissatisfaction and disordered eating has motivated countless academics and practitioners to better understand and treat these issues. Many researchers have found familial, and more specifically maternal influence, to impact daughters' development of body dissatisfaction and disordered eating. Researchers have demonstrated that mothers who struggle with body dissatisfaction and disordered eating tend to transmit and reinforce harmful weight-related attitudes and behaviours to their daughters, which has been found to result in the development of daughters' own body dissatisfaction and disordered eating. Regardless of these findings, little research has been conducted to explore the ways in which mothers can attempt to end the intergenerational transmission of body dissatisfaction and disordered eating to daughters. As such, in this article, we call researchers and practitioners to fill this gap in knowledge.

Effectiveness of arts interventions to reduce mental-health-related stigma among youth: a systematic review and meta-analysis

BACKGROUND

Educational interventions engage youth using visual, literary and performing arts to combat stigma associated with mental health problems. However, it remains unknown whether arts interventions are effective in reducing mental-health-related stigma among youth and if so, then which specific art forms, duration and stigma-related components in content are successful.

METHODS

We searched 13 databases, including PubMed, Medline, Global Health, EMBASE, ADOLEC, Social Policy and Practice, Database of Promoting Health Effectiveness Reviews (DoPHER), Trials Register of Promoting Health Interventions (TRoPHI), EPPI-Centre database of health promotion research (Bibliomap), Web of Science, PsycINFO, Cochrane and Scopus for studies involving arts interventions aimed at reducing any or all components of mental-health-related stigma among youth (10-24-year-olds). Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Data were extracted into tables and analysed using RevMan 5.3.5.

RESULTS

Fifty-seven studies met our inclusion criteria (n = 41,621). Interventions using multiple art forms are effective in improving behaviour towards people with mental health problems to a small effect (effect size = 0.28, 95%CI 0.08-0.48; p = 0.007) No studies reported negative outcomes or unintended harms. Among studies using specific art forms, we observed high heterogeneity among intervention studies using theatre, multiple art forms, film and role play. Data in this review are inconclusive about the use of single versus multiple sessions and whether including all stigma components of knowledge, attitude and behaviour as intervention content are more effective relative to studies focused on these stigma components, individually. Common challenges faced by school-based arts interventions included lack of buy-in from school administrators and low engagement. No studies were reported from low- and middle-income countries.

CONCLUSION

Arts interventions are effective in reducing mental-health-related stigma to a small effect. Interventions that employ multiple art forms together compared to studies employing film, theatre or role play are likely more effective in reducing mental-health-related stigma.

Mitigating infodemics: The relationship between news exposure and trust and belief in COVID-19 fake news and social media spreading

Introduction

Misinformation surrounding COVID-19 poses a global public health problem that adversely affects governments’ abilities to mitigate the disease and causes accidental deaths and self-harm due to false beliefs about the virus, prevention measures, vaccines and cures. We aim to examine the relationship between exposure to and trust in COVID-19 news (from Television, social media, interpersonal communication) and information sources (healthcare experts, government, clerics) and belief in COVID-19 myths and false information, as well as critical verification practices before posting on social media.

Methods

We use a cross-sectional researcher-administered phone survey of adults living in Lebanon between March 27 and April 23, 2020.

Results

The sample included 56.1% men and 43.9% women, 37.9% with a university degree, 63.0% older than 30, and 7% with media literacy training. Those who trust COVID-19 news from social media [95%CI:(1.05–1.52)] and interpersonal communication [95%CI:(1.25–1.82)], and those who trust information from clerics [95%CI:(1.25–1.82)] were more likely to believe in COVID-19 myths and false information. University graduates [95%CI:(0.25–0.51)] and those who trust information from government [95%CI:(0.65–0.89] were less likely to believe in myths and false information. Those who believe in COVID-19 myths and false information [95%CI:(0.25–0.70)] were less likely to engage in critical social media posting practices. Only those who underwent media literacy training [95%CI:(1.24–6.55)] were more likely to engage in critical social media posting practices.

Conclusion

Higher education and trust in information from government contributed to decreasing belief in COVID-19 myths and false information. Trust in news from social media, interpersonal communication and clerics contributed to increasing belief in COVID-19 myths and false information, which in turn contributed to less critical social media posting practices, thereby exacerbated the infodemic. Media literacy training contributed to increasing critical social media posting practices, thereby played a role in mitigating the infodemic.

Effectiveness of a multi-session positive self, appearance, and functionality program on women's body satisfaction and response to media

Women's relationship with their bodies may be improved through activities which encourage them to focus on the positive elements of their appearance, the functional qualities of their body, and positive aspects of themselves in general. This study examined the effectiveness a multi-session program addressing these elements. Across two online sessions, 117 Australian women (M_age = 23.48) completed writing tasks about the positive elements of their appearance, body functionality, and who they are as a person, as well as engaging with functionality-focused public health campaigns. A control group completed matched tasks on stress management. Results showed that both groups had improvements across trait body appreciation, self-objectification, and weight concern across the program. Within-session state improvements were found across stress, body appreciation, appearance and functionality satisfaction for both groups. An online media exposure task was used one week post-program completion (n = 81). Idealised media exposure reduced functionality satisfaction in both groups but did not impact any other outcome measure. Findings suggest that tasks encouraging positive reflections on appearance, functionality, and self are useful in improving women's body satisfaction. Issues around choice of control group are discussed.

Eating Disorders: An Evolutionary Psychoneuroimmunological Approach

Eating disorders are evolutionarily novel conditions. They lead to some of the highest mortality rates of all psychiatric disorders. Several evolutionary hypotheses have been proposed for eating disorders, but only the intrasexual competition hypothesis is extensively supported by evidence. We present the mismatch hypothesis as a necessary extension to the current theoretical framework of eating disorders. This hypothesis explains the evolutionarily novel adaptive metaproblem that has arisen when mating motives conflict with the large-scale and easy availability of hyper-rewarding but obesogenic foods. This situation is exacerbated particularly in those contemporary environments that are characterized by sedentary lifestyles, ever-present junk foods, caloric surplus and the ubiquity of social comparisons that take place via social media. Our psychoneuroimmunological model connects ultimate-level causation with proximate mechanisms by showing how the adaptive metaproblem between mating motives and food rewards leads to chronic stress and, further, to disordered eating. Chronic stress causes neuroinflammation, which increases susceptibility to OCD-like behaviors that typically co-occur with eating disorders. Chronic stress upregulates the serotonergic system and causes dysphoric mood in anorexia nervosa patients. Dieting, however, reduces serotonin levels and dysphoric mood, leading to a vicious serotonergic-homeostatic stress/starvation cycle whereby cortisol and neuroinflammation increase through stringent dieting. Our psychoneuroimmunological model indicates that between-individual and within-individual variation in eating disorders partially arises from (co)variation in gut microbiota and stress responsivity, which influence neuroinflammation and the serotonergic system. We review the advances that have been made in recent years in understanding how to best treat eating disorders, outlining directions for future clinical research. Current evidence indicates that eating disorder treatments should aim to reduce the chronic stress, neuroinflammation, stress responsivity and gut dysbiosis that fuel the disorders. Connecting ultimate causes with proximate mechanisms and treating biopsychosocial causes rather than manifest symptoms is expected to bring more effective and sophisticated long-term interventions for the millions of people who suffer from eating disorders.

Prevention of eating disorders in argentine adolescents

In the last few decades much effort has been devoted to developing prevention programs for eating disorders, as most individuals with these pathologies do not receive treatment and tend to become chronic. The purpose of this study was to evaluate a cognitive dissonance and media literacy intervention aimed at preventing eating disorders in female adolescents. Eighty-eight female students (aged 12-17) from Argentina, participated in a 3-session program. Adolescents completed a baseline, post-intervention and a 6-month follow-up survey. A significant decrease in thin-ideal internalization, body image concerns, influence of advertising, drive for thinness and bulimic attitudes was found at post-intervention. In addition, the number of participants with disturbed eating attitudes and behaviors decreased at post-intervention. Results for body image concerns and drive for thinness were maintained at follow-up.

A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders

OBJECTIVE

Most weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions.

METHODS

Databases Medline, PsycInfo and Cochrane Library (2011-2016) were searched for randomised controlled trials and systematic reviews of obesity treatments (dietary, exercise, behavioural, psychological, pharmacological or surgical). Data extracted included study features, risk of bias, study outcomes, and an assessment of treatment impacts on physical, psychological or eating disorder outcomes.

RESULTS

From 3628 novel records, 134 studies met all inclusion criteria and were evaluated in this review. Lifestyle interventions had the strongest evidence base as a first-line approach, with escalation to pharmacotherapy and bariatric surgery in more severe or complicated cases. Quality of life was the most common psychological outcome measure, and improved in all cases where it was assessed, across all intervention types. Behavioural, psychological and lifestyle interventions for weight loss led to improvements in cognitive restraint, control over eating and binge eating, while bariatric surgery led to improvements in eating behaviour and body image that were not sustained over the long-term.

DISCUSSION

Numerous treatment strategies have been trialled to assist people to lose weight and many of these are effective over the short-term. Quality of life, and to a lesser degree depression, anxiety and psychosocial function, often improve alongside weight loss. Weight loss is also associated with improvements in eating disorder psychopathology and related measures, although overall, eating disorder outcomes are rarely assessed. Further research and between-sector collaboration is required to address the significant overlap in risk factors, diagnoses and treatment outcomes between obesity and eating disorders.

Disclaimer labels on fashion magazine advertisements: Impact on visual attention and relationship with body dissatisfaction

Globally there is increasing advocacy for the implementation of laws requiring disclaimer labels to be attached to media images that have been digitally altered, with the goal of reducing the known negative effects of exposure to unrealistic thin ideal imagery for women. The current study used eye tracking technology to establish how digital alteration disclaimer labels affect women's visual attention to fashion magazine advertisements, and the interrelationship with body dissatisfaction and state appearance comparison. Participants were 120 female undergraduate students who viewed four thin ideal advertisements with either no disclaimer, a generic disclaimer, or a more detailed specific disclaimer. It was found that women did attend to the disclaimers. Specifically worded disclaimers directed visual attention towards target body areas, which resulted in increased body dissatisfaction, while state appearance comparison predicted increased body dissatisfaction. Further research is imperative to provide guidance on the most effective use of disclaimer labels.

Body image after mastectomy: A thematic analysis of younger women’s written accounts

This study investigated younger women’s body image after mastectomy. In all, 49 women, aged 29–53 years (mean age: 39 years) who had had bilateral ( n = 8) or unilateral ( n = 41) mastectomy responded to open-ended questions online. Inductive thematic analysis revealed that aesthetics were less important than survival between diagnosis and mastectomy. Following mastectomy, women negotiated new body identities. Treatment effects such as weight gain were significant concerns. However, impacts on body confidence varied, and some participants rejected mainstream body shape ideals and reported feeling proud of their scars. Implications for supporting younger women post-mastectomy, including promotion of body acceptance, are discussed.

Assessment of two school-based programs to prevent universal eating disorders: media literacy and theatre-based methodology in Spanish adolescent boys and girls

AIMS

To evaluate the long-term effects of two school-based prevention programs administered to a universal mixed-sex sample of school-going adolescents on disturbed eating attitudes, aesthetic ideal internalization, and other eating disorder risk factors, when compared to a control group.

METHODS

Participants were 200 adolescents aged 12-15 selected by means of incidental sampling from second-year compulsory secondary education at schools. An interactive multimedia media literacy program (ML + NUT, Media Literacy and Nutrition) and a program focused on the same topics using dramatic arts (Theatre Alive) were applied and compared with a control group. Pretest, posttest (1 month later), and 5- and 13-month follow-up measurements were taken. Analyses were conducted with two-way mixed 3 × 3 ANCOVA (group × phase) adjusted by baseline levels, body mass index, and sex.

RESULTS

Participants in both experimental groups showed significantly higher self-esteem scores than the control group over time. The ML + NUT group also presented lower aesthetic ideal internalization scores than the control group.

DISCUSSION

Both programs can benefit students' self-esteem. Moreover, ML + NUT program was useful in reducing thin-ideal internalization. However, differences in body dissatisfaction and disordered eating attitudes were not found. The programs may be protective on the core psychological variables, which are essential to adaptive adolescent development.

Media exposure, mediated social comparison to idealized images of muscularity, and anabolic steroid use

This study examined the association between anabolic-androgenic steroid (AAS) use and dominant sociocultural factors, specifically media exposure to idealized images of male muscularity, and mediated social comparison trends among a sample of young Arab adults. The study found evidence that participants more exposed to content that promotes muscularity and those who idealize images of muscularity and perceive them as motivators for achieving muscularity are more likely to be AAS users. It also found that a significant percentage of participants used at least one kind of dietary supplement and that the level of AAS use among health club participants indicates it is a significant public health problem in Lebanon. The study suggests that dealing with this problem requires a unique approach, beyond the typical awareness of risks strategy, since some users were well aware of the risks yet continue to use AAS, and their motivations pertain more to body image and sexuality. A stronger approach that utilizes critical media literacy teaching that ingrains these issues into school and university curricula will have a more lasting impact.

The paradoxical moderating effect of body image investment on the impact of weight-based derogatory media

Weight-based derogatory media consist of derogation of celebrities for failing to meet the thin ideal. This study examined the impact of weight-based derogatory media on women's body satisfaction, appearance self-esteem, fear of negative appearance evaluation, and negative affect. Female undergraduates (N=240) were exposed to either tabloid-style pictures and articles derogating average size celebrities for gaining weight, or to the same images accompanied by neutral information. Women in the derogation condition reported greater fear of negative appearance evaluation than did women in the neutral media condition. Contrary to predictions, women low in maladaptive body image investment reported lower body satisfaction and appearance self-esteem in the derogatory media condition than they did in the neutral condition, while women high in maladaptive investment did not differ across conditions. Highly invested women's unexpected reaction may be understood as a defence against a threat to a valued domain of the self.

A group intervention to improve body image satisfaction and dietary habits in gay and bisexual men living with HIV/AIDS

A healthy diet is essential to maintaining a strong immune system for people living with HIV and AIDS. Prior studies have shown that HIV-positive gay and bisexual men are more susceptible to poor body image, which can negatively impact dietary habits. Interventions that simultaneously address body image and nutrition are therefore critical for this population. This paper describes the curriculum for a 14-week group designed to improve body image satisfaction and dietary habits in gay and bisexual men living with HIV/AIDS.