Perfectionism as a social identity in eating disorders: A qualitative investigation of identity navigation

Traumatic stress, body shame, and internalized weight stigma as mediators of change in disordered eating: a single-arm pilot study of the Body Trust® framework

To enhance access to evidence-based treatment it is increasingly important to evaluate scalable virtual programs that support the needs of those struggling with disordered eating. This study described a scientifically grounded, trauma-informed framework known as Body Trust,® and aimed to pilot test the preliminary effectiveness and mechanisms of change in a Body Trust® program to improve disordered eating. Using quality outcomes data, we examined 70 mostly white (87%) female-identifying (97%) individuals enrolled in a 6-module online program based in the Body Trust® framework (M_age = 45.5 ±10.9; M_BMI = 33.7 ±8.0). Putative mediators included traumatic stress, internalized weight stigma, and body shame. Outcomes were objective and subjective binge episodes, overvaluation of weight and shape, and eating concerns. Generalized estimating equations were applied to determine pre-to-post changes. We applied Montoya's MEMORE macro, the joint-significance test, and calculated 95% Monte Carlo confidence intervals to assess mediation. Significant pre-to-post improvements with medium to large effect sizes were detected for all outcomes and mediators (ps<.008). All hypothesized mechanisms supported mediation. Using the Body Trust® framework shows early promise for alleviating disordered eating symptoms through targeting traumatic stress, body shame, and internalized weight stigma. Given the program's use of mindfulness techniques, future research should test target mechanisms like interoception.

Superhero ideal, authenticity in relationships, and depressive symptoms: A multiple mediation analysis

Striving for high achievement across multiple domains to achieve an unrealistic ideal may predict adolescents' depressive symptoms, and this relation may be explained by authenticity in meaningful relationships. This is the first known study to examine the relation between internalization of the superhero ideal, defined as the socially prescribed desire for achievement across personal and professional domains, and depressive symptoms, and to examine authenticity in relationships as a mediator in the relation between the superhero ideal and depressive symptoms. Participants were 163 adolescents (ages 12-14). Multiple mediation results utilizing cross-sectional data indicated that the superhero ideal was related to depressive symptoms and that authenticity in relationships with peers and parents partially mediated this relation. These results identify a possible explanation for understanding the relation between the superhero ideal and depressive symptoms.

The relationships between socially prescribed perfectionism, in-group affect, negative urgency, and disordered eating in women

Socially prescribed perfectionism (SPP) is often considered as a key risk factor for disordered eating (DE). However, current conceptualizations of SPP largely assume that this perfectionism pressure is non-specific (i.e., a global pressure), despite research indicating that for females experiencing DE, female-dominated groups impose this pressure (as a perceived norm). Furthermore, this relationship may be mediated by a negative reaction to this pressure, in the form of impulsivity (or negative urgency). To date, no research has investigated whether the relationship between SPP and DE is mediated by negative urgency, nor has there been research clarifying how in-group identification relates to DE, independent of SPP and negative urgency. To address these gaps, we assessed these variables in 147 female dieters (M_age  = 25.12 years, SD = 3.08) using a cross-sectional design. Consistent with our hypotheses, negative urgency fully mediated the link between female-based SPP and disordered eating, while female-based in-group affect (identification) was predictive of disordered eating (although the latter relationship was not sustained in a multiple regression model). These findings suggest that the SPP from other women may relate to DE through increasing negative urgency, and that the link between in-group (female) affect and DE may be better explained by SPP's link to DE.