Thinking Fat: Self-Schemas for Body Weight and the Processing of Weight Relevant Information1

Associations of childhood poly-adversity with alcohol problems among undergraduates: adolescent alcohol use trajectories and drinker self-schema

OBJECTIVE

Undergraduate drinking is associated with childhood adversity, early alcohol experience, and drinker self-schema. However, the pathway linking childhood adversity to undergraduate drinking problems remains undefined. This study aimed to identify the effects of childhood poly-adversity on the sequelae of adolescent alcohol-use trajectory, drinker self-schema, and alcohol problems among undergraduates. We also examined whether adolescent alcohol-use trajectory and drinker self-schema mediated the effects of childhood poly-adversity on undergraduate alcohol problems.

METHODS

Baseline data from an ongoing prospective study, which included 851 first- and second-year full-time college students in Taiwan, were used. An anonymous online questionnaire was administered.

RESULTS

The results showed that low poly-adversity and high poly-adversity were associated with the mean of initial alcohol use frequency during adolescence and further alcohol problems at college than those with no adversity. High poly-adversity was also associated with the increase in alcohol use frequency during adolescence. Both initial and increase in alcohol use frequency were associated with higher drinker self-schema scores and further alcohol problems. The indirect effects of high poly-adversity on undergraduate alcohol problems were mediated through adolescent alcohol-use trajectories and drinker self-schema.

CONCLUSION

Findings suggest that early identification of childhood poly-adversity and interventions to decrease adolescent drinking may prevent the formation of drinker self-schema and reduce undergraduate drinking problems.

Attentional Biases Towards Body-Related Stimuli in Healthy Males: A Systematic Review

Recent literature has discussed the role of attentional biases towards body-related stimuli. Specific foci have been on those with high levels of body image concerns and female samples. Unfortunately, there has been limited focus on male samples within existing literature. The aim of the current study was to provide a critical synthesis of the findings of existing studies exploring attentional biases in adult males towards body-related stimuli. Critical synthesis of the findings of 20 studies explored four key methodologies: eye-tracking, dot-probe, visual search, and other methodologies (e.g. ARDPEI task). The current review provides evidence of specific attentional biases towards body-related stimuli in adult males experiencing body image concerns. Similar patterns of attentional biases are also demonstrated in males with body image pathologies. However, there appears to be distinct patterns of attentional biases for male and female participants. It is recommended that future research considers these findings and utilises measures developed specifically for male samples. Furthermore, additional variables require further attention, i.e. reasons for engaging in social comparison and/or engaging in physical activity.

Evidence of attentional bias toward body stimuli in men

Over the past 30 years, attentional bias for body shape and weight content has been implicated in the precipitation and maintenance of body dissatisfaction and eating disorders. Although the existence of this bias toward body stimuli is well-established in female populations, it is comparatively understudied in men. This review aimed to examine the nature of this visual attentional bias toward male bodies in male samples across a range of different attentional paradigms, including eye-tracking, dot-probe, and the visual search task. Results were heterogenous, finding some evidence that men with higher body dissatisfaction and eating disorder symptoms demonstrated an attentional bias toward desirable bodies of other men, and undesirable features of their own bodies. These results suggest that schematic cognitive models of body dissatisfaction and eating disorders body may also be applicable to men, however more research is needed.

What do we measure when we measure perceptions of everyday discrimination?

RATIONALE

The Everyday Discrimination Scale forms the backbone of hundreds of studies documenting the health effects of perceived discrimination. Researchers regularly use the scale to examine specific types of discrimination (e.g., racial, ethnic, gender- and age-based) as well as discrimination more generally among the "general population." To date, no study has analyzed the frameworks respondents use to interpret and answer the questions that comprise the scale. As such, what exactly researchers are measuring when they ask about "everyday discrimination" - and how this may vary within and across social groups - remains unknown.

OBJECTIVE

This study analyzes data from cognitive interviews to assess patterns of interpretation and response to the EDS to assess whether the meaning of the resulting data may vary across diverse social groups.

METHODS

Researchers conducted structured cognitive interviews with a diverse sample of thirty-eight adults in the Southeastern United States (US). Interview transcripts were qualitatively analyzed using MAXQDA, in a process of reiterative coding.

RESULTS

Results show that respondents interpret the survey questions in markedly different ways, with some interpreting the scale as asking about negative interactions; others viewing it through a lens of social inequalities; and still others through a lens specifically of racism. Racial/ethnic and gender statuses may structure question interpretation.

CONCLUSIONS

Pronounced and patterned variation in respondents' interpretation raises questions about its validity. Findings underscore the importance of schemas for assessing the meaning of data generated by the EDS and for measuring the health effects of perceived discrimination and mistreatment.

Weight in the mind: Weight perception and depressive symptoms in Chinese adolescents

BACKGROUND

Increasing evidence demonstrates the significant role of weight perception in shaping the mental health of adolescents. This study sought to extend previous literature by examining the associations of weight perception categories with depressive symptoms for both boys and girls in China, and further explored whether the associations varied between urban and rural areas.

METHODS

Data were from a large-scale, national survey of Chinese middle school students. The analytical sample had 8568 respondents with a mean age of 13.9 years (SD=0.7). Bivariate and multiple regression analyses were adopted to examine the links between weight perception and depressive symptoms.

RESULTS

Overweight perceptions were more prevalent in girls than in boys (47.0% vs. 29.3%), whereas underweight perceptions were less common in girls than in boys (15.7% vs. 29.3%). After adjusting for sociodemographic characteristics and health conditions, self-perceiving as "slightly overweight" and "very overweight" were significantly related to more depressive symptoms for both boys (p<0.05) and girls (p<0.05). A "very underweight" perception, however, was found to be only linked to greater depressive symptoms in boys (p<0.05). Notably, these patterns showed no significant rural-urban difference, as evidenced by the lack of significant interactive effects of all weight perceptions categories and region (urban/rural) on depressive symptoms.

LIMITATIONS

This study was based on a cross-sectional design, which essentially precludes the possibility to determine the causality of the observed associations.

CONCLUSION

Findings in this study indicated that the impacts of subjective physical attractiveness have been gendered and regionally pervasive in affecting emotional well-being of Chinese adolescents.

A stronger latent‐variable methodology to actual–ideal discrepancy

We introduce a latent actual–ideal discrepancy (LAID) approach based on structural equation models (SEMs) with multiple indicators and empirically weighted variables. In Study 1, we demonstrate with simulated data, the superiority of a weighted approach to discrepancy in comparison to a classic unweighted one. In Study 2, we evaluate the effects of actual and ideal appearance on physical self‐concept and self‐esteem. Actual appearance contributes positively to physical self‐concept and self‐esteem, whereas ideal appearance contributes negatively. In support of multidimensional perspective, actual‐ and ideal‐appearance effects on self‐esteem are substantially—but not completely—mediated by physical self‐concept. Whereas this pattern of results generalises across gender and age, multiple‐group invariance tests show that the effect of actual appearance on physical self‐concept is larger for women than for men. Copyright © 2008 John Wiley & Sons, Ltd.

Evidence of a Processing Advantage for Deservingness-Relevant Information

Abstract. We investigated processing speed for deservingness-relevant versus deservingness-irrelevant information. Female students read stories involving deserved, undeserved, or neutral outcomes. We recorded participants’ reaction time (RT) in processing the outcomes. We also measured individual differences in “belief in a just world” as a proxy for deservingness schematicity. RTs for deserved and undeserved outcomes were faster than for neutral outcomes, B = −8.45, p = .011, an effect that increased the stronger the belief in a just world (e.g., B = −3.18, p = .006). These findings provide novel evidence that the construct of deservingness is central in human social relations, and suggest both universal and particularistic schemas for deservingness.

The influence of identity on the prevalence and persistence of disordered eating and weight control behaviors in Mexican American college women

Disordered eating behaviors are prevalent in Mexican-American college-enrolled women and contribute to compromised physical and psychological health. Although disordered eating behaviors are multi-determined, few studies have examined individual difference factors that contribute to disordered eating behaviors in Mexican women beyond acculturation. Evidence suggests that individual differences in the constellation of identities may be an important factor influencing the disordered eating behaviors. We hypothesized that individual differences in the collection of identities (self-schemas) increases susceptibility to defining oneself as fat (fat self-schema) and contribute to disordered eating behaviors over time in Mexican American college women. A 12-month longitudinal design was used to measure the level of disordered eating behaviors at 5 points over 12 months in 477 Mexican American women. Identity properties (i.e., positive self-schemas, negative self-schemas, fat self-schema) were measured at baseline. Controlling for relevant covariates, latent growth curve models showed that Mexican American women with few positive and many negative self-schemas were more likely to define themselves as fat, which in turn, predicted purging and fasting/restricting behaviors across the year. However, identity properties were not predictive of binge eating and excessive exercise episodes. Interventions focused on development of positive self-schemas that reflect areas of interest and competence and the revision of negative self-schemas may protect against purging and fasting/restricting in Mexican American college-enrolled women.

Effects of a healthy-eater self-schema and nutrition literacy on healthy-eating behaviors among Taiwanese college students

Unhealthy eating behaviors contribute to obesity and chronic illness. This study examined the relative contributions of a healthy-eater self-schema (a self-conception as a healthy eater) and nutrition literacy on healthy-eating behaviors and whether nutrition literacy was a mediator among Taiwanese college students. A total of 1216 undergraduate students from six universities in Taiwan participated in the study from April to June 2016. Healthy-eating behaviors, nutrition literacy, healthy-eater self-schema and known determinants of eating behaviors (e.g. nutrition-related information, health status, nutrition knowledge needs, sex, year in college and residence) were measured by a self-report questionnaire. A hierarchical multiple regression and mediation analysis were conducted with the known determinants of eating behaviors as covariates. Results showed that a healthy-eater self-schema and nutrition literacy explained 9% and 12% of the variance in healthy-eating behaviors, respectively, and both had unique effects on healthy-eating behaviors. The effect of a healthy-eater self-schema on healthy-eating behaviors was partially mediated through nutrition literacy. Findings suggest that both a healthy-eater self-schema and nutrition literacy should be considered when promoting healthy-eating behaviors. Additionally, nutrition literacy interventions should be tailored to the healthy-eater self-schema status and emphasize the personal relevance of being a healthy-eater to improve the intervention's effectiveness.

Maternal and child dietary intake: The role of maternal healthy-eater self-schema

BACKGROUND

Mothers play a key role in shaping the dietary intake of their young children through their own dietary intake and the foods they make available at home. Therefore, understanding the mechanisms underlying maternal food choices is crucial. Cognitions about the self as a healthy eater, referred to as healthy-eater self-schema (HESS), predict dietary intake in diverse samples, but the linkage has not been investigated in mothers and their feeding behaviors. This study examined the relationship between a maternal HESS, maternal and child intake of fruits, vegetables, saturated fat, and added sugar, and home food availability.

METHODS

A cross-sectional, descriptive design was used with mothers and their 2-5 year old children (N = 124 dyads). Kendzierski's Healthy-Eater Self-Schema questionnaire was used to measure HESS. Block Food Frequency Screeners were used to measure diets (mother and child) and the Home Environment Survey was used to measure home availability of fruits/vegetables and fats/sweets. Multiple regression and multiple mediation analyses were performed.

RESULTS

Maternal HESS was positively associated with maternal intake of fruits and vegetables, and negatively associated with intake of added sugar. Maternal HESS was not directly associated with child dietary intake, but was indirectly associated with child intake of fruits, vegetables, and added sugar through maternal intake of the same foods. Home food availability was not significantly associated with HESS.

CONCLUSION

This study found that a mother's HESS was positively associated with her diet, which was subsequently associated with aspects of her child's diet. Interventions to foster development of HESS in mothers may be an effective means to promote healthy dietary intake in mothers and their young children.

The effects of priming in a cued dot-probe task on appearance-related attentional biases in women

The dot-probe task (DPT) is a reaction time measure of attentional bias. Research using this task has found inconsistent patterns of appearance-related attentional biases in women. This study examined the effects of a novel priming variation of the DPT, which incorporated additional cues into each trial of the task, on measurement of such biases. The study also examined associations between these biases and body image, a component of eating disorder symptomatology. A convenience sample of women from the general community (N = 103) completed body image measures online and attended a laboratory session to complete one of four DPTs: (1) an appearance-cued DPT containing images of thin-ideal models between each trial; (2) neutral-cued DPT containing images of forests; (3) time-delayed DPT controlling for time in place of an image; or (4) typical DPT containing only word stimuli. Women who completed the appearance-cued DPT demonstrated a stronger attentional bias for positive, but not negative, appearance words than women who completed the other DPT versions. Furthermore, for the appearance-cued and time-delayed DPTs, this bias correlated with poorer body image across several indicators (appearance evaluation, body dissatisfaction, self-evaluative salience of appearance, and state body satisfaction). Although it was unexpected that no attentional bias for negative-appearance words was found, the attentional bias for positive-appearance words may suggest that effects were driven by the ego-threat of positive-appearance words. Further research is warranted to determine whether such biases contribute to and maintain body image disturbance and disordered eating.

Perceptions of early body image socialization in families: Exploring knowledge, beliefs, and strategies among mothers of preschoolers

This study sought to explore parental perceptions of body image in preschoolers. We conducted semi-structured interviews with 30 primary caregivers of preschoolers to examine knowledge, beliefs, and strategies regarding early body image socialization in families. Thematic Analysis yielded three themes highlighting knowledge gaps, belief discrepancies, and limited awareness of strategies. Findings regarding knowledge: Most participants defined body image as objective attractiveness rather than subjective self-assessment (53%) and focused on negative body image. Beliefs: Although 97% of participants believed weight and shape impact children's self-esteem, 63% believed preschoolers too young to have a body image. Strategies: Most participants (53%) said family was a primary influence on body image, but identified few effective strategies and 63% said they did not do anything to influence children's body image. Findings suggested family body image socialization in preschoolers is occurring outside the awareness of parents and the concept of positive body image is underdeveloped.

“Is That All There Is?” Possible Selves, Self-Change, and Weight Loss

Possible selves typically are conceptualized as resources that facilitate identity development and that motivate and sustain self-change. The concept of possible selves, however, generally has not been extended to examining the aftermath of personal transformation. In this article I explore the self and social processes that operate during efforts to validate possible selves after self-change is complete. Using data gathered during in-depth qualitative interviews with 46 respondents who sustained weight loss over time, I analyze the role of possible selves in efforts to maintain intentional self-change. Findings show that many possible selves associated with weight loss are not fulfilled, and that the gap between potential and actual selves must be negotiated before persons can consider their weight loss both “successful” and “complete.” This gap is bridged by drawing on structural and cultural resources found within processes of self-verification and identity control and in the revision of personal narrative. By combining these resources, persons recognized and negotiated the gap between their expectations and the reality of intentional self-change.

Measurement of body dissatisfaction in college-enrolled Mexican American Women: A Rasch-based examination of the validity and reliability of the EDI-III

Measures of body dissatisfaction have not been validated for Mexican American (MA) women, who evaluate their bodies differently than Caucasian women. In this study, the psychometric properties of the EDI-III, Body Dissatisfaction Subscale (BDS) were examined in a sample of college-enrolled MA women using the Rasch Rating Scale Model. Criterion validity was also addressed. BDS evidenced good item fit, person and item reliability, once poorly correlated items were removed. Two qualitatively distinct dimensions of body dissatisfaction were identified: (1) overall body shape and stomach, and (2) the lower body. Validity of the scales was supported. Results suggest: MA women's satisfaction with overall body shape is not synonymous with attitudes toward their lower body.

Desirable possible selves and depression in adult women with eating disorders

PURPOSE

Possible selves are conceptions of our selves in future states. Previous findings indicated that women with anorexia nervosa tended to have more negative possible selves than a control group, even when rating future situations normally regarded in our society as desirable. The present study investigated whether this was a general pattern in women with eating disorders, relating findings on possible selves to depression. Possible selves concerning treatment were also included.

METHODS

Patients with anorexia nervosa (n = 19), bulimia nervosa (n = 29) or an eating disorder not otherwise specified (EDNOS) (n = 18) and a control group (n = 27) rated the valence of five possible selves on Likert's scales. Levels of depression were measured among the patients using the Beck Depression Inventory.

RESULTS

The patients rated the valence of the possible selves significantly less positively and more negatively than did the control group. A strong correlation between valence and depression was found in patients with anorexia nervosa and bulimia nervosa. No such correlation was found in patients with EDNOS. Possible selves concerning future treatment were rated even more negatively.

CONCLUSIONS

The results indicate that, when compared to a non-patient group, eating disorder patients make more negative evaluations of possible selves usually seen as desirable. Depression may be a mediating factor in these evaluations for the anorexia and bulimia patients.

Breaking the circle: challenging Western sociocultural norms for appearance influences young women's attention to appearance-related media

Paying attention to thin media models may negatively affect women's self-evaluation. This study aimed to reduce the amount of attention that young women give to appearance-related information by challenging the sociocultural norms for appearance, and studied the moderating role of self-esteem. Seventy-one college women either received norm-confirming, norm-challenging, or no information regarding the sociocultural norms for appearance. Subsequently, participants' visual attention to appearance-related and neutral advertisements was measured using an eye-tracker. The results demonstrate that when no information or norm-confirming information was received, women with lower self-esteem paid more attention to the appearance-related advertisements than women with higher self-esteem. Importantly however, when norm-challenging information was received, women with lower self-esteem paid significantly less attention to the appearance-related ads than women with lower self-esteem who did not receive this manipulation. These findings indicate that challenging the sociocultural norms for appearance can attenuate the amount of attention women give to appearance-related media.

The Weight Influenced Self-Esteem Questionnaire (WISE-Q): factor structure and psychometric properties

Weight-based self-esteem (WBSE) is hypothesized to be the core cognitive feature of eating disorders. The Weight Influenced Self-Esteem Questionnaire (WISE-Q) was designed to measure the influence of a negatively perceived body image on multiple dimensions of self-esteem, which we believe to be one aspect of WBSE. Study 1 sought to determine the factor structure of the WISE-Q as well as to examine the reliability and concurrent validity of WISE-Q scores among eating disorder and undergraduate student participants. In Study 2, validity was further investigated by examining changes in WISE-Q scores with treatment. The WISE-Q has two factors representing generalized and expected WBSE. Evidence of internal and test-retest reliability was found. Also, the pattern of correlations between WISE-Q scores and other constructs was in line with predictions. As expected, WISE-Q scores improved with treatment yet remained high.

The moderated relationship of appearance valence on appearance self consciousness: development and testing of new measures of appearance schema components

This paper describes the creation and psychometric properties of two independent measures of aspects of appearance schematicity – appearance salience and valence, assessed by the CARSAL and CARVAL, and their relation to appearance self-consciousness. Five hundred and ninety two participants provided data in a web based task. The results demonstrate the sound psychometric properties of both scales. This was demonstrated by good item total characteristics, good internal reliability of each scale, and the independence of the two scales shown through principal components analysis. Furthermore, the scales show independent and moderated relationships with valid measures of appearance related psychosocial distress. Negatively valenced appearance information was associated with increased appearance self-consciousness. More crucially, the impact of negative valence on appearance self-consciousness was exacerbated by the moderating effect increased salience of appearance.

Latent-Variable Approaches to the Jamesian Model of Importance-Weighted Averages

The individually importance-weighted average (IIWA) model posits that the contribution of specific areas of self-concept to global self-esteem varies systematically with the individual importance placed on each specific component. Although intuitively appealing, this model has weak empirical support; thus, within the framework of a substantive-methodological synergy, we propose a multiple-item latent approach to the IIWA model as applied to a range of self-concept domains (physical, academic, spiritual self-concepts) and subdomains (appearance, math, verbal self-concepts) in young adolescents from two countries. Tests considering simultaneously the effects of self-concept domains on trait self-esteem did not support the IIWA model. On the contrary, support for a normative group importance model was found, in which importance varied as a function of domains but not individuals. Individuals differentially weight the various components of self-concept; however, the weights are largely determined by normative processes, so that little additional information is gained from individual weightings.

A randomized clinical trial of an identity intervention programme for women with eating disorders

OBJECTIVE

Findings of a randomized trial of an identity intervention programme (IIP) designed to build new positive self-schemas that are separate from other conceptions of the self in memory as the means to promote improved health in women diagnosed with eating disorders are reported.

METHOD

After baseline data collection, women with anorexia nervosa or bulimia nervosa were randomly assigned to IIP (n = 34) or supportive psychotherapy (SPI) (n = 35) and followed at 1, 6, and 12 months post-intervention.

RESULTS

The IIP and supportive psychotherapy were equally effective in reducing eating disorder symptoms at 1 month post-intervention, and changes were stable through the 12-month follow-up period. The IIP tended to be more effective in fostering development of positive self-schemas, and the increase was stable over time. Regardless of baseline level, an increase in the number of positive self-schemas between pre-intervention and 1-month post-intervention predicted a decrease in desire for thinness and an increase in psychological well-being and functional health over the same period.

DISCUSSION

A cognitive behavioural intervention that focuses on increasing the number of positive self-schemas may be central to improving emotional health in women with anorexia nervosa and bulimia nervosa.

On the Validity of Idiographic and Generic Self–Concept Implicit Association Tests: A Core–Concept Model

We present a core–concept model (CCM) suggesting that stimulus centrality is an important factor in category representations in implicit measures. We tested the hypothesis that idiographic stimuli (first name, birthday) are more central and therefore assess self–concept in Implicit Association Tests (IATs) more validly than generic and nonspecific stimuli (me, you). Superior validity of the idiographic variant emerged across three different domains of self–concept. First, an idiographic self–esteem IAT displayed higher correlations than a generic IAT with self–assessments and observer–assessments of self–esteem. Second, an idiographic body scheme–IAT predicted subjective ratings of body image and objective body–mass index. Third, an idiographic aggressiveness–IAT had higher incremental validity for unprovoked aggression when interacting with explicit measures of aggressiveness. We conclude that idiographic stimuli focus participants’ attention on the core features of the self, hence, tapping into self–related associations to a stronger degree than generic stimuli. Copyright © 2011 John Wiley & Sons, Ltd.

Short term exposure to attractive and muscular singers in music video clips negatively affects men's body image and mood

Viewing idealized images has been shown to reduce men's body satisfaction; however no research has examined the impact of music video clips. This was the first study to examine the effects of exposure to muscular images in music clips on men's body image, mood and cognitions. Ninety men viewed 5 min of clips containing scenery, muscular or average-looking singers, and completed pre- and posttest measures of mood and body image. Appearance schema activation was also measured. Men exposed to the muscular clips showed poorer posttest levels of anger, body and muscle tone satisfaction compared to men exposed to the scenery or average clips. No evidence of schema activation was found, although potential problems with the measure are noted. These preliminary findings suggest that even short term exposure to music clips can produce negative effects on men's body image and mood.

The possible selves of adult women with anorexia nervosa

Adopting the construct of possible selves, which are conceptions of our selves in future situations, the objective of this study was to investigate how anorexia patients differ from a non-clinical control group in their conceptions of the future on qualitative content, and the four quantitative dimensions positive and negative emotional valence, and beliefs about probability and controllability. The Possible Selves Statements Test was employed. Participants presented 14 possible selves by completing the question "I can see myself …" and rating each possible self on the 4 dimensions. The patients reported a larger number of negative possible selves, with higher negative valence, often seeing future everyday situations as negative, whereas the control group saw similar situations as positive. The anorexia patients also reported negative possible selves with high controllability and high probability in relation to such situations and in some cases rated recovery from anorexia with a negative valence. Clinical implications are discussed.

Development and validation of an instrument to measure the impact of genetic testing on self-concept in Lynch syndrome

A positive genetic test result may impact on a person's self-concept and affect quality of life. The purpose of the study was to develop a self-concept scale to measure such impact for individuals carrying mutations for a heritable colorectal cancer Lynch syndrome (LS). Two distinct phases were involved: Phase 1 generated specific colorectal self-concept candidate scale items from interviews with eight LS carriers and five genetic counselors, which were added to a previously developed self-concept scale for BRCA1/2 mutation carriers, Phase II had 115 LS carriers complete the candidate scale and a battery of validating measures. A 20-item scale was developed with two dimensions identified through factor analysis: stigma/vulnerability and bowel symptom-related anxiety. The scale showed excellent reliability (Cronbach's α = 0.93), good convergent validity by a high correlation with impact of event scale (r(102) = 0.55, p < 0.001) and Rosenberg self-esteem scale (r(108) = -0.59, p < 0.001), and a low correlation with the Fear questionnaire (r(108) = 0.37, p < 0.001). The scale's performance was stable across participant characteristics. This new scale for measuring self-concept has potential to be used as a clinical tool and as a measure for future studies.

Salience of physical appearance characteristics among young women in Thailand

Our aim in the present study was to identify key components of physical appearance among young Thai women. Free listings, focus groups and pile sorting were used. One-hundred twenty young women generated 78 unique physical appearance characteristics. Ninety-four nursing students validated these characteristics in focus groups and then sorted them into piles that reflected separate domains of physical appearance and labeled them. Salience analysis revealed that facial appearance (e.g., bright facial skin, high nose bridge, big eyes) was the most important domain, followed by body weight and shape, skin color and texture, hair (color, texture, length), and 'other' physical appearance (e.g., slender neck, slim fingers). This is the first study to identify aspects of physical appearance that are most salient to young Thai women and that may differ from women in other cultural contexts. These findings could be used to develop culturally grounded measures of physical appearance in Thai women.

Cross-Cultural Constructions of Self-Schemas

A “spontaneous approach” was used to define self-schemas within and across cultures. Specifically, self-schemas were extracted from open-ended personality descriptions from Americans ( n = 560) and Mexicans ( n = 496) using the Meaning Extraction Method (MEM). The MEM relies on text analytic tools and factor analyses to learn about the most salient and chronically activated dimensions of personality that influence individuals’ self-defining process. The results showed that there were seven relevant self-schemas for Americans and six dimensions for Mexicans. Using qualitative and quantitative analyses, it was possible to observe which self-schemas were cross-cultural and which were culture-specific: Self-schemas common across cultures were Sociability, Values, Hobbies/Daily Activities, and Emotionality. Self-schemas unique to Americans were Fun, Existentialism, and College Experience. Self-schemas unique to Mexicans were Relationships and Simpatía. We discuss cross-cultural differences in self-schemas, along with the advantages and limitations of using the MEM in cross-cultural research.

An eating disorder randomized clinical trial and attrition: profiles and determinants of dropout

OBJECTIVE

This study sought to determine whether differential treatment effects in the targeted mechanisms of change and eating disorder (ED) symptoms are associated with patterns of attrition from a RCT.

METHOD

The main study was a RCT of a psychotherapy designed to alter the non-weight related self-cognitions as the means to promote recovery and health in a sample of 69 women with AN or BN. Four groups based on point of dropout were compared on demographic, self-cognitions and ED symptoms using logit and piecewise mixed effects modeling.

RESULTS

Attrition was highest during treatment phase but no significant predictors were found. During the measurement phase, the direction and amount of change in self-cognition interrelatedness and body dissatisfaction differed according to point of dropout and treatment group.

DISCUSSION

Attention to changes both in symptoms and mediating factors that occur during treatment and follow-up may help to identify those who are at risk for dropout and to develop strategies to promote RCT participant retention.

“Now my ‘old self’ is thin”

In this article, I employ a structural symbolic interaction framework to examine the processes by which persons can exit a stigmatized identity. Using the empirical example of weight loss, I analyze how individuals evolve from an identity as “fat” and stigmatized to one that is “normal” with respect to weight and free from identification with stigmatizing self-labels. The results suggest that stigma exits are possible but not easy and that simply sustaining weight loss over time does not necessarily produce an exit from stigma. Instead, stigma exits require evolutions in the responses of significant others and shifts in the way exiters view themselves. Moreover, individuals vary in the intensity of their identification with stigma and this is associated with the kinds of obstacles they find most troublesome as they attempt to exit stigma. Finally, I discuss the application of these findings to theories of structural symbolic interaction and to other forms of stigma.

Attentional bias in untreated panic disorder

The role of attentional biases in panic disorder has been well characterised. However, recent studies suggest an important effect of antidepressant and anxiolytic drugs on cognitive bias and most studies have included medicated patients in their sample. This study therefore examined cognitive bias in an untreated sample of participants with panic disorder (PD). A sample of 23 untreated participants with panic disorder with or without agoraphobia (PPD) and 22 healthy controls (HC) were tested with a Facial Expression Recognition task featuring different emotional intensities, a Faces Dot Probe task, a Self Beliefs task and an Emotional Stroop task. PPD showed exaggerated attentional biases to negative face and word stimuli in two different paradigms and endorsed more panic-related and negative self-attributions. They also showed enhanced perception of facial expressions of sadness. These tasks are sensitive to cognitive bias in a community-based sample of untreated PD participants. Attentional biases in panic disorder cannot be explained by the use of medication in this group and may therefore play a critical role in the underlying pathogenesis of the disorder.

Cognitive interference from food cues in weight loss maintainers, normal weight, and obese individuals

Much attention has been paid to the behavioral characteristics of successful weight loss maintenance, but less is known about the cognitive processes that underlie this process. The purpose of this study was to investigate cognitive interference from food-related cues in long-term weight loss maintainers (WLM; N = 15) as compared with normal weight (NW; N = 19) and obese (OB; N = 14) controls. A Food Stroop paradigm was used to determine whether successful WLM differed from controls in both the speed and accuracy of color naming words for low-calorie and high-calorie foods. A significant group × condition interaction for reaction time was observed (P = 0.04). In post hoc analyses, no significant differences in reaction time across the three groups were observed for the low-calorie foods (P = 0.66). However, for the high-calorie foods, WLM showed a significantly slower reaction time than the NW (0.04) and OB (0.009) groups (885 ± 17.6, 834 ± 15.8, 816 ± 18.3 ms, respectively). No significant group differences were seen for number of correct trials in 45 s (P = 0.12). The differential interference among WLM did not appear to generalize to other types of distracters (i.e., nonfood). Overall, findings from this study suggest that WLM differ from OB and NW controls in their cognitive responses to high-calorie food cues. Future research is needed to better understand why this bias exists and whether and how interventions can change cognitive processes to better facilitate long-term weight control.

Information processing of food cues in overweight and normal weight adolescents

OBJECTIVES

Based on cognitive theory (CT), the aim of this study is to investigate the cognitive processing of food cues in clinically overweight adolescents.

DESIGN

An experimental design with performance-based measures.

METHODS

Eighty-seven (45 overweight, 42 normal weight) adolescents between the ages of 12 and 18 years were examined. All completed an imbedded word task (IWT), containing high caloric food words and matched control words, as a measure of attention interference. A free-recall task was used to detect explicit memory biases. To study the effects of cognitive avoidance, participants were instructed to suppress thoughts about food or merely to monitor them, prior to completing the IWT and memory task.

RESULTS

No evidence was found for interference in the attention processing of food cues. Also, no effects of thought suppression were found. However, consistent with hypotheses, the overweight adolescents did show an explicit memory bias for food stimuli, not due to a more general negative evaluation of food words.

CONCLUSIONS

The results provide at least partial support for the applicability of CT to adolescent obesity. The study was the first to reveal a memory bias for high caloric food cues in overweight youngsters, which may well reflect a later-stage activation of food-related schemata. These may play a role in food-related preoccupations and overeating. The existence of an early-stage attention bias is less clear and requires further investigation.

Regional Differences in Physical Appearance Identity Among Young Adult Women in Thailand

Physical appearance concerns lead to serious health compromising behaviors among women in Thailand. The purpose of this study was to examine differences in physical appearance identity among young women in four regions of Thailand based on 30 physical appearance characteristics generated and validated in two previous samples of young Thai women. Using Q methodology, 200 Thai young women sorted the physical appearance characteristics in terms of importance. Across-region differences exist for the most important physical appearance characteristics. Regional differences in physical appearance identity may explain the variety of behaviors used by Thai women to enhance their physical appearance. Further research should focus on regional factors that contribute to these aspects of physical appearance becoming a dominant source of self-definition so that effective prevention strategies can be developed and targeted to women at high risk.

Personal identities and disordered eating behaviors in Mexican American women

Eating disorder behaviors are prevalent in Latina populations. This study tested Schwartz's (2006) theoretical view that a broad array of personal identities serves as an internal resource during acculturation and prevents internalization of dysfunctional weight related beliefs. Sixty-six Mexican American women completed measures of personal identities, fat self-definition, eating disorder symptoms and acculturation. Results show that few positive and many negative personal identities predict higher eating disorder scores and effects are mediated through the fat self-definition. Characteristics of personal identities may influence internalization of cultural values related to weight. Interventions focused on overall identity may prevent eating disorders in Latinas.

Changes in desired body shape after bariatric surgery

Bariatric surgery frequently leads to rapid weight loss post-surgery that may impact participants' ability to gauge a realistic ideal body shape. In the present study, 57 obese participants' perception of their current and ideal body shape pre and post gastric bypass surgery were assessed. Results indicate prior to surgery, participants reported a 4 point difference between current and desired body shape. One year post surgery, as their own body shape decreased, so did the size of their ideal body shape (4.1-3.3). These findings suggest a consequence of rapid weight loss may suggest to participants that unrealistic body shapes are attainable. Implications for patient counseling are discussed.

Automatic evaluation of body-related words among young women: an experimental study

Background

Previous research has demonstrated that exposure to images depicting the thin female ideal has negative effects on some females' levels of body dissatisfaction. Much of this research, however, has utilised relatively long stimulus exposure times; thereby focusing on effortful and conscious processing of body-related stimuli. Relatively little is known about the nature of females' affective responses to the textual components of body-related stimuli, especially when these stimuli are only briefly encountered. The primary aim of the current research was to determine whether young women automatically evaluate body-related words and whether these responses are associated with body image concerns, including self-reported levels of appearance schematicity, thin internalisation, body dissatisfaction, and dietary restraint.

Methods

An affective priming task was used to investigate whether females automatically evaluate body-related words, and whether this is associated with self-reported body image concerns. In a within-participants experimental design, the valence congruence of the prime and target pairs was manipulated. Participants selected body words as primes in Experiment 1 (N = 27), while normatively selected body words were primes in Experiment 2 (N = 50). Each prime was presented briefly, followed by a target word which participants judged as "good" or "bad". The dependent variable was response latency to the target.

Results

Automatic evaluation was evident: responding to congruent pairs was faster than responding to incongruent pairs. Body image concerns were unrelated to automaticity.

Conclusions

The findings suggest that brief encounters with body words are likely to prompt automatic evaluation in all young women, and that this process proceeds unintentionally and efficiently, without conscious guidance.

The image in the mirror and the number on the scale: weight, weight perceptions, and adolescent depressive symptoms

Double jeopardy and health congruency theories suggest that adolescents' joint experience of their weight and weight perceptions are associated with depressive symptoms, but each theory offers a different prediction about which adolescents are at greatest risk. This study investigates the proposed associations and the applicability of both theoretical perspectives using data from 6,557 male and 6,126 female National Longitudinal Study ofAdolescent Health (Add Health) Wave II participants. Empirically, results indicate that focusing on the intersection of weight and weight perceptions better shows which adolescents are at risk of depressive symptoms than an approach that treats both predictors as independent, unrelated constructs. Weight pessimists are at greatest risk of depressive symptoms. Thus, results support the health congruency framework, its extension to subpopulations outside of older adults, and its extension to optimism and pessimism about specific health conditions.

Attentional and interpretative biases in appearance concern: An investigation of biases in appearance-related information processing

The present study examined associations between high levels of appearance concern and information processing biases in interpretation and attention. An opportunity sample (N=79) categorised ambiguous stimuli as related or unrelated to appearance. Participants then responded to the same stimuli in a modified visual dot-probe task assessing attentional bias. Participant responses were assessed in relation to level of appearance concern. The results indicated a valence specific bias towards interpretation of ambiguous stimuli as negative and appearance-related in individuals with higher levels of concern. There was also evidence of attentional bias towards information perceived as appearance-related in participants with higher levels of appearance concern. The study findings suggest that association between appearance-orientated information processing biases and level of appearance concern; this association may lead to mutually reinforcing bias and concern.

The BRCA Self-Concept Scale: a new instrument to measure self-concept in BRCA1/2 mutation carriers

Genetic testing for BRCA1/2 has psychosocial impacts including those related to views of personal health, sense of self and identity and body image. The centrality of a person's self-concept in maintaining physical and psychosocial well-being has been well recognized; however, to date research exploring altered self-concept related to carrier knowledge is limited.

OBJECTIVE

The objective of the study was to develop and validate a scale to measure the self-concept among individuals testing positive for BRCA1/2 mutations.

METHODS

The study was conducted in two phases: phase I: item generation and refinement and phase II: scale selection and initial validation. During phase I, scale items were generated through individual interviews and focus groups of women with BRCA1/2 mutations, including women with or without a prior diagnosis of cancer. In phase II items were selected based on several criteria resulting in a 25-item scale, which underwent a reliability analyses and preliminary validation with 115 women. A second sample of 126 women was used to conduct further validation and samples were pooled to conduct factor analysis and the final scale selection.

RESULTS

A 17-item self-concept scale emerged having three factors: stigma, vulnerability and mastery demonstrating evidence for an instrument with promising psychometric properties (total scale alpha=0.90).

CONCLUSIONS

The scale has direct relevance for research in facilitating our understanding of the specific aspects of the self, which are vulnerable to BRCA1/2 testing and which play a role in clinical outcomes, to facilitate the development and specific testing of interventions and may be used as an outcome measure. Specific measurement tools for genetic populations will ultimately assist in the clinical management of these populations.

Cognitive Theory in Anorexia Nervosa and Bulimia Nervosa: A Review

This paper reviews cognitive theories of eating disorders as they are usually applied in treatment. More recent theoretical contributions and theory that is not widely applied are also reviewed. A set of hypotheses is derived from these theories and evidence for the validity of each hypothesis is discussed: this includes evidence from treatment studies, questionnaire studies and from experimental psychology. Following review of existing evidence, the paper summarizes the current status of cognitive theory in eating disorders. It then considers ways in which theory and research could be developed in order to improve and extend our understanding of cognitive content and processes in eating disorders. Limitations of existing models are highlighted and gaps in our knowledge, including knowledge of variables that typically have a central role in cognitive theory, are identified. Further strategies to test the validity of hypotheses derived from cognitive theory are suggested, together with strategies that might extend existing theory. It is concluded that much further research is needed, both to test the validity of existing theoretical contributions and to extend theory so that it will be more useful in clinical practice.

The relation of body dissatisfaction to salience of particular body sizes

OBJECTIVE

Research examining body image schemas has found that individuals high in body dissatisfaction direct increased attention toward body shapes relative to neutral stimuli. However, it is not known whether attention is attracted to particular body shapes over others (e.g., thin or obese). The present study examined whether body dissatisfaction would moderate the extent to which women find thin, average, and/or obese body sizes salient.

METHOD

Women with high and low body dissatisfaction (N=32) completed an indirect cognitive task assessing the relative salience of different body sizes (thin, average, obese).

RESULTS

Degree of body dissatisfaction was inversely related to frequency estimates of obese body sizes; highly dissatisfied participants found obese body sizes less salient.

CONCLUSION

These results highlight the importance of examining the salience of specific body sizes. The present study has implications for understanding cognitive aspects of social comparison and body dissatisfaction.

Automatic evaluation of body-related images

An affective priming task was used to determine whether females automatically evaluate body-related images, and to establish whether this is moderated by appearance schematicity, thin internalisation, body dissatisfaction, and dietary restraint. In a within participants design, the valence congruence of the prime and target pairs was manipulated, as was the interval between them. Undergraduate females (N=87, Experiment 1 and N=72, Experiment 2) individually selected colour images as the primes. Each prime was presented briefly, followed by a target word which the participant judged as "good" or "bad". The dependent variable was response latency to the target word. Automatic evaluation was evident; responding to congruent pairs was faster than responding to incongruent pairs. The individual difference variables were not related to automaticity. The findings suggest that brief encounters with body-related images are likely to produce automatic affective responses in young women irrespective of body-related concerns.