Cristiana Duarte

Physical appearance as a measure of social ranking: The role of a new scale to understand the relationship between weight and dieting

This study presents the development of a new self-report instrument to assess how an individual perceives himself as social agent within his group having physical appearance as a reference, the Social Comparison through Physical Appearance Scale (SCPAS). This scale adds to the existent measures by assessing the social ranking based on ones physical appearance, and not the tendency to make comparisons of the general physical appearance or specific body parts. Its psychometric characteristics are investigated in a sample of 828 female participants from normal population. Principal components analysis was conducted for each part of the instrument: the Part A: peers shows a 2-factor structure (Attractiveness/Rank and Group Fit) explaining 72.142% of the variance; the Part B: models presents a one-dimensional structure that explains 69.191% of the variance. Findings show very good internal consistency coefficients and test-retest reliability. The two parts of the SCPAS are significantly associated to social comparison and shame measures, to anxiety, depression and stress indicators, and to eating disorders symptomatology. The scale discriminates between a clinical sample of 91 patients with an eating disorder and a non-clinical sample of 102 participants. Regression analyses pointed out that social comparison through physical appearance with peers and models partially mediates the effect of the dissatisfaction with current weight on disordered eating, namely drive for thinness.

Expanding binge eating assessment: Validity and screening value of the Binge Eating Scale in women from the general population

There is growing recognition that binge eating is a prevalent problem with serious implications for both clinical and nonclinical samples. The current study aimed at examining the factor structure, psychometric properties and the screening usefulness of the Binge Eating Scale (BES) in a large sample of female college students and women from the Portuguese general population. A sample of 1008 participants was collected to conduct a confirmatory factor analysis and test the BES psychometric properties; 150 participants were further evaluated through the Eating Disorder Examination 16.0D to assess the discriminant validity of the BES. Results confirmed that the BES presents a sound one-dimensional factorial structure, with very good construct reliability and convergent validity. Also, the scale presented very good retest-reliability. Findings also offered evidence that the BES is positively associated with measures of eating and general psychopathology, and BMI. Furthermore, the BES revealed an excellent performance (96.7%) on discriminating clinically significant cases of binge eating, showing a sensitivity of 81.8% and a specificity of 97.8%. Results support the validity and usefulness of the BES as an assessment and screening tool for binge eating in women from the general population.

Escaping from body image shame and harsh self-criticism: exploration of underlying mechanisms of binge eating.

Shame has been highlighted as a key component of eating psychopathology. However, the specific impact of body image shame on binge eating and the mechanisms through which it operates remained unexplored. The current study tests a model examining the role that body image shame plays in binge eating and the mediator effect of self-criticism on this association, while controlling for the effect of depressive symptoms, in 329 women from the general population and college students. Correlation analyses showed that binge eating is positively associated with depressive symptoms, body image shame, and self-criticism, namely with a more severe form of self-criticism characterized by self-disgust, hating and wanting to hurt the self - hated self. Furthermore, results indicated that the path model explained 32% of binge eating behaviours and confirmed that body image shame has a significant direct effect on binge eating, and that this effect is partially mediated by increased hated self. These findings suggest that binge eating may emerge as a maladaptive way to cope with the threat of being negatively viewed by others because of ones physical appearance and the consequent engagement in a severe critical self-relating style marked by hatred, disgust and contempt towards the self. This study contributes therefore for the understanding of the processes underlying binge eating. Also, these findings have important research and clinical implications, supporting the relevance of developing eating disorder treatments that specifically target shame and self-criticism, through the development of self-compassionate skills.

Body Image as a Source of Shame: A New Measure for the Assessment of the Multifaceted Nature of Body Image Shame

UNLABELLED Theoretical and empirical accounts highlight the link between shame and body image difficulties, and disordered eating behaviours. Specifically, body image shame seems to play a particularly important role in this association. The current study aimed at developing and validating a new measure of body image shame and its phenomenology, the Body Image Shame Scale (BISS). Distinct samples of women from the general and student populations were used to test the BISS factorial structure using principal component analysis (PCA) and confirmatory factor analysis (CFA), and to examine the psychometric properties of the BISS. Principal component analysis results indicated that the scale presents a two-factor structure assessing an externalized and an internalized dimension underlying body image shame, which explains a total of 62.41% of the variance. A confirmatory factor analysis further corroborated the adequacy of this structure, which revealed good global and local adjustment indices. The BISS also presented very good internal consistency, construct and discriminant validities and good test-retest reliability. The scale also showed good concurrent and divergent validities. Furthermore, the scale discriminates between women with higher or lower levels of disordered eating behaviours. Finally, a mediation analysis revealed that the BISS fully mediates the previously established association between external shame and eating psychopathology. The BISS is a psychometrically robust and short measure of body image shame and its external and internal dimensions. KEY PRACTITIONER MESSAGE The BISS is a brief and reliable self-report instrument of body image-related shame. The BISS assesses the phenomenology of body image shame considering an externalized dimension and an internalized dimension, which may have important clinical implications. The BISS presents very good internal consistency, construct and discriminant validities, test-retest reliability, concurrent and divergent validities, and accurately distinguishes between women with higher and normative levels of disordered eating behaviours. Body image shame, as assessed by the BISS, contributes to a better understanding of eating psychopathology with findings suggesting that the association between external shame and eating psychopathology fully depends on the extent to which ones body image becomes the source of shame, with the consequent activation of defensive attitudes and behaviours.

Shame Memories and Eating Psychopathology: The Buffering Effect of Self-Compassion

OBJECTIVE Research suggests that self-compassion may protect against shame in eating disorders. This study examines the association between shame memories, self-compassion, self-judgment and eating psychopathology severity and tests the moderator effect of self-compassion on the relationships between shame memories and eating psychopathology. METHOD Participants were 34 patients with the diagnosis of an eating disorder, who were assessed using Eating Disorder Examination and the Shame Experiences Interview and self-report instruments measuring the traumatic and centrality to identity features of shame memories, self-compassion and self-judgment. RESULTS Self-compassion was negatively correlated to shame memory features and eating psychopathology, and self-judgment was positively associated with such variables. Self-compassion had a moderator effect on the association between shame traumatic and central memories and eating psychopathology severity. CONCLUSION This is the first study to explore the buffering effect of self-compassion against the pathogenic effects of shame memories on eating psychopathology severity in eating disorders, with relevant clinical and research implications.

Body image and college women’s quality of life: The importance of being self-compassionate:

This study explored self-compassion as a mediator between body dissatisfaction, social comparison based on body image and quality of life in 662 female college students. Path analysis revealed that while controlling for body mass index, self-compassion mediated the impact of body dissatisfaction and unfavourable social comparisons on psychological quality of life. The path model accounted for 33 per cent of psychological quality of life variance. Findings highlight the importance of self-compassion as a mechanism that may operate on the association between negative body image evaluations and young women’s quality of life.

Getting entangled with body image: Development and validation of a new measure

OBJECTIVES Several studies have highlighted the role of cognitive fusion on human suffering and a wide range of psychopathological conditions. Namely, this process has been regarded as a core aspect in eating disorders. Nevertheless, the study of cognitive fusion on eating psychopathology is scarce and a measure that specifically concerns body image was still to be created. The present study aimed therefore at developing and validating such measure, the Cognitive Fusion Questionnaire - Body Image (CFQ-BI). DESIGN AND METHODS The current study was conducted using different samples of both genders, collected in the general and student populations. The dimensionality of the CFQ-BI was tested through an exploratory factor analysis and a confirmatory factor analysis (CFA). The scales internal reliability and other psychometric qualities were also analysed. RESULTS The CFQ-BIs final structure was one-dimensional and comprised 10 items that assess body image-related cognitive fusion. This final structure explained a total of 73.41% of the variance. The adequacy of the questionnaire was corroborated through a CFA which revealed that CFQ-BI presents good global and local adjustment values and goodness-of-fit indices. Results also showed that the CFQ-BI holds a very good internal consistency (α = .96), convergent, divergent and temporal reliabilities, and is able to discriminate cases from non-cases of eating psychopathology. CONCLUSIONS The CFQ-BI was thus established as a short, robust, and reliable measure of body image-related cognitive fusion. This new measure may correspond to a significant contribution to research and clinical practice in the field of body image and eating-related difficulties. PRACTITIONER POINTS A new measure of body image-related cognitive fusion (CFQ-BI) was developed. The CFQ-BI was proved to be a short, robust, and reliable measure. Body image-related cognitive fusion was strongly linked to eating psychopathology. CFQ-BI may be useful in eating psychopathologys research and clinical practice.

Ashamed and Fused with Body Image and Eating: Binge Eating as an Avoidance Strategy

Binge Eating Disorder (BED) is currently recognized as a severe disorder associated with relevant psychiatric and physical comorbidity, and marked emotional distress. Shame is a specific negative emotion that has been highlighted as central in eating disorders. However, the effect of shame and underlying mechanisms on binge eating symptomatology severity remained unclear. This study examines the role of shame, depressive symptoms, weight and shape concerns and eating concerns, and body image-related cognitive fusion, on binge eating symptomatology severity. Participated in this study 73 patients with the diagnosis of BED, established through a clinical interview-Eating Disorder Examination 17.0D-who completed measures of external shame, body-image related cognitive fusion, depressive symptoms and binge eating symptomatology. Results revealed positive associations between binge eating severity and depressive symptoms, shame, weight and shape concerns, eating concerns and body image-related cognitive fusion. A path analysis showed that, when controlling for the effect of depressive symptoms, external shame has a direct effect on binge eating severity, and an indirect effect mediated by increased eating concern and higher levels of body image-related cognitive fusion. Results confirmed the plausibility of the model, which explained 43% of the severity of binge eating symptoms. The proposed model suggests that, in BED patients, perceiving that others see the self negatively may be associated with an entanglement with body image-related thoughts and concerns about eating, which may, in turn, fuel binge eating symptoms. Findings have important clinical implications supporting the relevance of addressing shame and associated processes in binge eating. Copyright

Being bullied and feeling ashamed: implications for eating psychopathology and depression in adolescent girls

The current study examined the associations between peer victimization, body image shame, self-criticism, self-reassurance, depressive symptoms and eating psychopathology in 609 female adolescents. Correlational analyses showed that being the victim of bullying was positively associated with body image shame, self-criticism, with low self-reassurance, depressive symptoms and eating psychopathology. A path analysis indicated that victimization experiences were associated with increased depressive symptoms partially through increased levels of body image shame, and a severe form of self-criticism - hated self. Body image shame and hated-self self-criticism fully mediated the association between victimization experiences eating psychopathology. The tested model accounted for a total of 51% of depressive symptoms variance and for 52% of eating psychopathology variance. These findings may have important intervention and prevention implications, by suggesting that bullying experiences fuel body image shame and consequent self-directed hostility and anger, which, in turn, predict increased depressive symptomatology and eating psychopathology in female adolescents.

Returning to emotional eating: the emotional eating scale psychometric properties and associations with body image flexibility and binge eating

AbstractPurposeThis study tests the Emotional Eating Scale (EES) psychometric properties and correlates, and the moderator effect of body image flexibility on the association between emotional eating and binge eating.MethodsThe EES factorial structure was examined in female college students and women from the general population, through a principal component analysis and a confirmatory factor analysis. EES psychometric properties and moderation analyses were further conducted.ResultsThe EES presented a three-factor structure—Depression, Anxiety and Anger—a good model fit, internal consistency, construct validity and temporal stability. EES was positively associated with general and eating psychopathology, binge eating, and negatively associated with mindfulness and body image flexibility. Body image flexibility moderated the association between emotional eating and binge eating.ConclusionsFindings showed that EES is a valid measure of emotional eating, and clarified the association between emotional eating and binge eating moderated by body image flexibility.