Eva V. Monsma

Correlates of eating disorders risk among female figure skates: a profile of adolescent competitors

Abstract Objectives: To present a profile of eating disorder risk among figure skaters by (a) comparing somatotype and BMI as biological variables in explaining Eating Disorder Inventory (EDI) variance; (b) examining relationships among physical characteristics, physique-related perceptions, and psychological indicators of eating disorders, and (c) determining if a composite of physical and psychological variables could discriminate solo skaters from dance and pair skaters. Design: Cross-sectional. Methods: A battery of anthropometric dimensions was taken, and the Physical Self Description Questionnaire, Social Physique Anxiety Scale, and EDI were completed by 114 competitive female figure skaters 12–22 yrs of age. Results: Correlation analyses indicated that the BMI was the most robust biological variable for subsequent analyses. Using hierarchical stepwise regression analysis to determine if physical self-perceptions predicted EDI subscale score, age was forced into each analysis at the first step followed by the BMI at step two. A composite of psychological variables (SPAS and select PSDQ subscales) were randomly entered at step three. Beyond age and the BMI, each of the EDI subscales was predicted by at least one psychological variable, with the SPAS predicting six of the eight subscales. Physical and psychological variables accounted for 3% to 63% of the variance in the EDI subscale scores. Dancers and pair skaters were older and less endomorphic, and reported higher Health scores, but lower Appearance scores compared to solo skaters. Conclusion: Contextual, physical and psychological variables appear to be germane features of eating disorder risk among competitive adolescent female figure skaters.

Puberty and physical self-perceptions of competitive female figure skaters: an interdisciplinary approach

This study considered the interrelationships among biological maturation and its physical correlates, social physique anxiety, and appearance-related physical self-perceptions in 113 adolescent female figure skaters participating in solo (n = 73) or partner contexts (n = 40). Participants were interviewed about their menarcheal status, underwent a battery of anthropometric measurements, and completed the Physical Self Description Questionnaire and the Social Physique Anxiety Scale. Menarcheal status was a stronger correlate of physical self-perceptions than age. A combination of biological and psychological characteristics accounted for 25% of the variance in appearance-related physical self-perceptions. Younger, premenarcheal, ectomorphic skaters reporting lower social physique anxiety were more satisfied with their body fat and sport competence but reported lower self-esteem, global physical self-concept, and appearance scores. Skating context did not predict physical self-perceptions.

Psychometric properties of the revised movement imagery questionnaire (MIQ-R).

The revised Movement Imagery Questionnaire (MIQ-R: Hall & Martin, 1997) assesses visual and kinesthetic movement imagery abilities and has become a popular questionnaire in sport and exercise psychology research. The purpose of this study was to examine the psychometric properties of the MIQ-R including internal consistency, stability, factor structure, and gender invariance. There were 325 male (n = 136) and female (n = 189) athletes/dancers who participated in the study. Gender-specific internal consistency coefficients ranged from .83 to .89 and the test-retest reliabilities over a one week period for the subscales were .80 for visual and .81 for kinesthetic imagery abilities. The best model fit from confirmatory factor analyses results was for a 2-factor structure with an interrelationship between the subscales. These results support the finding that visual and kinesthetic imagery abilities are separate but related constructs. An examination of invariance by gender indicated that the model fit females better than males.

Keeping Your Head in the Game: Sport-Specific Imagery and Anxiety Among Injured Athletes

CONTEXT The use of sport-specific imagery during rehabilitation is sparse. Athletes who used imagery (either facilitative or debilitative) during injury rehabilitation were compared with injured athletes who did not use imagery. Return-to-practice anxiety in the groups was investigated also. OBJECTIVE To (1) explore debilitative images used during rehabilitation, (2) examine athlete and injury characteristics in relation to variations in imagery content and return-to-practice anxiety, (3) compare the frequency of imagery use early in injury rehabilitation with that just before return to practice, and (4) examine the relationship between image use and return-to-practice anxiety. DESIGN Observational design. SETTING Athletic training facilities. PATIENTS OR OTHER PARTICIPANTS Thirty-six injured National Collegiate Athletic Association Division I collegiate athletes sustaining at least an 8-day practice suspension due to injury. MAIN OUTCOME MEASURE(S) Sport Imagery Questionnaire, Sport Anxiety Scale. RESULTS Athletes used both facilitative and debilitative images during different phases of rehabilitation. Men used more sport skill, strategy, and excitement imagery content than did women, who reported higher scores for worry and concentration disruption than did men. Athletes used fewer images related to their sport skills and strategies early in rehabilitation than just before they returned to practice. Additionally, athletes who used more arousal and less strategic imagery experienced more somatic anxiety. CONCLUSIONS Similar to research findings on healthy athletes, sport-specific image content in injured athletes is related to return-to-practice anxiety during rehabilitation, and some of the images were perceived as debilitative. Practitioners should advise injured athletes to use sport-specific imagery, especially that related to sport skills and strategies, but they should caution athletes against using arousal imagery, because it may elevate somatic anxiety before return to practice. Image content recommendations should encompass the cognitive and motivational functions of imagery, and the practitioner should assess if any image used by the athlete is debilitative.

An assessment of burnout in graduate assistant certified athletic trainers.

CONTEXT Graduate assistant athletic trainers (GAATs) must balance the demands of clinical care and the academic load of graduate-level students. OBJECTIVE To examine burnout among GAATs with clinical assistantships at National Collegiate Athletic Association (NCAA) Division I institutions and to identify the personal and situational variables that are related to burnout. DESIGN Cross-sectional study. SETTING Division I universities offering graduate assistantship programs. PATIENTS OR OTHER PARTICIPANTS Two hundred one GAATs enrolled at NCAA Division I universities with graduate assistantship positions. MAIN OUTCOME MEASURES(S) The Athletic Training Burnout Inventory, which assesses stress and burnout among ATs through 4 constructs: emotional exhaustion and depersonalization, administrative responsibility, time commitment, and organizational support. The 6-point Likert scale is anchored by 1 (never true) and 6 (always true). RESULTS The GAATs who traveled with athletic teams (4.051 ± 0.895) and those who provided classroom instruction (4.333 ± 1.16) reported higher levels of stress due to time commitment than those who did not travel (3.713 ± 1.22) or teach (3.923 ± 0.929). We also found a difference in administrative responsibility across clinical settings (F(6,194) = 3.507, P = .003). The results showed that GAATs in NCAA Division I clinical settings (44.55 ± 13.17 hours) worked more hours than those in NCAA Division III clinical settings (33.69 ± 12.07 hours) and those in high school settings (30.51 ± 9.934 hours). CONCLUSIONS Graduate assistant ATs are at risk for burnout because of the time necessary to complete their clinical and academic responsibilities and their additional administrative responsibilities. Graduate assistants who work in the Division I clinical setting are at greater risk for burnout than those in the secondary school setting because of the large number of hours required.

Prevalence of Eating Disorder Risk and Body Image Distortion Among National Collegiate Athletic Association Division I Varsity Equestrian Athletes

CONTEXT Participation in appearance-based sports, particularly at the collegiate level, may place additional pressures on female athletes to be thin, which may increase the likelihood of their resorting to drastic weight control measures, such as disordered eating behaviors. OBJECTIVES (1) To estimate the prevalence and sources of eating disorder risk classification by academic status (freshman, sophomore, junior, or senior) and riding discipline (English and Western), (2) to examine riding style and academic status variations in body mass index (BMI) and silhouette type, and (3) to examine these variations across eating disorder risk classification type (eg, body image disturbances). DESIGN Cross-sectional study. SETTING Seven universities throughout the United States. PATIENTS OR OTHER PARTICIPANTS A total of 138 participants volunteered (mean age = 19.88 ± 1.29 years). They represented 2 equestrian disciplines English riding (n = 91) and Western riding (n = 47). MAIN OUTCOME MEASURE(S) Participants self-reported menstrual cycle history, height, and weight. We screened for eating disorder risk behaviors with the Eating Attitudes Test and for body disturbance with sex-specific BMI silhouettes. RESULTS Based on the Eating Attitudes Test, estimated eating disorder prevalence was 42.0% in the total sample, 38.5% among English riders, and 48.9% among Western riders. No BMI or silhouette differences were found across academic status or discipline in disordered eating risk. Overall, participants perceived their body images as significantly larger than their actual physical sizes (self-reported BMI) and wanted to be significantly smaller in both normal clothing and competitive uniforms. CONCLUSIONS Disordered eating risk prevalence among equestrian athletes was similar to that reported in other aesthetic sports and lower than that in nonaesthetic sports. Athletic trainers working with these athletes should be sensitive to these risks and refer athletes as needed to clinicians knowledgeable about disordered eating. Professionals working with this population should avoid making negative comments about physical size and appearance.

Eating Disorder Risk and the Role of Clothing in Collegiate Cheerleaders' Body Images

CONTEXT With increased media coverage and competitive opportunities, cheerleaders may be facing an increase in eating disorder (ED) prevalence linked to clothing-related body image (BI). OBJECTIVE To examine ED risk prevalence, pathogenic weight control behaviors, and variation in clothing-specific BI across position and academic status among collegiate cheerleaders. DESIGN Cross-sectional study. SETTING National Collegiate Athletic Association Division I and II institutions. PATIENTS OR OTHER PARTICIPANTS Female collegiate cheerleaders (n = 136, age = 20.4 ± 1.3 years, height = 160.2 ± 8.1 cm, weight = 57.2 ± 8.3 kg). MAIN OUTCOME MEASURE(S) Participants self-reported height, weight, and desired weight and completed the Eating Attitudes Test. Body image perceptions in 3 clothing types (daily clothing, midriff uniform, full uniform) were assessed using sexbased silhouettes (body mass index = 18.3 kg/m(2) for silhouette 1, 23.1 kg/m(2) for silhouette 4). RESULTS The ED risk for cheerleaders was estimated at 33.1%. However, when body mass index was controlled using backward stepwise logistic regression, flyers had greater odds (odds ratio = 4.4, 95% confidence interval = 1.5, 13.2, P = .008) of being at risk compared with bases, but no difference was noted between the base and back-spot positions (odds ratio = 1.9, 95% confidence interval= 0.5, 6.6, P = .333). A main effect of BI perceptions was seen (P < .001), with a significant interaction by clothing type (F(2,133) = 22.5, P < .001, η(2) = 0.14). Cheerleaders desired to be smaller than their perceived BIs for each clothing type, with the largest difference for midriff uniform (2.6 ± 0.8 versus 3.7 ± 0.9), followed by full uniform (2.7 ± 0.8 versus 3.5 ± 0.9) and daily clothing (2.8 ± 0.8 versus 3.5 ± 0.9). CONCLUSIONS Cheerleaders, especially flyers, appear to be at risk for EDs, with greatest BI dissatisfaction when wearing their most revealing uniforms (ie, midriffs). Universities, colleges, and the national governing bodies of these squads need to focus on preventing eating disorders and BI dissatisfaction and promoting self-esteem.

Give or take a few? Comparing measured and self-reported height and weight as correlates of social physique anxiety.

Statistically controlling for physical size is common practice, especially in self-perception studies uncovering the etiology of maladaptive behaviors, such as eating disorders. For example, social physique anxiety (SPA)—apprehension about social evaluations while presenting oneself in front of others (Leary, 1992)—is a prominent correlate of eating disorder indicators (Hausenblas & Mack, 1999; Monsma & Malina, 2004), body image (Ackard, Croll, & Kearny-Cook, 2002; Markey & Markey, 2005), and self-esteem (Caldwell, Brownell, & Wilfley 1997; Forbes, Doroszewicz, Card, & Adams-Curtis, 2004). Physical size may potentially mask relationships among the psychological variables between SPA relationships and such constructs. Psychological analyses frequently control for height, weight, or body mass index (BMI) by examining partial correlations or using physical variables as covariates in mean comparison tests with SPA as well as other psychological disorder symptoms. Among female participants in aesthetic sports, Monsma, Pfeiffer, and Malina (2008) found that physical size characteristics, such as weight, percentage of body fat, and BMI, were the strongest correlates of SPA. Other studies of adolescent and young adult women supported the association of BMI and SPA, with correlations of .14 (Haase & Prapavessis, 1998) and .11 (Russell & Cox, 2003), respectively. Self-reported BMI accounted for 21% of the variance in predicting body satisfaction in 7,200 young adult female dieters (Caldwell et al., 1997), 7.8% of the variance in SPA in 373 college women (Sabiston, Crocker, & Munroe-Chandler, 2005), and measured BMI explained 5% of the variance in eating disorder symptoms among 114 adolescent and young adult figure skaters (Monsma & Malina, 2004). Physical size is particularly important to consider among adolescents because of the variability associated with growth and maturation. In general, participants with higher BMI tend to report higher scores in SPA, decreased body satisfaction, and increased eating disorder symptoms. Given that social desirability to have a lean figure is prevalent in American society, individuals with symptoms of eating disorders, low to moderate increases in SPA, and body dissatisfaction may be more likely to misreport their height and weight (Klesges et al., 2004). Both biological and contextual factors are possible reasons for overor underreporting height and weight among adolescents. Plausible biological explanations include the timing and tempo of growth (Fortenberry, 1992) and time since menarche in girls (Abraham, Luscombe, Boyd, & Oleson, 2004), while contextual factors include those such as the amount of time spent exercising (Abraham et al., 2004) and pressures associated with sports context. Aesthetic activities such as ballet, gymnastics, cheerleading, and figure skating frequently hold weighins, involve high-energy expenditure, and, in some cases, recommendations to diet or lose weight. Aligned with timing and tempo variations of biological events, such as breast development and menarche (Brooks-Gunn, 1988), the ages of ≤ 12.9, 13.0–15.9, 16.0–18.9, ≥ 19 years should be considered because of the associated gains in weight and height. The average age at menarche is 12.8 ± 1.0 years in the North American population and slightly later (13.5–16.8 years) among aesthetic activity participants (Malina, Bouchard, & BarOr, 2004). Peak height followed by peak weight velocities typically occur approximately one year prior to menarche. Give or Take a Few? Comparing Measured and SelfReported Height and Weight as Correlates of Social Physique Anxiety

Developmental and Contextual Risks of Social Physique Anxiety among Female Athletes.

Abstract In the present study, we examined developmental and contextual factors that may increase the odds of reporting higher social physique anxiety (SPA) among 404 adolescent athletes 11 to 16 years old. Findings showed older, later maturing athletes past peak height velocity and with greater body mass index (BMI) reported higher SPA. Individual aesthetic sport athletes were older at menarche, had lower BMI, and reported higher SPA. The odds of reporting higher SPA were 4.5 times higher (odds ratio = 4.61) for individual aesthetic sport athletes than for nonaesthetic sport athletes. Team aesthetic sport contexts were not implicated in SPA risk. Results are discussed in terms of self-selection away from individual aesthetic sports and the relevance of physical size and puberty in the SPA construct.

Relationship of Social Physique Anxiety to Indicators of Physique

Social physique anxiety (SPA) refers to feelings of anxiety an individual experiences in anticipation or presence of interpersonal evaluation of her/his physique (Hart, Leary, & Rejeski, 1989). Aligned with self-presentation theory (Schlenker & Leary, 1982), SPA is theorized to emanate from the motivation to portray a particular image with regard to physique and the probability of succeeding in a specific context. The matching hypothesis from contextual theory (Lerner, 1985) suggests that negative self-perceptions (SPA) are manifested when individual characteristics are incongruent with contextual demands. Subjectively evaluative contexts of dance and figure skating, which tend to consider changing physical characteristics associated with normal growth and maturation during adolescence as potential liabilities to artistry, may conceivably promote SPA. However, the prevalence of SPA in subjective evaluative contexts is equivocal. For example, SPA has been shown to be prevalent among cheerleaders (Reel & Gill, 1996) and aerobic instructors (Thorgersen-Ntoumanis & Ntoumanis, 2007), while another study found SPA to be higher among figure skaters than soccer players (Martin, Engels, Wirth, & Smith, 1997). In contrast, other researchers have found moderate SPA scores among synchronized skaters (Greenleaf, 2004) and no differences between divers and nonathletic samples (Haase & Prapavessis, 2001; Hausenblas & Mack, 1999). The failure to comprehensively assess and/or consider interindividual biological variation in research designs might explain the findings. SPA tends to vary with physical size so that even extremely thin individuals can be susceptible to SPA. Thus, capturing the magnitude of SPA above and beyond physical size is important before considering more omnibus hypotheses such as those involving maladaptive behaviors (e.g., disordered eating, substance abuse). Surprisingly, systematic assessment and statistical control for physical size is not common practice in SPA research. Among biological parameters, body mass index (BMI; weight/height2; kg/m2) and body weight are considered most often in SPA research (Davison & McCabe, 2006; Diehl, Johnson, Rogers, & Petrie, 1998; Hausenblas & Mack, 1999; Thompson & Chad, 2000); they are generally treated as covariates in analyses to remove the potential effects of body size. Weight by itself is limited; it is difficult to interpret weight independent of height. On the other hand, BMI essentially adjusts weight for variation in height, but it has limitations as an indicator of body composition and, in particular, physique due to major changes in body proportions and composition during adolescence (Malina, Bouchard & Bar-Or, 2004). It is conceivable that adolescents may be unaware of growth that occurred between their most recent measurement and the time of a given study. Accordingly, the accuracy of self-reported height and weight among adolescents is questionable (Himes & Faricy, 2001) and a potential source of measurement error. By definition, the concept of SPA includes the individual’s physical characteristics. Physique refers to body Relationship of Social Physique Anxiety to Indicators of Physique