J. Menzel

Media effects of experimental presentation of the ideal physique on eating disorder symptoms: A meta-analysis of laboratory studies ☆

BACKGROUND Older meta-analyses of the effects of the medias portrayal of the ideal physique have found small effects revealing that exposure to the ideal physique increases body image concerns. These meta-analyses also included correlational, quasi-experimental, and experimental studies, with limited examination of moderators and other relevant outcomes besides body image. METHODS We conducted a systematic literature search and identified 33 experimental (i.e., pre and post data for both experimental and control groups) laboratory studies examining the effects of acute exposure to the medias portrayal of the ideal physique on eating disorder symptoms (i.e., body image, positive affect, negative affect, self-esteem, anger, anxiety and depression) and the mechanisms that moderate this effect. RESULTS Fourteen separate meta-analyses revealed a range of small to moderate effect sizes for change in outcomes from pre to post for both experimental and control groups. Exposure to images of the ideal physique resulted in small effect sizes for increased depression and anger and decreased self-esteem and positive affect. Moderator analyses revealed moderate effect sizes for increased depression and body dissatisfaction among high-risk participants. CONCLUSIONS This meta-analysis makes it clear that media exposure of the ideal physique results in small changes in eating disorder symptoms, particularly with participants at high risk for developing an eating disorder. Further research is needed to examine the longitudinal effects of media exposure of eating disorder symptoms.

Development and validation of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS)

The goal of the current investigation was to develop and validate a measure to assess an individuals eating-related behaviors related to alcohol consumption, specifically behaviors intended to compensate for calories so that more alcohol could be consumed or restrict calories to enhance the psychoactive effects of alcohol consumption. Two hundred and seventy four undergraduate students (n=51 males; 75.2% Caucasian) completed a newly developed scale, the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS), along with measures of eating restriction, bulimia, and body dissatisfaction. An exploratory factor analysis on the CEBRACS revealed the existence of 4 clear-cut factors: alcohol effects, bulimia, dieting and exercise, and restriction. Internal consistency statistics for all subscales ranged from .79 to .95. Pearson product-moment correlations between the CEBRACS and measures of bulimia, restriction, and body dissatisfaction ranged from .04 to .44. T-tests revealed no gender differences in compensatory eating behaviors. Future research directions and limitations of the current study are discussed.

Differences in appearance-related commentary, body dissatisfaction, and eating disturbance among college women of varying weight groups.

This study examined appearance-related commentary, body dissatisfaction, and eating disturbance in 924 undergraduate females. Significant group differences were found in type of appearance-related commentary received across weight groups. Overweight and obese women experienced negative weight and shape-related comments at greater frequencies and positive weight and shape-related comments at lower frequencies compared to underweight and normal weight women. A higher frequency of positive weight and shape-related commentary was associated with less body dissatisfaction for all women and less shape and weight concerns for obese women. These findings suggest that the weight status of young women likely influences the appearance-related commentary that they receive and the manner in which such commentary affects their body image and eating behaviors.

Internalization of Thin-Ideal and Muscular-Ideal

The construct of internalization has a long history in psychology dating to the early work of Freud. This article reviews the contemporary theorizing of this construct and its application to body image. Internalization of appearance ideals, as it relates to the field of body image, has been defined as the personal acceptance and endorsement of prevailing notions of beauty and attractiveness. This article focuses on two specific aspects of appearance internalization – thinness and muscularity. Theoretical models, measurement strategies, and treatment/prevention approaches related to an internalization of thinness and muscularity ideals are reviewed. Limitations of the current knowledge base and indications for future research are outlined.

Two Cases of Early Childhood Selective Mutism Variations and Treatment Complexities

Selective Mutism (SM) is a highly impairing disorder which typically presents upon entry to school and affects approximately 0.7% of children. Despite its impact on social and academic development, it is a difficult disorder to treat and there is a small evidence base for behavioral treatment. Preliminary evidence suggests that behavioral treatment focused on exposure to social interactions, social skill building, and involvement of caregivers in treatment may be promising. This article presents two cases of early childhood SM to demonstrate the importance of tailored treatment implementation to meet the individual needs of each family and help children resume typical social development.

Assessment and Treatment of Comorbid Anorexia Nervosa and Obsessive–Compulsive Disorder

Anorexia nervosa and obsessive–compulsive disorder (OCD) have many overlapping features in the cognitive, affective, and behavioral aspects of the two disorders. This chapter examines the challenges presented by comorbid anorexia nervosa and OCD on assessment and treatment approaches. Finally, the chapter concludes with two examples, a child and adult, of the clinical presentation and treatment for anorexia nervosa and comorbid OCD.

Self-objectification, body shame, and disordered eating: Testing a core mediational model of objectification theory among White, Black, and Hispanic women.

Objectification theory asserts that self-objectification, which manifests as self-surveillance, leads to increased body shame and subsequent eating pathology. Although evidence supports the core mediational model, the majority of this work utilizes primarily White samples, limiting generalizability to other ethnic groups. The current study examined whether the core tenets of objectification theory generalize to Black and Hispanic women. Participants were 880 college women from the United States (71.7% White, 15.1% Hispanic, 13.2% Black) who completed self-report measures of self-surveillance, body shame, and disordered eating. Multivariate analysis of variance tests indicated lower levels of self-surveillance and disordered eating among Black women. Moreover, body shame mediated the relationship between self-surveillance and disordered eating for White and Hispanic women, but not for Black women. These analyses support growing evidence for the role of body shame as a mediator between body surveillance and eating pathology, but only for women in certain ethnic groups.

Mirtazapine and Weight Gain in Avoidant and Restrictive Food Intake Disorder

Avoidant and restrictive food intake disorder (ARFID) is a newly classified disorder in the DSM-5 that describes a pattern of restrictive eating across the lifespan that results in significant weight loss, nutritional deficiency, dependence on enteral feeding or nutritional supplements, or marked interference in psychosocial functioning.1 Currently, there are no evidence-based treatment approaches or medications for this disorder.2 We have administered a range of psychoactive medications to those with ARFID in our treatment program in an attempt to find an effective medication. One medication of interest has been mirtazapine because it promotes appetite and weight gain, decreases nausea and vomiting, and improves gastric emptying. Although mirtazapine is an off-label approach in a pediatric population and carries a black box warning for an increased risk of suicide, it is an effective treatment for depression and anxiety symptoms in adults and is generally well tolerated.3,4 There are no studies to date reporting on the use of mirtazapine in patients with ARFID.