Jane Ogden

Some problems with social cognition models: A pragmatic and conceptual analysis

Empirical articles published between 1997 and 2001 from 4 health psychology journals that tested or applied 1 or more social cognition models (theory of reasoned action, theory of planned behavior, health belief model, and protection motivation theory; N = 47) were scrutinized for their pragmatic and conceptual basis. In terms of their pragmatic basis, these 4 models were useful for guiding research. The analysis of their conceptual basis was less positive. First, these models do not enable the generation of hypotheses because their constructs are unspecific; they therefore cannot be tested. Second, they focus on analytic truths rather than synthetic ones, and the conclusions resulting from their application are often true by definition rather than by observation. Finally, they may create and change both cognitions and behavior rather than describe them.

Eating style and eating behaviour in adolescents

The relationship between eating style, attitudes towards food and food intake was investigated in 846 British adolescent schoolchildren. Eating style was assessed with the Dutch Eating Behaviour Questionnaire, attitudes towards food with a series of specially prepared questions, and food intake with a diet history taken by a dietitian. The results showed that restraint, external and emotional eating were associated with very different profiles of attitudes and behaviour. Restrained subjects had a higher body weight, more negative attitudes towards food, a lower likelihood of overeating and a lower overall energy intake. External eaters had a lower body weight, positive attitudes to food, and reported a higher energy intake. Emotional eaters fell in between in some ways, with some signs of situational loss of control combined with a negative attitude towards overeating. While external eating appeared to be attenuated by restraint, emotional eating was enhanced by it. The implications of these eating styles for later patterns of eating and weight are discussed.

The effect of the media on body satisfaction: the role of gender and size,

Media images of stereotypically attractive women are often cited as contributory factors in body size distortion and body dissatisfaction. In fact, recent research suggests that acute exposure to such images may exacerbate body distortion in women with eating disorders. The present study examined the effects of acute exposure to images of stereotypical attraction (thin pictures) compared to images of overweight individuals (fat pictures) in both men and women. Twenty men and 20 women completed measures of body satisfaction before and after viewing images of either thin or overweight individuals matched for the subjects gender. The results suggested that subjects of both gender reported feeling less satisfied with their bodies as measured by rating scales (e.g. feeling fat, feeling attractive), body silhouettes and body size estimation, after viewing the thin pictures and showed improved body satisfaction after viewing the overweight pictures. The results also suggested that this response was greater in the female than in the male subjects for some of the measures (e.g. feeling fat, feeling toned) and was unrelated to levels of restrained eating. The results are discussed in terms of the role of the media in determining body image and the possible use of such images in clinical practice.

The impact of obesity surgery and the paradox of control: A qualitative study

In light of the failure of psychological approaches to obesity some clinicians and patients are turning to surgery. The present qualitative study aimed to explore patients’ experiences of having obesity surgery and in-depth interviews were carried out with 15 men and women, who had had surgery in the past four years. The data were analysed using Interpretative Phenomenological Analysis (IPA). The patients described their experiences in terms of four broad themes: personal weight histories; the decision-making process, which involved general motivations such as worries about health and specific triggers such as symptoms; the impact of surgery on eating behaviour and their relationship with food; the impact of weight loss on health status, self-esteem and relationships with others. The central theme of control permeated all areas of the interviews. The current clinical climate highlights the importance of self-control and patient choice as the path to patient empowerment. Obesity surgery illustrates that in contrast to this perspective, imposed control and limited choice can sometimes paradoxically result in a renewed sense of control.

Psychosocial theory and the creation of the risky self

This paper examines the transformation of individual identity in twentieth century psychological theory from the passive through to the interactive to the intra-active using models of behaviour, learning, beliefs, stress and pain. This shift in identity and the corresponding realignment of individual and environment is discussed in terms of changing locations of risks to health and the construction of the contemporary risky self.

The role of knowledge and beliefs in help seeking behaviour for cancer: a quantitative and qualitative approach

The study involved quantitative methods to assess the relationship between knowledge about cancer related symptoms and help seeking behaviour and qualitative methods to explore the role of patients beliefs about cancer in explaining the gap between knowledge and behaviour. Patients (288) (response rate 72%) from one urban general practice completed a questionnaire consisting of 25 symptoms which they rated for whether they were cancer symptoms (knowledge) and whether the symptoms would prompt them to visit the doctor (hypothetical help seeking behaviour). Twenty patients were then selected who represented a range of knowledge levels and help seeking behaviour and interviewed about their beliefs about cancer. The results showed that the majority of patients had fair knowledge and appropriate help seeking behaviour and indicated a significant association between these variables. However, this relationship was not absolute and although significant the correlation was low. Accordingly, although the subjects knew which symptoms were indicative of cancer, this knowledge was not entirely predictive of their help seeking behaviour. The interviews provided insights into the beliefs which may explain the knowledge/behaviour gap. In particular, analysis of the interviews indicated that the interviewees represented cancer in terms of feelings of fear and death, that they described the process of symptom recognition as involving a fear of finding out the truth, they regarded screening programmes as something to be avoided and understood the causes of cancer either in terms of personal behaviour and internal causes which may result in recriminations or external causes which were beyond their control. The results are discussed in terms of the role of beliefs in mediating the association between knowledge and behaviour and the possible implications for developing educational programmes.

The correlates of long-term weight loss: a group comparison study of obesity

OBJECTIVE: Although the majority of weight loss attempts are unsuccessful, a small minority succeed in both weight loss and maintenance. The present study aimed to explore the correlates of this success.METHOD: A group comparison design was used to examine differences between women who were classified as either weight loss maintainers (had been obese (body mass index, BMI=30+ kg/m2) and had lost weight to be considered non-obese (BMI<30 kg/m2) and maintained this weight loss for a minimum of 3 y; n=44), stable obese (maintained an obese weight (BMI=30+ kg/m2) for longer than 3 y; n=58), and weight loss regainers (been obese (BMI=30+ kg/m2), lost sufficient weight to be considered non-obese (BMI<30 kg/m2) and regained it (BMI=30+ kg/m2), n=40). In particular, the study examined differences in profile characteristics, historical factors, help-seeking behaviours and psychological factors.RESULTS: The results showed that in terms of profile and historical factors, the weight loss maintainers had been lighter, were currently older and had dieted for longer than the other groups but were matched in terms of age, class and ethnic group. In terms of help-seeking behaviours, the weight loss maintainers reported having tried healthy eating more frequently but were comparable to the other subjects in terms of professionals contacted. Finally, for psychological factors the weight loss maintainers reported less endorsement for medical causes of obesity, greater endorsement for psychological consequences and indicated that they had been motivated to lose weight for psychological reasons.CONCLUSIONS: Weight loss and maintenance is particularly correlated with a psychological model of obesity. This has implications for improving the effectiveness of interventions and the potential impact of current interest in medical approaches to obesity.

The measurement of restraint: confounding success and failure?

The present study examined the concept of restrained eating as measured by the Restraint Scale and the restrained eating section of the Dutch Eating Behaviour Questionnaire. The results showed that when answering questionnaires, subjects do not differentiate between items relating to attempts at dieting and actual restrictive behavior and that restrained eating can be conceptualized in terms of both successful and failed restraint. In addition, the results suggest that subjects who report high scores on both these measures of restraint represent a population of dieters prone to overeating behavior. The results are discussed in terms of the population selected by measures of restrained eating and in relation to the definition of restraint.

The role of family status and ethnic group on body image and eating behavior

OBJECTIVE To examine the role of ethnic group and family status on body dissatisfaction and eating behavior. METHOD One hundred women (Asian mothers and daughters, n = 50; white mothers and daughters, n = 50) completed a questionnaire about their perceived ethnic identity (acculturation), body image, and eating behavior. RESULTS The results showed no matching between mothers and daughters and no effect of acculturation on body image and eating behavior. However, mothers reported greater body dissatisfaction and white subjects reported higher levels of restrained eating. In addition, the results showed a significant Ethnic Group x Family Status interaction for both body image and eating behavior irrespective of body mass index (BMI). Accordingly, white daughters were found to be the most dissatisfied with their bodies and most concerned with the calorie content of their food, followed by the Asian mothers. White mothers were found to be the most satisfied with their body and Asian daughters were the least concerned with calories. DISCUSSION The results are discussed in terms of the changing nature of media images in both Asian and white cultures and the impact of the transition between these two cultures.

Effects of smoking cessation, restrained eating, and motivational states on food intake in the laboratory.

Twenty smokers, 20 abstaining smokers (for 24 hr), and 20 nonsmokers completed ratings of motivational state before and after a taste test, to examine the mediating effects of motivations to eat and smoke, cross-motivational satiating effects, and restrained eating on post-smoking-cessation food intake in the laboratory. The results suggest that the abstaining smokers consumed more carbohydrates, calories, fat, protein, and mass than the smokers; that food intake was related to the urge to eat, the urge to smoke, and craving for a cigarette; and that eating could reduce the desire to smoke. However, these effects were only apparent for the female smokers. In addition, restrained eating predicted increases in postcessation food intake. The results are discussed in terms of a substitution theory of motivational states.