Joel K. Thompson

Weight Bias in the Media: A Review of Recent Research

Background: There is ample evidence that overweight and obese individuals are stigmatized in various forms of media. This weight bias is particularly disconcerting when it targets children and adolescents. Objective: The current review surveys the most recent 15 years of research on weight bias and stigmatization in the media and discusses some theoretical models that might help explain the negative effects of such material. Method: PsycINFO searches were conducted using weight bias- and stigmatization-related terms and phrases. Results were limited to journal articles published in English between 1994 and 2009. Results: Overall, the data indicate that a wide range of media – from television shows to books, newspapers, and the internet – portray over-weight and obese individuals in a stigmatizing manner. Conclusion: More research on this topic is needed to dis-cern a direct connection between exposure to such ma-terial and psychological or physical harm to the viewer. Additionally, virtually all of the research has been conducted in the USA; research in other countries should be a top priority. Efforts to try to educate the media to the deleterious effects of media presentations of weight bias are indicated.

Biology and behavior: a set-point hypothesis of psychological functioning

This article provides a broad overview of an exploratory thesis designed to enhance an understanding of perturbations and rigidities of psychological functioning a set-point hypothesis of psychological functioning. Historical precedents and parallels with Keeseys set-point theory of obesity are offered. Basic tenets of the hypothesis are detailed, and relevance to clinical behavioral theory is outlined. It is concluded that the set-point hypothesis may provide a framework for conceptualizing clinical cases and optimizing interventions. The thesis appears to be testable; however, the articulation of specific methodologies and research designs must be undertaken before the ultimate usefulness of the set-point hypothesis can be determined.

Fear of negative appearance evaluation: Development and evaluation of a new construct for risk factor work in the field of eating disorders

The psychometric properties and correlates of a measure designed to assess fear of negative appearance evaluation are presented. In Study 1, 165 college females completed the Fear of Negative Appearance Evaluation Scale [FNAES; Thomas, C.M., Keery, H., Williams, R., & Thompson, J. K. (1998, November). The Fear of Negative Appearance Evaluation Scale: Development and preliminary validation. Paper presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Washington, DC] along with measures of body image, eating disturbance, and depression. Results replicated previous analyses indicating the presence of a single factor, good internal consistency, and significant association with measures of body image and eating disturbance. Additionally, the FNAES accounted for unique variance beyond that explained by general fear of negative evaluation, and other measures of body image and eating disturbance, in the prediction of body shape dysphoria, dietary restraint, and trait anxiety. Study 2 further examined the validity of the FNAES, finding it to correlate significantly with measures of social physique anxiety, body image, eating attitude, and mood. The FNAES did not significantly correlate with body mass index (BMI). Regression analyses found the FNAES to predict levels of body image, eating attitude, and mood beyond variance explained by social physique anxiety. The FNAES appears to measure a conceptually unique aspect of body image that has not been indexed by previous measures and may serve a useful role in risk factor and preventive work.

Factor analysis of multiple measures of body image disturbance: Are we all measuring the same construct?

Two studies were conducted to determine the overlap among multiple measures of subjective body image disturbance. Study 1 was conducted on 219 adolescent females (ages 14-18 years) who completed seven widely used indices of self-reported body image disturbance. Study 2 involved 162 college females (ages 17-35 years) and six measures of disturbance, five of which were identical with those instruments used in Study 1. Factor analyses indicated the existence of two factors in the adolescent sample, however, one factor was quite strong and accounted for most of the variance. Analyses on the adult subjects revealed the existence of a single body image factor. It was concluded that the measures under investigation largely reflect an underlying single factor of body image, despite their common usage in the literature as indicators of multiple aspects of body image disturbance.

A comparative evaluation of cognitive-behavioral therapy (CBT) versus exercise therapy (ET) for the treatment of body image disturbance: preliminary findings

Cognitive-behavioral therapy (CBT) was compared to a combination of aerobic/anaerobic exercise therapy (ET) for the treatment of elevated levels of body image disturbance in college females. CBT consisted of a modification of the 1987 Butters and Cash procedure that was tailored for group intervention; ET consisted of weightlifting and aerobic dancing. Using a counterbalancing procedure, the same therapists conducted both 6-week interventions, which were compared to a nontreated control group. Results revealed equivalent reductions for both treatment groups when compared to controls on measures of body image disturbance reflective of trait and state body weight anxiety, cognitive-behavioral aspects of appearance, and overall body dissatisfaction. Unfortunately, few subjects were available for follow-up analyses, preventing an evaluation of the stability of changes. The findings are discussed with regard to the potential role of fitness training as an adjunct to cognitive-behavioral interventions for body image disturbance.

Psychophysiological characteristics of headache patients.

Abstract Migraine, muscle‐contraction headache patients, and non‐headache controls were physiologically assessed during self‐selected ‘stressful’ and ‘relaxing’ imagery in headache and non‐headache states. Musculoskeletal (frontalis, bilateral temporalis), vascular (heart rate, bilateral temporal artery pulse volume), and autonomic (skin conductance response) measures failed to differentiate the groups on resting response levels — in both headache and non‐headache states. ‘Stressful’ imagery elicited greater reactivity than ‘relaxing’ imagery in all three response systems, regardless of headache type. However, a group by condition interaction eventuated only for the electromyographic measures, indicating that the muscle‐contraction patients were significantly more reactive during stressful imagery than migrainers and controls.

The Sociocultural Internalization of Appearance Questionnaire - Adolescents (SIAQ-A): Psychometric analysis and normative data for three countries

A brief measure of internalization of societal norms regarding appearance was developed and validated on six early adolescent female samples (mean ages 11.7–13.3) from three countries (US, Australia, India; total n=2210). Internal consistency levels were uniformly high in all samples, ranging from 0.83 to 0.92. Convergent validity estimates were high in all samples. Level of internalization was significantly positively correlated with levels of body dissatisfaction and restriction for all samples. Internalization was also significantly positively correlated with bulimic behaviors and negatively correlated with levels of self-esteem for the four samples that included these variables. The findings indicate that the Sociocultural Internalization of Appearance Questionnaire — Adolescents (SIAQ-A) may be used to further explore a media influence cross-culturally, allowing for the investigation of the role of internalization as a potential risk factor for body image problems and eating disturbances in different contexts.

Menstrual Cycle, Body Image, and Eating Disturbance

Sixty females (ages 17–25) were blocked into four groups on the basis of contraceptive use (pill, non-pill) and level of menstrual distress (high, low). All subjects were tested for levels of body image and eating disturbance during three phases of the menstrual cycle: menstrual, intermenstrual, premenstrual. High menstrual distress subjects had greater body image and eating disturbance than low distress subjects. There was marginal evidence that body image disturbance for the high menstrual distress subjects was greater perimenstrually (premenstrual plus menstrual). There was also suggestive evidence that subjects overestimated the size of the waist greater perimenstrually. The findings are discussed with regard to etiological mechanisms, methodological issues, and treatment implications.

MMPI and headache: a special focus on differential diagnosis, prediction of treatment outcome, and patient—Treatment matching

&NA; The relation between personality characteristics and the psychological functioning of headache patients has long been a topic of interest. Early investigations focused on clinical and anecdotal reports while recent research has moved toward a more objective evaluation of headache groups by using the MMPI. However, the findings from diverse studies have not been integrated, nor has a rationale for the use of these data in the clinical management of headache been formally presented. The focus of this review is to present a concise, integrated analysis of previous group MMPI headache studies and apply these findings to differential diagnosis, prediction of treatment outcome, and client‐treatment matching. Five selected clinical case studies indicating various degrees of psychopathology in migraine headache patients are presented to highlight treatment issues in support of an idiographic utilization of the MMPI for the clinical treatment of headache patients.

The drive for muscle leanness: A complex case with features of muscle dysmorphia and eating disorder not otherwise specified

Muscle dysmorphia has been described as a subtype of body dysmorphic disorder in which an individual experiences severe body image disturbance related to muscularity. The current case is of a 20-year-old man who describes a history of muscle dysmorphia in which the nature of the body image concern is related to leanness (i.e., muscularity in the absence of body fat), as opposed to increasing muscle mass, which is how muscle dysmorphia has typically been characterized in the literature. The case illustrates the need to consider this additional facet of body image when diagnosing muscle dysmorphia.