Siân A. McLean

Longitudinal Relationships among Internalization of the Media Ideal, Peer Social Comparison, and Body Dissatisfaction: Implications for the Tripartite Influence Model.

Sociocultural theory of body dissatisfaction posits that internalization of the media ideal and appearance comparison are predictors of body dissatisfaction, a key risk factor for eating disorders. However, no data exist regarding the longitudinal relationships between these variables. The aim of this study was to explore longitudinal relationships among internalization of the media-ideal, social appearance comparison, and body dissatisfaction. A sample of 277 Grade 7 school girls (M age = 12.77 years, SD = 0.44) completed measures of internalization of the media ideal, social appearance comparison, and body dissatisfaction at baseline, 8 months, and 14 months. Path analyses indicated that baseline internalization of the media ideal predicted social appearance comparison and body dissatisfaction at 8 months, and social appearance comparison at 8 months predicted body dissatisfaction at 14 months. A reciprocal effect emerged with body dissatisfaction at 8 months predicting internalization of the media ideal at 14 months. The findings inform sociocultural theory of body dissatisfaction, suggesting that internalization of the media ideal precedes and predicts appearance comparison and that body image interventions that target internalization of the media ideal, and social appearance comparison as well as body dissatisfaction are likely to be effective.

Mediators of the relationship between media literacy and body dissatisfaction in early adolescent girls: implications for prevention.

This study examined in young adolescent girls the fit of a theoretical model of the contribution of media literacy to body dissatisfaction via the mediating influences of internalisation of media ideals and appearance comparisons. Female Grade 7 students (N=469) completed self-report assessments of media literacy, internalisation, appearance comparisons, body dissatisfaction, and media exposure. Strong, significant inverse associations between media literacy and body dissatisfaction, internalisation, and appearance comparisons were observed. Path analysis revealed that a slightly modified revision of the model provided a good fit to the data. Specifically, body dissatisfaction was influenced directly by appearance comparisons, internalisation, and body mass index, and indirectly by media literacy and media exposure. Indirect pathways were mediated by appearance comparisons and internalisation. Thus, a relationship between media literacy and eating disorder risk factors was observed. Findings may explain positive outcomes of media literacy interventions in eating disorder prevention.

Factors associated with body dissatisfaction and disordered eating in women in midlife

OBJECTIVE In this study, we examined developmentally appropriate factors that may be associated with body dissatisfaction and disordered eating in women in midlife. METHOD Participants were a community sample of 200 women aged 35-65. Outcome measures were the weight concern, shape concern, eating concern, and restraint subscales of the Eating Disorder Examination-Questionnaire (EDE-Q). Independent variables were importance of appearance, importance of function, cognitive reappraisal (of aging changes to appearance), and body-related self-care. RESULTS Importance of appearance, self-care, and body mass index (BMI) accounted for variance in regression modeling for all EDE-Q variables. In addition, cognitive reappraisal was related to shape concern and restraint, and importance of function and age were also associated with restraint. Participants identified as probable eating disorder cases had significantly higher BMI, importance of appearance and function, and significantly lower cognitive reappraisal and self-care scores than participants identified as noncases. DISCUSSION This study provides support for the role of developmentally relevant factors in body dissatisfaction and disordered eating in midlife women.

Sex differences in the relationships between body dissatisfaction, quality of life and psychological distress

Background: Body dissatisfaction is associated with impairment in womens quality of life (QoL). To date, research has not examined the relationship between body dissatisfaction and mens QoL, or sex differences in this relationship.

Stigmatizing attitudes and beliefs about bulimia nervosa: Gender, age, education and income variability in a community sample

OBJECTIVE Stigmatizing attitudes towards eating disorders negatively impacts treatment seeking. To determine the effect of interventions to reduce stigma, a measure of stigma that is simple to implement is required. This study aimed to develop a measure of stigmatizing attitudes and beliefs towards bulimia nervosa (SAB-BN) and evaluate the distribution of beliefs across gender, age, education, and income groups. METHOD Participants were 1828 community adults (890 men; 938 women) aged 18-65 sampled from the Australian Electoral Roll responded to a mailed questionnaire. Participants provided demographic information and completed the SAB-BN questionnaire. RESULTS Five components of stigmatizing attitudes and beliefs were identified; advantages of BN, minimization/low seriousness, unreliability, social distance, and personal responsibility. Stigma was low except on social distance and personal responsibility sub-scales, which indicated negative attitudes toward people with bulimia. Men compared with women and lower compared with higher education and income groups held significantly higher stigmatizing attitudes and beliefs. There were few differences between age groups in stigma. Differences between demographic groups provides evidence for known-groups validity. DISCUSSION The SAB-BN questionnaire provides a potentially useful tool for evaluating stigma in relation to BN. Results provide insight into components of stigma and the demographic groups to whom interventions should be targeted.

Relationships between body size attitudes and body image of 4-year-old boys and girls, and attitudes of their fathers and mothers.

BackgroundBody size attitudes and body image form early in life, and understanding the factors that may be related to the development of such attitudes is important to design effective body dissatisfaction and disordered eating prevention interventions. This study explored how fathers’ and mothers’ body size attitudes, body dissatisfaction, and dietary restraint are associated with the body size attitudes and body image of their 4-year-old sons and daughters.MethodsParticipants were 279 4-year-old children (46% boys) and their parents. Children were interviewed and parents completed questionnaires assessing their body size attitudes and related behaviours.ResultsSocially prescribed stereotypical body size attitudes were evident in 4-year-old boys and girls; however, prevalence of body dissatisfaction was low in this sample. Correlation analyses revealed that boys’ body size attitudes were associated with a number of paternal body image variables. In boys, attributing negative characteristics to larger figures and positive characteristics to thinner figures were associated with fathers having more negative attitudes towards obese persons. Attributing positive characteristics to larger figures by boys was associated with greater levels of paternal dietary restraint. In girls, attributing positive characteristics to thinner figures was only associated with greater maternal dietary restraint.ConclusionsFindings suggest the possibility that fathers’ body size attitudes may be particularly important in establishing body size attitudes in their sons. Further research is necessary to better understand the role of fathers in the development of children’s body size attitudes.

The role of media literacy in body dissatisfaction and disordered eating: A systematic review

This study comprised a systematic review of literature examining empirical relationships between levels of media literacy and body dissatisfaction and disordered eating. The review aimed to integrate research on this topic. Electronic databases were searched for key concepts: media literacy, body dissatisfaction, and disordered eating. Media literacy measures were coded for consistency with media literacy constructs. Sixteen eligible studies were identified. Cross-sectional outcomes depended upon the media literacy construct assessed. Some relationships between high scores on measures consistent with media literacy constructs and low scores on body dissatisfaction and related attitudes were found. Media literacy-based interventions revealed improvements in media literacy constructs realism scepticism, influence of media, and awareness of media motives for profit, and improvements in body-related variables, but not disordered eating. Further research examining relationships between theoretically driven media literacy constructs and body and eating concerns is needed. Recommendations are made for evaluating media literacy-based eating disorder prevention.

Stigmatizing Attitudes and Beliefs Toward Bulimia Nervosa: The Importance of Knowledge and Eating Disorder Symptoms

Abstract Widely held stigmatizing attitudes and beliefs toward bulimic eating disorders may lead to self-blame and reduced treatment seeking. Knowledge and familiarity with mental disorders may help decrease associated stigma. However, these relationships are not well understood in bulimia nervosa (BN). A community sample of 1828 adults aged 18 to 70 years completed a survey assessing stigmatizing attitudes and beliefs toward BN, knowledge and familiarity with the disorder, as well as levels of eating disorder symptoms. Knowledge of BN was negatively associated with three dimensions of stigmatization, personal responsibility (&rgr; = −0.28), unreliability (&rgr; = −0.19), and advantages of BN (&rgr; = −0.23). Familiarity revealed no association with stigmatization. Both men and women with high levels of eating disorder symptoms perceived BN as less serious than the participants with low levels of symptoms. Increasing community knowledge about bulimia may help mitigate stigmatization and perceived barriers to treatment.

A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders

OBJECTIVE This pilot study investigated the effectiveness of a social media literacy intervention for adolescent girls on risk factors for eating disorders. METHOD A quasi-experimental pre- to post-test design comparing intervention and control conditions was used. Participants were 101 adolescent girls (Mage  = 13.13, SD = 0.33) who were allocated to receive three social media literacy intervention lessons (n = 64) or to receive classes as usual (n = 37). Self-report assessments of eating disorder risk factors were completed one week prior to, and one week following the intervention. RESULTS Significant group by time interaction effects revealed improvements in the intervention condition relative to the control condition for body image (body esteem-weight; d = .19), disordered eating (dietary restraint; d = .26) and media literacy (realism scepticism; d = .32). DISCUSSION The outcomes of this pilot study suggest that social media literacy is a potentially useful approach for prevention of risk for eating disorders in adolescent girls in the current social media environment of heightened vulnerability. Replication of this research with larger, randomized controlled trials, and longer follow-up is needed.

An evaluation of a body image intervention in adolescent girls delivered in single-sex versus co-educational classroom settings

Body dissatisfaction is now recognized as having considerable negative impact on social, psychological, and physical health, particularly in adolescent girls. Consequently, we have developed a six-session co-educational body image intervention (Happy Being Me Co-educational) designed to reduce body dissatisfaction and its risk factors in Grade 7 girls. In addition to evaluating the programs efficacy, we aimed to identify whether girls would benefit equally when it was delivered as a universal intervention to a whole class including both boys and girls (co-educational delivery), or delivered as a selective intervention to girls only (single-sex delivery). Participants were 200 Grade 7 girls from five schools in Melbourne, Australia. Schools were randomly allocated to receive the intervention in single-sex classes (n=74), co-educational classes (n=73), or participate as a no-intervention control (n=53). Girls completed self-report assessments of body dissatisfaction, psychological (internalization of the thin ideal, appearance comparison, and self-esteem) and peer environment (weight-related teasing and appearance conversations) risk factors for body dissatisfaction, and dietary restraint, at baseline, post-intervention, and at 6-month follow-up. Significant improvements in body dissatisfaction and psychological risk factors were observed in the intervention group at post-intervention and these were maintained at follow-up for psychological risk factors. Importantly, no significant differences between universal and selective delivery were observed, suggesting that the intervention is appropriate for dissemination in both modes.