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Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 25586

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Special Issue Editors

Dr. Gioia Bottesi

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Guest Editor

Department of General Psychology, University of Padova , via Venezia 8, 35131 Padova, Italy
Interests: clinical psychology; psychopathology; transdiagnostic factors; cognitive behavioral therapy

Dr. Silvia Cerea

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Guest Editor

Department of General Psychology, University of Padova , via Venezia 8, 35131 Padova, Italy
Interests: body image; prevention strategies; psychological interventions; mHealth app

Special Issue Information

Dear Colleagues,

Body dissatisfaction and disordered eating have increased worldwide over the last 30 years, and new phenomena pertaining to such psychological conditions are currently emerging. Even if body dissatisfaction and disordered eating are widespread phenomena, especially among adolescents and young adults, they have mostly been related to depressive symptoms, low self-esteem, decreased quality of life, eating disorders (EDs), and body dysmorphic disorder (BDD).

Given the strong impact that body dissatisfaction and disordered eating have on individual wellbeing and quality of life, as well as on societal costs, prevention efforts and intervention strategies targeting body dissatisfaction, disordered eating, and their specific and transdiagnostic risk factors are urgently needed. Simultaneously, efforts should be devoted to emphasizing and implementing protective factors for body image, with the aim of promoting a positive body image (i.e., body appreciation, body acceptance/love). At the same time, there is a need for prevention and intervention strategies that are cost-effective for the healthcare systems and easily accessible to people who are at high risk of developing body dissatisfaction and disordered eating (e.g., adolescents and young adults).

In this Special Issue, we are looking for high-quality research articles and reviews that focus on psychological prevention and intervention strategies for body dissatisfaction and disordered eating, especially those combining a high academic standard coupled with a practical focus on reducing body dissatisfaction and disordered eating and on promoting a positive body image. Research can target any group (e.g., general population, individuals at high-risk for body dissatisfaction/disordered eating, clinical population) and context (e.g., school, sport, and clinical context). Both quantitative and qualitative research papers as well as theoretical contributions are welcome. The keywords listed below provide an outline of some of the possible areas of interest.

Dr. Gioia Bottesi
Dr. Silvia Cerea
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

body image
body appreciation
positive body image
protective factors
recent advances in prevention
psychological interventions
mirror exposure
body image disturbance
specific risk factors
transdiagnostic risk factors
eating disorders
body dysmorphic disorder

Published Papers (9 papers)

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15 pages, 388 KiB

Open AccessArticle

Shifting the Focus: A Pilot Study on the Effects of Positive Body Exposure on Body Satisfaction, Body Attitude, Eating Pathology and Depressive Symptoms in Female Patients with Eating Disorders

by Marlies E. Rekkers, Lisanne Aardenburg, Mia Scheffers, Annemarie A. van Elburg and Jooske T. van Busschbach

Int. J. Environ. Res. Public Health 2022, 19(18), 11794; https://doi.org/10.3390/ijerph191811794 - 19 Sep 2022

Cited by 1 | Viewed by 1990

Abstract

One of the most commonly used techniques for the treatment of body image problems in eating disorders (ED) is body exposure (BE). However, evidence of its effectiveness in clinical populations is scarce. In the Positive Body Experience (PBE) protocol, the focus of positive BE is on aesthetic, functional and tactile aspects of the body. The current study evaluates the outcomes of positive BE with regard to changes in attitudinal body image and eating pathology, as well as the factors that influence these changes, in a sample of 84 adult female patients with different EDs who did not receive any other treatment for their EDs during the period in which BE treatment occurred. The results show significant positive changes in attitudinal body image, ED behaviors and depressive symptoms, with depressive symptoms at baseline mediating the changes in attitudinal body image. This study indicates that the PBE protocol is a suitable intervention for reducing negative attitudinal body image in anorexia and bulimia nervosa patients, as well as those with binge eating disorder. Furthermore, the results suggest that positive non-weight-related and functional body satisfaction are strong catalysts for change and that depressive symptoms play an important role in the ability to change. Additional RCTs are needed to gain more insight into the effects of PBE. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

15 pages, 827 KiB

Open AccessArticle

Parent-Focused Psychotherapy for the Preventive Management of Chronicity in Anorexia Nervosa: A Case Series

by María García-Anaya, Alejandro Caballero-Romo and Laura González-Macías

Int. J. Environ. Res. Public Health 2022, 19(15), 9522; https://doi.org/10.3390/ijerph19159522 - 3 Aug 2022

Cited by 1 | Viewed by 1893

Abstract

Background: Anorexia nervosa (AN) is a complex eating disorder where involvement of family plays a central role in first line treatment in adolescents, but which is not so for adults where poor response to treatment is frequent. Given the reluctance of some patients to receive treatment, we set out to explore the hypothesis that certain family dynamics may be involved in the maintenance of the disorder. Methods: We aimed to understand what is underlying in the cases of patients who present clinical improvement with their parents, but not the ones who received a parent-focused psychotherapeutic intervention. We conducted a mixed methods study. On the one hand we performed a case series of 14 patients who dropped out of treatment while their parents actively attended the intervention, and on the other hand, we followed the evolution of the parents of those patients reluctant to continue treatment, through non-participant observation. Results: We present preliminary evidence where we found the parent-focused psychotherapeutic intervention was able to elicit a reflective function of the parents. We also observed that the intervention modified certain family dynamics that could be related to maintaining factors of the disorder. In patients, we found that in parallel to the assistance of their parents to psychotherapeutic treatment, and even when they were receiving no intervention, they showed significant clinical improvement of symptomatology and global functioning; we observed 9 of 14 of them who voluntarily decided to return to pharmacological treatment. Conclusions: This parent-focused intervention elicited changes in reflective functioning of participant parents; the intervention produced favorable changes in family dynamics, which we believe is probably related to improvement of global functioning, symptomatology, and insight of patients. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

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14 pages, 570 KiB

Open AccessArticle

Validation of the Muscle Dysmorphic Disorder Inventory (MDDI) among Italian Women Practicing Bodybuilding and Powerlifting and in Women Practicing Physical Exercise

by Silvia Cerea, Matteo Giraldo, Corrado Caudek, Gioia Bottesi, Antonio Paoli and Marta Ghisi

Int. J. Environ. Res. Public Health 2022, 19(15), 9487; https://doi.org/10.3390/ijerph19159487 - 2 Aug 2022

Cited by 4 | Viewed by 2327

Abstract

Studies pertaining to muscle dysmorphia (MD) have concentrated the most on males. However, a new body ideal for women is emerging: a very toned, athletic body with flat, smooth muscles. The emphasis on the level of muscularity represents a contribution to the growth of MD symptoms in women. The aim of this study was to evaluate the factorial structure and psychometric properties of the muscle dysmorphic disorder inventory (MDDI) in two samples of physically active Italian women. One-hundred and sixty-five women practicing non-competing bodybuilding/powerlifting and 353 women practicing physical exercise completed the MDDI and measures of features associated with MD. Findings of the confirmatory factor analysis showed a three-factor structure with acceptable fit and invariant across groups. Omega coefficients revealed adequate internal consistency for all the scales and for the total score of the MDDI. Furthermore, convergent and divergent validity as well as retest reliability emerged to be good. MDDI represents a reliable measure of MD symptoms in physically active Italian women. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

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16 pages, 423 KiB

Open AccessArticle

Broad and Narrow Transdiagnostic Risk Factors in Eating Disorders: A Preliminary Study on an Italian Clinical Sample

by Sara Iannattone, Silvia Cerea, Eleonora Carraro, Marta Ghisi and Gioia Bottesi

Int. J. Environ. Res. Public Health 2022, 19(11), 6886; https://doi.org/10.3390/ijerph19116886 - 4 Jun 2022

Cited by 3 | Viewed by 2033

Abstract

Eating disorders are multifaceted psychopathologies and the transdiagnostic approach is currently considered a useful framework to understand their complexity. This preliminary study aimed to investigate both broad (i.e., intolerance of uncertainty and emotion dysregulation) and narrow (i.e., extreme body dissatisfaction) transdiagnostic risk factors underlying eating disorders. 50 Italian female patients seeking treatment for an eating disorder were involved (M_age = 31.6 years ± 12.8, 18–65). They completed self-report measures assessing emotion regulation difficulties, intolerance of uncertainty, extreme body dissatisfaction, general psychological distress, and eating disorder symptomatology. To explore whether the abovementioned transdiagnostic factors predicted patients’ psychological distress and eating disorder symptoms, two linear regressions were performed. Emotion dysregulation emerged as the only significant predictor of distress, while extreme body dissatisfaction was the only significant predictor of overall eating disorder symptomatology. Then, to analyze the differences between patients with anorexia nervosa and bulimia nervosa in intolerance of uncertainty and emotion regulation problems, t-tests were conducted. The two groups differed significantly in intolerance of uncertainty levels only, with higher scores obtained by patients with anorexia nervosa. Overall, our findings suggest that emotion dysregulation and extreme body dissatisfaction may be relevant constructs in eating disorders in general, while intolerance of uncertainty may be more involved in restrictive eating disorders. The clinical implications of such results are discussed. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

9 pages, 332 KiB

Open AccessArticle

Knowledge and Myths about Eating Disorders in a German Adolescent Sample: A Preliminary Investigation

by Johannes Feldhege, Sally Bilic, Kathina Ali, Daniel B. Fassnacht, Markus Moessner, Louise M. Farrer, Kathleen M. Griffiths and Stephanie Bauer

Int. J. Environ. Res. Public Health 2022, 19(11), 6861; https://doi.org/10.3390/ijerph19116861 - 3 Jun 2022

Viewed by 4866

Abstract

Eating disorder mental health literacy (ED-MHL) refers to knowledge about the symptoms, causes, and treatment of eating disorders (EDs) and is an important factor in people’s attitudes towards individuals with EDs and help-seeking for EDs. Associations between ED-MHL, stigma, ED symptomatology, and gender were investigated in a sample of N = 194 German high school students. Knowledge and myths about EDs were assessed with 18 factual statements about EDs and agreement/disagreement with common myths about ED. Students also completed the Universal Stigma Scale (USS), the Weight Concerns Scale (WCS), and demographic items. Students judged M = 8.39 (SD = 3.40) statements correctly, while the average agreement with all ED myths was low (M = 0.19, SD = 0.14). Greater ED-MHL was associated with lower stigmatization of EDs. Male participants were less knowledgeable and more likely to agree with the ED myths. Participants displayed moderate ED-MHL; however, certain aspects such as ED risk factors or symptoms of specific disorders such as anorexia nervosa and bulimia nervosa were less well known. These results can inform the design of future MHL interventions for adolescents. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

14 pages, 397 KiB

Open AccessArticle

Resilience Is Associated with Less Eating Disorder Symptoms in the NutriNet-Santé Cohort Study

by Margaux Robert, Rebecca Shankland, Valentina A. Andreeva, Mélanie Deschasaux-Tanguy, Emmanuelle Kesse-Guyot, Alice Bellicha, Christophe Leys, Serge Hercberg, Mathilde Touvier and Sandrine Péneau

Int. J. Environ. Res. Public Health 2022, 19(3), 1471; https://doi.org/10.3390/ijerph19031471 - 27 Jan 2022

Cited by 6 | Viewed by 2928

Abstract

Resilience is a positive psychological trait associated with a lower risk of some physical and mental chronic diseases and could be an important protective factor against eating disorders (EDs). The aim of this study was to assess cross-sectional and longitudinal associations between resilience and ED in a large cohort of French adults. In 2017, a total of 25,000 adults from the NutriNet-Santé cohort completed the Brief Resilience Scale (BRS). ED symptoms were measured in 2017 and 2020, with the Sick-Control-One-Fat-Food (SCOFF) questionnaire. Cross-sectional and longitudinal associations between resilience and EDs were analyzed using logistic regression, controlling for sociodemographic and lifestyle characteristics. Cross-sectional analyses showed that more resilient participants exhibited EDs less frequently than did less resilient participants (p < 0.0001). Longitudinal analyses showed that, during the three years of follow up, higher resilience was negatively associated with incident EDs (OR: 0.67, 95%CI: 0.61–0.74), persistent EDs (0.46 (0.42–0.51)), and intermittent EDs (0.66 (0.62–0.71)), compared with no ED. More resilient participants were also less likely to have a persistent ED than to recover from EDs (0.73 (0.65–0.82)). This study showed that resilience was associated with less ED symptoms and a higher chance of recovery. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

13 pages, 352 KiB

Open AccessArticle

The Power of Words: Appearance Comments from One’s Partner Can Affect Men’s Body Image and Women’s Couple Relationship

by Elena Fornaini, Camilla Matera, Amanda Nerini, Giulia Rosa Policardo and Cristian Di Gesto

Int. J. Environ. Res. Public Health 2021, 18(17), 9319; https://doi.org/10.3390/ijerph18179319 - 3 Sep 2021

Cited by 9 | Viewed by 3133

Abstract

Background: The purpose of the present study was to examine, through an experimental vignette design, the effects of appearance-related comments from one’s partner on body image and the perceived quality of one’s relationship. Body image was considered both in negative (body dissatisfaction) and positive (body compassion) terms. Methods: Appearance-related commentary from one’s partner was manipulated through a vignette describing the purchase of a swimsuit. The participants (n = 211) were women and men who were randomly assigned to one of the three experimental conditions (positive comment, negative comment, no comment). Results: A series of ANOVAs showed different findings for women and men. Being criticized for body weight and shape caused an increase in body dissatisfaction and a decrease in body compassion in men but not in women. Regarding couple satisfaction, women who imagined receiving a compliment about their body perceived being more accepted by their partner and were less afraid of being abandoned or rejected. Conclusions: Our findings highlight the importance of appearance-based comments from one’s partner on men’s body image and on women’s perception of their couple relationship. Therefore, appearance comments might be addressed by interventions aimed at enhancing positive body image, reducing body dissatisfaction, and fostering couple relationships, carefully considering sex differences. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

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9 pages, 317 KiB

Open AccessCase Report

Telephone-Administered Cognitive Behavioral Therapy for Body Dysmorphic Disorder: Case Series

by Marie Drüge, Tanja Roth and Birgit Watzke

Int. J. Environ. Res. Public Health 2022, 19(12), 7373; https://doi.org/10.3390/ijerph19127373 - 16 Jun 2022

Viewed by 1950

Abstract

Cognitive behavioral therapy is an effective treatment for body dysmorphic disorder (BDD), but many patients do not receive appropriate treatment due to several treatment barriers and psychosocial care structures. Low-threshold interventions, including those from the field of e-mental health, could improve access to psychotherapy. In addition to internet-administered therapy, telephone-administered therapy may reduce treatment barriers, especially during the COVID-19 pandemic. This article presents four case reports of the same treatment (12 weeks of telephone-administered cognitive behavioral therapy accompanied by a workbook) applied to patients with body dysmorphic disorder during the summer of 2020. Three patients who completed the treatment had clinically relevant reductions in body dysmorphic and depressive symptoms and improved insight. One patient did not complete the telephone-administered therapy because her symptoms worsened, and she needed a more intensive form of treatment. These findings encourage future studies on the efficacy and effectiveness of telephone-administered treatment for BDD and its role in stepped-care models. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

9 pages, 347 KiB

Open AccessBrief Report

Validation and Measurement Invariance of the Body Appreciation Scale-2 between Genders in a Malaysian Sample

by Chee-Seng Tan, Siew-May Cheng, Chin Wen Cong, Afi Roshezry Bin Abu Bakar, Edwin Michael, Mohamad Iqbaal Bin Mohd Wazir, Muliyati Binti Mat Alim, Bazlin Darina Binti Ahmad Tajudin, Nor Ez-Zatul Hanani Binti Mohamed Rosli and Alfian Bin Asmi

Int. J. Environ. Res. Public Health 2021, 18(21), 11628; https://doi.org/10.3390/ijerph182111628 - 5 Nov 2021

Cited by 2 | Viewed by 2521

Abstract

The 10-item Body Appreciation Scale-2 (BAS-2) is a measurement for individuals to self-report the extent to which they accept and respect their bodies. Although the BAS-2 has been translated into the Malay language and found to have promising qualities, the psychometric characteristics of the English version of BAS-2 remain unknown in the Malaysian context. The present study thus administered the English version BAS-2 and selfie-editing frequency scale to 797 individuals aged 18 to 56 years old in Malaysia. The dataset that was randomly divided into two halves were submitted to exploratory factor analysis and confirmatory factor analysis respectively. Both of the factor analyses consistently support a one-factor model. The Cronbach’s alpha and McDonald omega coefficients were greater than 0.90, indicating that the BAS-2 has good internal consistency. The incremental validity is also evident. A hierarchical multiple regression showed that the BAS-2 score had a positive relationship with selfie-editing frequency after controlling for age and gender. Moreover, the measurement invariance test supported scalar invariance between genders, and an analysis of covariance did not find significant gender differences. Overall, the findings replicate past findings and regularly support the usability of the BAS-2 in the Malaysian context. The implications of the BAS-2 and future directions are also discussed. Full article

(This article belongs to the Special Issue Psychological Prevention and Intervention Strategies for Body Dissatisfaction and Disordered Eating)

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