The relationship between body dysmorphic disorder symptoms and self-construals

Background:  Cognitive models of body dysmorphic disorder (BDD) suggest that beliefs and evaluations related to self-concept are central to the maintenance of the disorder, but such beliefs have received little empirical attention. This study examined the relative importance of contingent self-worth and self-ambivalence to BDD symptoms in comparison to their importance to obsessive–compulsive disorder and social phobia symptoms.

Method:  The sample comprised 194 non-clinical participants (female, N = 148; males, N = 46) with a mean age of 24.70 years (standard deviation = 9.34). Participants were asked to complete a battery of self-report questionnaires. Results:  While significant relationships were found between the self-beliefs and symptoms of all three disorders, some specificity was found in the relationships.

Conclusions:  Self-worth based upon appearance was most important in BDD, while contingent self-worth based on the approval of others was important in social phobia. Self-ambivalence was associated with each disorder. Implications and limitations are discussed.

Is body dysmorphic disorder associated with abnormal bodily self-awareness? A study using the rubber hand illusion.

Evidence from past research suggests that behaviours and characteristics related to body dissatisfaction may be associated with greater instability of perceptual body image, possibly due to problems in the integration of body-related multisensory information. We investigated whether people with body dysmorphic disorder (BDD), a condition characterised by body image disturbances, demonstrated enhanced susceptibility to the rubber hand illusion (RHI), which arises as a result of multisensory integration processes when a rubber hand and the participant's hidden real hand are stimulated in synchrony. Overall, differences in RHI experience between the BDD group and healthy and schizophrenia control groups (n = 17 in each) were not significant. RHI strength, however, was positively associated with body dissatisfaction and related tendencies. For the healthy control group, proprioceptive drift towards the rubber hand was observed following synchronous but not asynchronous stimulation, a typical pattern when inducing the RHI. Similar drifts in proprioceptive awareness occurred for the BDD group irrespective of whether stimulation was synchronous or not. These results are discussed in terms of possible abnormalities in visual processing and multisensory integration among people with BDD.

Cultural issues in understanding and treating obsessive compulsive and spectrum disorders

This chapter discusses the cross-cultural understanding of the obsessive compulsive and spectrum disorders. Epidemiological studies suggest a reasonably consistent prevalence of OCD around the world. The role of other culturally influenced factors in the presentation of OCD is also considered (i.e., religiosity, superstition, and beliefs), with religion considered particularly important in the presentation of OCD, although not in its prevalence per se. Treatment effect sizes across countries and within minority cultures from Western countries are outlined. The influence of cultural factors on help-seeking behaviors, assessment, misdiagnosis, and treatment are considered. Limitations of the literature base are discussed, particularly the lack of non-Western studies of treatment effects, and the low evidence base for the spectrum disorders.

Bipolar disorder and adiposity : a study using whole body dual energy X-ray absorptiometry scans

Objective: Previous research has demonstrated a relationship between adiposity and bipolar disorder, although data are derived predominantly from patient samples and use indirect methods of assessing adiposity. This study investigated the association between bipolar disorder and several indices of adiposity, including body fat mass as measured by dual energy X-ray absorptiometry (DXA), in a community-based sample.

Methods: In this study, 21 women with bipolar disorder and 523 healthy controls were drawn from an age-stratified, random, community-based sample of women (20–93 years) participating in the Geelong Osteoporosis Study. Bipolar disorder was diagnosed utilising a semi-structured clinical interview. Anthropometric measurements (weight, height, waist and hip circumference) were taken and fat mass was determined from whole body DXA scans (Lunar DPX-L).

Results: Those with bipolar disorder tended to have greater adiposity. Age-adjusted mean (95% CI) values for bipolar versus controls according to adiposity indices were weight 75.6 (68.9–82.3) versus 72.6 (71.3–74.0) kg, waist circumference 89.8 (84.1–95.6) versus 87.3 (86.1–88.5) cm, waist:hip ratio 0.85 (0.82–0.87) versus 0.84 (0.83–0.84), body mass index 27.6 (25.1–30.1) versus 27.5 (27.0–28.0) kg/m2, fat mass 31.4 (26.5–36.3) versus 28.6 (27.5–29.5) kg and %body fat 40.4 (36.9–43.9) versus 38.0 (37.3–38.7)%; all p > 0.05. Further adjustment for height, smoking, alcohol, psychotropic medication, energy intake or physical activity did not influence these patterns.

Conclusion: Although a pattern suggestive of greater adiposity among those with bipolar disorder was observed, no significant differences were detected. We cannot exclude the possibility of a type II error. Further research with a larger sample may produce more conclusive results.

Disorder and the body of drugs : addiction, consumption, control, and city space

Different cultures and the specific culture manifested within them are intrinsically linked to addiction in a complex fashion which has a long history. For important thinkers, such as Nietzsche, addiction actually embodies human culture, rendering addiction and culture inseparable. This is clearly seen within the Western world’s addiction to the consumption of material goods and the damage that results.

Utopia has often become dystopia. Not only is an understanding of addiction key to understanding culture but to an understanding of the very act thinking itself and the way of being in the world. Addiction raises key philosophical questions, such as: do people really have a choice in their behavior, and what governs them; is it free will or predetermination? Is it biology or environment is it the external world or the internal that drives addiction, or a complex combination of both?

In a contemporary context the media frenzy around celebrity addiction continually fuels public debate in this area, and this book deepens the understanding of addiction within this contentious context. This book addresses a key concern over how addiction became the norm, and it seeks to understand its dominance comprehensively. How did it come to pass that not being an addict was a transgressive act and way of being?

While there has been a great deal of debate about addiction utilizing the discourse of individual and often competing disciplines such as biology and psychology, little attention has been paid to the cultural aspects of addiction. The innovative approach taken by this book is to offer insights into this complex area through a contemporary methodology that covers diverse interrelated areas. Drawing on different disciplines, offering deeper insights, from the analysis of music lyrics to empirical social science and anthropological work in AA groups in Mexico and the portrayal of the “addiction’ to therapy in film and television, amongst other areas, this book addresses the need for a more comprehensive approach.

Academic analysis is also given to the discourse on celebrity culture and addiction. A contemporary fusion of the humanities and the social sciences is the best way forward to tackle this subject and move the debate on. The focus of this study is an innovative interdisciplinary and intercultural approach to addiction, from the social sciences to the humanities, including cultural studies, film and media studies, and literary studies. Areas that have been overlooked, such as lost women’s writings, are examined, in addition to comics, popular film and television, and the work of AA groups.

This edited collection is the first study to provide such a comprehensive analysis of the cultures of addiction. Traversing cultures across the globe, including Asia, Central America, as well as Europe and America, this book opens up the debate in addiction studies and cultural studies. The important insights the book delivers helps to answer questions such as: In what way can Deleuze further the understanding of addiction through the analysis of rock lyrics? How does anthropology improve the understanding of AA groups? How can cultural studies deepen knowledge on the “addiction” to therapy? These are just some of the vast array of areas this book covers. Other areas include the condemnation of “addiction” to comic reading through an historical examination, violence in popular culture, and lost women’s writing on addiction. No other book has such depth and contemporary breadth.

Cultures of Addiction is an important book for those taking cultural studies courses across a range of interrelated disciplines, including English and literary studies, history, American studies, and film and media studies. This will be invaluable to library collections in these fields and beyond in the social sciences, and specifically in addiction studies and psychology.

(Jason Lee, Editor)

A biopsychosocial model for understanding body image and body change strategies among children

The present study was designed to assess the role of biopsychosocial factors in understanding body image concerns and cognitions and behaviors related to losing weight or increasing muscles among 507 children (270 girls and 237 boys) aged between 8 and 11 years. Biological, psychological, and sociocultural factors have been found to be relevant in understanding the development of body image concerns and weight loss strategies among children. However, these factors have not been examined together in a single study; thus, the relative influence of each factors and how these factors may interact is not known. In the current study, body mass index (BMI) was found to be a good indicator of girls' and boys' body dissatisfaction, while the main indicator of children's body change strategies was perceived pressure from parents, peers, and the media. Overall, there were more similarities than differences between girls and boys. The age between 8 and 11 years is a significant period to commence studying body image concerns and body change strategies, as it can be used to help us understand the emergence of gender differences in children's weight and muscle concerns.

Waist-to-Hip Ratio and Unhealthy Body Change in Women

The role of waist-to-hip ratio (WHR) in unhealthy body change was examined in a sample of 143 women university students. They completed the Eating Disorder Examination-Questionnaire (EDE-Q), reported their level of concern with weight and with WHR, and used unmarked measuring tapes to record their subjective (self-perceived), ideal, and objective (measured) waist and hip circumference. Although body shape was reported as important, and concern with WHR correlated significantly with symptoms of disordered eating, the relationships involving WHR were not independent of those involving body weight. Thus, there appears to be little behavioural and/or clinical significance in the aesthetic evaluations made by women of their WHR. Reasons for this are considered in light of evidence that women regard WHR as more difficult to control and less amenable to change than their overall body weight.

Emotional reactions following exposure to idealized bodies predict unhealthy body change attitudes and behaviors in women and men

Objective: We explored the extent to which changes in emotional states following exposure to images of idealized bodies predict unhealthy body change attitudes and behaviors in women and men, and whether particular psychological traits mediate these effects. Method: One hundred thirty-three women and 93 men were assessed for unhealthy attitudes and behaviors related to body weight and muscles using the Eating Disorder Inventory-2 (EDI-2), the Obligatory Exercise Questionnaire, and the strategies to increase muscles subscale of the Body Change Inventory. Psychological traits assessed included body dissatisfaction (EDI-2), internalization of the thin/athletic ideal (Sociocultural Attitudes Towards Appearance Questionnaire-3), body comparison (Body Comparison Scale), self-esteem (Rosenberg Self-Esteem Inventory), depression (Beck Depression Inventory-II), and identity confusion (Self-Concept Clarity Scale). Participants were then exposed to photographs of thin female models and muscular male models, and visual analogue scales were used to measure changes in postexposure state body dissatisfaction, anger, anxiety, and depression.
Results: Postexposure increases in state anger, anxiety, depression, and body dissatisfaction correlated with drive for thinness and disordered eating symptomatology in women, while postexposure increases in state body dissatisfaction correlated with muscle development in men. Analyses revealed that internalization and body comparison mediated these relationships, with trait body dissatisfaction, trait depression, self-esteem, and self-concept/identity confusion serving as mediators for women only. Conclusion: These results are indicative of gender differences in: (a) reactions to idealized bodies; (b) psychological traits that predispose individuals to experience these reactions; and (c) types of body change behavior that are associated with these reactions.

The role of ethnicity and culture in body image and disordered eating among males

An increasing number of researchers have examined body image concerns, disordered eating, and other behaviors associated with increasing muscle size among men from different cultural groups. However, to date there has been no synthesis or evaluation of these studies. In this paper we specifically review studies which have included a comparison between males from different cultural groups with White males on body image concerns or other related behaviors. The groups include Blacks, Hispanic Americans, Asians, Native Americans, Pacific Islanders, and men from Middle Eastern countries. Overall, evidence suggests that males from a range of cultural groups engage in more extreme body change strategies and binge eating than Whites. On the other hand, there is no consistent pattern which summarizes the nature of body image concerns across the different cultures. Mediating and/or moderating variables are proposed to account for the inconsistent findings. These include body build, levels of acculturation, socio-economic status, media exposure, and internalization of the muscular and lean body ideal.

Body weight, body image, and eating behaviours : relationships with ethnicity and acculturation in a community sample of young Australian women

A study was conducted to investigate associations between ethnicity and acculturation status and risk factors for eating disorders among young adult women. A community sample of 14,779 women aged 18–23 completed a comprehensive mail-out survey, which incorporated questions on country of birth, length of time spent in Australia, body weight, weight dissatisfaction, dieting, binge eating, and compensatory disordered eating behaviours. Results showed that risk factors for eating disorders were present across a range of ethnic groups. Further, a strong acculturation effect was observed, such that the longer the time spent in Australia, the more women reported weight-related values and behaviours similar to those of Australian-born women. Results challenge claims that risk factors for disordered eating are restricted to Caucasian females in Western societies. Implications for understanding ethnic and sociocultural influences on body weight, dieting, and disordered eating are considered.

Biopsychosocial factors related to Australian and Fijian adolescent body image distortion

The thesis study was a cross-cultural comparison of the biopsychosocial predictors of body image perception and ideals among 294 Australian and 101 Fijian adolescents. The results demonstrated similarities across cultural groups, but parents, peers and the media were stronger influences for Fijians. These findings have implications for body image intervention programs.The portfolio presented a thorough review of the evidence for the cognitive behavioural therapy (CBT) treatment option for adolescents with major depressive disorder (MDD). Four case studies are presented.

Body image, media influences, sexual risk, and sexuality in men

This thesis examined the relationships between men's body image, different media influences, sexual orientation, and sexual risk taking. In comparison to heterosexuals, gay men were significantly less satisfied with their bodies. Media influences predicted men's body image, and gay men demonstrated greater internalisation of media messages compared to heterosexual men. Based on four case studies the portfolio demonstrates that motivational interviewing might be a useful approach to manage ambivalence and resistance to clients presenting with an anxiety disorder or a parent-child relational issue.

Body image, drive for muscularity, and social comparisons in men

The results of this thesis indicated that males engage in comparisons when evaluating their bodies and more frequently use similar others, such as friends and the average male for comparison. The results showed that comparisons to males in the media and professional athletes indicated body dissatisfaction and drive for muscularity.The portfolio presents four eating disorder case studies to illustrate how a therapist can use manual-based CBT techniques in a flexible manner and adapt interventions to the individual needs of clients who have motivational issues or present with complex comorbidity, in order to improve treatment outcomes.