Self-awareness and Social Influences as Predictors of Body Dissatisfaction and Acceptance of Cosmetic Surgery for Social Reasons Among Men.

BACKGROUND: Body dissatisfaction and the use of surgery for purely aesthetic reasons among men is steadily increasing. Nevertheless, compared to women, few studies have focused on specific sociocultural and individual factors predicting men's body dissatisfaction and interest in cosmetic surgery procedures. The present study investigated the role of media, significant others, public and private self-awareness in predicting men's body dissatisfaction and acceptance of cosmetic surgery for social reasons. METHODS: Participants were 203 men (mean-age 24 years), who completed a questionnaire containing the Sociocultural Attitudes Toward Appearance Questionnaire-4R, the Situational Self-Awareness Scale, the Muscular internalization subscale, the Male Body Attitudes Scale, and the Social subscale of the Acceptance of Cosmetic Surgery Scale. A path analysis was performed. RESULTS: The influence of significant others and public self-awareness predicted men's body dissatisfaction directly and indirectly, via muscularity internalization, while media was only directly associated with body dissatisfaction. A significant link between private self-awareness and body dissatisfaction was found. Moreover, media was not associated with cosmetic surgery either directly or indirectly and public self-awareness showed only a significant association with internalization. CONCLUSIONS: These findings provide information about the role that self-awareness and sociocultural factor play on body dissatisfaction and acceptance of surgery for social reasons among men. The study highlighted the importance of designing preventive programs aimed at enhancing men's ability to resist various forms of pressure regarding body image and its management. Moreover, the advantages of focusing one's attention on internal states and feelings can limit body dissatisfaction and can discourage consideration of cosmetic surgery for social benefits. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Psychological Predictors of Aggressive Behavior Among Men and Women.

This study examined the relationships among attitude toward violence, self-esteem, emotion dysregulation, anger, and aggression in community men and women and male inmates. Overall, 166 community men, 197 community women, and 100 male inmates completed a battery of questionnaires containing self-reported measures. Self-esteem and attitude toward violence were significant predictors of aggressive behavior, with emotion dysregulation mediating the relationship between self-esteem and the criterion variable. Anger mediated the relationship between emotion dysregulation and aggressive behavior only among community people. Among men, inmates reported a more favorable attitude toward violence, lower self-esteem, higher emotion dysregulation, more aggressive behaviors, and a lower tendency to get angry. Women showed a less favorable attitude toward violence, lower self-esteem, higher emotion dysregulation, and a higher tendency for anger than men, while no differences emerged for aggressive behavior. These findings suggest that self-related constructs and emotion regulation strategies represent key processes associated with aggressive behavior among all participants, while the role of anger is more prominent in community people. To reduce aggressive tendencies, treatment and prevention interventions might increase self-esteem, emotion regulation skills, and one's ability to direct anger toward other goals. Moreover, programs aimed at changing attitudes toward violence could be useful.

Exploring the Links Between Self-Compassion, Body Dissatisfaction, and Acceptance of Cosmetic Surgery in Young Italian Women.

This study aimed to examine the association between positive (self-kindness, common humanity, and mindfulness) and negative (isolation, self-judgment, and over-identification) components of self-compassion, and both body dissatisfaction and acceptance of cosmetic surgery among women, through the mediation (for the negative components) of internalization and physical appearance comparison. The participants were 220 young Italian women aged 19-31 (M = 21) years, who completed a questionnaire assessing the variables of interest. Path analysis indicated that higher mindfulness was directly linked to lower acceptance of cosmetic surgery. Mindfulness presented the strongest link with cosmetic surgery, as it was directly associated with acceptance of cosmetic surgery for both social and interpersonal motivations and with consideration of undergoing some cosmetic procedures. Common humanity and self-kindness were related to acceptance of cosmetic surgery for social reasons. Over-identification seemed to be associated with body dissatisfaction and acceptance of cosmetic surgery both directly and indirectly through internalization and physical appearance comparison. Self-judgment and isolation did not present a significant association with either body dissatisfaction or acceptance of cosmetic surgery. These findings confirm that psychological assessment of women who are interested in cosmetic surgery is highly recommended. Interventions should not consider self-compassion as a whole, but they should rather focus on some of its components. The role of over-identification seems to be especially pivotal, as higher scores on this dimension are linked to higher levels of body dissatisfaction and greater acceptance of cosmetic surgery.

Sexual Orientation, Peer Influence, Body Dissatisfaction, and Eudaimonic Well-Being in Italian Men.

Having a lean and athletic physique is increasingly important for Italian men. The purpose of this cross-sectional study was to analyze the relationship between men's dissatisfaction with muscularity and well-being, conceptualized in terms of the realization of one's true potential and the experience of purpose or meaning in life (i.e., eudaimonic well-being), considering also the role of sexual orientation and peer influence. Participants (385 Italian men with a mean age of 28.61 years, SD = 9.65) completed a questionnaire assessing the variables of interest. Path analysis indicated that sexual orientation was linked to eudaimonic well-being via muscularity dissatisfaction. Teasing about muscularity predicted men's eudaimonic well-being both directly and via muscularity dissatisfaction. Peer attributions and appearance conversations predicted well-being through the mediation of athletic internalization and body dissatisfaction. Peer attributions, but not appearance conversations, were also directly linked to well-being. To improve broad aspects of men's well-being, prevention and treatment programs should be directed to increase men's ability to resist different forms of pressure, including that of their peers. These kinds of programs could be especially useful for gay men, who are more likely to experience body dissatisfaction and, in turn, poor psychological functioning.

Validation of an Italian version of the Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised (SATAQ-4R) on non-clinical Italian women and men.

Appearance-ideal internalization and appearance pressures are empirically-supported risk factors for body image disturbance and disordered eating in Western countries. Such a relationship has emerged also in the Italian context, where high rates of body dissatisfaction and disordered eating are present. The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) and its revisions are among the most commonly used instruments to assess the role of sociocultural influences on body image. Two studies were conducted to examine the psychometric properties of the female (Study 1, N = 732) and male (Study 2, N = 364) Italian versions of the SATAQ-4-Revised (SATAQ-4R-Female, SATAQ-4R-Male). Confirmatory factor analysis (CFA) indicated that the original seven-factor structure was replicated for women and men. The seven subscales (Internalization: Thin/Low Body Fat; Internalization: Muscular; Internalization: General Attractiveness; Pressures: Family; Pressures: Peers; Pressures: Significant Others; and Pressures: Media) showed good internal consistency and 4-week test-retest reliability. Associations between SATAQ-4R subscales and body dissatisfaction, eating disorder symptomatology, drive for muscularity, self-esteem, family influences, and peer influences, suggested good convergent validity among both women and men. The present study provides evidence for the validity and reliability of the male and female Italian versions of the SATAQ-4R.

Comparing internalization of appearance ideals and appearance-related pressures among women from the United States, Italy, England, and Australia.

Researchers have observed variation in levels of body image disturbance and eating pathology among women from different Western countries. Examination of cross-cultural differences in the established risk factors (i.e., thin-ideal internalization, muscular-ideal internalization, and appearance pressures from family, peers, and media) for negative outcomes may help to elucidate the prominence of specific risk factors within a given Western society and guide associated interventions. Women from the United States (US), Italy, England, and Australia completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4). Analysis of covariance controlling for age and BMI indicated significant cross-country differences for all SATAQ-4 subscales. Results typically indicated higher levels of appearance-ideal internalization and appearance pressures in the US and lower levels in Italy; however, associated effect sizes were generally small. A medium effect of country was observed for peer-appearance pressures, which were highest in the US compared with all other countries. Repeated-measures analysis of variance and paired samples t tests conducted within each country identified thin-ideal internalization and media appearance pressures as the predominant risk factors for all four countries. Overall, findings suggest more cross-country similarities than differences, and highlight the importance of delivering interventions to address thin-ideal internalization and media appearance pressures among women from Western backgrounds.Level of evidence Descriptive study, Level V.

Why are men interested in cosmetic surgery procedures? Examining the role of different forms of peer influence, social comparison, internalization, and body dissatisfaction.

The present research examined the roles of different forms of peer influence, internalization, social comparison, and body dissatisfaction in men's interest in cosmetic surgery. Participants were 204 Italian men (Mage = 34.02, SD = 11.21). Regression analyses showed that appearance conversations with friends and peer attribution were associated with consideration of cosmetic surgery for social reasons, while teasing on muscularity (but not teasing on general body and shape) was linked to interest in cosmetic surgery for intrapersonal motives. Social comparison was significantly and positively associated with men's interest in cosmetic surgery, while internalization was not. Dissatisfaction with body fat was linked to men's consideration of cosmetic surgery for social motivations, while muscularity and height dissatisfaction did not emerge as significant correlates of cosmetic surgery attitudes. These findings highlight the importance of psychosocial factors, such as peer influence, body fat dissatisfaction, and social comparison in men's interest in cosmetic procedures.

What messages can foster safer sex among young women? Experimental evidence concerning the role of emotions and moral norms.

Through a 2 × 2 × 2 quasi experimental design (N = 254), this research investigated if a social campaign eliciting positive emotions and activating moral norms might enhance condom negotiation skills, intended and estimated condom among young women with or without past sexual experience with casual partners. Emotions had a main effect on one of the six condom negotiation strategies we considered; for most of the other variables an interaction effect with moral norms and/or past behaviour emerged. Concerning estimated condom use, positive emotions worked better than negative ones when moral norms were salient. With respect to negotiations skills, positive rather than negative emotions seemed more effective for women with past causal sexual experience. In women without this kind of experience, positive emotions seemed to work better when moral norms were salient. Moral norms had a main effect on negotiation self-efficacy, but not in the predicted direction: when moral norms were more salient women were found to be less confident about their negotiation ability. These results suggest that a message which makes moral norms salient should at the same time elicit positive emotions in order to be effective; moreover, messages should be carefully tailored according to women's past behaviour.

Beyond Sociocultural Influence: Self-monitoring and Self-awareness as Predictors of Women's Interest in Breast Cosmetic Surgery.

BACKGROUND: The aim of the present research was to analyze the role of self-awareness, self-monitoring, perceived media pressures, and peer attributions on the consideration of breast cosmetic surgery among women. The internalization of thin ideals was taken into account as a key moderating variable. METHODS: Participants were 132 Italian women (mean age = 33.62), who completed a questionnaire aimed at measuring the variables of interest. Path analysis was used to test our hypotheses. RESULTS: The results indicated that perceived media pressure, self-monitoring, and peer attributions influenced participants' interest in breast modification procedures through the internalization of thin ideals. Self-awareness (both private and public) had a direct effect on women's consideration of breast cosmetic surgery. CONCLUSIONS: This research is one of few analyzing how specific aspects of the self could influence women's interest in cosmetic surgery. These findings contribute to the understanding of the reasons that trigger women's interest in cosmetic surgery. Not only sociocultural influences contribute to the development of favorable attitudes toward cosmetic surgery, but also specific aspects of the self have a relevant role. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the table of contents or the online Instructions to Authors www.springer.com/00266 .

Development and validation of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4).

The Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) and its earlier versions are measures designed to assess societal and interpersonal aspects of appearance ideals. Correlational, structural equation modeling, and prospective studies of the SATAQ-3 have shown consistent and significant associations with measures of body image disturbance and eating pathology. In the current investigation, the SATAQ-3 was revised to improve upon some conceptual limitations and was evaluated in 4 U.S. and 3 international female samples, as well as a U.S. male sample. In Study 1, exploratory and confirmatory factor analyses for a sample of women from the Southeastern United States (N = 859) indicated a 22-item scale with 5 factors: Internalization: Thin/Low Body Fat, Internalization: Muscular/Athletic, Pressures: Family, Pressures: Media, Pressures: Peers. This scale structure was confirmed in 3 independent and geographically diverse samples of women from the United States (East Coast N = 440, West Coast N = 304, and North/Midwest N = 349). SATAQ-4 scale scores demonstrated excellent reliability and good convergent validity with measures of body image, eating disturbance, and self-esteem. Study 2 replicated the factorial validity, reliability, and convergent validity of the SATAQ-4 in an international sample of women drawn from Italy, England, and Australia (N = 362). Study 3 examined a sample of college males from the United States (N = 271); the 5-factor solution was largely replicated, yet there was some evidence of an underlying structure unique to men. Future research avenues include additional item testing and modification of the scale for men, as well as adaptation of the measure for children and adolescents.

The factor structure and psychometric properties of the Italian version of the Acceptance of Cosmetic Surgery Scale.

The current study examined the validity of the Italian version of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005) in a sample of 378 Italian adult women. A series of confirmatory factor analyses were conducted. A three-factor solution provided the best fit to the data and confirmed the Intrapersonal, Social, and Consider dimensions. The three factors were strongly inter-correlated. Cronbach's alphas were high (all alphas>.86). The scale showed good convergent and discriminant validity (estimated by Composite Reliability and the Average Variance Extracted). The nomological validity of the Italian version of the ACSS was confirmed by its significant correlations with participants' body dissatisfaction and sociocultural influences (internalization of thin ideals and perceived media pressure). The ACSS seems to be a useful measure of acceptance of cosmetic surgery in the Italian context. This instrument can be used with Italian speakers for research, health promotion, and preventive interventions.

Psychosocial predictors in consideration of cosmetic surgery among women.

BACKGROUND: This study aimed to analyze the influence of psychosocial factors on the consideration of cosmetic surgery. The authors hypothesized that the internalization of thin ideals and social comparisons mediate the relationship between media pressure, family and peer influence (appearance conversations, perception of teasing, and peer attributions), and the desire to pursue cosmetic surgery. METHODS: The study participants were 429 Italian women (mean age, 33 years). They completed a questionnaire containing the Appearance Conversations With Friends Scale, the Perception of Teasing Scale for Friends, the Peer Attribution Scale, the "Pressure and Internalization-General" subscales of the Sociocultural Attitudes Towards Appearance Questionnaire-3, the Feedback on Physical Appearance Scale, the Physical Appearance Comparison Scale, and the "Consider" subscale of the Acceptance of Cosmetic Surgery Scale. Hierarchical linear regression was performed. RESULTS: The results indicated that media pressure and appearance conversations with peers predicted the outcome variable through the full mediation of internalization of thin ideals. The relation between peer attributions and interest in cosmetic surgery was partially mediated by internalization of thin ideals. Although social comparison was significantly related to both sociocultural variables and consideration of cosmetic procedures, it was not a significant mediator of this relationship. Neither family influence nor perception of teasing predicted the outcome variable. CONCLUSIONS: Overall, these results provide important information about the factors implicated in the consideration of cosmetic surgery by women. This research confirms that cosmetic surgeons need to adopt a base psychological approach. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Validation of an Italian version of the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) on adolescent girls.

The present study used exploratory factor analysis (EFA) to investigate the factor structure of an Italian version of the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) with a sample of 598 adolescent girls. Results of EFA indicated a four-factor structure: Information, Pressures, Internalization-General, and Internalization-Athlete. Factor loadings confirmed the original structure of the scale, except for one item. As expected, the four factors appeared to be slightly correlated. Cronbach's alphas for the four subscales were uniformly high: Information=.91, Pressures=.91, Internalization-General=.94, Internalization-Athlete=.84. Convergent validity of this Italian version of the SATAQ-3 was found to be good. SATAQ-3 seems useful to measure different aspects of societal influences on body image in Italian contexts. Future studies could subject SATAQ-3 to a confirmatory factor analysis in order to confirm the adequate fit of the model according to conventional criteria.