Body-related cognitive distortions (thought-shape fusion body) associated with thin-ideal exposure in female students-An ecological momentary assessment study.

Etiological models of eating disorders (EDs) describe body dissatisfaction (BD)as one of the major influences fostering dysfunctional body-related behaviour and disordered eating behaviour. BD is influenced by repeated exposure to thin ideals that evoke high self-ideal discrepancy and result in body-related cognitive distortions such as thought-shape fusion body (TSF-B). The aim of this study was to investigate the covariation of daily media exposure and the experience of TSF-B in a naturalistic setting. It was further analysed whether TSF-B is associated with self-ideal discrepancy, dysfunctional body-related behaviour, and disordered eating behaviour. Moreover, person-related predictors of TSF-B were explored. Altogether, 51healthy female students (mean age 21.06years, SD = 1.76) participated in an ecological momentary assessment study with four daily surveys during 10consecutive days. Exposure with thin ideals in contrast to exposure to unspecific media contents went along with the experience of TSF-B. TSF-B was associated with higher self-ideal discrepancy and dysfunctional body-related behaviour as well as more pronounced disordered eating behaviour, suggesting that TSF-B is a common phenomenon in young healthy females' everyday life. A main effect of trait measures (e.g., pre-existing BD) on TSF-B was observable but has no moderating effect. Thus, a specific vulnerability has not been detected.

Cognitive Distortions Associated with Imagination of the Thin Ideal: Validation of the Thought-Shape Fusion Body Questionnaire (TSF-B).

Thought-shape fusion (TSF) describes the experience of body-related cognitive distortions associated with eating disorder (ED) pathology. In the laboratory TSF has been activated by thoughts about fattening/forbidden foods and thin ideals. This study aims at validating a questionnaire to assess the trait susceptibility to TSF (i.e., body-related cognitive distortions) associated with the imagination of thin ideals, and developing an adapted version of the original TSF trait questionnaire, the Thought-Shape Fusion Body Questionnaire (TSF-B). Healthy control women (HC, n = 317) and women diagnosed with subthreshold and clinical EDs (n = 243) completed an online-questionnaire. The factor structure of the TSF-B questionnaire was examined using exploratory (EFA) and subsequent confirmatory factor analysis (CFA). EFA pointed to a two-factor solution, confirmed by CFA. Subscale 1 was named Imagination of thin ideals, containing five items referring to the imagination of female thin ideals. Subscale 2 was named Striving for own thin ideal, with seven items about pursuing/abandoning attempts to reach one's own thin ideal. The total scale and both subscales showed good convergent validity, excellent reliability, and good ability to discriminate between individuals with subthreshold/clinical EDs and HCs. Results indicate that cognitive distortions are also related to the imagination of thin ideals, and are associated with ED pathology. With two subscales, the TSF-B trait questionnaire appropriately measures this construct. Future studies should clarify whether TSF-B is predictive for the development and course of EDs. Assessing cognitive distortions with the TSF-B questionnaire could improve understanding of EDs and stimulate the development of cognitively oriented interventions. CLINICAL TRIAL REGISTRATION NUMBER: DRKS-ID: DRKS00005709.