Pragmatic randomized controlled trial of the Mind Management Skills for Life Programme as an intervention for occupational burnout in mental healthcare professionals.

BACKGROUND: Occupational burnout is highly prevalent in the mental healthcare workforce and associated with poorer job satisfaction, performance and outcomes. AIMS: To evaluate the effects of the Mind Management Skills for Life Programme on burnout and wellbeing. METHODS: N = 173 mental health nurses were recruited from the English National Health Service during the acute phase of the COVID-19 crisis. Participants were allocated to an immediate intervention or a delayed intervention control group, using a stepped wedge randomized controlled trial design. Measures of burnout (OLBI) and wellbeing (WEMWBS) were completed at four time-points: [1] baseline; [2] after the first group finished the intervention; [3] after the second group finished the intervention; and [4] six-months follow-up. RESULTS: Between-group differences were compared at each time-point using ANCOVA adjusting for baseline severity. Statistically significant effects on burnout (d = 0.60) and wellbeing (d = -0.62) were found at time-point 2, favouring the intervention relative to waitlist control. No significant differences were found at subsequent time-points, indicating that both groups improved and maintained their gains after the intervention. CONCLUSIONS: This intervention led to moderate improvements in burnout and wellbeing, despite the adverse circumstances of the COVID-19 pandemic at the time of the study.

Does comparison of self with others influence body image among adult women? An experimental study in naturalistic settings.

BACKGROUND AND OBJECTIVES: It has been suggested that body comparison is a safety behavior in eating disorders. This experimental study investigates the causal impact of upward and downward body comparison on body image, eating pathology, self-esteem, anxiety and mood. It also considers whether trait body comparison and eating pathology are associated with responsiveness to upward and downward comparison. METHODS: Thirty-nine women participated. Each completed trait comparison and eating pathology measures. Following this, each participant spent an hour (on different days) making an upward, downward or neutral comparison in a naturalistic setting. After each condition, the participant completed measures of body satisfaction, self-esteem, anxiety, depression and eating pathology. RESULTS: Participants were significantly less satisfied with their bodies following upward comparison. Both upward and downward comparison were associated with particularly negative effects if an individual had greater trait eating concerns. The effects of downward comparison were correlated with increased anxiety. LIMITATIONS: The sample was lacking in diversity. Compliance with the experimental tasks was not strictly monitored. CONCLUSIONS: Upward comparison resulted in lower body satisfaction, but downward comparison did not result in positive effects. However, trait eating concerns and comparison influenced the impact of both forms of comparison. Body comparison should be a target for treatment in CBT for eating disorders, particularly where the individual has a strong tendency to make comparisons with other people. LEVEL OF EVIDENCE: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

The development of a body comparison measure: the CoSS.

PURPOSE: This study reports on the development and validation of a brief and widely applicable measure of body comparison (the Comparison of Self-Scale-CoSS), which is a maintaining feature of eating disorders. METHODS: A sample of 412 adults completed the CoSS, an existing measure of aspects of body comparison, and eating pathology and associated states. Test-retest reliability was examined over 2 weeks. RESULTS: Exploratory factor analysis showed that 22 CoSS items loaded onto two factors, resulting in two scales-Appearance Comparison and Social Comparison-with strong internal consistency and test-retest reliability. CONCLUSIONS: In clinical terms, the CoSS was superior to the existing measure of body comparison in accounting for depression and anxiety. Given that it is a relatively brief measure, the CoSS could be useful in the routine assessment of body comparison, and in formulating and treating individuals with body image concerns. However, the measure awaits full clinical validation. LEVEL OF EVIDENCE: Level 3.

Experimental analysis of the impact of body comparison on non-clinical women.

BACKGROUND AND OBJECTIVES: Two experimental studies examined the impact that body comparison has on women's body satisfaction and self-esteem. The two studies differed in the use of a human comparator or an avatar (non-human) comparator. The independent variables were the type of body comparison (upward, downward and neutral) and the perceived personality of the comparator. METHODS: Each study used a within-participant design. Participants compared themselves to images of women or avatars (previously rated as 'attractive', 'neutral' or 'unattractive'), with an accompanying 'positive' or negative' personality descriptor. Participants rated their body satisfaction and self-esteem after each image. RESULTS: Upward comparison resulted in negative effects for the participant compared to downward and neutral conditions, but downward comparison's impact was only found for human images. The described personality of the image had a more complex impact when using human images, but was still relevant for avatars. LIMITATIONS: The sample for this study was lacking in diversity. Compliance within the experimental tasks was not strictly monitored. The use of a within-subject design might have allowed some participants to deduce the nature of the study. CONCLUSIONS: These findings provide causal evidence for the theorised effects of body comparison on body satisfaction self-esteem. Upward comparison has especially problematic outcomes, even causing negative effects when comparing to a non-human avatar. Downward comparison had positive effects, but only for human images. Furthermore, personality played some moderating role in these outcomes. Social comparison theory needs to be reviewed in light of these findings, and practical implications are discussed.