Socio-cultural agents and their impact on body image and body change strategies among adolescents in Fiji, Tonga, Tongans in New Zealand and Australia.

This paper reports on the findings of studies that were conducted as part of the Pacific Obesity Prevention in Communities project. The studies evaluated the types of messages that adolescents received in relation to body image, physical activity and eating. The participants were male and female adolescents from Fiji (two cultural groups), Tonga, New Zealand (Tongans) and Australia (European Australians). Three studies were conducted: interviews with 48 adolescents (24 male, 24 female) from each cultural group, questionnaires with 600 adolescents (300 male, 300 female) from each cultural group and the perceptual distortion study with 100 adolescents (50 male, 50 female) from the two cultural groups in Fiji and European Australians. The results demonstrate that parents, peers, the media, as well as religious influences impact on the type of body valued by adolescents in each of the cultural groups, as well as their levels of body satisfaction. These influences also shape the type and volume of food consumed, and the type and frequency of physical activity. The results of these studies highlight the major role played by the broader societal values in shaping the nature of the messages that adolescents receive in relation to their body size, eating and physical activity.

The role of alcohol expectancy and drinking refusal self-efficacy beliefs in university student drinking.

AIMS: University student alcohol misuse is a considerable problem. Alcohol expectancy research has contributed significantly to our understanding of problem drinking in young adults. Most of this research has investigated positive expectancy alone. The current study utilized two measures of alcohol expectancy, the alcohol expectancy questionnaire (AEQ) and the drinking expectancy profile [consisting of the drinking expectancy questionnaire (DEQ) and the drinking refusal self-efficacy questionnaire] to predict severity of alcohol dependence, frequency of drinking, and the quantity of alcohol consumed per occasion. METHODS: Measures of drinking behaviour and alcohol expectancy were completed by 174 undergraduate university students. RESULTS: Positive alcohol expectancy factors accounted for significant variance in all three drinking indices, with the DEQ adding additional variance to AEQ scores on frequency and severity of alcohol dependence indices. Negative expectancy did not add incremental variance to the prediction of drinking behaviour in this sample. Drinking refusal self-efficacy and dependence beliefs added additional variance over positive and negative expectancies in the prediction of all three drinking parameters. CONCLUSIONS: Positive expectancy and drinking refusal self-efficacy were strongly related to university student drinking. The incorporation of expectancy as a means of informing prevention approaches in tertiary education shows promise.

A longitudinal study to explain strategies to change weight and muscles among normal weight and overweight children.

Previous research has indicated that both boys and girls strive for a slim body, with boys having an additional focus on a muscular body build. The current study was designed to evaluate the utility of a biopsychosocial model to explain body image and body change strategies among children. The study evaluated changes over time in body image and strategies to lose weight and increase muscles among 132 normal weight and 67 overweight boys (mean age = 9.23 years) and 158 normal weight and 55 overweight girls (mean age = 9.33 years). The predictive role of BMI, positive and negative affect, self-esteem and perceived sociocultural pressures to lose weight or increase muscle on body image and body change strategies over a 16 month period was evaluated. All participants completed the questionnaire on both occasions. The results demonstrated that both overweight boys and girls were more likely to be dissatisfied with their weight, place more importance on their weight, engage in more strategies to lose weight as well as perceive more pressure to lose weight. Overweight boys and girls were also more likely to report lower levels of self-esteem and positive affect, and higher levels of negative affect, and reported a reduction in their self-esteem over time. Regression analyses demonstrated that among overweight boys, low self-esteem and high levels of perceived pressure to lose weight predicted weight dissatisfaction; for overweight girls, weight dissatisfaction was also predicted by low levels of self-esteem. The implication of these findings in terms of factors contributing to the adoption of health risk behaviors among children is discussed.

Dietary restraint and negative affect as mediators of body dissatisfaction and bulimic behavior in adolescent girls and boys.

Stice's dual pathway model of dietary restraint and negative affect was examined in both adolescent girls and boys. Self-report measures assessing body dissatisfaction, dietary restraint, negative affect and bulimic behavior were administered to 267 girls and 199 boys aged between 12 and 16 years. The findings for the girls were consistent with Stice's model, in that they indicated that both dietary restraint and negative affect mediated the relationship between body dissatisfaction and bulimic behavior. For the boys who desired a thinner body size, only negative affect was found to mediate the relationship between body dissatisfaction and bulimic behavior. On the other hand, for boys who desired a larger body size, both body dissatisfaction and dietary restraint were found to exert an independent effect on bulimic behavior. As boys can aspire to two contrasting and seemingly opposite body size ideals, the findings highlight that the relationship between body dissatisfaction, dietary restraint, negative affect and bulimic behavior are more complex in males than in females. Further research using longitudinal designs is needed in order to test the directional and bidirectional nature of the observed interrelationships.

Restraint as misregulation in drinking and eating.

The present study was designed to increase our understanding of the co-morbidity between problem drinking and binge eating. The study investigated both consummatory behaviors in relation to restrained drinking, restrained eating, and a general measure of self-control. The participants were a sample of 658 boys and 414 girls aged between 14 and 17 years. The dimension of restraint, which best predicted the two problem behaviors when examined separately for both boys and girls, was cognitive and emotional preoccupation (CEP) about controlling one's consummatory intake. In addition, evidence was found linking both problem drinking and binge eating to restraint and poor general self-control. The struggle with self-control and the high emphasis on CEP about controlling one's consummatory intake, which characterise restrained drinking and restrained eating, closely resembles Baumeister and Heatherton's notion of misregulation [Psychol. Inquiry 7 (1996) 1.]. Discussed are the similarities between restraint and misregulation, and the kinds of strategies that can be used to improve self-control.

Parent, peer, and media influences on body image and strategies to both increase and decrease body size among adolescent boys and girls.

This study investigated the nature of body image and body change strategies, as well as the sociocultural influences on these variables, among a group of 1,266 adolescents (622 males, 644 females). In particular, it investigated weight gain and increased muscle, as well as weight loss. It was found that females were less satisfied with their bodies and were more likely to adopt strategies to lose weight, whereas males were more likely to adopt strategies to increase weight and muscle tone. Respondents with higher body mass index (BMI) evidenced greater body dissatisfaction and more weight loss strategies, but there were no differences between BMI groups in weight gain or strategies to increase muscles. Weight gain and strategies to increase muscles were more likely to be undertaken by older adolescents, but there were no grade level differences in weight loss. Media influences to alter weight, as well as feedback from mother, father, and both male and female peers, were greater for females. There were few grade level or BMI differences in regard to any of the sociocultural influences. The importance of these findings in terms of providing a better understanding of factors which may lead to a disturbed body image and body change disorders, particularly among adolescent boys, is discussed.

Children's body image concerns and eating disturbance: a review of the literature.

In recent years a large number of studies have examined body image concerns, and early symptoms of eating disturbance among children. However, to date there has been no synthesis or evaluation of these studies. The purpose of the present article is to review and evaluate the research that has examined body image concerns, and eating attitudes and behaviors among children 6 to 11 years of age. The instruments used to assess body image concerns and eating disturbance in children closely resemble those used with adolescents and adults. Overall, the psychometric data for these instruments are very good and there is sufficient evidence indicating that they can be used reliably and validly. In addition, similar variables to those studied in adolescent and adult samples have been found to be associated with children's body image concerns and early eating disturbance. These include gender, age, body mass index, race, sociocultural pressures, and self-concept. Our understanding of the development of body image concerns and eating disturbance in children is limited, however, by the fact that most of the research in this field has been based on cross-sectional data, and the studies have focused almost exclusively on weight loss cognitions and behaviors.

Gender stereotypes and drinking cognitions as indicators of moderate and high risk drinking among young women and men.

The study examined differences in gender stereotypes, restrained drinking and self-efficacy for alcohol refusal between moderate and high risk drinkers among a university sample of 301 women and 118 men. Both female and male high risk drinkers displayed a response conflict, typified by high scores on restrained drinking but low scores on self-efficacy. This pattern of response conflict was more pronounced for high risk drinking women, who also identified poorly with feminine traits (e.g. 'nurturing', 'love children', 'appreciative'). The findings are discussed in relation to society's double standard that accepts intoxication in men but condemns it in women.

Body image, strategies to change muscles and weight, and puberty: do they impact on positive and negative affect among adolescent boys and girls?

The purpose of this study was to examine the impact of strategies to both decrease weight and increase muscle tone on negative (depression, anxiety) and positive affect among adolescent males and females. The respondents were 1185 adolescents (587 males, 598 females) who were enrolled in grades 7 and 9 (mean age for males=13.22 years; mean age for females=13.21 years). Respondents completed the Body Image and Body Change Inventory that assessed body image satisfaction, body image importance, body change strategies to decrease weight, body change strategies to increase muscle tone, and food supplements. Respondents also completed the Pubertal Development Scale, the depression and anxiety scales of the Depression Anxiety and Stress Scale, and the positive affect items from the Positive and Negative Affect Scale. Structural equation modelling was used to determine how body satisfaction and importance, body change strategies, and puberty impacted on depression, anxiety, and positive affect. The results demonstrated that for both boys and girls, there was a strong association between body change strategies and negative affect. For boys, body dissatisfaction did not predict negative affect, although this was a strong predictor for girls. Body change strategies did not strongly predict positive affect for either boys or girls, although body image satisfaction was a strong predictor for both genders. The implications of these findings for obtaining a better understanding of the role of pubertal development, body image, and body change strategies in predicting positive and negative affect among adolescent males and females are discussed.

Sex-role traits and the comorbidity of symptoms of disordered eating and problem drinking.

The symptoms of problem drinking and disordered eating were studied independently in relation to sex-role traits and also for evidence of comorbidity in a student sample of 217 women. The participants completed surveys that assessed positive and negative sex-role traits, reported drinking levels, alcohol dependence, problem drinking, bulimic symptoms, dietary restraint, and drive for thinness. Eating symptoms were related to both the negative and positive traits of Femininity, but self-descriptions involving negative traits (passivity, dependence, unassertiveness, etc.) showed the strongest relationship. High scores on identification with the traits typically labelled as Masculinity were related to drinking but there was an important difference between drinking per se (which was related to Positive Masculinity) and drinking found to be associated with drinking problems, which was related to Negative Masculinity (aggression, showing-off, rudeness, etc.). Feminine traits were also related to drinking. Low identification with the traits of Negative Femininity was associated with non-problem drinking, whereas low identification with the traits of Positive Femininity were associated with problem-related drinking. Young women who displayed comorbid symptoms described themselves by a high identification with the traits of both Negative Masculinity and Negative Femininity. It was argued that comorbidity reveals a more extreme form of the sex-role conflict previously described in relation to disordered control over both eating and drinking when considered independently.

Body image and body change methods in adolescent boys. Role of parents, friends and the media.

OBJECTIVE: This study examines sociocultural influences affecting both body image and body change methods in adolescent boys. METHODS: Twenty boys in grade 7 (aged 12-13) and twenty boys in grade 9 (aged 14-15) were individually interviewed. The influence of parents, siblings, friends and the media on both body image and body change methods was evaluated. RESULTS: For approximately a third of the boys, parents, siblings, friends and the media were perceived to have at least some influence over boys' feelings about their bodies and body change methods. In particular, feedback from mothers and female friends were viewed as having a positive impact on boys' body image whereas feed-back from fathers and male friends was viewed as more important in influencing body change methods. The media was also viewed as contributing to boys' body satisfaction but it was seen to encourage greater exercise to alter body size and shape. CONCLUSION: The differences and similarities between the sociocultural messages received by males and females are discussed. The implication of these findings in fostering better health among adolescent males are explored.

Sex-role traits and self-monitoring as dimensions of control: women with bulimia nervosa vs. controls.

OBJECTIVE: The study investigated sex-role traits and self-monitoring styles as two dimensions of self-control amongst women with bulimia nervosa and normal controls. DESIGN AND METHODS: The participants were 30 women with bulimia nervosa and 40 normal controls who completed questionnaires, which assessed bulimic symptoms, sex-role traits, and Synder's Self-Monitoring Scale. RESULTS: Women with bulimia nervosa were found to identify more strongly than controls with negative feminine traits and Other Directedness, a style of self-monitoring that focuses on pleasing others. CONCLUSIONS: These findings reinforce the notion that women with bulimia nervosa lack assertiveness skills and that the strategies they have developed in their interactions with others can be described as a Negative Yielding style of self-control.

Drinking restraint versus alcohol expectancies: which is the better indicator of alcohol problems?

OBJECTIVE: The relationship between expectancies and other psychological constructs related to drinking is unclear. The current study assesses the power of drinking restraint, measured by the Temptation and Restraint Inventory (TRI), along with alcohol expectancy and drinking refusal self-efficacy, measured by the Drinking Expectancy Profile (DEP), as indicators of alcohol use and problem drinking. METHOD: Volunteer students (N = 359), consisting of 113 men with a mean (+/-SD) age of 25.31 +/- 10.61 years and 246 women with a mean age of 23.04 +/- 8.90, completed the TRI, DEP and Alcohol Dependence Scale (ADS) as well as frequency and quantity measures of self-reported drinking. RESULTS: Drinking Restraint was a stronger indicator of higher scores on the ADS, accounting for 54% and 45% of the variance for men and women, respectively, with Alcohol Expectancies and Drinking Refusal Self-Efficacy being the better indicator of frequency of alcohol consumption, accounting for 20% of the variance for men and 26% for women. Both measures were represented by similar variances within the quantity of drinking measure. CONCLUSIONS: Drinking restraint and alcohol expectancies were seen to measure kindred but unique cognitive subsets, providing further insight into the progression of alcohol problems. Alcohol expectancies and drinking refusal self-efficacy may be acquired early in the development of drinking behavior, as evidenced by stronger associations with risky drinking; drinking restraint and its associated loss of control factors appear to be more specifically related to problem drinking. Alcohol expectancy and drinking refusal self-efficacy may thus have broader use in the assessment of drinking behavior.

Self-control in relation to problem drinking and symptoms of disordered eating.

The present study investigated problem drinking and symptoms of disordered eating in relation to (a) restrained drinking and eating and (b) cognitive self-control. One hundred ninety-eight high school students (97 males and 101 females: mean age = 16.45 years) completed questionnaires which assessed problem drinking, symptoms of disordered eating, restrained eating and drinking, and cognitive self-control. Using principal components analysis, three factors with eigenvalues greater than one were found to summarise the interrelationships among the examined measures. For both sexes, the first two factors primarily reflected problem drinking and restrained drinking, and problem eating and restrained eating, respectively. The third factor reflected a more general problem with control underlying aspects of both problem drinking and problem eating.

Factorial validity of the Bulimia Test-Revised in adolescent boys and girls.

The present study examined the psychometric properties and principal components structure of the Bulimia Test Revised (BULIT-R; [Thelen, M.H., Farmer, J., Wonderlich, S. & Smith, M. (1991). A revision of the Bulimia Test: the BULIT-R. Psychological Assessment, 3, 119-124.]) using a sample of early adolescent males and females. Three hundred and six girls (mean age = 13.66; S.D. = 1.12) and 297 boys (mean age = 13.89: S.D. = 1.13) from grades 7-10 completed the BULIT-R as part of a larger study investigating disordered eating in early adolescence. In comparison to the 5 factors identified in adult female samples, the factor analysis identified four similar factors for adolescent boys and girls: bingeing, control, normative weight loss (dieting and exercise) and extreme weight loss behaviors (vomiting, diuretics and laxatives). The findings highlight similarities between boys and girls and differences in the factorial nature of the BULIT-R for adult and adolescent samples. The BULIT-R also demonstrated good reliability with adolescent samples and adequate concurrent validity with the DFT, DEBQ and binge eating as defined by the DSM-IV criteria. The emergence of bingeing and control as two distinct factors is an important distinction that needs to be considered when attempting to provide accurate incidence rates of binge eating and bulimic symptomatology in adolescents.

Gender differences in drinking restraint.

OBJECTIVE: This study examines the factor structure and the predictive power of drinking restraint for men and women as measured by the Temptation and Restraint Inventory (TRI). The TRI assesses two factors: Cognitive-Emotional Preoccupation (CEP) and Cognitive-Behavioral Control (CBC). METHOD: A group of 418 drinkers was drawn from a university sample and divided by gender into two groups. Men (n = 122) were of a mean age (+/-SD) of 23 +/- 7 years; women (n = 296) were of a mean age of 22.5 +/- 8 years. Subjects completed the TRI and the Alcohol Dependence Scale (ADS) and validated quantity and frequency of drinking indices. RESULTS: Drinking restraint for the men was found to better predict alcohol dependence, quantity of drinking and frequency of drinking. Moreover, two factors confirming the TRI's CEP and CBC model were extracted for the men, but only one factor was extracted for the women. CONCLUSIONS: It was proposed that, as men tend to drink greater amounts of alcohol more often, they have learned to distinguish more clearly the conflicts in their personal control over drinking. If the TRI is to be used as a diagnostic and treatment tool, it is recommended that clinicians be cognizant of possible gender differences in restrained drinking behavior.

Bulimic symptoms in adolescent girls and boys.

OBJECTIVE: The factor structure of the Bulimic Investigatory Test (BITE) was examined in adolescent girls and boys. METHOD: Seven hundred and seventy seven adolescents (427 girls and 350 boys) completed the BITE. RESULTS: Consistent with the original scale, one factor describing overall bulimic symptoms was found for the girls. However, two factors were required to summarize the boys' symptoms: "Emotional and Rigid/Disruptive Eating Style" and "Food Preoccupation and Binging." DISCUSSION: The results are discussed in relation to Fairburn's (Fairburn. (1995). Overcoming Binge Eating. New York: Guilford) distinction which separates problem from nonproblem binge eating. Further studies are now needed to examine the mechanisms underlying the development of bulimic eating in boys and young men.

Self-control in relation to problem drinking and symptoms of disordered eating.

The present study investigated problem drinking and symptoms of disordered eating in relation to (a) restrained drinking and eating, and (b) cognitive self-control. One hundred and ninety-eight high school students (97 males and 101 females; mean age = 16.45 years) completed questionnaires that assessed problem drinking, symptoms of disordered eating, restrained eating and drinking, and cognitive self-control. Using principal components analysis, three factors with eigenvalues greater than 1 were found to summarize the interrelationships among the examined measures. For both sexes, the first two factors primarily reflected problem drinking and restrained drinking, and problem eating and restrained eating, respectively. The third factor reflected a more general problem with control underlying aspects of both problem drinking and problem eating.

Gender congruence in confirmatory and compensatory drinking.

The relationship between gender-stereotypical traits and drinking behaviors was examined in 422 university students via both positive and negative measures of masculinity and femininity. Two canonical variates summarized the underlying relationships. The 1st canonical variate indicated that both high negative masculinity and low positive femininity predicted alcohol consumption and alcohol-related problems. This behavior was labeled confirmatory drinking because it depicts a style of drinking that reinforces gender-stereotypical images about alcohol use; masculine characteristics are typically associated with high levels of alcohol consumption. The 2nd canonical variate indicated that both low positive masculinity and low positive femininity predicted problem drinking. This behavior was labeled compensatory drinking because drinkers often use alcohol to express their masculinity and femininity. The distinction between confirmatory and compensatory drinking has important implications for the development of more effective education and preventative strategies.