Clinically significant body dissatisfaction: prevalence and association with depressive symptoms in adolescent boys and girls.

Body dissatisfaction is distressing and a risk factor for adverse consequences including eating disorders. However, data pertaining to the prevalence of body dissatisfaction in adolescence, a key period for its emergence, are lacking. This is a substantial barrier to tailored assessment and early intervention. This study addresses this gap and provides the prevalence of body dissatisfaction and associations with depressive symptoms and body change strategies. Adolescent boys (n = 367; Mage = 12.8, SD = 0.7) and girls (n = 368; Mage = 12.7, SD = 0.7) completed measures of body dissatisfaction and depressive symptoms with established cut-off levels. They also completed measures of dietary restraint and strategies to increase muscle size. Of boys and girls, 37.9% and 20.7%, respectively experienced moderate, and 6.8% and 19.6% experienced clinically significant body dissatisfaction, with higher rates among girls than boys and among adolescents aged 13 and 14 than aged 12. More than one-quarter of boys (26.70%) and one-third of girls (33.15%) reported subthreshold depressive symptoms or possible, probable or major depressive episodes. Girls revealed a higher prevalence of possible-, probable-, or major depressive episode than boys. Relative to those with no or low body dissatisfaction, adolescents with clinically significant body dissatisfaction were 24 times more likely to also report possible-, probable-, or major depressive episodes. Among boys and girls, clinically significant body dissatisfaction was associated with higher levels of dietary restraint and engagement in strategies to increase muscle size. Greater attention to identification and early intervention for body dissatisfaction is needed, especially for girls.

Motivations for Social Media Use: Associations with Social Media Engagement and Body Satisfaction and Well-Being among Adolescents.

Adolescents are spending considerable time on social media, yet it is unclear whether motivations for social media use drive different forms of social media engagement, and their relationships with body satisfaction and well-being. This study tested a proposed model of the relationships between motivations for social media use, types of social media engagement and body satisfaction and well-being. Responses to an online survey from 1432 Australian adolescents (Mage = 13.45 years, SD = 1.14, range 11-17; 55.4% boys) were collected. Structural equational modelling indicates excellent model fit. Specifically, motivations for social media use (information sharing, passing time, escapism, social interaction, social capital and appearance feedback) were associated with engagement (intensity, photo-based use, active use, passive use and liking use) and revealed mixed associations with body satisfaction and well-being. The findings support the importance of considering motivations for social media use in future research.

Prospective Pathways to Depressive Symptoms and Disordered Eating in Adolescence: A 7-Year Longitudinal Cohort Study.

Eating pathology and depressive symptoms increase during adolescence, yet predictive pathways remain predominantly unexplored, despite their implications for prevention. The present study aimed to identify shared risk factors for eating pathology and depressive symptoms by evaluating an adapted Dual-Pathway Model of disordered eating, which postulated that higher BMI would predict disordered eating and depressive symptoms via pathways between body dissatisfaction, later BMI, depressive symptoms, and visible indicators of puberty (breast development for girls, height for boys). The participants were 8915 children (49% girls) from the Avon Longitudinal Study of Parents and Children, a population-based cohort study of British children, who were assessed at different intervals between the age of 7 to 14 years. Path analyses revealed that, for girls, childhood BMI exerted indirect effects on disordered eating via body dissatisfaction, depressive symptoms, and more advanced breast development, with indirect pathways identified to depressive symptoms via earlier depressive symptoms and more advanced breast development. For boys, childhood BMI had indirect effects on disordered eating via later BMI and body dissatisfaction, while only earlier depressive symptoms were found to have an independent and direct effect on adolescent depressive symptoms. This study reveals shared and independent risk factors for eating pathology and depressive symptoms in adolescence and suggests targets for preventative interventions, including higher BMI, body dissatisfaction, and depressive symptoms, in addition to advanced breast development, for girls.

A Biopsychosocial Model of Social Media Use and Body Image Concerns, Disordered Eating, and Muscle-Building Behaviors among Adolescent Girls and Boys.

Social media use is associated with body image concerns, disordered eating and body change behaviors in adolescents. This study aimed to examine these relationships within a biopsychosocial framework and test an integrated model. A sample of 681 adolescents (49% female), mean age = 12.76 years (SD = 0.74), completed a questionnaire assessing social media use, depression, self-esteem, body mass index, social media and muscular ideal internalization, appearance comparison, body dissatisfaction, disordered eating, and muscle-building behaviors. Path analysis was used to test the hypothetical model, which after modification revealed good fit to the data, although gender differences emerged. The findings suggest that biopsychosocial frameworks are useful for conceptualizing relationships between social media use and body image, eating, and muscle building outcomes.

Promoting positive body image and tackling overweight/obesity in children and adolescents: A combined health psychology and public health approach.

This article draws attention to the dual global problems of disordered eating and overweight/obesity among children and adolescents. It is well recognised that the main risk factor for disordered eating is body dissatisfaction, yet public health messages to tackle overweight/obesity are likely to increase body dissatisfaction. This tension between key public health messages and a health psychology approach is examined, with the goal of seeking a common way forward. We focus on the UK as a case study, where there is currently no statutory education in schools on body image. Since more prescriptive guidance on the curriculum covering personal/social/health issues is soon to be introduced, it is timely to consider the content, and in particular its impact on body image as well as overweight/obesity. Having reviewed current interventions and policy, we argue for a more holistic approach to the obesity problem, using a whole school approach to create a body confident culture.

Determinants of red blood cell alloantibody detection duration: analysis of multiply alloimmunized patients supports peritransfusion factors.

BACKGROUND: Alloimmunization to red blood cells (RBCs) can cause serious transfusion reactions and complicate the search for compatible blood products. Alloantibodies can be detected for periods ranging from a few days to several years, yet the mechanisms controlling the duration of detectability remain unknown. We studied the detection durations in patients forming multiple antibodies to investigate whether the duration is more strongly determined by conditions present at the time of each transfusion (peritransfusion factors) or by more stable patient-specific factors likely to persist across transfusions. STUDY DESIGN AND METHODS: We studied retrospective medical records for alloimmunized patients at Massachusetts General Hospital and Brigham and Women's Hospital (1461 patients; 2187 antibodies). RESULTS: Antibodies discovered simultaneously in a patient shared similar fates: 76% persisted through the last screen or first became undetectable during the same screen. Simultaneously identified antibodies were also more persistent than sequentially identified antibodies (mean, 9.2 months vs. 4.9 months; p < 10-3 ). Within a patient, antibodies discovered simultaneously tended to be detected for similar periods of time (mean difference, 25 days), compared to the detection period for sequentially discovered antibodies (107 days, p < 10-3 ). CONCLUSIONS: The similarity in detection duration of simultaneously identified antibodies suggests that peritransfusion factors are important determinants of alloantibody detectability and duration. We also find some evidence that detection durations for sequentially identified antibodies are also more highly correlated than those for randomly selected antibodies across all patients, suggesting that patient-specific factors also play a role in determining alloantibody persistence.

Facebook and body image concern in adolescent girls: A prospective study.

OBJECTIVE: The primary aim of the study was to examine the relationship across time between Facebook use and body image concern in adolescent girls. METHOD: A sample of 438 girls in the first two years (Years 8 and 9) of high school (aged 13-15 years) at Time 1 completed questionnaire measures of Facebook consumption and body image concerns, and again two years later (Time 2). RESULTS: Facebook involvement increased substantially over the two year time period. Body image concerns also increased. Number of Facebook friends was found to prospectively predict the observed increase in drive for thinness. On the other hand, internalization and body surveillance prospectively predicted the observed increase in number of Facebook friends. DISCUSSION: It was concluded that Facebook "friendships" represent a potent sociocultural force in the body image of adolescent girls. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:80-83).

More than Just Child's Play?: An Experimental Investigation of the Impact of an Appearance-Focused Internet Game on Body Image and Career Aspirations of Young Girls.

In recent years, elements of the modern environment (such as television, Internet, toys and clothes) have been criticized for having an increasingly sexualized or appearance focus, which has been suggested to be detrimental to girls' development. The current study examined the impact of an appearance-focused Internet game on young girls' body image and career cognitions and aspirations. Eighty British girls aged 8-9 years were randomly assigned to play an appearance-focused or a non-appearance focused game for 10 minutes. Girls in the appearance-focused game condition displayed greater body dissatisfaction compared to the control condition. Type of game did not impact girls' perceived capacity to do various jobs. However, girls who played the appearance-focused game reported a greater preference for feminine careers compared to the control group. This provides preliminary evidence that appearance-focused Internet games may be detrimental to young girls' body image and aspirations. Internet games should be included in our consideration of influential messages for young girls.

The Role of Self-Objectification in the Mental Health of Early Adolescent Girls: Predictors and Consequences.

OBJECTIVES: The overall aim of the study was to investigate the applicability of Objectification Theory to the mental health of early adolescent girls, in particular, their dieting behaviors and depressive symptoms. Both predictors and consequences of self-objectification were examined. METHODS: A sample of 204 girls with a mean age of 11.6 years completed questionnaire measures of media consumption, time spent on sports and hobbies, appearance conversations, self-objectification, body shame, dieting, and depressive symptoms. RESULTS: Structural equation modeling showed that magazine and Internet exposure and appearance conversations with friends predicted self-objectification. Self-objectification itself predicted body shame, which in turn predicted both dieting and depressive symptoms, in accord with the pathways postulated by Objectification Theory. CONCLUSIONS: The results confirm that, as is the case with adult women, self-objectification plays a significant role in the mental health of early adolescent girls.

The effect of beverages varying in glycaemic load on postprandial glucose responses, appetite and cognition in 10-12-year-old school children.

Reducing glycaemic index (GI) and glycaemic load (GL) inconsistently improves aspects of cognitive function and appetite in children. Whether altering the GL by lowering carbohydrate relative to protein and fat has a role in these effects is unknown. Therefore, we assessed the differential effects of beverages varying in GL and dairy composition on appetite, energy intake and cognitive function in children. A total of forty children (10­12 years) completed a double-blind, randomised, crossover trial, receiving three isoenergetic drinks (approximately 1100 kJ): a glucose beverage (GI 100, GL 65), a full milk beverage (GI 27, GL 5) and a half milk/glucose beverage (GI 84, GL 35). For 3 h post-consumption, subjective appetite and cognitive performance (speed of processing, memory, attention and perceptual speed) were measured hourly. At completion, each child was provided a buffet-style lunch and energy intake was calculated. Blood glucose was objectively measured using the Continuous Glucose Monitoring System. Blood glucose AUC values were significantly different between the drinks (P,0·001), but did not sustain above the baseline for 3 h for any drink. Mixed modelling revealed no effect of beverage on subjective appetite or energy intake. Participant sex and drink GL significantly interacted for short-term memory (P,0·001). When girls consumed either milk-containing beverage, they recalled 0·7­0·8 more words compared with 0·5 less words after the glucose drink (P#0·014). Altering GL of drinks by reducing carbohydrate and increasing protein did not affect appetite or cognition in children. Girls may demonstrate improved short-term memory after consuming beverages with higher protein and lower GL.

NetGirls: the Internet, Facebook, and body image concern in adolescent girls.

OBJECTIVE: The primary aim of the study was to examine the relationship between Internet exposure and body image concern in adolescent girls, with a particular focus on the social networking site of Facebook. METHOD: A sample of 1,087 girls in the first two years (Years 8 and 9) of high school (aged 13-15 years) completed questionnaire measures of Internet consumption and body image concerns. RESULTS: The overwhelming majority of girls (95.9%) had access to the Internet in their home. Time spent on the Internet was significantly related to internalization of the thin ideal, body surveillance, and drive for thinness. Further, 75% of the girls had a Facebook profile, and spent an average of 1.5 hours there daily. Facebook users scored significantly more highly on all body image concern measures than non-users. DISCUSSION: It was concluded that the Internet represents a potent socio-cultural medium of relevance to the body image of adolescent girls.

Rewards can be used effectively with repeated exposure to increase liking of vegetables in 4-6-year-old children.

OBJECTIVE: To examine whether parents offering a sticker reward to their child to taste a vegetable the child does not currently consume is associated with improvements in children's liking and consumption of the vegetable. DESIGN: A randomized controlled trial evaluated the effectiveness of exposure only (EO) and exposure plus reward (E + R), relative to a control group, on children's liking and consumption of a target vegetable. Assessments were conducted at baseline and 2 weeks from baseline (post-intervention). Follow-up assessments were conducted at 4 weeks and 3 months from baseline. SETTING: The study took place in Adelaide, South Australia. Participants were self-selected in response to local media advertisements seeking to recruit parents finding it difficult to get their children to eat vegetables. SUBJECTS: Participants were 185 children (110 boys, seventy-five girls) aged 4-6 years and their primary caregiver/parent (172 mothers, thirteen fathers). RESULTS: The E + R group was able to achieve more days of taste exposure. Both EO and E + R increased liking at post-intervention compared with control and no further change occurred over the follow-up period. All groups increased their intake of the target vegetable at post-intervention. Target vegetable consumption continued to increase significantly over the follow-up period for E + R and control but not for EO. CONCLUSIONS: The findings provide support for the effectiveness of using a sticker reward with a repeated exposure strategy. In particular, such rewards can facilitate the actual tastings necessary to change liking.

Imagery versus captions: The effect of body positive Instagram content on young women's mood and body image.

Body positive social media content aims to positively impact young women's body image and mood by challenging traditionally narrow beauty ideals. This online experiment investigated the effect of viewing body positive Instagram posts on young women's body image and mood, whilst focusing on understanding the impact of the images and captions in the posts. Overall, 195 young women (18-30 years old) were randomly assigned to view either body positive (consisting of images and captions), body positive captions only, body positive images only, or thin-ideal Instagram posts. Positive mood increased in all conditions pre to post exposure. Further, body satisfaction and negative mood improved pre-post exposure for all body positive conditions. However, when controlling for trait body appreciation significant effects only remained for the combined image and caption body positive condition. There were no significant differences in positive mood, state body appreciation, self-objectification, or broad conceptualisations of beauty between the three body positive exposure conditions. Therefore, to improve body satisfaction and mood, body positive content should include a combination of images and captions.

Can following body positive or appearance neutral Facebook pages improve young women's body image and mood? Testing novel social media micro-interventions.

Small changes to social media use could have a large impact across the population. The present study tested novel social media micro-interventions (i.e., brief content delivered in everyday life) in which young women (N = 159) were instructed to either (1) follow a body positive Facebook group, (2) follow an appearance neutral Facebook group, or (3) use Facebook as usual. Relevant content was posted to the Facebook groups three times per day for two weeks. Primary outcomes were trait body image (body dissatisfaction and appreciation) and mood, and secondary outcomes were trait self-objectification, appearance comparison tendency, and body activism. Outcomes were assessed across three timepoints: pre-test (T1), post-test (T2) after the 14-day intervention period, and follow-up (T3) 4-weeks after T2. Participants in both the body positive and appearance neutral conditions reported decreased body dissatisfaction from T1 to T2 (small-medium effects) and participants in the body positive condition reported decreased appearance comparisons from T1 to T2 (medium effect). There were no changes for those variables from T2 to T3. No other significant differences were found. Viewing a small number of body positive or appearance neutral posts on social media may be an effective inexpensive micro-intervention for improving young women's body image.

Parent- and child-reported parenting. Associations with child weight-related outcomes.

The present study aimed to investigate associations of both parent-reported and child-perceived parenting styles and parent-reported parenting practices with child weight and weight-related behaviours. Participants were 175 children (56% female) aged between 7 and 11, and their primary caregivers (91% female), recruited through South Australian primary schools. Children completed measures of parenting style, attitude toward fruit, vegetables, and non-core food, and attraction to physical activity. Parents completed measures of parenting style and domain-specific parenting practices (feeding and activity-related practices) and reported on child dietary intake, physical activity, and sedentary behaviour. Objective height and weight measurements were taken from children, from which body mass index (BMI) was calculated. Child-reported parenting style and parent-reported parenting practices were uniquely associated with child weight-related outcomes, but styles and practices did not interact in their association with child outcomes. Child-reported parenting style was associated with child food and activity attitudes, whereas parent-reported parenting style was not associated with child outcomes. The findings of the present study generally support the recommendation of a parenting style high in demandingness and responsiveness for supporting healthy child weight-related behaviours, along with appropriate domain-specific practices. The child's perspective should be incorporated into research involving child outcomes wherever possible.

Gender differences in adolescent sport participation, teasing, self-objectification and body image concerns.

This study examined gender differences in adolescent participation in sport and physical activity, in teasing experiences specific to the physical activity domain, and the relationship between adolescent physical activity and body image. A sample of 714 adolescents (332 girls, 382 boys) aged between 12 and 16 years completed measures of participation in organised sport and other physical activities, experiences of teasing specific to sport, self-objectification and body image. Adolescent girls participated in organised sport at a lower rate than boys, but experienced higher levels of teasing. Both girls and boys reported being teased by same-sex peers, but in addition, girls also reported being teased by opposite-sex peers (i.e. boys). Time spent on aesthetic physical activities was related to disordered eating symptomatology for both girls and boys. It was concluded that teasing and body image concerns may contribute to adolescent girls' reduced rates of participation in sports and other physical activities.

The case for body positivity on social media: Perspectives on current advances and future directions.

In recent years, the body-positive movement has emerged on social media and has generated both support and criticism in pop-cultural discourse. We review the potential benefits and disadvantages of 'body positivity' on social media in light of theory and the available research. Based on the early evidence showing potential benefits of engaging with body-positive content on social media for positive body image, a case is made in support of this emerging content. Nevertheless, recommendations are made for future research with an emphasis on experimental and longitudinal investigations of actual health outcomes of engaging with body positivity on social media and clarification of the potential relationship between body positivity and objectification.

The impact of completing body image assessments on adolescents' body image and engagement in body change strategies: Harmful or harmless?

Parents and educators have raised concerns that participating in body image research may cause or increase poor body image and engagement in body change strategies. This quasi-experimental study compared body image and body change strategy outcomes among adolescents who had, and had not, previously been exposed to the same assessment questions 6-months prior (twice- vs once-completers). Comparison was also made between groups who completed an assessment containing only positively worded items or both positive and negative items (positive vs mixed valence). Boys and girls (N = 1,532, Mage = 13.83, SD = 1.18) completed online measures of body dissatisfaction, body appreciation, overvaluation of weight and shape, appearance esteem, and body change strategies. In regression analyses, neither body image nor body change strategies were predicted by group (completion or valence groups), except lower body dissatisfaction and higher body appreciation among twice-completers. Most participants did not experience individual-level change in body image or body change strategies over 6-months. Findings suggest that body image assessments may not put adolescents at risk of poor body image or engagement with body change strategies, however; experimental research is needed. Some improvement in body image may have implications for prospective and prevention research.

Social media, body satisfaction and well-being among adolescents: A mediation model of appearance-ideal internalization and comparison.

Despite adolescents' prolific use of social media, relationships between social media and body satisfaction and well-being are not yet well understood, especially among boys. This study tested a sociocultural model of body image within the context of social media among adolescent boys and girls. Specifically, this study examined whether appearance-ideal internalization and social appearance comparisons mediated relationships between social media engagement (intensity and appearance-focused use) and body satisfaction and subjective well-being. Australian adolescents between 11 and 17 years (N = 1,579, Mage = 13.45 years, SD = 1.15; 55.4 % boys) completed an online survey. Structural equational modelling indicated that only higher appearance-focused social media use was directly associated with lower body satisfaction and well-being. Generally, higher appearance-ideal internalization and comparisons mediated the relationships between higher social media engagement and lower body satisfaction and well-being. Multi-group analyses indicated these relationships were equivalent across gender. Findings supported the proposed model among boys and girls and extend existing theoretical knowledge to encompass male body image and well-being. Interventions which target internalization and comparisons in the context of social media are likely to be valuable in improving body satisfaction and subjective well-being in co-educational settings.

Outcomes of a Cluster Randomized Controlled Trial of the SoMe Social Media Literacy Program for Improving Body Image-Related Outcomes in Adolescent Boys and Girls.

Although the negative effect of social media use among youth on body image and eating concerns has been established, few classroom-based resources that can decrease these effects through targeting social media literacy skills have been developed. This study aimed to test the efficacy of SoMe, a social media literacy body image, dieting, and wellbeing program for adolescents, through a cluster randomized controlled trial. Participants (n = 892; Mage = 12.77, SD = 0.74; range 11-15; 49.5% male) were randomized by school (n = 8) to receive either weekly SoMe (n = 483) or control sessions (lessons as usual; n = 409) over 4 weeks in their classroom. Participants completed surveys at four timepoints (baseline, 1-week post-intervention, and 6- and 12-month follow-up) assessing body dissatisfaction, dietary restraint, strategies to increase muscles (primary outcomes), self-esteem and depressive symptoms (secondary outcomes), and internalization of appearance ideals and appearance comparison (exploratory outcomes). Modest positive intervention effects were found in dietary restraint and depressive symptoms at 6-month follow-up in girls but few positive effects emerged for boys. The findings provide only preliminary support for a social media literacy intervention, but suggest the usefulness of both identifying those who benefit most from a universally delivered intervention and the need to refine the intervention to maximize intervention effects.