Body dissatisfaction, negative affect, and engagement in healthy behaviors: The conditional effect of future-self continuity.

The relationship between body dissatisfaction and negative affect is complex, with some research suggesting that this combination motivates individuals to engage in more health-related behaviors; while other studies find it increases unhealthy behavior. To bridge this gap, it may be the case that to the extent these individuals have continuity between their present and future selves, the more likely they are able to make positive health-related choices with this future self in mind. We examined individuals (n = 344; 51.74% men) aged between 18 and 72 years (M = 39.66, SD = 11.49) who endorsed high negative affect along with body dissatisfaction but either had high or low levels of future self-continuity. We found individuals experiencing body dissatisfaction and negative affect reported higher engagement in healthy behaviors only if they had a strong connection to their future self, index of moderated mediation = 0.07 (95% CI = 0.02, 0.13). These findings support targeting future-self continuity in therapeutic regimens to bolster engagement in healthy behaviors among individuals with body dissatisfaction and high negative affect.

Pet Attachment and the Interpersonal Theory of Suicide.

Background: Pet ownership is often assumed to have mental health benefits, but the effect of pets on suicide risk has a scant literature. Aims: Using the interpersonal theory of suicide, we examined the relationships between perceived burdensomeness (PB), thwarted belongingness (TB), overall attachment to one's pet, pet attachment avoidance or anxiety, and suicide risk. The following three hypotheses were investigated: (1) Higher attachment would be indirectly associated with lower suicide risk via lower TB and lower PB; (2) attachment would be associated with higher suicide risk, as conditioned on attachment avoidance/anxiety; and (3) attachment avoidance/anxiety would be associated with higher suicide risk via higher TB/PB. Method: Undergraduates (N = 187) completed surveys, and indirect effect and conditional effect analyses were utilized. Results: Overall attachment was associated with lower PB, which was associated with lower suicide risk. The relationship between overall attachment and suicide risk was not conditional upon attachment anxiety/avoidance. Attachment avoidance was associated with increased levels of TB, which was associated with increased suicide risk. Attachment anxiety was associated with increased suicide risk via TB and PB. Limitations: We used a university sample that had limited access to pets. Conclusions: Findings suggest that pet ownership may provide mixed associations with suicide risk.

The roles of weight stigma, emotion dysregulation, and eating pathology in suicide risk.

Using an interpersonal theory of suicide and affect regulation framework, we investigated the relationships between perceived burdensomeness, thwarted belongingness, weight stigmatization, emotion dysregulation, eating pathology, and suicide risk. Three main hypotheses were investigated. First, we predicted a positive linear relationship between weight stigmatization and risk. Second, an indirect effect of weight stigmatization on risk via perceived burdensomeness and thwarted belongingness was posited. Third, we hypothesized that weight stigmatization would indirectly affect suicide risk via emotion dysregulation and eating pathology. Undergraduates (N = 156) completed online surveys. Linear regressions and indirect effect analyses were performed. Weight stigmatization was directly, positively associated with increased suicide risk. Weight stigmatization indirectly affected suicide risk via perceived burdensomeness but not thwarted belongingness. Higher stigmatization was associated with higher levels of perceived burdensomeness, which was associated with higher risk. An indirect effect of weight stigmatization on suicide risk through emotional dysregulation emerged. Higher weight stigmatization was associated with higher emotional dysregulation, which was associated with higher suicide risk. When all models were combined, only an indirect effect via perceived burdensomeness remained. Our findings may have clinical and public health implications for suicide prevention among people with weight stigma-related risk factors.

The interaction of sociocultural attitudes and gender on disordered eating.

OBJECTIVE: The Tripartite Influence Model posits that social agents emphasize a thin ideal for women and a muscularity ideal for men. There is a gap in the literature of how sociocultural body ideal internalization affects overall disordered eating symptoms in men and specifically drive for muscularity in women. METHOD: The sample consisted of 1,929 participants (44.2% men) who completed online surveys. It was predicted that internalization would be a stronger predictor for overall disordered eating in women and for muscularity in men. RESULTS: Women with high internalization had increased disordered eating symptoms in comparison to men, whereas for men, increased internalization was linked to more drive for muscularity, as compared with women. CONCLUSIONS: It is important to emphasize, however, that men still exhibited higher rates of disordered eating symptoms when they had increased internalization and women exhibited an increased drive for muscularity when they had higher internalization.

Warning labels on fashion images: Short- and longer-term effects on body dissatisfaction, eating disorder symptoms, and eating behavior.

OBJECTIVE: Fashion warning labels that caution readers about digitally altered images have been recommended and adopted by several countries to prevent body dissatisfaction and eating disorders. This study investigated the short- and longer-term influence of fashion warning labels on affect, body dissatisfaction, eating disorder symptoms, and snack consumption using a randomized-controlled experiment. METHOD: Female undergraduates (n = 118) were randomized to view and rate responses to fashion images either with or without a warning label. They then consumed snacks and completed questionnaires. Sixty-four participants (54%) completed follow-up online surveys asking them to view and rate new fashion images with or without warning labels once per week for 4 weeks. Primary outcomes were affect, body dissatisfaction, eating disorder symptoms, and kilocalories consumed. RESULTS: Overall, fashion warning labels had no short-term effects on affect, body dissatisfaction, or kilocalories consumed in the lab. However, individuals who reported engaging in restrictive eating consumed fewer kilocalories when exposed to advertisements with warning labels (M = 170.33, SD = 120.78) versus no labels (M = 286.46, SD = 166.30), p = .008. Warning labels also had no protective effects after repeated exposure over 4 weeks on affect or eating disorder symptoms, and significantly increased appearance orientation (p = .001). DISCUSSION: Warning labels on media images are unlikely to be an effective policy tool to prevent negative affect, body dissatisfaction, and eating disorder symptoms, and, in some cases, may exacerbate these concerns.

An examination of the relationships between acculturative stress, perceived discrimination, and eating disorder symptoms among ethnic minority college students.

Empirical evidence suggests the importance of considering acculturative stress and perceived discrimination in understanding the mental health of ethnic minority groups, including their eating behaviors and associated psychopathology. The current study examined the effect of acculturative stress and perceived discrimination on eating disorder symptoms among ethnic minority undergraduate students. A total of 187 ethnic minority undergraduate students (41.2% men) completed this cross-sectional study by completing self-report questionnaires on a secure online system. Regression analyses revealed a main effect of acculturative stress on eating concern, shape concern, weight concern, drive for thinness, and bulimia but not restraint or body dissatisfaction. Gender moderated the effect of acculturative stress on drive for muscularity, suggesting that this effect was only significant in women, but not men. The main effect of perceived discrimination was significant for restraint, eating concern, shape concern, weight concern, and drive for muscularity but not drive for thinness, bulimia, or body dissatisfaction. Acculturative stress and perceived discrimination are important factors to consider in understanding the development and maintenance of eating disorder symptoms among ethnic minority populations. Targeting these two factors may improve the effectiveness of intervention programs for eating disorder symptoms among ethnic minority undergraduate students.

Empirically derived classes of eating pathology in male and female college students.

BACKGROUND: The empirical structure of eating disorder (ED) pathology has often been studied in female, clinical samples, leaving questions about the structure of ED pathology in males and nonclinical samples. METHOD: A latent class analysis was performed on data combined from two different studies (N = 1,751) using the behavioral items in the Eating Disorder Examination Questionnaire (EDE-Q; binge eating, self-induced vomiting, laxative use, and excessive exercise), with the addition of an item representing restraint. Validation analyses examined weight, shape, and eating concern among the classes. RESULTS: Three similar classes emerged for both the men and women's models: very low ED behaviors, binge eating, and high ED behaviors. DISCUSSION: These results suggest that binge eating occurs within the context of lower symptom and higher symptom presentations, and that the empirical structure of ED symptoms does not differ in men and women in the nonclinical population. Further research is needed to clarify whether ED phenotypes differ in men and women.

Bulimic symptoms and interpersonal functioning among college students.

Integrating interpersonal theory and the stress generation hypothesis, two studies investigated the association between bulimic symptoms and interpersonal distress and the mechanism underlying this association. In Study 1, 36 pairs of female roommates completed self-report questionnaires in a laboratory while Study 2 recruited 539 undergraduate men and women to participate in a longitudinal online study by completing self-report measures at two time points. Multilevel modeling revealed that targets' bulimic symptoms predicted roommates' intention to continue living with them in Study 1. Greater bulimic symptoms predicted lower intention. In Study 2, bulimic symptoms had a direct and an indirect effect on interpersonal distress, with reassurance-seeking as a mediator in the indirect effect. Findings replicated previous studies showing that bulimic symptoms generate further distress and, in our studies, interpersonal distress specifically. Moreover, reassurance-seeking was a newly identified mechanism underlying this association. These findings provide support for the usefulness of interpersonal theory and the stress generation hypothesis as a framework for understanding bulimic symptomatology. Clinicians may find it useful to target reassurance-seeking behaviors during the treatment of bulimic symptoms in order to improve treatment outcomes.

An Examination of the Connections Between Eating Disorder Symptoms, Perceived Burdensomeness, Thwarted Belongingness, and Suicide Risk Among Undergraduate Students.

Suicide attempts and premature mortality due to suicide are elevated in people with eating disorders. Informed by the interpersonal theory of suicide, two studies examined the role of perceived burdensomeness and thwarted belongingness in explaining the association between eating disorder symptoms and suicide risk. Results indicated that various eating disorder symptoms had an indirect effect on suicide risk through perceived burdensomeness and thwarted belongingness. Targeting perceived burdensomeness and thwarted belongingness may be useful for decreasing suicide risk among undergraduates with eating disorder symptoms.

The effects of social support and stress perception on bulimic behaviors and unhealthy food consumption.

Two studies tested a model where perceived stress was the proposed mediator for the relationship between perceived social support and bulimic behaviors, and between perceived social support and unhealthy food consumption among undergraduate students. Study 1 was a longitudinal, online study in which undergraduate students completed the Multidimensional Scale of Perceived Social Support and the Bulimia Test-Revised at the Time 1 assessment, and the Perceived Stress Scale and the Eating Disorder Examination Questionnaire at the Time 2 assessment, approximately four weeks later. Study 2 was an experimental study in which female participants were randomly assigned into a group with or without social support. Stress was induced with a speech task, followed by a bogus taste task paradigm designed to assess unhealthy food consumption. Bootstrap analyses revealed an indirect effect of perceived social support on bulimic behaviors and unhealthy food consumption through perceived stress. Perceived social support was associated with lower perceived stress in both studies. Lower perceived stress was associated with less self-reported bulimic behaviors in Study 1 and greater consumption of unhealthy foods in Study 2. The negative association between perceived stress and calorie consumption in Study 2 was moderated by dietary restraint. Findings suggest that stress perception helps to explain the relationship between perceived social support and bulimic behaviors, and between perceived social support and calorie consumption. Stress perception may be an important treatment target for eating disorder symptoms among undergraduate students.

An examination of the prospective impact of bulimic symptoms and dietary restraint on life hassles and social support.

BACKGROUND: The stress generation hypothesis posits that individuals with psychopathology engage in maladaptive behaviors that create stress. Although extensively researched in the depression literature, few studies have investigated whether the stress generation hypothesis applies to eating disorders. This study examined whether bulimic symptoms and dietary restraint predict future life hassles and low social support among undergraduate students. METHODS: Three hundred seventy-four undergraduate students participated in this two-part prospective study through a secure online system. They completed questionnaires assessing depressive symptoms, bulimic symptoms, dietary restraint, life hassles, and social support. RESULTS: Regression analyses revealed that baseline bulimic symptoms predicted greater life hassles but not lower social support one month later, after statistically controlling for baseline measures. Baseline dietary restraint did not predict future life hassles or social support. LIMITATIONS: Limitations include use of self-report measures, suboptimal response rates at the follow-up assessment, and use of a non-clinical sample with primarily White participants. CONCLUSIONS: These results provide preliminary support for the stress generation hypothesis in relation to bulimic symptoms. Individuals with bulimic symptoms may generate stressors similar to those experiencing depressive symptoms. Our findings suggest that emphasizing stress management in the treatment of individuals with bulimic symptoms could potentially improve treatment outcomes.

Emotion Dysregulation and Affective Intensity Mediate the Relationship Between Childhood Abuse and Suicide-Related Behaviors Among Women with Bulimia Nervosa.

Self-harm and suicide attempts occur at elevated rates among individuals with bulimia nervosa, particularly among those who have experienced childhood abuse. This study investigated the potential mediating roles of emotion dysregulation and affective intensity in the relationship between these variables in 125 women with bulimia nervosa. Analyses revealed that emotion dysregulation mediated the relationship between sexual and emotional abuse with both self-harm and suicide attempts. Negative affective intensity mediated the relationship between abuse and suicide attempts. The findings may advance the understanding of mechanisms underlying suicide-related behaviors in women with bulimia nervosa who experienced abuse and suggest potential clinical targets.

Gender differences in coping responses and bulimic symptoms among undergraduate students.

This prospective study examined the predictive role of three types of coping responses (i.e., voluntary disengagement, involuntary engagement, and involuntary disengagement) in response to social stress on bulimic symptoms among undergraduate women and men. A total of 883 (308 men; 35%) participants completed the Response to Stress Questionnaire, the Beck Depression Inventory, and the Eating Disorder Inventory (EDI) at baseline assessment and the EDI at follow-up assessment 8-12 weeks later. After controlling for baseline bulimic symptoms, depression, and body dissatisfaction, involuntary disengagement predicted bulimic symptoms at follow-up among men (b=.21, p<.001), but not among women (b=.06, p>.05). Results indicated that men who responded to social stress through involuntary disengagement (e.g., emotional numbing, inaction) had higher risk for increased bulimic symptoms. Future studies are needed to replicate these findings and to further understand the role of these coping responses on bulimic symptoms.