A case report demonstrating the efficacy of a comprehensive cognitive-behavioral therapy approach for treating anxiety, depression, and problematic eating in polycystic ovarian syndrome.

Despite elevated prevalence of anxiety and depression among women with polycystic ovarian syndrome (PCOS), there is a dearth of evidence-based psychotherapies to treat mood-related symptoms among this population. This case report describes the efficacy of The PCOS Workbook in treating symptoms of anxiety, depression, and problematic eating in a 19-year-old female previously diagnosed with PCOS. Using the cognitive-behavioral framework presented in the workbook, the participant experienced a significant reduction in symptoms of anxiety, depression, problematic eating, and general psychosocial dysfunction while simultaneously losing a significant amount of weight during treatment. Six months after the termination of treatment, the participant maintained several improvements in psychological functioning, although she did report a resumption of problematic eating and experience weight regain. These findings provide initial empirical support for the efficacy of this manualized psychotherapy at improving psychosocial functioning in women with PCOS. Recommendations on ways to best utilize this resource and enhance its long-term efficacy, particularly when intervening for problematic eating, are also discussed.

Patients' perceptions of laparoendoscopic single-site surgery: the cosmetic effect.

BACKGROUND: Laparoendoscopic single-site (LESS) surgery can be performed without apparent scarring, while maintaining the salutary benefits of conventional laparoscopic surgery. The purpose of this study was to compare patients' preoperative and postoperative perceptions of LESS surgery. METHODS: Before and after undergoing LESS surgery, 120 patients were given questionnaires; their responses were assimilated and analyzed. RESULTS: Of 120 patients, 62% were female (age, 52 ± 16.6 y), and 54% had prior abdominal surgery. Preoperatively, women and older patients reported heightened appearance dissatisfaction. Preoperatively, most patients would not accept more risk, pain, surgery/recovery times, and/or costs than associated with standard laparoscopy. Postoperatively, patients reported increased satisfaction in their overall and abdominal region appearance. Satisfaction was noted by 92%; satisfaction was related significantly to scar appearance and cosmesis. CONCLUSIONS: Preoperatively, patients were most concerned with safety; postoperatively, patients' concerns shifted to cosmetic outcome. LESS surgery provides an opportunity for improved patient satisfaction.

Genetic and environmental influences on thin-ideal internalization.

OBJECTIVE: Current research on the etiology of thin-ideal internalization focuses on psychosocial influences (e.g., media exposure). The possibility that genetic influences also account for variance in thin-ideal internalization has never been directly examined. This study used a twin design to estimate genetic effects on thin-ideal internalization and examine if environmental influences are primarily shared or nonshared in origin. METHOD: Participants were 343 postpubertal female twins (ages: 12-22 years; M = 17.61) from the Michigan State University Twin Registry. Thin-ideal internalization was assessed using the Sociocultural Attitudes toward Appearance Questionnaire-3. RESULTS: Twin modeling suggested significant additive genetic and nonshared environmental influences on thin-ideal internalization. Shared environmental influences were small and non-significant. DISCUSSION: Although prior research focused on psychosocial factors, genetic influences on thin-ideal internalization were significant and moderate in magnitude. Research is needed to investigate possible interplay between genetic and nonshared environmental factors in the development of thin-ideal internalization.

Public perception of LESS surgery and NOTES.

INTRODUCTION: This study was undertaken to determine public attitudes toward laparoendoscopic single-site (LESS) surgery and natural orifice transluminal endoscopic surgery (NOTES) and to determine how they are impacted by age, gender, and obesity. METHODS: One hundred fifty-two citizens completed a validated questionnaire. Pearson correlations were computed to determine relationships among items queried. Scores ranged from 1 (lowest) to 5 (highest) and are presented as median, mean ± SD. RESULTS: The citizens generally liked their physique (4, 4 ± 1.0) and felt attractive (4, 4 ± 1.0). LESS surgery was appealing if it involved no more risk or recovery and none to minimally more pain, operative time, and cost. Older and heavier citizens were more interested in reduced risk, pain, and operative/recovery time and less interested in scarring/appearance. Thirty-nine percent would consider NOTES, though only with no more risk, pain, operative time, and cost (<$200). Older people regarded NOTES more favorably. Lack of scarring with NOTES was most important by only 32% of those participants that would consider undergoing a NOTES procedure. CONCLUSION: Acceptance of LESS surgery and NOTES depends upon no additional risk and no or minimally increased pain, recovery time, and cost. Improved cosmesis is not generally a priority, particularly in older or heavier people. Safety, pain, and recovery time remain major issues in deciding operative choices.

Cosmetic surgery reality TV viewership: relations with cosmetic surgery attitudes, body image, and disordered eating.

BACKGROUND: According to the American Society of Plastic Surgeons (2007), the number of cosmetic procedures has increased to over 10 million in 2006, representing a 48% increase from 2000. This increase in cosmetic surgery prevalence is paralleled by a surge in reality cosmetic surgery television programming. METHODS: The current study examined the relationships among cosmetic surgery reality TV viewership, cosmetic surgery attitudes, body image, and disordered eating in a sample of 2057 college women. RESULTS: Viewership of reality cosmetic surgery shows was significantly related to more favorable cosmetic surgery attitudes, perceived pressure to have cosmetic surgery, past attainment of a cosmetic procedure, a decreased fear of surgery, as well as overall body dissatisfaction, media internalization, and disordered eating. CONCLUSIONS: Although the current study is correlational, it provides a framework for future hypothesis testing and elucidates the link between contemporary media influences, body dissatisfaction, disordered eating, and cosmetic surgery attitudes. Additionally, the findings indicate that surgeons may want to assess the relevance of cosmetic surgery reality TV viewership for patients' attitudes towards and expectations about cosmetic surgery.

Appearance motives to tan and not tan: evidence for validity and reliability of a new scale.

BACKGROUND: Risk for skin cancer is increased by UV exposure and decreased by sun protection. Appearance reasons to tan and not tan have consistently been shown to be related to intentions and behaviors to UV exposure and protection. PURPOSE: This study was designed to determine the factor structure of appearance motives to tan and not tan, evaluate the extent to which this factor structure is gender invariant, test for mean differences in the identified factors, and evaluate internal consistency, temporal stability, and criterion-related validity. METHOD: Five-hundred eighty-nine females and 335 male college students were used to test confirmatory factor analysis models within and across gender groups, estimate latent mean differences, and use the correlation coefficient and Cronbach's alpha to further evaluate the reliability and validity of the identified factors. RESULTS: A measurement invariant (i.e., factor-loading invariant) model was identified with three higher-order factors: sociocultural influences to tan (lower order factors: media, friends, family, significant others), appearance reasons to tan (general, acne, body shape), and appearance reasons not to tan (skin aging, immediate skin damage). Females had significantly higher means than males on all higher-order factors. All subscales had evidence of internal consistency, temporal stability, and criterion-related validity. CONCLUSIONS: This study offers a framework and measurement instrument that has evidence of validity and reliability for evaluating appearance-based motives to tan and not tan.

Viewership of pro-eating disorder websites: association with body image and eating disturbances.

OBJECTIVE: To evaluate the association between pro-eating disorder website viewership and concurrent levels of body dissatisfaction and eating disturbance. METHOD: A sample of 1575 women were surveyed for viewership of a variety of websites, including those promoting disordered eating (pro-eating disorder) and those providing information about eating disorders (professional). RESULTS: Individuals who frequented pro-eating disorder sites had higher levels of body dissatisfaction and eating disturbance than a control group. The group who frequented only professional information websites, but not pro-eating disorder websites, differed from controls on only one of the four measures of disturbance. The pro-eating disorder group did not differ from the professional group on any measure. CONCLUSION: The findings offer moderate evidence indicating that viewers of pro-eating disorder sites have higher levels of disturbance than a control sample of nonviewers, but limited evidence that those who view pro-eating disorder sites differ from individuals who view professional sites offering information regarding eating disorders. The findings are discussed in light of the difficulty determining causality in this area of inquiry and a cautionary note regarding the potential iatrogenic effects of this type of research is offered.

The influence of communicator weight on psychoeducational message acceptance in females with high vs. low levels of body image disturbance.

Researchers have yet to examine the effect of the communicator's weight status on participants' responses to an eating disorder or body dissatisfaction prevention program. It is plausible that participants may be reactive to the weight of the communicator (e.g., therapist), which might adversely affect acceptance of the message contained in the program. In the current study, 217 college females were randomly assigned to three communicator weight conditions (underweight, average weight, and overweight). Participants in each group were subdivided by trait body dissatisfaction level, based on a median split. The procedure involved the implementation of a well-established psychoeducational intervention designed to decrease endorsement of the thin-ideal. Results supported the overall efficacy of the intervention but indicated a minimal effect for participant's trait dissatisfaction level and communicator weight status on a variety of outcome measures. Limitations of the current study are provided, as well as recommendations for future research.