Pornography use, problematic pornography use, impulsivity, and sensation seeking: a meta-analysis.

BACKGROUND: While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU. AIM: The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship. METHODS: A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher's Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger's regression intercept. OUTCOMES: Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU. RESULTS: Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher's Z = 0.21, P < .001) and PPU (n = 20174, k = 13, Fisher's Z = 0.17, P < .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher's Z = 0.14, P < .001) and PPU (n = 20152, k = 9, Fisher's Z = 0.06, P < .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (ß = -0.50, Q = 101.26, df = 11, P < .001) and gender (female = 1; ß = -0.46, Q = 102.54, df = 12, P < .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged. CLINICAL IMPLICATIONS: Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences. STRENGTHS AND LIMITATIONS: The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since >30% of relevant studies had to be excluded because information could not be gathered from the study authors. CONCLUSION: These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.

Self-awareness and Social Influences as Predictors of Body Dissatisfaction and Acceptance of Cosmetic Surgery for Social Reasons Among Men.

BACKGROUND: Body dissatisfaction and the use of surgery for purely aesthetic reasons among men is steadily increasing. Nevertheless, compared to women, few studies have focused on specific sociocultural and individual factors predicting men's body dissatisfaction and interest in cosmetic surgery procedures. The present study investigated the role of media, significant others, public and private self-awareness in predicting men's body dissatisfaction and acceptance of cosmetic surgery for social reasons. METHODS: Participants were 203 men (mean-age 24 years), who completed a questionnaire containing the Sociocultural Attitudes Toward Appearance Questionnaire-4R, the Situational Self-Awareness Scale, the Muscular internalization subscale, the Male Body Attitudes Scale, and the Social subscale of the Acceptance of Cosmetic Surgery Scale. A path analysis was performed. RESULTS: The influence of significant others and public self-awareness predicted men's body dissatisfaction directly and indirectly, via muscularity internalization, while media was only directly associated with body dissatisfaction. A significant link between private self-awareness and body dissatisfaction was found. Moreover, media was not associated with cosmetic surgery either directly or indirectly and public self-awareness showed only a significant association with internalization. CONCLUSIONS: These findings provide information about the role that self-awareness and sociocultural factor play on body dissatisfaction and acceptance of surgery for social reasons among men. The study highlighted the importance of designing preventive programs aimed at enhancing men's ability to resist various forms of pressure regarding body image and its management. Moreover, the advantages of focusing one's attention on internal states and feelings can limit body dissatisfaction and can discourage consideration of cosmetic surgery for social benefits. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Measurement invariance of the Liebowitz Social Anxiety Scale-Self-Report.

OBJECTIVE: The Liebowitz Social Anxiety Scale-Self Report (LSAS-SR) is a self-report measure of social anxiety (SA), which has shown adequate psychometric properties across cultures. However, no study has systematically evaluated its measurement invariance (MI) between (a) individuals with and without a diagnosis of social anxiety disorder (SAD) and (b) males and females. The current study addresses this issue. METHODS: We collected data on 257 (158 females) Italian individuals diagnosed with SAD and 356 (232 females) community-dwelling adults. RESULTS: We initially found support for the unidimensionality of the Italian LSAS-SR measurement model in all samples. Using the Graded Response Model, we obtained evidence of partial MI and differential item functioning between community-dwelling and SAD-diagnosed individuals and evidence of strong MI between male and female participants. CONCLUSIONS: The results of this study suggest that the Italian LSAS-SR measures the same trait in the same way across the symptom continuum and sexes, making it a psychometrically sound tool for assessment, screening, and research purposes.

Retouched or Unaltered? That is the Question. Body Image and Acceptance of Cosmetic Surgery in Young Female Instagram Users.

BACKGROUND: Viewing Instagram altered images of attractive women has negative effects on women's body image. This study examined the effects of exposure to a 'before' and 'after' retouched image, in combination with a disclaimer, on female Instagram users' thin-ideal internalization, body dissatisfaction and acceptance of cosmetic surgery. METHODS: An experimental design with a control group without pretesting was adopted. Participants (N = 105) were randomly assigned to one of three groups: Group 1 was exposed to a replica of an Instagram post with an enhanced image of a woman; Group 2 was shown the same enhanced image and the original one in combination with a disclaimer that the enhanced image had been digitally edited; Group 3 (the control) was exposed to a neutral image. RESULTS: The MANOVA showed that participants in Group 2 reported lower levels of thin-ideal internalization and acceptance of cosmetic surgery for social reasons compared to those in Group 1. Contrary to our hypothesis, the degree of body dissatisfaction was not significantly different among the three groups. CONCLUSIONS: The present study could be promising for the development of brief interventions aimed at reducing the negative effects of Instagram exposure on young women's body image. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Predictors of Acceptance of Cosmetic Surgery: Instagram Images-Based Activities, Appearance Comparison and Body Dissatisfaction Among Women.

BACKGROUND: This study aimed to test a model in which Instagram images-based activities related to self, friends, and celebrities were associated with acceptance of cosmetic surgery via Instagram appearance comparison and body dissatisfaction. We predicted that Instagram use for images-related activities involving celebrities and self (but not friends) was associated with acceptance of cosmetic surgery both directly and indirectly. METHODS: The study participants were 305 Italian women (mean age, 23 years). They completed a questionnaire containing the Instagram Image Activity Scale, the Instagram Appearance Comparison Scale, the Body Shape Questionnaire-14, the Acceptance of Cosmetic Surgery Scale. A path analysis was performed in which the Instagram images-based activities were posited as predictors of the Instagram appearance comparison, body dissatisfaction and acceptance of cosmetic surgery, respectively. RESULTS: We found that only image-based activities related to celebrities and self were significantly related to acceptance of cosmetic surgery, whereas friends' Instagram-related activities were not significantly related to this criterion variable. Moreover, the indirect effect of both Instagram self- and celebrities-images activities on acceptance of cosmetic surgery through Instagram appearance comparison and body dissatisfaction was significant. Friends' Instagram images-related activities were not associated with acceptance of cosmetic surgery. CONCLUSIONS: Overall, these findings provide information about the role that activities carried out on Instagram, appearance comparison and body dissatisfaction, play on the acceptance of surgery for aesthetic reasons among women. The study highlighted the importance for surgeons to consider some psychological aspects and the influence of sociocultural factors on the interest for cosmetic surgery. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Invited Response on: "Letter to the Editor: Predictors of Acceptance of Cosmetic Surgery- Instagram Images-Based Activities, Appearance Comparison and Body Dissatisfaction Among Women".

This response letter highlights the importance for cosmetic surgeons to take a psychosocial perspective, considering the role of social media influences on the acceptance of cosmetic surgery in young women. Furthermore, through this article we have provided a brief overview of possible interventions useful to prevent the negative influences that social media can have on body image and the acceptance of procedures aimed at modifying one's body for purely aesthetic reasons. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Measuring childbirth-related posttraumatic stress disorder: Psychometric properties of the Italian version of the City Birth Trauma Scale (City BiTS).

OBJECTIVE: The City Birth Trauma Scale (City BiTS) assesses postpartum posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria. Although it has been validated worldwide, predictive validity has not been previously examined. Moreover, no Italian version of the scale exists. This study aimed to test the bifactor latent structure and alternative models, internal consistency, test-retest reliability, convergent validity, divergent validity, and predictive validity of the City BiTS. METHOD: Women (N = 629) who had given birth within the past 3 months completed an online survey including sociodemographic and obstetric characteristics, the City BiTS, the Impact of Event Scale-Revised, and the Edinburgh Postnatal Depression Scale. After 3 months, women completed the City BiTS again and reported their intention to breastfeed during the 1-year postpartum. RESULTS: Exploratory factor analysis confirmed the two-factorial structure. In confirmatory factor analysis, the two-factorial solution showed the best model fit. Internal consistency was good to excellent for the subscales and the total scale. Correlation analyses showed strong convergent validity with the Impact of Event Scale-Revised, high divergent validity with the Edinburgh Postnatal Depression Scale, high test-retest reliability, and good predictive validity with the intention to exclusively breastfeed. Moreover, the Birth-Related Symptoms subscale distinguished between different types of delivery. CONCLUSIONS: The City BiTS-Italian is the first measure evaluating and diagnosing childbirth-related PTSD symptoms based on Diagnostic and Statistical Manual of Mental Disorders (5th ed.) in Italy. The factorial structure and validity reported in other cultural contexts were confirmed; moreover, findings add evidence to the scale's temporal stability and predictive validity. Besides contributing to clinical purposes, the City BiTS-Italian will facilitate international comparability regarding the prevalence of PTSD following childbirth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Positive Body Image and Psychological Wellbeing among Women and Men: The Mediating Role of Body Image Coping Strategies.

This study aimed to examine the mediating role of body image coping strategies in the relationship between positive body image and wellbeing. Three hundred and seventy-two women and three hundred and seventy-seven men completed a questionnaire assessing body appreciation, body appreciation functionality, body compassion, body image coping strategies (appearance fixing, avoidance, positive rational acceptance), self-acceptance and overall psychological wellbeing. Path analysis showed that avoidance significantly mediated the relationship between body appreciation and overall psychological wellbeing among both women and men; its mediating role was confirmed for men's but not for women's self-acceptance. Positive rational acceptance was a significant mediator of the relationship between body compassion and both psychological wellbeing and self-acceptance among men but not among women. These findings show that higher body appreciation is associated with a lower tendency to avoid appearance-related cognitions or thoughts that are interpreted as threatening, with an indirect effect on women's and men's psychological wellbeing. Analogously, but only for men, body compassion is associated with mental activities and self-care behaviors that foster rational self-talk and the acceptance of one's experiences, which, in turn, are linked to higher wellbeing. These findings can help to plan programs aimed at fostering individuals' wellbeing by focusing on their positive body image considering gender differences.

My Exposed Body: Psychometric Properties of the Italian Version of the Social Physique Anxiety Scale-7 among Women.

BACKGROUND: Social Physique Anxiety (SPA) is the anxiety resulting from the prospect or presence of the interpersonal evaluation of one's physique. It is a construct related to body image and body esteem. The Social Physique Anxiety Scale-7 (SPAS-7) is a self-report scale aimed at measuring the degree of anxiety that people experience when others evaluate their physique. METHODS: This study aimed to investigate the factor structure (through Confirmatory Factor Analysis followed by multi-group confirmatory factorial analyses), reliability, and convergent validity of an Italian version of the SPAS-7 among a sample of women (N = 520; mean age = 33.5, SD = 10.5). RESULTS: Confirmatory Factor Analysis attested the unidimensional factorial structure of the SPAS-7, which achieved full invariance across age groups. The strength of the inter-relationships between the SPAS-7 and measures of negative (i.e., body dissatisfaction) and positive body image (i.e., body appreciation and body compassion) provided evidence of good convergent validity. The Cronbach's alpha was very good. CONCLUSION: According to our results, the Italian version of the SPAS-7 could be a valid and agile instrument for assessing self-presentational concerns associated with body image among Italian-speaking women across age.

Proxemic Behaviors During Gay/Straight Interactions: An Automated Analysis Through Kinect Depth-Sensing Camera.

Through two experimental studies (N = 150), we investigated proxemic behaviors featuring gay/straight dyadic interactions. In doing so, for the first time, we relied on an IR depth camera and considered the interpersonal volume between the interactants, a novel feature that exhaustively captures interactants' proxemic behaviors. Study 1 revealed that the straight participants' implicit sexual bias - but not the explicit prejudice - significantly predicted their volume while interacting with a study accomplice who was presented as gay (vs. straight). However, unlike previous research, mixed-model analyses revealed the higher their implicit bias was, the smaller the interpersonal volume that they maintained with the gay study accomplice, especially when the conversation focused on an intergroup-related (vs. neutral) topic. Study 2 was mainly designed to deepen this main finding. Results documented that highly implicitly biased participants who maintained a smaller interpersonal volume with a gay (vs. straight) study accomplice were more cognitively depleted after the interaction than low-biased participants, possibly suggesting that highly implicitly biased straight people can control this nonverbal behavior to appear as nonprejudiced in the gay interactant's eyes. Implications for research on sexual prejudice and intergroup nonverbal behaviors are discussed.

Not All That Glitters Is Gold: Attractive Partners Provide Joys and Sorrows.

Through a 2 × 2 experimental vignette design, we tested if partner perceived attractiveness in interaction with appearance-related comments from one's partner might affect women and men's body dissatisfaction, body shame, acceptance of cosmetic surgery, and perceived relationship quality. Participants were 154 women and 157 men living in Italy (mean age = 30.97; all of them were in a couple relationship), who read a vignette describing the purchase of a swimsuit, through which partner attractiveness (poor versus high) and partner commentary (negative versus positive) were manipulated. Some ANCOVAs were performed on women and men separately. For men, partner commentary affected body dissatisfaction with low body fat. Moreover, the main effect of partner attractiveness was found in their consideration of undergoing cosmetic procedures. Among women, a significant partner attractiveness X partner commentary interaction effect emerged on acceptance of cosmetic surgery for social reasons. As regards relationship quality, for women, there was a main effect of partner attractiveness on relational communication, while a marginally significant interaction effect between partner attractiveness and partner commentary emerged for men's self-disclosure. Our findings suggest that partner attractiveness is generally beneficial, but when combined with negative feedback concerning the appearance, it might lose its advantages. These findings should be considered for planning interventions aimed at both preventing body dissatisfaction and acceptance of cosmetic surgical procedures for not medical reasons and promoting relationship satisfaction among women and men.

The Power of Words: Appearance Comments from One's Partner Can Affect Men's Body Image and Women's Couple Relationship.

BACKGROUND: The purpose of the present study was to examine, through an experimental vignette design, the effects of appearance-related comments from one's partner on body image and the perceived quality of one's relationship. Body image was considered both in negative (body dissatisfaction) and positive (body compassion) terms. METHODS: Appearance-related commentary from one's partner was manipulated through a vignette describing the purchase of a swimsuit. The participants (n = 211) were women and men who were randomly assigned to one of the three experimental conditions (positive comment, negative comment, no comment). RESULTS: A series of ANOVAs showed different findings for women and men. Being criticized for body weight and shape caused an increase in body dissatisfaction and a decrease in body compassion in men but not in women. Regarding couple satisfaction, women who imagined receiving a compliment about their body perceived being more accepted by their partner and were less afraid of being abandoned or rejected. CONCLUSIONS: Our findings highlight the importance of appearance-based comments from one's partner on men's body image and on women's perception of their couple relationship. Therefore, appearance comments might be addressed by interventions aimed at enhancing positive body image, reducing body dissatisfaction, and fostering couple relationships, carefully considering sex differences.

Exploring the Links Between Self-Compassion, Body Dissatisfaction, and Acceptance of Cosmetic Surgery in Young Italian Women.

This study aimed to examine the association between positive (self-kindness, common humanity, and mindfulness) and negative (isolation, self-judgment, and over-identification) components of self-compassion, and both body dissatisfaction and acceptance of cosmetic surgery among women, through the mediation (for the negative components) of internalization and physical appearance comparison. The participants were 220 young Italian women aged 19-31 (M = 21) years, who completed a questionnaire assessing the variables of interest. Path analysis indicated that higher mindfulness was directly linked to lower acceptance of cosmetic surgery. Mindfulness presented the strongest link with cosmetic surgery, as it was directly associated with acceptance of cosmetic surgery for both social and interpersonal motivations and with consideration of undergoing some cosmetic procedures. Common humanity and self-kindness were related to acceptance of cosmetic surgery for social reasons. Over-identification seemed to be associated with body dissatisfaction and acceptance of cosmetic surgery both directly and indirectly through internalization and physical appearance comparison. Self-judgment and isolation did not present a significant association with either body dissatisfaction or acceptance of cosmetic surgery. These findings confirm that psychological assessment of women who are interested in cosmetic surgery is highly recommended. Interventions should not consider self-compassion as a whole, but they should rather focus on some of its components. The role of over-identification seems to be especially pivotal, as higher scores on this dimension are linked to higher levels of body dissatisfaction and greater acceptance of cosmetic surgery.