Racial and body image differences in coping for women diagnosed with breast cancer.

Although more White women develop breast cancer, African American women more frequently die of the disease (American Cancer Society, 2003). Despite higher morbidity among African American women, few studies have included racially diverse samples. The purposes of this study were to explore racial and body image differences in coping and self-efficacy in coping and racial differences in body image perceptions among breast cancer patients. The 92 participants ranged in age from 28 to 86 years (M=57.64, SD=12.48). Participants with higher body image perceptions had significantly higher self-efficacy in coping compared with participants with lower body image perceptions. There were no significant racial or ethnic differences in coping, self-efficacy in coping, or body image perceptions.     

Relations among exercise type,self-objectification,and body image in the fitness centre environment: The role of reasons for exercise

ObjectiveThe study aimed to investigate different types of exercise, the role of exercise motivation and body image outcomes within the fitness centre environment.Design and methodParticipants were 571 female fitness class participants recruited from fitness centres. They ranged in age from 18 to 71 years and participated in a variety of fitness activities both within and outside of the fitness centre environment. Reasons for exercise, self-objectification, body esteem, and disordered eating symptomatology were assessed using questionnaire measures.ResultsTime spent exercising within the fitness centre environment was more highly related to body image and eating disturbance than time spent exercising outside of the fitness centre environment. Participation in cardio-based workouts (e.g., cardiovascular machines) was positively related to self-objectification, disordered eating behaviour, and appearance-related reasons for exercise, and negatively related to body esteem. In contrast, participation in yoga-based fitness classes was related to lower self-objectification and exercising more for health and fitness. Appearance-focused reasons for exercise were found to mediate the relationship between exercise types and self-objectification, disordered eating, and body esteem.ConclusionThe results show that the reasons women have for doing exercise provide a mechanism through which different types of exercise are associated with negative body image outcomes. Thus, despite the physical health-related benefits associated with regular physical activity, exercise motivated by appearance reasons (e.g., weight control) can lead to poorer body image in some women.     

Body image issues in women with breast cancer

Diagnosis and treatment of breast cancer affects women physically as well as psychologically. There are many obvious and real factors that are related to psychological distress in women coping with breast cancer, such as facing a life-threatening illness, painful and impairing treatments, and significant role changes. Although these factors are clearly important, issues related to body image in women faced with breast cancer can also add to psychological distress. Women, in general, are concerned with their appearance, their weight, and their body, with recent studies suggesting 89% of women reported concerns with weight. Such premorbid concerns are often deeply ingrained and can contribute to psychological distress in women treated for breast cancer. The present article is a summary of the literature that has examined body image issues and related psychological adjustment in women with breast cancer. Implications for clinical practice and recommendations for future investigations are discussed.     

Beyond Body Size: Focusing on Body Functionality to Improve Body Image Among Women Who Have Undergone Bariatric Surgery

This study investigated a novel technique to improve body image among women who have undergone bariatric surgery—namely, by having them focus on their body functionality (everything the body can do, rather than how it looks). Participants were 103 women (M_age = 46.61) who had undergone bariatric surgery 5–7 months prior to the study. They were randomized to the 1-week online intervention, comprising three functionality-focused writing exercises (Expand Your Horizon; Alleva et al., 2015), or to a wait-list control group. Body appreciation, appearance and functionality satisfaction, body awareness, self-objectification, self-esteem, and self-kindness were assessed at pretest, posttest, and at 1-week and 3-month follow-up. Multilevel modeling analyses showed that, compared to the control, the intervention group experienced improved body appreciation at posttest, and these improvements persisted at both follow-ups. These findings were nonsignificant when intent-to-treat analyses were performed. Both available case and intent-to-treat analyses showed that all participants experienced improvements in facets of body image across time. Qualitative analyses of participants’ responses to the intervention writing exercises provided more insight. Via coding reliability thematic analysis, we identified 11 themes that together provide evidence that intervention participants experienced facets of a more positive body image, while also facing challenges to their body image and well-being. Together, findings suggest that focusing on body functionality may contribute to improved body image among women who have undergone bariatric surgery, but effects may be nuanced compared to prior functionality research among general samples of women. The study was registered retrospectively (ClinicalTrials.gov; identifier NCT04883268).     

Spirituality Among College Freshmen: Relationships to Self‐Esteem,Body Image,and Stress

The authors investigated the relationships between spirituality, body image, self‐esteem, and stress in 204 college freshmen who identified themselves as being highly spiritual. A positive relationship was found between spirituality and self‐esteem. Although self‐esteem was found to be negatively related to stress, spirituality served as a buffer in this relationship. When gender of participants was examined, men and women did not differ in spirituality. Greater spirituality was related to lower body surveillance, an aspect of body image, for men, but it was not related to body image for women. Overall, however, women experienced greater body image dissatisfaction than did men.     

Patient Motivation, Satisfaction, and Coping in Genetic Counseling and Testing for BRCA1 and BRCA2

Women with a strong family history of breast and/or ovarian cancer can now have genetic testing, that may identify mutations associated with increased cancer predisposition. Within the context of a clinical trial evaluating printed educational materials, we examined motivation, satisfaction, coping, and perceptions of genetic counseling and testing among 159 women who underwent pretest counseling and made a testing decision. Ninety-six percent of the participants elected to have BRCA1/2 testing. When making a decision about genetic testing, study participants were concerned less about the potential negative effects that could result from testing than the potential benefits. After counseling, participants said that they felt better able to make decisions that were right for them and that their questions and concerns were adequately addressed during the session. Ninety-five percent of the women were satisfied with their test decision. Participants used a range of strategies to cope with thoughts and feelings about cancer and/or genetic testing immediately following test decision. Results suggest that the genetic counseling session helped women make decisions about testing for BRCA1 and BRCA2, even in the setting of a trial in which all women also received detailed educational materials. Further, the results indicate that future research focusing on perceptions of risks and benefits of testing and of coping strategies immediately following test decision may be warranted.     

The link between women's body image disturbances and body-focused cancer screening behaviors: A critical review of the literature and a new integrated model for women

A large body of literature demonstrates the association between body image disturbances and health compromising behaviors among women (e.g., pathological eating, substance use, inappropriate exercise). However, given that disturbed body image is a pervasive problem, it is likely inversely related to health maintenance behaviors. Cancer screenings for breast, skin, and cervical cancer represent an important type of health maintenance behavior, yet adherence rates are low. Given the body-focused nature of these screenings, body image may be a salient predictor. This paper reviews the literature on the relationship between body image disturbances and cancer screening behaviors among women culminating in the proposal of a theoretical model. This model posits that body shame and body avoidance predict performance of cancer screenings and that variables drawn from the cancer literature, including risk perception, health anxiety, subjective norms, and self-efficacy, may moderate this relationship. Clinical implications and suggestions for research are discussed.     

The stage-specific role of spirituality among African American Christian women throughout the breast cancer experience

This study presents the results of semistructured interviews conducted with 18 African American Christian women regarding the role of spirituality throughout their breast cancer experiences. The spiritual themes relevant for phases of the breast cancer experience are identified. Analysis resulted in the identification of 11 codes and 5 subcodes that corresponded to the diagnosis, treatment, and posttreatment phases of the breast cancer experience. Most of the survivors indicated that their spirituality and faith assisted them throughout the breast cancer experience. Discussion focuses on the spiritual resources used by the participants at the different stages in the breast cancer experience. Attention is given to implications for how professionals can use these resources to assist African American women coping with breast cancer.     

Move2Love and Vibrancy: Community Dance/Fitness

The Move2Love program demonstrates the feasibility of establishing community-based programs involving dance and exercise to support physical and social well-being in older women. The social fitness program has been running continuously for 23 years. It currently involves 125 to 175 women between the ages of 54 and 94 in weekly rhythmic training sessions. In addition to meeting the initial goals of addiction avoidance in an at-risk population, this program has contributed to the well-being of participants, both by lowering disease burden, and by increasing physical, social, and psychological fitness. This article describes the program and explores the reasons that it has continued to work for over two decades. It also demonstrates the value experienced by participants in their own words. The Move2Love program could serve as a feasibility pilot for other communities wishing to create sustainable, salutary activity programming to enhance the well-being of senior women.     

Physical fitness, body image, and locus of control in college freshman men and women

This study examined the relations among physical fitness, body image, and locus of control. The Hall-Physical Fitness Test Profile, the Winstead and Cash Body Self-relations Questionnaire (BSRQ) and the Nowicki-Strickland Locus of Control Scale were administered to 243 freshmen. Women were significantly more positive about their physical appearance than men. Men were more positive about their physical fitness than women. Men were more physically fit than women. Men and women scoring in the internal direction viewed the physical fitness domain of their body image positively. Unlike men, internally oriented women had more positive perceptions of the health aspect of their body image. Physically fit men and women had positive attitudes toward the physical fitness component of their body image. Physically fit men differed from physically fit women in that men were more internal and held more positive attitudes toward the physical health dimension of their body images.     

An investigation of preconditions necessary for the introduction of a campaign to promote breast self-examination amongst Zimbabwean women

This study examines elements of the health belief model as predictors of intentions to self-examine breasts in two samples of women. Undergraduate samples from London and Harare are compared on levels of knowledge of breast cancer and breast self-examination (BSE), and on scales measuring perceived susceptibility to breast cancer, exposure to information and experience of breast cancer and perceived costs, barriers and benefits of BSE. Analysis of results indicates that an education campaign to promote awareness and the practice of BSE which incorporates factors of the health belief model could increase the number of Zimbabwean women performing this valuable preventive health behaviour.     

To Learn the World Again: Examining the Impact of Elective Breast Surgery on Body Schema

This paper comprises a feminist phenomenological exploration of women’s experiences with breast augmentation and breast reduction. Situating the results of semi-structured interviews in the context of body schema, this study discloses how women perceive, think, feel and respond to bodily change created by elective breast surgery. Women’s narratives express that breast augmentation and reduction shifted their conception of the lived body and its possibilities by provoking bodily reorientations and adjustments as well as changes in bodily sensations. In contrast with body image studies that emphasize elective breast surgery as transforming attitudes towards the body, this phenomenological investigation reveals that elective breast surgery also galvanizes a relearning of the world and a rearticulation of embodied doing.     

Factors Influencing Perceptions of Breast Cancer Genetic Counseling among Women in an Urban Health Care System

The study assessed perceptions of breast cancer genetic counseling. Focus groups were conducted with twenty women (ages < = 50 years) in a Midwestern, urban health system identified as at above average risk of developing hereditary breast cancer and referred for breast cancer genetic counseling following mammography. All participants associated the words “breast cancer” with fear. African American women who received breast cancer genetic counseling may have channeled their fear into increased vigilance related to breast health. African American women who did not receive breast cancer genetic counseling were most knowledgeable about it. In contrast, Caucasian women who did not receive it reported uncertainty about the role of genetic counseling and testing in assessing breast cancer risk, mistrust in medical professionals, and lack of trust in the accuracy of genetic tests. The results could be used to help develop interventions to improve informed decision-making regarding breast cancer genetic counseling.     

The Impact of Contemplated Exposure to a Survivor of Rape on Attitudes toward Rape1

Male and female college students were asked to rate the truth of myths about rape either before or after contemplating how they would react if a close friend or relative told them she had been raped. It was expected that such contemplation would decrease endorsement of rape myths, by increasing sympathy for victims and reducing the tendency to blame victims for sexual assault. Typically, studies have found that women are less accepting of rape myths and more sympathetic to rape victims than men. A reason for this may be that women have thought about rape more and are more likely to have experienced sexual assault or to be acquainted with a survivor. Based on the above findings, it was hypothesized that contemplating exposure to a rape survivor would be particularly beneficial to men's attitudes. Results contradicted the hypothesis and showed that contemplating exposure increased rejection of rape myths for women but slightly increased men's endorsements. In contrast, men and women who were actually acquainted with a rape survivor rejected rape myths more strongly than those who did not claim acquaintance.     

Breast and Chest Size: Ideals and Stereotypes Through the 1990s

This study investigated differences in ideals and stereotypes associated with breast and chest size through the 1990s. Five cohorts of primarily Caucasian participants between 1990 and 1998 completed the Breast/Chest Rating Scale that consists of figures of men and women of varying upper torso sizes and a series of questions related to ideal size, perceptions of others' ideals, and characteristics associated with different sizes. Although the breast size women perceive as preferred by others has increased, the ideal breast size has remained stable for men and women. Men's ideal breast size was consistently larger than the breast size women prefer, and men also preferred a significantly larger chest size. Despite an increasing cultural emphasis on large chest size, there was a significant decrease in the chest size preferred by women across cohort groups. The chest size men think women prefer, however, has increased. Although there was little evidence of changes in stereotypes associated with chest size, the breast size associated with a variety of positive characteristics was significantly larger in 1998 than in 1992. These results are discussed in relation to body image and social implications.     

术后乳腺癌患者体象对创伤后应激障碍和创伤后成长的影响：反刍的中介作用

为探讨乳腺癌患者反刍这一认知情绪调节方式在体象和创伤后应激障碍（PTSD）、创伤后成长（PTG）之间的中介作用,采用体象量表（BIS）、认知情绪调节问卷中文版（CERQ-C）、创伤后应激障碍量表（PSS）和创伤后成长问卷（PTGI）对150名乳腺癌术后患者进行研究。结果发现：（1）乳腺癌患者的体象可以正向预测PTSD和PTG;（2）乳腺癌患者的反刍在体象和PTSD的闯入性症状、回避性症状中起中介作用,在体象与PTG中的中介作用不显著。结果表明,体象既可以正向预测乳腺癌患者的PTSD和PTG,也可以通过反刍的中介作用影响PTSD。     

Thin Is In? Think Again: The Rising Importance of Muscularity in the Thin Ideal Female Body

Research has documented an increased emphasis on fitness in media targeting women. However, it is unclear whether this emphasis has resulted in increased muscularity in the perceived ideal female body shape. We sought to evaluate whether the ideal female figure has incorporated increased muscularity into the existing ideal body type that already emphasizes thinness. In Study 1, 78 female undergraduates evaluated images of U.S. beauty pageant winners over the past 15 years on dimensions of thinness, muscularity, and attractiveness. Results indicated that muscularity and thinness ratings of pageant winners significantly increased over time. In Study 2, 64 female undergraduates evaluated two different versions of the same image of a model: a Thin Muscular image and a Thin Only image in which the appearance of muscularity was removed through digital editing. When images were presented in pairs, results indicated that participants found the Thin Muscular image more attractive than the Thin Only image. These results suggest that the current perceived ideal female figure includes both extreme thinness and muscularity and that women prefer this muscular thin figure to a solely thin figure. These findings have implications for clinical treatments related to body image, compulsive exercise, and media literacy.     

Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients.

Much work on psychosocial sequelae of breast cancer has been guided by the assumption that body image and partner reaction issues are focal. In a tri-ethnic sample of 223 women treated for early-stage breast cancer within the prior year, the authors assessed a wider range of concerns and relations to well-being. Strongest concerns were recurrence, pain, death, harm from adjuvant treatment, and bills. Body-image concerns were moderate; concern about rejection was minimal. Younger women had stronger sexual and partner-related concerns than older women. Hispanic women had many stronger concerns and more disruption than other women. Life and pain concerns and sexuality concerns contributed uniquely to predicting emotional and psychosexual disruption; life and pain concerns and rejection concerns contributed to predicting social disruption. In sum, adaptation to breast cancer is a process bearing on several aspects of the patient's life space.     

The Body Grid as an Assessment Tool for Body Image

The aim of this study was to analyze the body grid (BG) as an assessment tool for body image in a sample of patients with breast cancer, after surgery. We explored two measures of cognitive structure, percentage of variance accounted for by the first factor (PVAFF) and polarization, and we compared measures of body image and body self-esteem obtained by means of the BG with those obtained via a validated body image questionnaire. Our sample was composed of 23 patients (12 subjected to radical mastectomy, 11 subjected to conserving surgery) and 24 healthy controls. Participants were administered the BG and the Multidimensional Body Self Relations Questionnaire (MBSRQ). We analyzed the similarities between instruments using correlations and nonparametric tests. We have also provided two case studies to exemplify the use of the BG.

?We found statistical differences in cognitive structure between patients and healthy controls. There were no differences between women subjected to mastectomy and women with breast conserving surgery in the level of PVAFF, but there were significant differences between them in the level of polarization. We found significant correlations between body image indices of both instruments, especially self-evaluated attractiveness (MBSRQ) and distance between real and ideal body (BG). We found similar distributions of these indices in all of the samples. We concluded that the BG provides useful information about body image. The results show that both instruments assess similar constructs. This suggests that the BG is a valid instrument for body image assessment.