Attitudes to doctors and medicine: The preliminary development of a new scale

Abstract

The preliminary development of a new scale to measure attitudes towards medicine and doctors is described. The scale comprises four factors: “positive attitude towards doctors,” “positive attitude towards medicine,” “negative attitude towards doctors,” and “negative attitude towards medicine.” Alpha coefficients for the four scales were satisfactory, ranging from 0.69 to 0.76. Test re-test reliabilities ranged from 0.69 to 0.81. Evidence of criterion-related validity was obtained from comparison of the attitudes of five groups involved in health care: nurses, medical students, patients, and sociologists and psychologists who are teachers in medical schools. Patients and medical students held significantly more positive attitudes towards doctors and medicine that did nurses and behavioural scientists. While nurses were as negative towards doctors as sociologists and psychologists, they were significantly less negative about medicine.     

Étude de validation de la version française de l’Échelle d’Estime Corporelle (Body Esteem Scale) chez les adolescentes et les jeunes adultes

IntroductionThe literature of body image suggests that many women and young women suffer from body dissatisfaction and this dissatisfaction is an important risk factor for the development of eating disorders.ObjectiveThe aim of the study was to validate the French female version of the Body Esteem Scale (BES; Mendelson et al., 2001).MethodThis self-administered questionnaire assesses body esteem and includes three subscales: “Weight”, “Appearance” and “Attribution”. The questionnaire was given to a sample of 835 adolescent girls and young adults (mean age = 16.62 ± 1.50).ResultsExploratory factorial analysis yielded three factors “Weight”, “Appearance” and “Desire to modify and negative affect associated with the general appearance”, somewhat similar to those of the original validation study. The goodness-of-fit of the three factors model was satisfactory. Correlations were found between the three subscales of the BES, BMI and general self-esteem.ConclusionThe French version of the BES shows satisfactory psychometric properties and provides a useful tool for better understanding the psychological aspects of attitudes towards one's body. In France, very few questionnaires are available to measure body attitudes, despite the fact that the body dissatisfaction affects many adolescent girls and represents a risk factor for the development of eating disorders.     

Protecting Women from the Negative Effects of Body Dissatisfaction: The Role of Differentiation of Self

ABSTRACT

Body dissatisfaction is a prevalent and concerning issue among college age women. Due to its strong association with eating pathology, identification of moderating variables is a crucial line of inquiry. The present study investigated the ability for an intrapersonal differentiation-of-self variable (“I” position) to attenuate the impact of body dissatisfaction on anorexia and bulimia symptoms among college women participants. Study findings indicated that an “I” position moderated the body dissatisfaction-bulimia relationship and the body dissatisfaction-anorexia relationship. These findings signified the protective influence of a high “I” position for women with high levels of body dissatisfaction. Research and therapeutic implications are discussed.     

Bulimia Nervosa: Professional and Lay People's Beliefs About the Causes

This study examined the explanatory models of bulimia nervosa (BN) held by members of professionals in the medical, psychological, and allied health fields; the general public; and female university students. The participants (N = 787) were presented with 44 potential causal explanations for BN and were asked to rate the importance of each in the development of this condition on a 5‐point rating scale (“unimportant” to “extremely important”). Principal component analysis identified four causal components. These were interpreted as corresponding to (1) socio‐cultural pressure, (2) eating and dieting practices, (3) family dynamics, and (4) psychological vulnerability. A high degree of consistency in the mean ratings for the four causal components was observed among the professional groups. However, important differences were found between the professional and the lay respondents in their beliefs about the role of socio‐cultural pressure, eating and dieting practices, and family dynamics in the development of BN. The congruence in beliefs among the professionals groups would contribute to the ease of interdisciplinary collaboration required in the multi‐modal treatment approach to BN. However, the differences observed between the professional and lay groups may have implications for educational and preventative strategies for BN.     

Validation française de l’échelle de mesure de l’orthorexie ORTO-15 et étude des liens avec les troubles des conduites alimentaires et l’image du corps

IntroductionAlthough orthorexia is described as a pathological obsession over healthy food, its nature remains unclear. The results of the majority of studies, mainly using the ORTO-15 measurement scale, remain limited to certain countries and cannot be generalized to every culture. Furthermore, recent studies suggest that body image should be included in the orthorexia research, in addition to eating disorders.ObjectiveThe aim of this study was to propose a French adaptation of the ORTO-15 measurement scale using the Vallerand's transcultural validation procedure, explore its psychometric properties and the links between orthorexic behvaiour, symptoms of eating disorders and body image.MethodFour hundred and nine young adults (89% female), aged 18 to 25 years, completed the online version of the following scales: ORTO-15, Dunn et al. criteria (2016), the Eating-Attitudes Test (EAT-26), Binge Eating Scale (BES) and the Multidimensional Body Self Relations Questionnaire-Appearance Scale (MBSRQ-AS). Exploratory and confirmatory factor analysis (EFA and CFA, respectively) were carried out on two randomly split samples and links between different variables were explored using Spearman correlation coefficients.ResultsThe EFA yielded a single-factor 11-items structure explaining 24% of variance. The adjustment indices from the CFA were excellent. The stability of the scale was satisfactory (ICC = 0.71), despite a questionable internal consistency (α = .50). Links with other scales indicated good structural validity.ConclusionORTO-11-Fr presented satisfactory psychometric properties. Further studies are needed for identifying predictors of orthorexia as well as improving its definition and assessment.     

Effects of exposure to thin-ideal media images on body dissatisfaction: Testing the inclusion of a disclaimer versus warning label

The current study was designed to determine whether the inclusion of a disclaimer (i.e., “Retouched photograph aimed at changing a person's physical appearance.”) or warning (i.e., “Warning: Trying to look as thin as this model may be dangerous to your health.”) added to images of thin/attractive models would affect body dissatisfaction and intent to diet in female undergraduate students (n = 342). Participants were randomly assigned to one of four groups: (a) disclaimer, (b) warning, (c) model control, or (d) car control. Results revealed a significant interaction between group and time, whereby only the car control group reported a significant change (i.e., decrease) in body dissatisfaction over time. Groups did not differ on intent to diet measured at post-exposure. The results largely replicate other findings in this area and call into question advocacy efforts to label media images as a strategy to decrease women's identification with the stimuli.     

Body attitudes and eating behaviors of female clothing sales personnel

Recent research suggests that social standards for ideal female beauty are related to negative body-image and dieting among young women. We hypothesized that women who work in settings that emphasize physical appearance (women's fashion clothing sales) would have more disturbed body attitudes and eating behaviors than college women. Sales personnel (n = 21) and students (n = 25) answered questions about their occupational status, weight, and demographic characteristics, and completed the Body-esteem Scale and the Eating Disorder Inventory. Weight and scores on the two scales were similar in both groups except that sales personnel reported more dissatisfaction with their body parts on the Body dissatisfaction scale of the Eating Disorder Inventory. Among sales personnel, those who perceived their appearance to be of greater importance in their work also reported more concern about dieting and weight, as reflected on the Drive for thinness subscale of the Eating Disorder Inventory. Results are discussed with regard to situational influences on women's body attitudes and their implications for eating behaviors.     

Media influence and body dissatisfaction in preadolescent ballet dancers and non-physically active girls

ObjectivesThe present study analysed media influences and body dissatisfaction in preadolescent non-professional female ballet dancers and non-physically active girls.DesignCross-sectional design.MethodParticipants were 135 Italian preadolescent girls: 67 non-professional ballet dancers (M = 12.28 years) and 68 non-physically active girls (M = 12.56 years). Participants completed a questionnaire assessing body mass index (BMI), perceived media pressure to reach the societal body ideal, thin-ideal internalization, athletic internalization and body dissatisfaction.ResultsNo significant differences between ballet dancers and non-dancers emerged on age; however, dancers had a significantly lower BMI. Therefore, BMI was used as a covariate. No significant difference between the two groups emerged on perceived media pressure or thin-ideal internalization. Ballet dancers reported a higher level of athletic internalization and were more dissatisfied with their bodies than non-physically active girls. BMI emerged as the most important predictor of preadolescents' body dissatisfaction for both groups. Among non-dancers, perceived media pressure predicted body dissatisfaction both directly and indirectly via thin-ideal internalization. Among dancers, perceived media pressure predicted body dissatisfaction both directly and indirectly via athletic internalization but not via thin-ideal internalization.ConclusionsMedia influence emerged as an important predictor of body dissatisfaction for both groups, although the internalization of an athletic body ideal was more salient for the ballet dancers. These findings are noteworthy because they offer some clues for possible intervention programs aimed at promoting healthier body images in preadolescent ballet dancers and non-dancers and extend the existing literature on ballet dancers' body dissatisfaction.     

Evidence that ideal and attractive figures represent different constructs: A replication and extension of Fingeret, Gleaves, and Pearson (2004)

Figure rating scales are commonly used to measure body dissatisfaction through discrepancy indexes (e.g., difference between current and ideal body) and recent methodological work by Fingeret, Gleaves, and Pearson suggests that distinctions between referent bodies (e.g., ideal or most attractive) are unnecessary. The purpose of the current study was to replicate these findings using both male and female figure rating scales and an opposite-sex comparison group. We examined the relationship between three referent figures (Ideal, Most Attractive to the Opposite Sex, and Most Attractive) and attractiveness attributions in 365 undergraduate men (n = 164) and women (n = 201). Results suggested that referent figures were associated with different attractiveness attributions for both male and female figures, but physical characteristics differed only in male figures. The impact of referent bodies on discrepancy indexes was also explored. Considerations for future research using figure rating scales are discussed.     

Examining body dissatisfaction in young men within a biopsychosocial framework

This study examined biopsychosocial factors related to body dissatisfaction in young men within multivariate and moderator contexts. A female sample was included as a gender comparison. Male (n = 111) and female (n = 236) undergraduates filled out self-report questionnaires assessing body mass index (BMI), media influence, a history of weight-related teasing, and socially prescribed perfectionism, along with various indices of body dissatisfaction. Perceived pressure from the media was consistently related to body dissatisfaction in men whereas multiple biopsychosocial variables accounted for body dissatisfaction in women. Socially prescribed perfectionism and a history of weight teasing each moderated the relationship between BMI and male body dissatisfaction, identifying men low in body dissatisfaction. Findings indicate that applying a biopsychosocial framework to the study of body dissatisfaction in men is useful and suggest the need for including other factors, such as male peers and sports involvement, in understanding contributors to male body image.     

The relationships between subjective well-being,health, and religiosity among young adults from Qatar

Introduction: The aims of this study were to explore the associations between, and the factors of, subjective well-being, health, and religiosity among Qatari undergraduates. A sample of 113 male and 133 female college students from University of Qatar responded to the Oxford Happiness Inventory, Satisfaction With Life Scale, and Love of Life Scale, as well as to five self-rating scales to assess happiness, satisfaction with life, mental health, physical health, and religiosity. Men obtained a significantly higher mean score on self-rating of mental health than did their female counterparts. All the correlations between the scales were significant and positive. Principal components analysis yielded one factor in both the sexes and labelled “Well-being, health and religiosity.” The only predictor of religiosity was the self-rating scale of satisfaction in men and women. It was concluded that those who consider themselves as religious in the present study reported higher subjective well-being and good health.     

The Effect of Attachment Insecurity in the Development of Eating Disturbances across Gender: The Role of Body Dissatisfaction

The present study examined the effects of insecure attachment on the development of negative body image as a contributing factor to the development of disturbed-eating patterns in male and female university students. Participants were nonclinical male (n = 100) and female (n = 381) university students. Administering self-report questionnaires, the authors assessed demographic information (gender, age), anthropometric data (Body Mass Index [BMI], age), romantic attachment (ECRS-R; R. C. Fraley, N. G. Waller, & K. A. Brennan, 2000), body dissatisfaction (BSQ), and disturbed eating (EAT-26). The authors found body dissatisfaction to fully mediate the relationship between attachment anxiety and disordered eating in women. Body dissatisfaction mediated anxious attachment and dieting in men. In addition, attachment avoidance had a direct impact on eating behaviors for both genders, without the mediation of any variables measured in this study. The findings of the present study suggest that the anxiety and avoidance dimensions of attachment insecurity affect eating behaviors differently, and the effects are different across genders. The authors discuss results in the context of therapeutic interventions design.     

The role of peer influence on girls’ body dissatisfaction and dieting

IntroductionPeer influence is considered a global construct, although the effects of its various dimensions on body dissatisfaction and dieting via internalisation of the thin ideal and social comparison have yet to be analysed.ObjectiveThe aim of this study was to analyse how the different dimensions of peer influence (i.e., perception of teasing, appearance conversation with friends and peer attributions about the importance of appearance with regard to popularity) affect body dissatisfaction and dieting.MethodA total of 298 Italian adolescent girls and young women completed a questionnaire assessing different dimensions of peer influence, internalisation of the thin ideal, social comparison, body dissatisfaction and dieting.ResultsThe results indicated that peer attributions and appearance conversations with friends affect body dissatisfaction and dieting through internalisation and social comparison. Teasing had a direct effect on girls’ dissatisfaction levels.ConclusionsThe current findings have important preventive and treatment implications. Preventive interventions should not target sociocultural influences as a whole, rather they should analyse the specific dimensions of peer influence, with consideration for the degree to which girls internalise sociocultural messages and engage in social comparison.     

Breakdown in communication: On finding the child in the analysis of an adult

SUMMARY

In this paper a patient is described in whom communication with parts of herself and with her objects, internal and external, had broken down. I suggest that her way of communicating was achieved by projective identification, as described by Klein (1946) and Bion (1962). The only way she could deal with and communicate her own very “bothered” feelings was to “put them” into the analyst. In this way she “bothered” the maternal or analytic mind in such a way as to make the analyst experience feeling like a “bothered” child.

I have tried to show how the analyst holds or contains these feelings, and to show the gradual establishment in the patient of a different way of communicating with the analyst and with the more primitive parts of herself.     

A Systematic Review and Quality Assessment of Therapeutic Group Process Questionnaires

ABSTRACT

The aims of this study were to systematically review the literature on questionnaire-based group process measures and assess the psychometric scale development properties of these measures. A systematic search of questionnaire-based measures of group process was conducted from four databases: PsycINFO, Medline, EMBASE and AMED. A quality assessment was undertaken using established criteria. Only studies that described the development of questionnaire-based scales were included. Seventeen studies which described thirteen measures were included in the analysis. The developed list highlights a range of questionnaires that can be used by clinicians and researchers seeking to measure either “specific therapeutic group mechanisms” or “overall group experiences.” Further research should focus on developing the content validity of these scales by involving the target population during item selection and reduction.     

Do students really prefer repeated rereading over testing when studying textbooks? A reexamination

ABSTRACT

Experimental studies have shown that testing promotes better long-term retention than repeated rereading. Regarding implications for educational practice, based on a survey study seemingly showing that students prefer repeated rereading over testing when studying [Karpicke, J. D., Butler, A. C., & Roediger, H. L. (2009). Metacognitive strategies in student learning: Do students practise retrieval when they study on their own? Memory, 17, 471–479. doi:10.1080/09658210802647009], it has been concluded that increasing the number of tests may boost students’ achievement. However, a closer look at the survey study reveals that “repeated rereading” has been operationalised in terms of “restudying” which represents a term that may subsume a variety of study strategies. We reexamined the study behaviour of students in a more fine-grained way by surveying both their hypothetical (Study 1) and real (Study 2) study behaviour when restudying texts. Results showed that rereading is preferred only by few students early in the learning process, with almost all shifting to testing late in the learning process, and that rereading is mainly performed in terms of “rereading not understood parts”, and rarely in terms of “repeated rereading”. These results indicate that the implications of the testing effect for educational practice may have to be reconsidered.     

Does body dissatisfaction have the same meaning for males and females? A measurement invariance study

ObjectivesThe aim of this study was to assess the psychometric equivalence of body dissatisfaction (BD) between males and females.MethodTwo scales, BD and Drive to Thinness (DT), from the Eating Disorder Inventory-3 were evaluated. The sample was comprised of 1616 adolescent males and 1429 adolescent females. Factorial invariance across gender of two scales was assessed in order to evaluate the equivalence of scores.ResultsThe results showed full invariance for the DT scale items, and partial invariance for BD scale items. The content analysis of the items confirmed that items related to the perception of thighs, stomach and hips showed differential functioning across gender.ConclusionsDifferent representation of the BD construct between males and females was concluded, and caution was recommended in assessing and interpreting BD in male samples with questionnaires designed for women.     

Gender differences existing in the general population in relation to body dissatisfaction associated with the ideal of beauty: a systematic review / Diferencias de género existentes en la población general en relación a la insatisfacción corporal asociada al ideal de belleza: una revisión sistemática

Abstract

Body dissatisfaction has been studied extensively due to its relationship with issues such as eating disorders, mainly in the female and adolescent population. However, it seems that there are differences in the type of body dissatisfaction that females and males manifest with respect to their body image. On this basis, the objective of this work was to review systematically the studies published from 2010 to July 2018 into gender differences in body dissatisfaction associated with the ideal of beauty in the general population. A total of 18 studies were selected from the MeSH/PubMed, Dialnet and DOAJ databases. The results obtained from the studies analysed showed that the female population continues to show greater body dissatisfaction associated with the ideal of beauty compared to the male population. However, the manifestation of body dissatisfaction is expressed differently for men and women.