Impact of negative cognitions about body image on inflammatory status in relation to health

Objective: Evidence suggests that body dissatisfaction may relate to biological processes and that negative cognitions can influence physical health through the complex pathways linking psychological and biological factors.

Design: The present study investigates the relationships between body image satisfaction, inflammation (cytokine levels), aerobic fitness level and obesity in 96 middle-aged men and women (48 normal and 48 overweight). All participants underwent measurements of body satisfaction, body composition, serological measurements of inflammation and aerobic capabilities assessment.

Results: Body image dissatisfaction uniquely predicted inflammation biomarkers, C-reactive protein and tumour necrosis factor-α, even when controlled for obesity indicators. Thus, body image dissatisfaction is strongly linked to inflammation processes and may promote the increase in cytokines, representing a relative metabolic risk, independent of most traditional risk factors, such as gender, body mass index and intra-abdominal (waist to hip ratio) adiposity.

Conclusion: Results highlight the fact that person’s negative cognitions need to be considered in psychologically based interventions and strategies in treatment of obesity, including strategies for health promotion. Results contribute to the knowledge base of the complex pathways in the association between psychological factors and physical illness and some important attempts were made to explain the psychological pathways linking cognitions with inflammation.     

Physical activity and body image: Intertwined health priorities identified by transmasculine young people in a non-metropolitan area

Abstract

Background: A dearth of research exists about the health behaviors of transgender young people (TYP). As we seek to learn more about transgender (trans) health, community-based participatory research (CBPR) approaches are crucial for incorporating TYP’s needs into the formulation of research questions and development of health behavior programing.

Aim: Explore body image and exercise as priorities among TYP.

Methods: Trans masculine young adults (N?=?16) in a small city in the Midwest took part in semi-structured interviews about their health behaviors and priorities. Theme analysis was used to capture key patterns in participants’ responses. Specific analysis steps included initial and more specific coding, analytical memos, organizational matrices and reports, and discussion about results with participants.

Results: Participants identified exercise and body image as connected primary health concerns. They discussed these issues in terms of three themes: Body shape as motivation for exercise; Poor body image, stigma and fear as exercise barriers, and; Exercise or lack of, as destructive. Participants wanted to exercise to achieve a certain body shape, not for health or as stress relief. They cited gyms as unwelcoming, however. They also worried about discrimination and did not feel sufficiently comfortable with their bodies to exercise. When they could not exercise, they used harmful behaviors, like restricted eating, to achieve a specific male shape.

Conclusions: Using participatory methods allowed us to understand the priorities of a group of Transmasculine young people. Our findings suggest that it is important to continue to explore TYP’s body-related motivations for exercise and understand the balance between exercise as a positive health behavior, and a potentially harmful one, in light of TYP’s complex body image concerns. Trans friendly gyms and gym policies could promote safe exercise and continued anti trans discrimination work and policy advocacy can promote the safety of TYP in all spaces.     

Menopausal stage and age and perceptions of body image

Abstract

The aim of This study was to investigate the association between menopausal stage and age and women's perception of their body image. Females from a community sample (n = 304. age range from 35 to 65 years) volunteered to complete a structured questionnaire which contained the Multidimensional Body Self Relations Questionnaire (MBSRQ) and the Stunkard Body Shape Figure Scale. One hundred and twenty women were premenopausal, 76 women were perimenopausal and 108 were postmenopausal. The effects of age and menopausal stage could not be separated in ratings of appearance evaluation, fitness evaluation, current, ideal and societal ratings of the Stunkard Body Shape Figure Scale. Premenopausal women (who were likely to be younger) had more positive ratings of appearance evaluation and fitness evaluation than menopausal women (who were likely to be older). Women who were premenopausal nominated smaller figures from the Stunkard Body Shape Figure Scale for ratings of the current, ideal and societal body shape than women who were perimenopausal and postmenopausal. The implications of these findings as they relate to women as they progress through the menopausal transition and as they become older is discussed.     

Making snacking less sinful: (Counter-)moralising obesity in the public discourse differentially affects food choices of individuals with high and low perceived body mass

Objective: As public discourse surrounding obesity highlights the societal costs of obesity and individual’s own responsibility for their weight, being overweight is often framed as immoral. Such ‘moralizing’ messages about being overweight may be a psychological threat for those with high body mass. Attempting to counter-moralise the public discourse (i.e. actively arguing that there is nothing ‘immoral’ about being overweight) may relieve this threat, inducing people, especially those with higher (perceived) weight, to engage in healthier behaviours.

Method: Two experiments were performed among Dutch and US participants. (Counter-)moralisation was manipulated. Body mass and weight-related self-perceptions were measured. The dependent variable was healthy vs. unhealthy snack choice.

Results: (Counter-)moralisation and (perceived) overweight jointly predicted snack choice: counter-moralising messages induced healthy snacking, but only among those who regarded themselves to have a high body mass.

Conclusions: The effects of moralising vs. counter-moralising obesity depended on one’s (perceived) overweight. This suggests that, for people with relatively high weight, the current moralising public discourse on obesity works in counterproductive ways. Campaigns that ‘counter-moralize’ obesity (i.e. that refute moralising messages) are more productive, although they should be tailored to those who see themselves as being overweight.     

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Abstract

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.

Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.

Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.

Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.

Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.     

The role of state mindfulness during yoga in predicting self-objectification and reasons for exercise

ObjectivesObjectification theory is a useful framework for understanding how individuals internalize the sexual objectification of male and female bodies. This internalization, called self-objectification, can result in negative psychological and behavioral outcomes (e.g., body shame, disordered eating). Exercise that uses mindfulness to draw attention to the body's function and sensations rather than appearance may be one way to minimize self-objectification and improve associated outcomes. Therefore, the objective of this study was to explore how state mindfulness during exercise may associate with change in self-objectification, body image variables, and reasons for exercise.DesignThis study prospectively followed participants (N = 148, 80% female) from six yoga classes that met 2–3 times a week across an 8-week period.MethodRepeated measures MANOVAs were used to examine change over time in state mindfulness, self-objectification, physical self-concept, and reasons for exercise. Regression analysis was used to examine how state mindfulness predicted change in outcome variables.ResultsMANOVAs revealed significant decreases in self-objectification and increases in physical self-concept, health/fitness-related reasons for exercise, and state mindfulness. Further, results indicated that mindfulness during exercise was linked with decreases in self-objectification and increases in more internal reasons for exercise over time.ConclusionsState mindfulness plays a role in predicting change in self-objectification and reasons for exercise during yoga practice.     

Mental health and quality of life in non-binary transgender adults: a case control study

Abstract

Background: The social challenges that non-binary people experience, due in part to social intolerance and the lack of validation of non-binary gender identities, may affect the mental health and quality of life of this population. However, studies that have distinguished between non-binary and binary transgender identities are lacking.

Aim: To compare the mental health and quality of life of a community sample of non-binary transgender adults with controls (binary transgender people and cisgender people) matched on sex assigned at birth.

Method: A total of 526 participants were included. Ninety-seven were classified as non-binary and were compared with two control groups: 91 people classified as binary and 338 cisgender people. Only transgender people not on gender affirming hormone treatment or who had not undergone gender affirming surgery were included. Participants were invited to complete an online survey that included mental health and quality of life measures.

Results: Non-binary people reported significantly better mental health than binary transgender people, but worse than cisgender people. Overall, there were no significant differences in quality of life between non-binary and binary transgender participants assigned male at birth and transgender females, but non-binary assigned males at birth had better scores on the psychological and social domains of quality of life than transgender males. Quality of life was better across all domains in cisgender people than transgender groups.

Conclusion: There is an inequality with regard to mental health and quality of life between non-binary (and binary) transgender people and the cisgender population that needs to be addressed. The better mental health scores in non-binary people may reflect lower levels of body dissatisfaction among the non-binary population. Mental health problems and poor quality of life are likely to have social causes and hence legislative measures and broader government-led inclusive directives should be put in place to recognize and to validate non-binary identifying people.     

A structural equation model of intuitive eating with adolescents

IntroductionThe tendency to eat by paying attention and respecting the body's hunger and satiety cues is called intuitive eating. This eating behavior has been linked to positive health and well-being outcomes.ObjectiveThe purpose of this study was to test a global model linking intuitive eating with self-esteem, body esteem, media influence and including fear of negative appearance evaluation in adolescents’ boys and girls.MethodIn total, 740 adolescent high school students (51.5% girls; M age = 14, SD = 1.5) completed self-report questionnaires with measures of intuitive eating, body esteem, self-esteem, media influence and fear of negative appearance evaluation.ResultsStructural equation modeling revealed an overall excellent fit for the final four-variable model excluding the fear of negative appearance evaluation variable. Mediation analyses showed an indirect relationship between intuitive eating and body esteem via media influence, for girls but not for boys. Body esteem mediated the relationship between intuitive eating and self-esteem, for girls and boys.ConclusionA new model is proposed where intuitive eating is associated with self-esteem through body esteem and media influence. These findings suggest that regulating attitudes and behaviors toward food may be related to higher psychological well-being.     

How people make decisions about predictive genetic testing: An analogue study

Abstract

Persons scoring high on negative affectivity (NA) have more subjective health complaints. In this study, we tested the hypothesis that high NA persons are more likely to experience internal sensations as threatening signs of health problems. Low and high NA participants (N=44) were given four breathing trials: one room air trial followed by three trials containing 5.5% CO₂ which induced transient low intensity somatic sensations. Prior to each CO₂ trial, participants received either positive, negative or uncertain labelings of the sensations that might occur. Participants rated the (un)pleasantness of the experienced somatic sensations and the perceived intensity. Also respiratory responses were measured. During CO₂ trials, reliable main effects of information were found but no effects involving NA were observed, neither on pleasantness ratings nor on respiratory responses. However, during room air breathing, high NA participants reported more intense somatic sensations than low NA participants. Post-experimental data suggested that high NA participants had more negative meanings and worries about the consequences of the physical sensations. It is concluded that interpretational biases in high NA is situated at the level of attributional processes.     

Family characteristics and health behaviours of adolescents and families

Abstract

The relationship between general family characteristics, represented by family cohesion and adaptability, and health behaviours (smoking, alcohol use, food choice, sleeping, Body Mass Index, and physical activity) is studied in a first study of 429 adolescents and young adults, and in a second study of 522 family triads (adolescent-mother-father). Using cluster analysis, adolescent groups with four different profiles of health behaviour were identified. Very similar results were found in the two studies. The health behaviour patterns in the different subgroups show that forms of (un)desirable health behaviours are interrelated in some clusters. Adolescents in the most healthy clusters, consistently reported highest levels of family cohesion. The relationship between family adaptability and health behaviours showed only limited significance. In families characterised by a high level of emotional bonding between family members together with stability and regularity in roles rules and power structure, adolescents' behaviour is the most healthy. The findings suggest that parental involvement is desirable in health promotion intervention. Further, it seems possible that health behaviours originate from a relatively small set of family Characteristics and that modifying family interactions might be powerful, albeit very difficult to do so, in changing a variety of health behaviours in adolescents.     

Gender congruence and body satisfaction in nonbinary transgender people: A case control study

Abstract

Background: Binary transgender people access gender affirming medical interventions to alleviate gender incongruence and increase body satisfaction. Despite the increase in nonbinary transgender people, this population are less likely to access transgender health services compared to binary transgender people. No research has yet understood why by exploring levels of gender congruence and body satisfaction in nonbinary transgender people.

Objective: The aim of this study was to compare levels of gender congruence and body satisfaction in nonbinary transgender people to controls [binary transgender people and cisgender (nontrans) people].

Method: In total, 526 people from a community sample in the UK took part in the study (97 nonbinary, 91 binary, and 338 cisgender identifying people). Participants were asked to complete an online survey about gender congruence and body satisfaction.

Results: There were differences in gender congruence and body satisfaction between nonbinary and binary transgender people. On sex-specific parts of the body (i.e., chest, genitalia, and secondary sex characteristics), nonbinary transgender people reported significantly higher levels of gender and body satisfaction compared to binary transgender people. However, there was no difference in congruence and satisfaction with social gender role between the two transgender groups (nonbinary and binary). Cisgender people reported significantly higher levels of gender congruence and body satisfaction compared to transgender people (nonbinary and binary).

Conclusions: There are differences in gender congruence and body satisfaction between nonbinary and binary transgender people. Nonbinary individuals may be less likely to access transgender health services due to experiencing less gender incongruence and more body satisfaction compared to binary transgender people. Transgender health services need to be more inclusive of nonbinary transgender people and their support and treatment needs, which may differ from those who identify within the binary gender system.     

An application of the stress-diathesis model: A review about the association between smoking tobacco,smoking cessation,and mental health

BackgroundWorldwide, approximately 24% of all adults smoke, but smoking is up to twice as prevalent in people with mental ill-health. There is growing evidence that smoking may be a causal risk factor in the development of mental illness, and that smoking cessation leads to improved mental health.MethodsIn this scholarly review we have: (1) used a modern adaptation of the Bradford-Hill criteria to bolster the argument that smoking could cause mental ill-health and that smoking cessation could reverse these effects, and (2) by considering psychological, biological, and environmental factors, we have structured the evidence to-date into a stress-diathesis model.ResultsOur model suggests that smoking is a psychobiological stressor, but that the magnitude of this effect is mediated and modulated by the individual's diathesis to develop mental ill-health and other vulnerability and protective factors. We explore biological mechanisms that underpin the model, such as tobacco induced damage to neurological systems and oxidative stress pathways. Furthermore, we discuss evidence indicating that it is likely that these systems repair after smoking cessation, leading to better mental health.ConclusionBased on a large body of literature including experimental, observational, and novel causal inference studies, there is consistent evidence showing that smoking can negatively affect the brain and mental health, and that smoking cessation could reverse the mental ill-health caused by smoking. Our model suggests that smoking prevention and treatment strategies have a role in preventing and treating mental illness as well as physical illness.     

A cognitive-behavioral treatment for irritable bowel syndrome using interoceptive exposure to visceral sensations

BackgroundIrritable bowel syndrome (IBS) is a chronic and debilitating medical condition with few efficacious pharmacological or psychosocial treatment options available. Evidence suggests that visceral anxiety may be implicated in IBS onset and severity. Thus, cognitive-behavioral treatment (CBT) that targets visceral anxiety may alleviate IBS symptoms.MethodsThe current study examined the efficacy of a CBT protocol for the treatment of IBS which directly targeted visceral sensations. Participants (N = 110) were randomized to receive 10 sessions of either: (a) CBT with interoceptive exposure (IE) to visceral sensations; (b) stress management (SM); or (c) an attention control (AC), and were assessed at baseline, mid-treatment, post-treatment, and follow-up sessions.ResultsConsistent with hypotheses, the IE group outperformed AC on several indices of outcome, and outperformed SM in some domains. No differences were observed between SM and AC. The results suggest that IE may be a particularly efficacious treatment for IBS.ConclusionsImplications for research and clinical practice are discussed.     

One ‘knows’: self-rated health and telomere length among ex-prisoners of war

Abstract

Objective: Ill-health and early mortality are amongst the most significant ramifications of trauma. Furthermore, trauma alters the subjective perception and experience of the body. The aim of this study is to examine the extent to which deteriorations in perceived health among traumatised individuals are associated with cellular health as manifested in telomere length.

Methods: Specifically, 88 former prisoners of war (ex-POWs) evaluated their health (self-rated health; SRH) at 18 (T1), 35 (T2) and 42 (T3) years after the war, and were assessed for telomere length at T3. Health behaviour, BMI, morbidity and PTSD were also examined at T3.

Results: The findings demonstrated that SRH was cross-sectionally correlated with telomere length. Furthermore, a significant sequential indirect effect was found, in which worse SRH in T1 was associated with shorter telomere length at T3, through worse SRH at T2 and at T3.

Conclusions: These findings demonstrate that long-term deteriorations in the subjective evaluations of health are implicated in actual cellular health among individuals exposed to trauma.     

Shoulder elevation affects joint position sense and muscle activation differently in upright and supine body orientations

ObjectiveInvestigate the effects of shoulder elevation on repositioning errors in upright and supine body orientations, and examine these effects on anterior and posterior deltoid muscle activation. We hypothesized decreased errors, and altered anterior and posterior deltoid activation with increasing elevation, in both orientations.DesignCrossover trial.SettingUniversity laboratory.ParticipantsThirty-five college-aged participants.InterventionSubjects attempted to replicate target positions of various elevation angles in upright and supine body orientations. Also, anterior and posterior deltoid activation was recorded in each shoulder position and body orientation.Main outcome measuresVector and variable repositioning errors, anterior and posterior deltoid percentage of maximal contraction.ResultsVector error was greater in supine compared to upright at 90° and 110°, but not at 70°. Variable error was larger in supine than upright, but was unaffected by elevation. Anterior deltoid activation increased with elevation in the upright posture only. Posterior deltoid activation increased with elevation across postures.ConclusionsMuscle activation, external torque, and cutaneous sensations may combine to provide afferent feedback, and be used with centrally-generated signals to interpret the state of the limb during movement. Clinicians may prescribe open kinetic chain exercises in the upright posture with the shoulder elevated approximately 90–100°.     

The Influence of Societal Factors on Female Body Image

Abstract

This study was designed to identify factors associated with the perceptual and attitudinal components of female body image. The influence of society and factors thought to mediate the relationship between body image and society (field dependence, locus of control, and self-esteem) were investigated. Age and body mass index (BMI) were also included as independent variables. A total of 101 female university students in Australia ranging in age from 18 to 55 years (M = 24.11) participated in the study. A video camera apparatus (VCA) was used to assess perceptual distortion of body size. The VCA, the Body Esteem Scale, and the Appearance Evaluation subscale of the Multidimensional Body Self Relations Questionnaire were used to assess body satisfaction. On average, women underestimated their body sizes by 4%, and they typically wanted to be smaller than their actual body sizes. About two fifths of the women expressed moderate to strong negative feelings about both individual body parts and their bodies as a whole. Multiple regression analyses revealed that perceptual distortion of body size could not be predicted from the independent variables. Body satisfaction was best explained by societal factors, self-esteem, and BMI.     

Health behaviour and attitudes to publicity campaigns for health promotion

Abstract

A sample of 403 members of the public responded to a postal questionnaire concerning their own health behaviour and their attitudes towards health publicity. A principal components analysis of these attitudes revealed three factors, the first of which reflected a tendency to deny the “relevance” of health campaigns. This tendency was higher among those who smoked, took less exercise and had less healthy diets. It is inferred that the direct effects of such campaigns may be impeded by the fact that they appeal most to those people whose own behaviour (from the point of view of health) is in least need of change.     

Increased anxiety and depression among collegiate athletes with comorbid ADHD and history of concussion

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is prevalent among student-athletes when compared to the general population. Mental health disruptions (i.e., depression or anxiety) are common among student-athletes, and risk of experiencing depressive and anxious symptoms may be even greater among student-athletes that have incurred concussion.ObjectiveTo examine the influence of pre-existing ADHD and history of concussion on mental health in collegiate student-athletes.DesignRetrospective cross-sectional study.SettingNational Collegiate Athletic Association Division-I (NCAA) athletics.PatientsBetween 2010 and 2017, student-athletes at a Southeastern NCAA Division-I institution were surveyed as part of a Performance, Health, and Wellness Program. Analyses were conducted using a sample of 324 student athletes (212 female) with either a prior diagnosis of ADHD, a prior history of a sport-related concussion, both prior diagnosis of ADHD and a history of sport-related concussion, or neither (controls).Main outcome measure(s)Symptomatology associated with ADHD was characterized using the Behavior Assessment System for Children Self-Report of Personality College Version. The State-Trait Anxiety Inventory and the Center of Epidemiological Studies-Depression Scale examined anxious and depressive symptomatology.ResultsStudent-athletes with ADHD and a history of concussion had 16.4 times greater odds of exhibiting clinically significant symptoms of state anxiety and 7.9 times greater odds of exhibiting clinically significant symptoms of depression, relative to control student-athletes. Every participant with both a diagnosis of ADHD and a history of concussion exhibited clinically significant attentional problems.ConclusionsHaving both ADHD and a history of concussion may have a synergistic effect on mental health beyond that of ADHD and/or concussion alone. Additional longitudinal research is necessary to verify current findings. However, athletic trainers and other health care professionals are encouraged to be mindful of student-athletes with ADHD, as they may be more vulnerable to experiencing symptoms of depression and state anxiety with elevated inattentive behaviors following a concussion.