Psychosocial moderators of the relationship between body dissatisfaction and symptoms of eating disorders: A look at a sample of young Italian women

IntroductionVarious psychosocial variables may affect the strength of the relationship between body image dissatisfaction and women's eating disorder symptomatology.ObjectiveInformed by Tylka (2004) and Brannan and Petrie (2011) research, the current study examined body surveillance and self-esteem as well as three additional theoretically relevant variables (social interaction anxiety, internalization of media ideals and attachment anxiety) as potential moderators of this relationship.MethodA cross-sectional design was used. A sample of 538 young Italian women completed self-report questionnaires.ResultsHierarchical moderated regression indicated that self-esteem buffered the deleterious effects of body dissatisfaction, whereas social interaction anxiety, body surveillance, internalization of media ideals and attachment anxiety intensified the primary body dissatisfaction-eating disorder symptomatology relationship.ConclusionSeveral risk and protective factors were found to interact with body dissatisfaction to influence its relation to women's eating disorder symptomatology. Practical implications and directions for future research are discussed.     

Effects of exposure to muscular and hypermuscular media images on young men's muscularity dissatisfaction and body dissatisfaction

This study examined the effects of exposure to muscular and hypermuscular media images on young men's body images, and the moderating roles of baseline body dissatisfaction (BD) and muscularity dissatisfaction (MD). Men (M age = 21.9, SD = 2.8) were exposed to pictures of muscular (n = 34) or hypermuscular (n = 29) male physiques throughout a 30-min health seminar. In support of the study hypotheses, higher levels of baseline BD and MD were associated with greater post-seminar BD and MD. In addition, MD moderated the effects of the exposure conditions on BD; greater baseline MD was associated with greater post-seminar BD, but only among men who viewed the muscular images. These results speak to the importance of pre-existing muscularity concerns in determining men's reactions to muscular physique images, and suggest that exposure to the media ideal of muscularity, and not muscularity per se, elicits body dissatisfaction in men with pre-existing muscularity concerns.     

Effectiveness of Cognitive/Behavioral Small Group Intervention for Reduction of Depression and Stress in Non-Hispanic White and Hispanic/Latino Women Dementia Family Caregivers: Outcomes and Mediators of Change

This study enrolled 184 middle-aged and older women (95 Non-Hispanic White and 89 Hispanic/Latino) who provided in-home hands-on care to an elderly relative with Alzheimer’s disease or another form of dementia. Within ethnic group they were randomly assigned to either a CBT-based small group intervention program called “Coping with Caregiving” (CWC) that taught a variety of cognitive and behavioral skills to reduce stress and depression, or to a minimal telephone based control condition (TSC). Intervention lasted about 4 months; one post-treatment assessment was completed 6 months after baseline by interviewers blind to the intervention condition. Interviews and interventions were conducted in English or Spanish by trained staff. Results indicated that those in the CWC (regardless of ethnicity) showed greater improvement from pre to post intervention than those in the TSC on measures of depressive symptoms, overall life stress, and caregiving-specific stress. In order to investigate if these changes may have been related to one proposed mechanism of change in CBT (skill utilization), a new measure was constructed. Change in frequency of use and perceived helpfulness of adaptive coping skills were assessed in all caregivers. Results indicated that caregivers in CWC reported greater frequency of use, and greater perceived helpfulness, of these skills at post intervention compared to caregivers in the TSC. Improvement measured by dependent measures was correlated with an increase in these indices for those in the CWC. Tests for mediation suggest that effective skill utilization may mediate the effect of treatment on outcome. Implications of these findings are discussed and recommendations provided for future research.     

Moderators of continuation phase cognitive therapy's effects on relapse, recurrence, remission, and recovery from depression

About half of patients who respond to acute-phase cognitive therapy (CT) for major depressive disorder (MDD) will relapse/recur within 2 years; continuation-phase CT lowers this risk. We analyzed demographic, clinical, cognitive, social-interpersonal, and personality variables to clarify which patients continuation-phase CT helps to avoid relapse and recurrence and achieve remission and recovery. Participants had recurrent MDD, responded to acute-phase CT, were randomized to 8 months of continuation-phase CT (n = 41) or assessment control (n = 43), and were assessed 16 additional months (Jarrett et al., 2001). Consistent with an underlying risk-reduction model, continuation-phase CT was helpful for responders to acute-phase CT with greater risk and/or dysfunction as follows: Younger patients with earlier MDD onset who displayed greater dysfunctional attitudes and lower self-efficacy; personality traits suggesting low positive activation (e.g., reduced energy, enthusiasm, gregariousness); and transiently elevated depressive symptoms late in acute-phase CT and residual symptoms after acute-phase CT response. We emphasize the need for replication of these results before clinical application.     

Prognostic significance of two sub-categorization methods for the treatment of binge eating disorder: negative affect and overvaluation predict, but do not moderate, specific outcomes

Given the absence of known predictors and moderators for binge eating disorder (BED) treatment outcome and recent findings regarding meaningful sub-categorizations of BED patients, we tested the predictive validity of two subtyping methods. Seventy-five overweight patients with BED who participated in a randomized clinical trial of guided self-help treatments (cognitive-behavioral therapy (CBTgsh) and behavioral weight loss (BWLgsh)) were categorized in two ways. First, a cluster analytic approach yielded dietary-negative affect (29%) and pure dietary (71%) subtypes. Second, research conventions for categorizing patients based upon shape or weight self-evaluation yielded clinical overvaluation (51%) and subclinical overvaluation (49%) subtypes. At the end of treatment, participants subtyped as dietary-negative affect reported more frequent binge episodes compared to the pure dietary subtype, and those with clinical overvaluation reported greater eating disorder psychopathology compared to the subclinical overvaluation group. Neither method predicted binge remission, depressive symptoms, or weight loss. Neither sub-categorization moderated the effects of guided self-help CBT and BWL treatments on any BED outcomes, suggesting that these two specific treatments perform comparably across BED subtypes. In conclusion, dietary-negative affect subtyping and overvaluation subtyping each predicted, but did not moderate, specific and important dimensions of BED treatment outcome.     

Sex differences in jealousy in response to infidelity: Evaluation of demographic moderators in a national random sample

Studies examining sex differences in jealousy have often relied on student samples and were restricted to the evaluation of a selected few moderators. In this study, a nationally representative survey of American households was presented with either an actual or a hypothetical infidelity scenario (which appeared as either a forced choice or as continuous measures). Significant sex differences only emerged for forced choice measures and not for continuous measures. Importantly, this effect appeared most strongly in participants reporting reactions to an actual infidelity. We also explored a number of potential moderators of this effect. These moderators were more influential for the hypothetical than for the actual infidelity scenario. Exploratory analysis of additional demographic variables was conducted.     

An Investigation of the Dynamic Processes Promoting Citizen Participation

This study expanded the citizen participation literature by examining the dynamic nature of citizen participation and the extent to which the factors associated with citizen participation may be moderated by resident leadership status. Longitudinal survey data collected from 542 residents in one small Midwestern city implementing a community change initiative provide some insight into the challenges surrounding the promotion of an active citizenry. Within this one community, citizenship behaviors of emergent resident leaders and residents uninterested in a leadership role were influenced, to some extent, by different factors and the importance of these factors shifted in only a 2 years time span. Future research is needed to determine if the dynamics uncovered in this study were due to the initiative or to the nature of citizen participation processes.     

Does parental mental health moderate the effect of a telephone and internet‐assisted remote parent training for disruptive 4‐year‐old children?

This study explores the moderators affecting the success of an Internet‐based and telephone assisted remote parent training intervention and compares them to an educational control group. We prospectively identified 464 parents who reported at a health check that their 4‐year‐old children showed elevated levels of externalizing behavior. The moderators explored included parental attention deficit and hyperactivity disorder (ADHD) and parental distress. The dependent variables were child externalization scores and self‐reported parenting skills. The measures were completed at baseline, six and 12‐months follow‐up. The 232 families randomized to active treatment received 11 Internet‐based training sessions with weekly phone calls from a coach. The other 232 families had access to a website that provided general positive parenting advice and one 45‐minute phone‐call from a coach. Using hierarchical linear models, we explored if the parental ADHD or parental distress modified the treatment effects on child externalizing behavior or parenting skills. The results showed that none of the independent variables moderated intervention effects on child externalizing behavior or parenting skills. The lack of significant moderator effects could have been due to the treatment's personalization, the format's flexibility and adaptability to when and how the parents wanted to complete the sessions or the relatively low levels of ADHD and parental distress among the participants.     

Self-esteem Interventions in Adults – A Systematic Review and Meta-analysis

Many types of intervention are used to boost adults’ self-esteem but their relative efficacy and the characteristics that moderate this efficacy remain unclear. We addressed these questions via a meta-analysis of 119 studies. Results obtained using a random-effects model showed a significant effect of interventions on adults’ global self-esteem, d = 0.38, 95% CI [0.33, 0.43]. This efficacy is moderated by some types of intervention, session format, experimenter contact, population type, and type of control group. We discuss these findings by addressing the limitations of our analyses and some issues related to this field of research (e.g., lack of power, heterogeneity of the studies included, publication bias, confounding effects) and by providing recommendations for future research and clinical practice.