Empirically Defining Treatment Response and Remission in Body Dysmorphic Disorder Using a Short Self-Report Instrument

Determining response or remission status in body dysmorphic disorder (BDD) usually requires a lengthy interview with a trained clinician. This study sought to establish empirically derived cutoffs to define treatment response and remission in BDD using a brief self-report instrument, the Appearance Anxiety Inventory (AAI). Results from three clinical trials of BDD were pooled to create a sample of 123 individuals who had received cognitive-behavioral therapy for BDD, delivered via the Internet. The AAI was compared to gold-standard criteria for response and remission in BDD, based on the clinician-administered Yale–Brown Obsessive Compulsive Scale, modified for BDD (BDD-YBOCS), and evaluated using signal detection analysis. The results showed that a ≥ 40% reduction on the AAI best corresponded to treatment response, with a sensitivity of 0.71 and a specificity of 0.84. A score ≤ 13 at posttreatment was the optimal cutoff in determining full or partial remission from BDD, with a sensitivity of 0.75 and a specificity of 0.88. These findings provide benchmarks for using the AAI in BDD treatment evaluation when resource-intensive measures administered by clinicians are not feasible.     

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.     

Microstructures and strengthening mechanisms in high-carbon titanium-microalloyed interstitial-free steels

We report the mechanical properties and microstructures of titanium-microalloyed interstitial-free (IF) steels with different carbon contents smelted and rolled in the laboratory. The results show an increase of yield strength and tensile strength with carbon content, which are enhanced with lower coiling temperature (CT). Microstructure analysis reveals that the ferrite grain size varies from 11 to 23?μm, while the average size of TiC as the main second-phase particle ranges from 10 to 35?nm. The sample with 80?ppm carbon and 853?K CT reaches a mechanical strength close to that of high-strength IF steels. The increase of yield strength is mainly attributed to both grain-refining and precipitation strengthening.     

Withdrawal of spatial overt attention following intentional forgetting: evidence from eye movements

Eye movements were measured to examine whether item-method directed forgetting involved a spatial overt attention shift. Experiment 1 showed that participants’ eyes were moved away from the study word following the forget and ignore cues, but not the remember cue. Experiment 2 revealed that the eyes were moved away from the area that covered by the study word even when the study word disappeared upon the presentation of the memory cue. Both the study word and memory cue were presented auditorily in Experiment 3. In all experiments, the to-be-remembered words were recalled better than both to-be-forgotten and to-be-ignored words. More importantly, mental effort, as indexed by the pupil size, increased following the remember, as compared with the forget and ignore cues. These findings are discussed in terms of controlling spatial overt attention after encoding to withdraw attention from irrelevant information and to allocate cognitive resources to relevant information for long-term retention.     

Emotion regulation through execution,observation, and imagery of emotional movements

According to Damasio’s somatic marker hypothesis, emotions are generated by conveying the current state of the body to the brain through interoceptive and proprioceptive afferent input. The resulting brain activation patterns represent unconscious emotions and correlate with subjective feelings. This proposition implies a corollary that the deliberate control of motor behavior could regulate feelings. We tested this possibility, hypothesizing that engaging in movements associated with a certain emotion would enhance that emotion and/or the corresponding valence. Furthermore, because motor imagery and observation are thought to activate the same mirror-neuron network engaged during motor execution, they might also activate the same emotional processing circuits, leading to similar emotional effects. Therefore, we measured the effects of motor execution, motor imagery and observation of whole-body dynamic expressions of emotions (happiness, sadness, fear) on affective state. All three tasks enhanced the corresponding affective state, indicating their potential to regulate emotions.     

Young men’s minimisation of their body dissatisfaction

Abstract

Objective: To examine men’s body dissatisfaction qualitatively.

Design: Forty-two British men aged 18–45 years took part in a two-session group intervention across 12 groups. The intervention was designed to improve body dissatisfaction by engaging them in a critique of the appearance ideal through written and behavioural exercises.

Main outcome measures/results: Analysis of the topics discussed during the intervention generated two core themes. Theme 1 showed that, in general, men minimised the existence of their own body dissatisfaction while (somewhat surprisingly) outlining the ubiquity and potency of the appearance ideal for men in general. Theme 2 involved men reporting the problematic impact of body dissatisfaction in their lives (despite earlier minimisation), such as social avoidance, strict eating and supplement regimes, or difficulty in situations where the body was exposed.

Conclusion: The results stress the need to acknowledge that men experience a range of impacts of body dissatisfaction beyond clinical presentations (such as disordered eating) that influence their everyday lives, while also recognising that they tend to minimise this dissatisfaction in conversation. These findings have important implications for advocacy and interventions to improve men’s body dissatisfaction.     

Dress fit and body image: A thematic analysis of women's accounts during and after trying on dresses

This study was designed to investigate women's experiences of dress fit and body image. Spontaneous speech of 20 women aged 18–45 years was audio-recorded while they tried on a number of dresses. They were also body-scanned and photographed in their chosen dress and discussed both the scan and the photograph in semi-structured interviews. Data were analysed using inductive thematic analysis and four key themes were found: the slim hourglass ideal, functional aspects of clothes fit, body confidence and clothes fit, and clothes dimensions and size coding. All themes and component sub-themes were ratified in follow-up sessions six months after the original interviews. It was concluded that these women had a complicated relationship with clothes fit and sizing and used well-fitting clothes to increase body confidence, cover perceived flaws, and to try to attain a slender hourglass look. Ideas for future directions for research in these areas are discussed.     

The effects of fat talk on body dissatisfaction and eating behavior: The moderating role of dietary restraint

Although research suggests that fat talk, the normalized conversations that involve degrading one's body shape/weight and size, can increase body dissatisfaction and disordered eating behavior, the extent to which dietary restraint may moderate these relationships remains uncertain. A pilot study (N = 30) comparing online videos with researcher-developed vignettes as prospective manipulations for fat talk exposure suggested use of the vignettes as potent yet subtle stimuli. In the main study, women undergraduates (N = 116) were randomized to read a fat talk or neutral vignette and then completed standardized measures of body dissatisfaction and dietary restraint while being concurrently presented with food stimuli. Results suggest significant moderation effects for dietary restraint: whereas fat talk exposure was associated with increased body dissatisfaction among low dietary restrainers, it appeared to reduce food consumption among high dietary restrainers. Findings highlight the importance of individual differences in shaping responses to fat talk.     

The impact of thin idealized media images on body satisfaction: Does body appreciation protect women from negative effects?

This article examines whether positive body image can protect women from negative media exposure effects. University women (N = 112) were randomly allocated to view advertisements featuring ultra-thin models or control images. Women who reported high levels of body appreciation did not report negative media exposure effects. Furthermore, the protective role of body appreciation was also evident among women known to be vulnerable to media exposure. Women high on thin-ideal internalization and low on body appreciation reported appearance-discrepancies that were more salient and larger when they viewed models compared to the control group. However, women high on thin-ideal internalization and also high on body appreciation rated appearance-discrepancies as less important and no difference in size than the control group. The results support the notion that positive body image protects women from negative environmental appearance messages and suggests that promoting positive body image may be an effective intervention strategy.     

What works in secondary schools? A systematic review of classroom-based body image programs

Governments, schools, and curriculum authorities are increasingly recognizing that body image during adolescence is a public health issue that warrants attention in the school setting. After 30 years of eating disorder prevention research, and given the current interest in this area, it seems timely to review the research on interventions to improve body image in schools. We reviewed universal-selective, classroom-based programs that have been conducted since the year 2000, among adolescents, and found 16 eligible intervention programs. Seven of these programs were effective in improving body image on at least one measure, from pre to post test, though effect sizes were small (d = 0.22–0.48). These effective programs were conducted among younger adolescents 12.33–13.62 years, and included activities focusing on media literacy, self esteem, and the influence of peers. Implications for school personnel and curriculum authorities are discussed, and we provide recommendations for a strategic approach to future research in this area.