New Directions in the Prevention of Body Image Concerns

Transcription

1 New Directions in the Prevention of Body Image Concerns Susan J Paxton School of Psychology and Public Health La Trobe University Melbourne, Australia

2 Overview Why should we be concerned about body dissatisfaction? What do we know about risk factors that could guide prevention? New directions in media literacy interventions; New directions in peer interventions social media literacy; New directions in parent interventions.

3 Body Image Multidimensional concept related to the experience of the body Thoughts, beliefs, self-evaluation, emotions, actions, function, behaviours Body image is an individual s subjective evaluation of their physical self and appearance (Harrison & Heffner, 2011) Females: Focus on perceived weight and shape Males: Focus on muscularity and leanness

4 Body Image Continuum Body satisfaction Moderate body dissatisfaction Severe body dissatisfaction/ Clinical disorder Body Dissatisfaction Intense dislike, loathing, shame, hatred, over-evaluation and preoccupation with appearance

5 Why Be Concerned About Body Dissatisfaction? Source of distress and reduced quality of life (Mond et al., 2013) Body dissatisfaction is a risk factor for: Low self-esteem and depression (Paxton, et al., 2006) Lower physical activity, increased smoking and sexual risk taking (Kaufman & Augustson, 2008; Neumark-Sztainer, Paxton et al., 2006; Schooler et al., 2012) Extreme weight loss or weight/muscle gain measures, binge eating (Neumark- Sztainer, et al., 2006; Pope, et al., 2012) Overweight and obesity (Haines, et al., 2010) Onset of clinical eating disorders (Stice, 2011).

6 Prevalence of Body Dissatisfaction and Related Behaviours % of 8- to 11-year-old girls and % of 8- to 11-year-old boys think a lot about being thinner (McCabe & Ricciardelli, 2003) Mission Australia Survey (2015) 18,994 Australians aged 15- to 19-years Girls 37.4% Extremely or Very Concerned about their body image Boys 13.1% Extremely or Very Concerned about their body image In Australian adults aged years extreme weight loss behaviours: regular purging (28.6%), and strict dieting or fasting (21.4%) (Hay et al., 2008) Clinical eating disorders: Females = 6.7% (1.9% AN, 2.4% BN, 2.4% BED and other disorders); Males = 1.9% (.2% AN,.9% BN,.7% BED and other eating disorders) (Mohler-Kuo et al., 2016)

7 Prevention - Where to Start? An Etiological (or Risk Factor) Approach An etiological or risk factor approach to prevention assumes that if you reduce the presence of important causal risk factors then you will reduce the likelihood of the development of the problem = prevention Body satisfaction Moderate body dissatisfaction Severe body dissatisfaction Factors that increase risk of moving up the continuum? Factors that increase risk of moving up the continuum?

8 Individual Low self-esteem, depression, perfectionism, life events Social Factors Appearance focused environments: Media, friends /peers, family Body size Internalisation of body ideals Body comparison Unknown genetic & biological factors Body dissatisfaction Rodgers, Paxton, & McLean, (2014).

9 Individual Low self-esteem, depression, perfectionism, life events Social Factors Appearance focused environments: Media, friends /peers, family Body size Internalisation of body ideals Body comparison Unknown genetic & biological factors Rodgers, Paxton, & McLean, (2014). Body dissatisfaction

10 Prevention Approaches Change the environment Change the way we cope with our environment and with the ways we think about appearance.

11 Media Exposure and Body Media establish appearance norms In young girls: Dissatisfaction In 5-8 year old girls - greater exposure to appearance focused media predicts the development of lower body satisfaction a year later (Dohnt & Tiggemann, 2006) In 5-year-old girls - greater media exposure is related to a greater intention to diet (Damiano et al., 2015) In adolescents: Exposure to idealised media images increases body dissatisfaction in females (Hausenblas et al., 2013) Exposure to men s magazines a unique predictor of drive for thinness and drive for muscularity in boys (Slater & Tiggemann, 2014)

12 Effect of Idealised Media Exposure But not all girls are effected in the same way (Durkin & Paxton, 2002) Which factors increase risk or provide protection against the negative impact of media exposure? High internalisation of the thin ideal, high body comparisons (Durkin, Paxton & Sorbello, 2007) Media literacy?

13 New Directions Understanding and Enhancing Media Literacy What is media literacy? Critical thinking and evaluation skills that facilitate independent judgements about media (Silverblatt, et al., 2014); Media literacy interventions aim to enhance participants critical viewing and thinking about media thereby reducing vulnerability to negative media influences (McLean, Paxton & Wertheim, 2016). Does media literacy protect against negative impact of media exposure on body dissatisfaction?

14 Media Literacy Interventions One piece of supportive evidence - school-based prevention interventions with media literacy components have been shown to be particularly helpful in reducing body dissatisfaction and its risk factors (Watson et al., 2016; Yager et al., 2013); Media Smart (Wilksch et al., 2008; Wilksch & Wade, 2009); Happy Being Me (Dunstan, Paxton & McLean, 2016; Richardson & Paxton, 2010; Bird et al., 2013).

15 Media Literacy and Body Dissatisfaction BMI.39** Media Literacy.07* -.25**.14* Appearance Comparisons.52**.41** Weight and Shape Concern -.27** Internalisation.25** Media Exposure.17**.10* McLean, Paxton & Wertheim (2013)

16 Media Literacy and Exposure to Thin Ideal Media McLean, Paxton & Wertheim (2016) 246 grade 7 girls, assessed 1 week prior to experimental exposure media literacy (critical thinking about media messages; realism of media messages), internalisation of thin ideal, comparison tendencies Body satisfaction assessment (VAS) - exposure to 10 thin ideal advertising images body satisfaction reassessed.

17 Mean Change in Body Satisfaction: Internalisation and Critical Thinking Low internalisation; Low critical thinking Low internalisation; High critical thinking High internalisation; Low critical thinking High internalisation; High critical thinking

18 Mean Change in Body Satisfaction: Upward Comparison and Realism Scepticism Low comparison; Low realism scepticism Low comparison; High realism scepticism High comparison; Low realism scepticism High comparison; High realism scepticism

19 Conclusions Media Literacy Research is building that supports media literacy as a moderator of negative effects of exposure to idealised appearance media; Further research is needed to identify effective components of media literacy interventions to enhance the impact of our programs.

20 Peers Adolescent girls friendships groups share similar levels of body dissatisfaction and dieting (Paxton et al., 1999); Prospective research shows that peer body image attitudes predict individual body image in: Australian 5- to 8-year-old girls (Dohnt & Tiggemann, 2006) German adolescents (Helfert & Warschburger, 2011) US adolescents (Eisenberg & Neumark-Sztainer, 2010; Paxton et al., 2006) Fijian adolescent girls (Gerbasi et al., 2014) Singapore adolescents (Lwin & Malik, 2012).

21 Prevention and the Peer Environment Positive outcomes from school-based interventions that incorporate activities that address peer interactions (Atkinson et al., 2016; Dunstan et al., 2016; Ross, Paxton & Rodgers, 2013); Activities which aim to challenge peer group norms, appearance conversations and teasing and fat talk. Develop alternatives using role play; Explore valued non-appearance qualities in friends and self. Oh, I need to lose weight I don t like my... I wish I was taller No, I m the one who needs to lose weight

22 New Directions Social Media Literacy Social media - a new media environment and a new peer environment the social aspect is critical adolescents have on average over 200 Facebook friends (Tiggemann & Slater, 2013); An environment for peer appearance conversations, appearance comparisons, and peer bullying (Frisén, Berne & Lunde, 2013); An environment that facilitates self-disclosure, and appearance is often central. Australia adolescents - 90% use the Internet for social networking (ABS, 2013); In 2013, of 13- to 15-year-old girls, 75% had a Facebook page and girls spent an average of 1.5 hrs there daily (Tiggemann & Slater, 2013).

23 Social Media and Body Dissatisfaction Social media users have significantly greater body dissatisfaction than nonusers (Rodgers & Melioli, 2016); Using Facebook involving photo-based activities is related to internalising appearance ideals and body dissatisfaction (Meier & Gray, 2014); Manipulating images for social media and photo investment (concern and effort in selecting and sharing photos) are related to body dissatisfaction, over-evaluation of weight and shape and dietary restraint (McLean, Paxton, Wertheim & Masters, 2015).

24 Social Media Literacy Pilot Intervention Social media literacy - being empowered with the knowledge and skills to analyse, evaluate, produce and participate in social media. Includes understanding and critical analysis of the social and peer engagement contexts of social media. Grade 7 girls Intervention = 3 social media literacy classes (n=60) No intervention control group (n=30). Analyses of total sample and a high risk subsample with existing body image concerns at baseline.

25 Lesson topic 1. Motives and consequences for social media posting to inform critical social media use. 2. Effects of social media viewing: manipulation of images, reduction of appearance comparison. 3. Understanding and coping with friend feedback, cybercitizenship. Teaching activities Exploring postings on social media; Small group activity - create advertisement to sell a product or improve health. Explore realism - view and critique favourite celebrity sites and friend and peer postings; Create social media posts using different online selfpresentation styles. Find social media images with positive and negative feedback and explore associated emotions, possible motives for negative feedback. Create non-appearance focused representative profile pictures.

26 Social Media Literacy Pilot Intervention Post-intervention: experimental compared to control group had: reduced overvaluation weight and shape (total d =.31; high concerns d =.49), reduced internalisation of media ideals (total d =.27; high concerns d =.42), reduced appearance conversations (total d =.35; high concerns d =.42), reduced dietary restraint (total d =.56; high concerns d =.68), and increased social media literacy (total d =.31; high concerns d =.49). Be social media savvy Small ES d =.20, moderate ES d =.50 Boost body confidence the BOOST program

27 Conclusions Social Media Social media we need better understanding of the nature of impact of social media on body dissatisfaction, especially prospective research; We need further development and long term evaluation of interventions that will support young people to use social media in positive ways.

28 Influence of Parents Role of parents in relation to body image of adolescents and young adults (Rodgers & Chabrol, 2009; Rodgers, Paxton & Chabrol, 2009); Direct - Encouragement to lose weight Indirect - Modelling

29 Weight Bias in Young Children Weight bias Positive attitudes towards thinner and negative attitudes towards fatter people: Results in isolation and exclusion of larger children; May be internalised and result in negative attitudes about the self. Assessment Using a story format, children asked to select a same-sex figure to illustrate either positive or negative qualities.

30 Weight Bias in 4-year-old Girls Selection of a thinner figure to illustrate positive characteristics (positive weight bias) is associated with greater maternal dieting and predicted by greater maternal dieting assessed one year previously (Damiano et al., 2015; Spiel et al., 2016).

31 Weight Bias in 4-year-old Boys Positive weight bias is associated with greater paternal negative attitudes towards obese people and more paternal dieting, while negative weight bias is associated with greater paternal negative attitudes towards obese people (Damiano et al., 2015); Both positive and negative weight bias in boys predicted by paternal negative attitudes towards obese people assessed one year previously (Spiel, Rodgers et al., 2016).

32 Parent Feeding and Child s Eating Patterns Feeding practices associated with potentially negative or positive eating behaviours in children: Instrumental feeding (feeding to reward) (Rodgers, Paxton et al., 2013) Emotional feeding (feeding to calm) (Rodgers, Paxton, et al., 2013) Restriction for weight management purposes may increase tendency to over-eat (inconsistently observed) Modelling health eating (Gregory, Paxton et al., 2010) Family meals protective (Fulkerson et al., 2006)

33 New Directions Parent Interventions Hart, Damiano & Paxton, (2016)

34 A. CBCC Resource + information session (N = 97) B. CBCC resource only (N = 111) C. Nutrition resource (N = 86) D. Wait list control Questionnaire completion only (N = 79) (Hart, Damiano & Paxton, 2016)

35 Mean score Mean score 2.5 Instrumental Feeding 2.2 Weight Restriction Baseline 6-weeks 6-month f/u 12-month f/u Group A Group B Group C Group D 1.2 Baseline 6-weeks 6-month 12-month f/u f/u Group A Group B Group C Group D

36 Child Body Satisfaction p <.05 p <.05 A B C D Hill, Hart & Paxton, (2016)

37 Conclusions Parent Involvement Parents play a crucial role in the development of body image attitudes in children and adolescents; They are hard to involve in interventions when their children are older but seem easier to engage when children are young; Further research is needed to identify ways to empower parents of young children to provide a positive body image and eating environment for their young children.

38 Acknowledgements Eleanor Wertheim Siân McLean Laura Hart Stephanie Damiano Karen Gregg Rachel Rodgers Candice Dunstan Shanel Richardson Emma Spiel Mathew Marques Joanna Doley Katie Hill Alicia Holborn Tanya Nichols Monique Alexander Sara Tran Fiona Sutherland Natalie Tamplin Sarah Durkin Dianne Neumark-Sztainer Sarah Durkin Dianne Neumark-Sztainer Helena Schutz Emma Gollings Brooke Heinicke Chelsea Cornell Jennifer Masters Amy Ross Natasha Hepworth Jane Gregory Anna Brozovic