Emotion regulation, perfectionism, and eating disorder symptoms in adolescents: the mediating role of cognitive eating patterns.

Poor emotion regulation, along with elevated perfectionism, is recognised as a risk factor for the development of eating disorder (ED) symptoms. Therefore, the aim of our study was to examine the relationship between emotion regulation difficulties and perfectionism with ED symptoms, while controlling for emotional eating, uncontrolled eating, and cognitive restraint as mediators. In total, 482 adolescents (246 girls and 236 boys; M = 15.00, SD = 0.31) participated in this study. Based on the participants' body height and weight measured by the medical team during their regular preventive health examinations, the body mass index (BMI) was calculated. Participants also answered the Difficulties in Emotion Regulation Scale, Multidimensional Perfectionism Scale, Three-Factor Eating Questionnaire, and Eating Disorder Examination Questionnaire. According to the results obtained, adolescent girls in our sample reported more difficulties in emotion regulation, more uncontrolled and emotional eating, and more ED symptoms. A significant direct effect was found for difficulties in emotion regulation and ED symptoms but not for perfectionism. In addition, only emotional eating and cognitive restraint (not uncontrolled eating) mediated the relationship between difficulties in emotion regulation and perfectionism and ED symptoms. The results suggest that difficulties in emotion regulation may be more important than perfectionism in explaining ED symptoms in a sample of healthy adolescents. When adolescents experience problems in emotion regulation in combination with emotional or uncontrolled eating, they might be at a higher risk of experiencing concerns about weight and a variety of other ED symptoms, and this should be considered when planning preventive interventions for adolescents.

Role of Sociocultural Pressures and Internalization of Appearance Ideals in the Motivation for Exercise.

This study examined the mediating role of sociocultural pressures (i.e., parental, peer, significant others, and media) and the internalization of appearance ideals (i.e., thin, muscular, attractive) on the relationship of Body Mass Index (BMI) and exercise frequency to exercise motives (i.e., weight management, appearance, positive health). A total of 262 young women, age 18 to 29, participated in the study. Average BMI in this sample was 22.09 (SD = 2.69) and ranged from 18.03 to 31.51, with 15.3% of the sample having a BMI of 25 and above, which qualifies as overweight. Participants completed Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised and Exercise Motivations Inventory-2 (EMI-2) along with some demographic information and questions regarding their exercise habits. The results indicated that women with higher BMI are more motivated to exercise to lose weight, and women who exercise more frequently are motivated by the aspect of positive health. Also, women with higher BMI perceive more sociocultural pressures to obtain a culturally acceptable body. The sociocultural pressures and appearance internalization mediated the relationship between BMI and the frequency of exercise with motives for exercise. The implications and future directions of research are discussed.

Illness perception in overweight and obese patients with cardiovascular diseases.

OBJECTIVE: This study explored the relationship of illness perception with different aspects of cardiac anxiety, general anxiety and depression in a sample of male and female overweight and obese patients with cardiovascular diseases (CVD). STUDY DESIGN: The clinical sample included 165 adults (113 males) aged from 32 to 89 years. The patients were admitted to the Department of Cardiology and Cardiac Rehabilitation for a major cardiovascular event, acute myocardial infarction or myocardial revascularization. MEASUREMENTS: Psychological measurement included questionnaires of illness perception, cardiac anxiety, general anxiety and depression. RESULTS AND CONCLUSIONS: Illness perception and cardiac anxiety in patients with CVD were associated with anxiety and depression. Regression analysis showed that illness perception accounts for a significant proportion of the variance in both anxiety and depression for males, but not for females. Gender-specific interrelations between perceptions of CVD and indices of mental health have an implication for interventions to maximize the effect of therapy with these patients. LEVEL OF EVIDENCE: Level V, Descriptive study.

Smile Aesthetics Satisfaction Scale: development and validation of a new brief five-item measure of satisfaction with smile aesthetics in adults and the elderly.

OBJECTIVE: To create and validate a brief questionnaire designed for the assessment of satisfaction with smile aesthetics and to test its efficiency as a patient-centred outcome measure of aesthetic interventions in dentistry. MATERIALS AND METHODS: A team of three specialists - two from prosthodontics and one psychologist - used a self-evaluation scale consisting of five elements in order to rate self-perceived smile aesthetics. A total of 671 subjects (63% female), 18-86 years of age, were included in the investigation. The internal consistency, validity and stability of the questionnaire, along with the responsiveness induced by the tooth-whitening procedure, were evaluated. The relationship between self-perceived satisfaction with the smile aesthetics and the clinical status of the dentition was assessed. RESULTS: The questionnaire had one dimension accounting for 64.3% of variance and showed a high level of reliability (Cronbach α = 0.859). It measured a construct similar to concern with tooth appearance and the desire to improve this appearance (r = -0.403 and r = -0.353, respectively; P < 0.001). High test-retest reliability was demonstrated (intraclass correlation coefficient = 0.985). The questionnaire was able to detect an increase in satisfaction with smile aesthetics as a result of the tooth-whitening procedure (P = 0.016). Clinical predictors of greater satisfaction with smile aesthetics were greater tooth display when smiling, decreased chroma and the absence of gingivitis, as well as absence of crowded, fractured and restored teeth in the anterior segment. CONCLUSIONS: A new questionnaire, titled the Smile Aesthetics Satisfaction Scale (SASS), showed good psychometric properties and its use can be recommended.

Quality of life as a mediator in the association between body mass index and negative emotionality in overweight and obese non-clinical sample.

PURPOSE: The present study investigates the differences in physical health-related quality of life (HRQoL) among overweight and obese people, as well as the correlates of HRQoL in this population and the association between BMI, depression, anxiety, and potential mediating effects of HRQoL. METHODS: The research was conducted on a sample of overweight and obese adults who visited their primary care physician. A total of 143 women and 130 men were enrolled in the study, 43% of the subjects were overweight, and 57% of the subjects were obese. The subjects ranged in age between 21 and 60 years. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale, and HRQoL was evaluated using the Medical Outcome Study Short-Form 36. RESULTS: The analysis of variance results showed that women in comparison to men have lower physical HRQoL (e.g. worst physical functioning, more bodily pain), and that severely obese patients have lower physical HRQoL in comparison to overweight ones. The regression analysis results indicated that some of the aspects of physical HRQoL (e.g. physical functioning, role limitations) mediate the relationship between BMI and depression only in women. The higher level of body mass decreased the physical HRQoL, which became a potential risk factor for the development of depressive symptoms. CONCLUSIONS: The results from the present study show that a different pattern of functioning exists between men and women. It is important to identify the factors that can effectively motivate and stimulate obese people to change their lifestyle and to consider the differences in psychological functioning between women and men.

Assessing the factor structure of the Body Uneasiness Test (BUT) in an overweight and obese Croatian non-clinical sample.

PURPOSE: The study objectives are to investigate the psychometric properties of the Body Uneasiness Test (BUT-A) in a general sample of overweight and obese persons in Croatia, to evaluate structure differences between men and women and to examine the relationship with other measures of body dissatisfaction as well as with objective body mass measure. METHODS: This study included 320 adults (156 women and 164 men; aged between 20 and 71) with BMIs ranging from 24 to 48.83 kg/m(2). RESULTS: The analysis confirmed a structural one-factor model for BUT-A. The one-factor model fits the data equally as well as the more complex five-factor model did and should be considered a more robust, parsimonious and adequate model. Female participants showed higher results (higher body uneasiness), but the importance of items is roughly comparable between genders. The BUT-A score significantly contributes to the prediction of general body dissatisfaction, even after gender and BMI are controlled. The multifaceted nature of the BUT-A might explain the relatively low measure of general body dissatisfaction in this sample. Congruent with previous studies, obese subjects expressed dissatisfaction with their body on the figure rating scale by selecting the ideal figure two units thinner than their current body figure. In overweight and obese men, body dissatisfaction is lower than in women. CONCLUSION: The BUT-A can be a reliable one-dimensional tool for the assessment of body uneasiness in a wide range of samples, including obese individuals.

Binge eating as a determinant of emotional state in overweight and obese males with cardiovascular disease.

OBJECTIVES: The present study investigates the association between depression, anxiety and binge eating at baseline with weight-change after an approximately 1-year period in a clinical sample of obese adult males with cardiovascular disease. METHODS: At the time of the first measurement, the sample consisted of 69 overweight and obese men (age range between 36 and 74); 34 patients attended a follow-up measurement 6-17 months after the first measurement, and completed selected psychological instruments. RESULTS: After the follow-up period, only 28.7% patients' lost weight, 29.9% patients' had the same weight, and finally 41.4% patients' gained weight. When comparing the first and the second assessments, the level of anxiety and depression is relatively stable. Men, who, at the time of the second assessment, gained weight, and were binge eating at baseline, were more depressed and anxious in comparison with the other two groups of patients. CONCLUSIONS: It is necessary to focus primarily on binge eating symptoms as a part of weight reduction treatment as well as to treat anxiety and depression in CVD patients. Binge eating is an eating disorder per se, and therefore it is important to treat it before the person starts weight reduction procedures as part of the risk prevention treatment for CVD patients.

The attractive female body weight and female body dissatisfaction in 26 countries across 10 world regions: results of the international body project I.

This study reports results from the first International Body Project (IBP-I), which surveyed 7,434 individuals in 10 major world regions about body weight ideals and body dissatisfaction. Participants completed the female Contour Drawing Figure Rating Scale (CDFRS) and self-reported their exposure to Western and local media. Results indicated there were significant cross-regional differences in the ideal female figure and body dissatisfaction, but effect sizes were small across high-socioeconomic-status (SES) sites. Within cultures, heavier bodies were preferred in low-SES sites compared to high-SES sites in Malaysia and South Africa (ds = 1.94-2.49) but not in Austria. Participant age, body mass index (BMI), and Western media exposure predicted body weight ideals. BMI and Western media exposure predicted body dissatisfaction among women. Our results show that body dissatisfaction and desire for thinness is commonplace in high-SES settings across world regions, highlighting the need for international attention to this problem.

Medical and psychological parameters in overweight and obese persons seeking treatment.

The aim of the study was to analyse psychological characteristics and medical parameters in obese and overweight to identify the possible psychosocial consequences of obesity that may occur along with the numerous medical problems associated with excess body weight. Analysis was made on 296 patients (103 males and 193 females, median age 50, range 16-81) divided in three groups, depending on their Body mass index (BMI). Group I included 41 patients with BMI ranging from 25 to 29.9, group II included 170 patients with BMI from 30 to 34.9, and group III 85 patients with BM > or =35. We compared medical (glucose, cholesterol, triglycerides, HDL-cholesterol, systolic and diastolic blood pressure, body fat percentage) and psychological parameters (anxiety, depression, pros and cons of losing weight, self efficacy and four stages of change) in the patients included in the study. Univariate analysis has shown statistically significant difference among obese and overweight patients in goal weight, systolic and diastolic blood pressure, body fat percentage, glucose and cholesterol serum level. People with higher BMI (>30) found more advantages (pros) over disadvantages (cons) of weight loss but the level of anxiety and depression did not differ significantly among those 3 groups of patients. The results have shown that overweight and obese people have serious medical problems. They also differ in some psychological characteristics which have to be taken into consideration. Therefore, approach to these patients should be multidisciplinary, including dietary care, physical activity, psychological and medical care.

Nine, seven, five, or three: how many figures do we need for assessing body image?

320 Croatian female students (M=20.4 yr.) were recruited to examine the validity and reliability of figural scales using different numbers of stimuli (3, 5, 7, and 9) and different serial presentation (serial and nonserial order). A two-way analysis of variance (4 numbers x 2 orders of stimuli) was performed on ratings of current self-size and ideal size as dependent variables. Analysis indicated a significant main effect of number of stimuli. This, together with post hoc tests indicated that ratings were significantly different for a scale of three figures from scales of more figures, which in turn did not differ among themselves. Main effects of order of stimuli, as well as the interaction, were not significant. The results support the hypothesis that the optimal number of figures on a scale is seven plus (or minus) two.

Body-size preferences in Croatian children ages seven to ten years.

288 Croatian school children, ages 7 to 10 years rated their current and ideal body sizes on Collins' figures and chose the favorite figure for their same- and opposite-sex friends. Girls aged 10 preferred their female friends' figure to be more similar to their own, while boys preferred a friend's to be larger. These findings support cultural ideal of thinness for girls and strength for boys.