"I felt so powerful to have this love in me": A grounded theory analysis of the experiences of people living with and recovering from eating disorders while in diverse romantic relationships.

Romantic partners have the potential to influence attitudes and behaviors related to body image and disordered eating. However, the role that romantic relationships can play in eating disorder (ED) recovery has not been comprehensively investigated. The present study aimed to explore the ways that people living with and recovering from EDs experience their romantic relationships, with the specific objective of developing a novel theoretical framework, grounded in the experiences of people in diverse romantic relationships, to guide future research on the topic. Semi-structured individual interviews were conducted with 66 people (45 cisgender women, 11 cisgender men, 9 nonbinary people, and 1 transgender man) living with and recovering from EDs while in romantic relationships. Our grounded theory analysis yielded a theoretical model of ED management in romantic relationships, revealing that Individual and Relationship Characteristics intersected with Relationship-Related Stressors and were navigated using Eating Disorder and Relationship Management Strategies. Combined with Partner Support and Tensions, these management strategies were related to Relationship and Mental Health Outcomes, which affected and were affected by Future Concerns. Future researchers should continue to build on, expand, and modify this model and further explore the role of romantic relationships in the experience of people living with EDs.

Promoting Resilience to Improve Disordered Eating (PRIDE): A case series of an eating disorder treatment for sexual minority individuals.

OBJECTIVE: Despite the increased risk for eating disorders (EDs) among sexual minority (SM) individuals, no ED treatments exist specifically for this population. SM stress and appearance-based pressures may initiate and/or maintain ED symptoms in SM individuals; thus, incorporating strategies to reduce SM stressors into existing treatments may help address SM individuals' increased ED risk. This mixed-methods study evaluated the feasibility, acceptability, and preliminary efficacy of Promoting Resilience to Improve Disordered Eating (PRIDE)-a novel ED treatment for SM individuals. METHODS: N = 14 SM individuals with an ED diagnosis received 14 weekly sessions integrating Enhanced Cognitive Behavioral Therapy for EDs (CBT-E) with techniques and principles of SM-affirmative CBT developed to address SM stressors. Participants completed qualitative interviews and assessments of ED symptoms and SM stress reactions at baseline (pretreatment), posttreatment, and 1-month follow-up. RESULTS: Supporting feasibility, 12 of the 14 (85.7%) enrolled participants completed treatment, and qualitative and quantitative data supported PRIDE's acceptability (quantitative rating = 3.73/4). By 1-month follow-up, 75% of the sample was fully remitted from an ED diagnosis. Preliminary efficacy results suggested large and significant improvements in ED symptoms, clinical impairment, and body dissatisfaction, significant medium-large improvements in internalized stigma and nonsignificant small-medium effects of sexual orientation concealment. DISCUSSION: Initial results support the feasibility, acceptability, and initial efficacy of PRIDE, an ED treatment developed to address SM stressors. Future research should evaluate PRIDE in a larger sample, compare it to an active control condition, and explore whether reductions in SM stress reactions explain reductions in ED symptoms. PUBLIC SIGNIFICANCE: This study evaluated a treatment for SM individuals with EDs that integrated empirically supported ED treatment with SM-affirmative treatment in a case series. Results support that this treatment was well-accepted by participants and was associated with improvements in ED symptoms and minority stress outcomes.

Who Is Invited to the Metaverse? Analyzing Media Coverage of an Emerging Virtual World.

As a new technology awaiting widespread immersive usage, public awareness and understanding of the metaverse is likely significantly shaped by its coverage in the media. This study explored how the metaverse is framed in U.S. news media coverage, including who the media targets as metaverse users, and reflects on how this could shape public attitudes and engagement with the metaverse. Specifically, this study asked: which people and institutions are included and excluded from media coverage of the metaverse? To answer this question, a systematic content analysis of 526 U.S. news articles was conducted, drawing from three media databases. Findings reveal that the media frames the metaverse as a corporate space for those with buying power: investors, technology experts, and consumers. Users without buying power and users from marginalized groups were rarely considered in media coverage. Despite this, most coverage of the metaverse was descriptive, with only 11 percent of articles critiquing this space. These findings raise broad questions about commodification, exclusion, and inequality in the metaverse.

Functions of disordered eating behaviors: a qualitative analysis of the lived experience and clinician perspectives.

BACKGROUND: One method to improve treatment outcomes for individuals with eating disorders (EDs) may be understanding and targeting individuals' motives for engaging in DE behaviors-or the functions of DE behaviors. The goal of this study was to investigate and categorize the various functions of DE behaviors from the perspectives of adults who engage in DE behaviors and clinicians who treat EDs. METHODS: Individuals who engage in DE behaviors (n = 16) and clinicians who treat EDs (n = 14) were interviewed, and a thematic analysis was conducted to determine key functions of DE behaviors. RESULTS: Four main functions of DE behaviors were identified by the authors: (1) alleviating shape, weight, and eating concerns; (2) regulating emotions; (3) regulating one's self-concept; and (4) regulating interpersonal relationships/communicating with others. CONCLUSIONS: Differences in participant responses, particularly regarding the relevance of alleviating shape and weight concerns as an DE behavior function, highlight the importance of individualized conceptualizations of DE behavior functions for any given client.

There are many reasons why individuals engage in disordered eating (DE) behaviors, and gathering information on these functions of one's DE behaviors might help clinicians decide which treatments to administer to individual clients. This study identified and organized numerous functions of DE behaviors based on perspectives of both adults who engage in DE behaviors and clinicians who treat EDs. These functions can be largely grouped into four categories: (1) reducing concerns about one's shape, weight, and/or eating habits; (2) managing one's emotions; (3) managing one's beliefs about themselves as a person; and (4) managing relationships with others or communicating with others. Using treatments that address these reasons for one's DE behaviors may be beneficial for clients.

A qualitative analysis of relationship advice from the perspective of people living with and recovering from eating disorders while in diverse romantic relationships.

Eating disorders (EDs) have adverse consequences across life domains, ranging from physical health to interpersonal relationships. While research suggests that romantic partners have the potential to support ED recovery, partners to those with EDs often report feeling confused and helpless in the face of the condition. The extant literature on EDs in relationships centers on the experiences of cisgender, heterosexual women. The present study aimed to garner a more comprehensive understanding of the types of support people with EDs believe are most helpful from romantic partners by analyzing relationship advice from a diverse group of individuals with EDs who were in romantic relationships. As part of a larger study on romantic relationships in ED recovery, we analyzed responses to the question, "If you had to give one piece of advice to someone who learns that their partner has an ED, what would it be?" Through Consensual Qualitative Research-Modified, we identified 29 themes, which we grouped into 7 domains: Foster Open Communication, Create an Environment of Emotional Intimacy, Let Your Partner Guide You, Educate Yourself, Be Compassionate with Yourself, Use Caution when Discussing Food and Bodies, and a Miscellaneous domain. These findings highlight the importance of patience, flexibility, psychoeducation, and self-compassion for individuals working to support their partner's ED recovery, and can inform future couples-based treatments and interventions for EDs.

Gender identity-based disparities in self-injurious thoughts and behaviors among pre-teens in the United States.

INTRODUCTION: Transgender individuals are at heightened risk for self-injurious thoughts and behaviors (SITBs). Evidence suggests that middle childhood-aged transgender individuals experience elevated rates of non-suicidal self-injury (NSSI) and passive suicidal ideation (SI), compared to cisgender children. Little is known about gender identity-based disparities in SI more broadly and suicidal behavior (SB) in children aged 9 and 10. The aim of this study was to examine gender identity-based disparities in SITBs among children in middle childhood (pre-teens) in a US-based sample. METHODS: Using data from the 3.0 baseline release of the Adolescent Brain Cognitive Development (ABCD) study, logistic regression models, unadjusted and adjusted for covariates, were performed to examine gender identity-based disparities in SITBs. RESULTS: In a model adjusted for birth sex, race/ethnicity, and household income, transgender children were at significantly higher odds for current (adjusted odds ratio [AOR] = 6.34) but not lifetime NSSI compared with cisgender children. Transgender children were at significantly higher odds for current and lifetime SI (AOR = 13.03; AOR = 5.39, respectively) and SB (AOR = 14.21; AOR = 12.64, respectively) compared with cisgender children. CONCLUSIONS: Gender identity-based disparities in SITBs may be present as early as age 9 and 10, demonstrating the need for SITB prevention and intervention efforts specific to transgender children.

Internalization of muscularity and thinness ideals: Associations with body dissatisfaction, eating disorder symptoms, and muscle dysmorphic symptoms in at risk sexual minority men.

OBJECTIVE: In the tripartite influence model, appearance-ideal internalization is identified as a prominent risk factor for the development of body dissatisfaction and subsequent eating disorder (ED) behaviors. For men, prior research has emphasized the importance of both thin-ideal internalization and muscular-ideal internalization in explaining later ED behaviors and muscle dysmorphia (MD) symptoms. Previous research in heterosexual men has shown that the associations between muscular-ideal internalization and ED or MD symptoms may depend on whether the individual has also internalized the thin ideal. However, this interaction has not been examined in research with sexual minority men (SMM). METHOD: The current study collected self-report data from 452 at risk SMM (i.e., endorsed body dissatisfaction), with ages ranging from 18 to 35 years. Linear regression models were conducted to test the interaction effects between thinness and muscularity internalization on ED symptoms, MD behaviors, and general body dissatisfaction. Simple slopes and the Johnson-Neyman technique were used to investigate significant interaction terms. RESULTS: Thin- and muscular-ideal internalization were positively associated with muscular appearance intolerance and dietary restriction with no significant interaction. Muscular drive for size was highest when both muscularity internalization and thinness internalization were high. Muscular-ideal internalization was positively associated with both cognitive restraint and general body dissatisfaction, but only at lower levels of thinness internalization. DISCUSSION: Given the interacting association between thinness and muscularity internalization and aspects of body dissatisfaction, attitudes, and behavior, prevention and intervention programs for EDs and MDs in SMM should seek to dismantle both thinness and muscularity internalization. PUBLIC SIGNIFICANCE STATEMENT: Internalizing-or adopting as one's own-the ideal of a body with low body fat and high muscularity has been shown to lead to muscle dysmorphia and eating disorder symptoms in men. The current study examines whether the combination of thin-ideal and muscular-ideal internalization is associated with worse symptoms than either facet alone in sexual minority men. Treatment efforts in sexual minority men should address both types of internalization.

"I feel more protective over my body:" A brief report on pregnant women's embodied experiences during the COVID-19 pandemic.

The COVID-19 pandemic has dramatically altered the experiences of pregnant people. For example, the pandemic has disrupted access to healthcare, social distancing has reduced social support, and vaccine rollout has led to safety concerns. Consistent with the Developmental Theory of Embodiment, which posits that our experiences of our bodies are influenced by social factors, studies have revealed an uptick in body dissatisfaction and disordered eating during this time. However, research on pregnant people's experiences of their body and body image during the pandemic has been largely overlooked. In this exploratory qualitative study, we aimed to broadly understand how the pandemic and quarantine have impacted the way pregnant women (N = 190) in the US and UK relate to their bodies. We used Consensual Qualitative Research-Modified (CQR-M) to analyze pregnant women's brief textual accounts of their embodied experiences during the pandemic and identified eight core domains across the dataset. Some participants reported no change in their embodied experiences, whereas others reported accounts of appearance and weight concerns, health behavior self-judgment, gratitude for isolation, body appreciation, maternal healthcare concerns, COVID health concerns, and health and safety strategies. We conclude with implications and recommendations for supporting pregnant people and their embodied well-being during health crises.

Eating disorders during the COVID-19 pandemic and quarantine: an overview of risks and recommendations for treatment and early intervention.

Individuals with eating disorders (EDs) are at significant risk for increases in symptomatology and diminished treatment access during the COVID-19 pandemic. Environmental precautions to limit coronavirus spread have affected food availability and access to healthy coping mechanisms, and have contributed to weight-stigmatizing social media messages that may be uniquely harmful to those experiencing EDs. Additionally, changes in socialization and routine, stress, and experiences of trauma that are being experienced globally may be particularly deleterious to ED risk and recovery. This paper presents a brief review of the pertinent literature related to the risk of EDs in the context of COVID-19 and offers suggestions for modifying intervention efforts to accommodate the unique challenges individuals with EDs and providers may be experiencing in light of the ongoing public health crisis.

Psychometric properties and validation of the Phenomenological Body Shame Scale - Revised (PBSS-R).

Body shame is a common experience among women yet a challenging phenomenon to operationalize, and measures of body shame often fail to capture its embodied aspects. In this article, we examined the structural and psychometric properties of an existing measure of body shame that was developed by Fredrickson et al. (1998) to assess the motivational and behavioral components of feeling body shame. Across three studies, women participants completed the Phenomenological Body Shame Scale (PBSS) and measures of theoretically related constructs in counterbalanced order via online survey platforms. The results demonstrate evidence of construct validity for an abbreviated, 8-item measure of phenomenological body shame (PBSS-R). In Study 1 (n = 341 community women), we evaluated and confirmed the scale's structural validity as a unidimensional measure. In Study 2 (n = 204 college women), we demonstrated positive associations between the PBSS-R and negative body image attitudes and behaviors, and negative associations with self-compassion, supporting the scale's external validity. In Study 3 (n = 235 community women), the PBSS-R explained variance in intuitive eating and happiness above theoretically related measures of self-objectification and body shame, supporting the scale's incremental validity. We recommend use of this abbreviated measure to assess the more embodied and less evaluative features of body shame in women.

Smile pretty and watch your back: Personal safety anxiety and vigilance in objectification theory.

[Correction Notice: An Erratum for this article was reported online in Journal of Personality and Social Psychology on Nov 19 2020 (see record 2020-89294-001). In Table 4, the mean, standard deviation, and range for the Personal Safety Anxiety and Vigilance (PSAVS) variable were incorrect.] Objectification Theory posits that everyday encounters with sexual objectification carry a diffuse nonspecific sense of threat that engenders personal safety anxiety in women. In this article, we provide direct evidence for this tenet across 5 studies and 1,665 participants using multiple methods. Study 1 (N = 207) and Study 2 (N = 161) explored and confirmed the factor structure of the Personal Safety Anxiety and Vigilance Scale (PSAVS), a measure of personal safety anxiety, and provided evidence for the reliability and construct validity of its scores. Study 3 (N = 363) showed that personal safety anxiety is a conceptually different construct for women and men, and differentially mediated the relation between sexual objectification and restricted freedom of movement and the relation between self-objectification and restricted freedom of movement for women and men. Study 4 (N = 460) included a comprehensive test of personal safety anxiety within an expanded Objectification Theory model, which supported personal safety anxiety as a mediator of the links from sexual and self-objectification to women's restricted freedom of movement. Study 5 (N = 474) replicated these results while also adjusting for specific fears of crime and rape. Our findings offer a newly validated assessment tool for future research on safety anxiety, illuminate the real and lasting sense of threat engendered by everyday sexual objectification, and broaden understanding of the mental and physical constraints on women's lived experiences posited in Objectification Theory. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Yes, (Most) Men Know What Rape Is: A Mixed-Methods Investigation Into College Men's Definitions of Rape.

Sexual violence, including rape, is a pervasive problem on college campuses in the United States. Although men perpetrate the majority of sexual violence, men's attitudes, experiences, and perspectives are not typically included in research on rape and sexual violence. We addressed this empirical gap through our mixed-methods analysis of 365 college-aged men's definitions of the term "rape." Our analysis via consensual qualitative research revealed that men's definitions fit into nine primary domains: lack of consent, taken advantage of, sex, sexual activity, unwanted, gender/sex-specific, harm to victim, relationship, and emotional response, as well as a miscellaneous domain. Further, using chi-square tests of independence, we compared responses from men with and without histories of sexual violence perpetration. Findings showed that the definitions generated by men with a history of perpetration were less likely to include nonpenetrative sexual violence and were more likely to use gender/sex-specific language. We conclude that most young men have a generally accurate understanding of rape, though perpetrators' understandings may be somewhat narrower and more limited than those without a history of perpetration. We end with recommendations for refocusing sexual education curricula to better aid in the prevention of sexual violence perpetration. Specifically, given that (most) men know what rape is, educators should emphasize the cultural and situational factors that make rape more likely so all people can reduce the risk of sexual violence and take proactive precautions to prevent it.

"It really presents a struggle for females, especially my little girl": Exploring fathers' experiences discussing body image with their young daughters.

Body dissatisfaction in children, particularly young girls, is a growing concern around the world. The home environment can have a strong influence on children's well-being, and parents may contribute to their children's positive or negative body image development. Nearly all research on parent influence on body image has focused on mothers, leaving fathers' attitudes and experiences poorly-understood. To address this gap in the literature, we interviewed 30 fathers (Mage = 40.30; SD = 7.48) of girls between the ages of 5 and 10 about the conversations they have with their daughters regarding body image. Through thematic analysis, we identified three primary themes: barriers to effective communication, combatting negative influences, and strategies for discussing body image. Fathers recognized the importance of talking about body image with their daughters, yet many did not feel confident or competent to do so effectively. They engaged in a variety of strategies to combat adverse cultural influences and encourage self-expression, character development, and mental and physical health in their daughters. However, messages about health were sometimes conflated with messages about thinness or food restriction. Implications for families and future research are discussed.

The protective role of self-compassion for women's positive body image: an open replication and extension.

The development and maintenance of positive body image in women may be disrupted by sociocultural appearance-related pressures. Therefore, it is critical to explore factors that may safeguard women's positive body image. A recent study by Homan and Tylka (2015) found that in a large sample (N = 263) of female MTurk workers and university-aged women, both appearance-contingent self-worth and body-based social comparisons were linked to less positive body image, but these links were attenuated in the face of high self-compassion. This research, an independent direct replication of the original study, supported the original findings. In a new, larger sample (N = 363 female-identified MTurk workers), signals were detected that were similar in size and magnitude to the original study. Specifically, while appearance-contingent self-worth and body-based social comparisons were negatively linked to body appreciation, those who endorsed higher levels of self-compassion reported a more positive body image, even in the presence of these potential threats. Findings are extended to eating- and exercise-based social comparisons. All materials, including the replication protocol, data management plan, dataset, SPSS syntax, and output are publicly available on the Open Science Framework at: https://osf.io/r274y/. Implications for research and practice are discussed.

Conformity to feminine norms and self-objectification in self-identified feminist and non-feminist women.

This study investigated the association between the endorsement of feminine gender role norms and self-objectifying beliefs and behaviors in self-identified feminist and non-feminist women. One hundred and ninety-seven predominantly White heterosexual cisgender women attending a large university in southwestern Canada completed the study questionnaires for course credit. A one-way ANOVA demonstrated no differences in self-objectification between self-identified feminist and non-feminist women. Compared to non-feminist women, however, feminist women were less likely to endorse feminine norms for sexual fidelity, romantic relationships, and domesticity. Regression analyses indicated more endorsement of thinness, investment in appearance, and romantic relationships and less endorsement of domesticity accounted for unique variance in self-objectification. Overall, this study provides further evidence for the association between endorsement of feminine norms, especially the norms for beauty and romance, and the adoption of an objectified self-view, even among feminist women.