Abstract
Mirror exposure (ME) is an effective technique to improve body image. However, evidence on the underlying mechanisms and the optimal verbalization instruction during ME is lacking. Therefore, this experimental study analyzed mechanisms of ME and therapeutic outcomes by comparing positive (PV) and negative (NV) full-body verbalization. N = 73 healthy females were randomized to a PV or an NV condition. PV participants verbalized positively while NV participants verbalized negatively about their whole body. Each participant underwent three standardized ME sessions. Before and after each ME session, positive affect, negative affect and body satisfaction were assessed. Before the first and after the third ME, participants completed questionnaires on cognitive-affective and behavioral aspects of body image, eating pathology and self-esteem. Regarding within-ME changes, the results indicate that positive affect and body satisfaction decreased while negative affect increased in the NV group but not in the PV group. In contrast, regarding between-ME changes, decreased negative affect as well as positive affect and increased body satisfaction were observed in both groups. However, eating pathology remained stable, whereas body-checking behavior increased and the PV condition was followed by higher levels of self-esteem compared to the NV condition. These findings suggest that both PV and NV improve negative affect and body satisfaction between-ME, and thus seem to be effective ME instructions. Given that NV led to increased negative affect within-ME and did not influence self-esteem, PV might represent the favorable instruction during ME for body-satisfied women.
Highlights
We proposed the following hypotheses: First, we assumed that NV compared to PV would result in decreased positive affect within the Mirror exposure (ME) sessions but that PV would lead to increased positive affect between the ME sessions, because participants were instructed to focus on positively valenced aspects of each body part [20, 22]
The groups did not differ in their Eating Disorder Inventory 2 (EDI-2) scores (Body Dissatisfaction [F(72) = .54, p = .464]; Drive for Thinness [F(72) = 1.52, p = .222]), Body Image Avoidance Questionnaire (BIAQ) (F(72) = .60, p = .441), Body Checking Questionnaire (BCQ) (F(72) = .51, p = .476), G-SISE (F(72) = 1.00, p = .320) and Body Areas Rating Scale (BARS) ([BARS global F(72) = 3.48, p = .066]; BARS least-liked body part [F(72) = 1.67, p = .201]; BARS most-liked body part [F(72) = .03, p = .874])
PV led to stable emotional activation, whereas NV resulted in worsened emotional states
Summary
All participants completed pre-questionnaires on body image issues and body dissatisfaction, but the selection for inclusion in the present study was not based on these pre-values, as we aimed to recruit a community-based sample with the full range of body dissatisfaction levels usually presented in such samples. This served as the wash-out phase, through which we aimed to neutralize the activated body-related thoughts and emotions in order to obtain valid data in the post-online questionnaire battery.
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