Body Image Outcomes Research Articles

A Randomized Experimental Test of the Efficacy of EMDR Treatment on Negative Body Image in Eating Disorder Inpatients

Eye Movement Desensitization and Reprocessing (EMDR) therapy is being used by some clinicians to treat eating disorders. Although there is anecdotal and case study data supporting its use, there are no controlled studies examining its effectiveness with this population. This study examined the short and long-term effects of EMDR in a residential eating disorders population. A randomized, experimental design compared 43 women receiving standard residential eating disorders treatment (SRT) to 43 women receiving SRT and EMDR therapy (SRT+EMDR) on measures of negative body image and other clinical outcomes. SRT+EMDR reported less distress about negative body image memories and lower body dissatisfaction at posttreatment, 3-month, and 12-month follow-up, compared to SRT. Additional comparisons revealed no differences between the conditions pre to posttreatment on other measures of body image and clinical outcomes. The empirical evidence reported here suggests that EMDR may be used to treat specific aspects of negative body image in conjunction with SRT, but further research is necessary to determine whether or not EMDR is effective for treating the variety of eating pathology presented by eating disorder inpatients.

Relations among exercise type, self-objectification, and body image in the fitness centre environment: The role of reasons for exercise

Objective The study aimed to investigate different types of exercise, the role of exercise motivation and body image outcomes within the fitness centre environment. Design and method Participants were 571 female fitness class participants recruited from fitness centres. They ranged in age from 18 to 71 years and participated in a variety of fitness activities both within and outside of the fitness centre environment. Reasons for exercise, self-objectification, body esteem, and disordered eating symptomatology were assessed using questionnaire measures. Results Time spent exercising within the fitness centre environment was more highly related to body image and eating disturbance than time spent exercising outside of the fitness centre environment. Participation in cardio-based workouts (e.g., cardiovascular machines) was positively related to self-objectification, disordered eating behaviour, and appearance-related reasons for exercise, and negatively related to body esteem. In contrast, participation in yoga-based fitness classes was related to lower self-objectification and exercising more for health and fitness. Appearance-focused reasons for exercise were found to mediate the relationship between exercise types and self-objectification, disordered eating, and body esteem. Conclusion The results show that the reasons women have for doing exercise provide a mechanism through which different types of exercise are associated with negative body image outcomes. Thus, despite the physical health-related benefits associated with regular physical activity, exercise motivated by appearance reasons (e.g., weight control) can lead to poorer body image in some women.

Ernährungsmanagement versus Body-Image-Therapie bei Anorexia nervosa

Body image disturbances are highly predictiveof the course of eating disorders, and addressingthese problems effectively, has been an ongoing challengeto clinicians. This study examines whether a specificgroup therapy program geared to body image reducesdifferent components of the body image disturbancemore effectively than an unspecific nutritionalmanagement program. Patients and Methods: All 57carefully diagnosed female inpatients who took part inthe study were diagnosed with anorexia nervosa accordingto DSM-IV criteria. Results: Patients of either group(similar in age, BMI, duration of illness, comorbidity)showed significant and clinically relevant improvementsover time in all scales. After an intervention of 4.5 weeksthe Body Image Group was superior with regard to severaltests assessing body image. However, this effect didnot persist over time. Two body image variables (globalestimation of attractiveness and figure size rating) constitutedthe most important predictors for course of treatment(change in body mass index) in the full sample.Conclusion: Effect sizes in both groups were medium tohigh, a finding that warrants paying more attention tothis rather promising new treatment module for anorexianervosa. The results of body image outcome studies willbe summarized.

Breast cancer treatment in older women: does getting what you want improve your long-term body image and mental health?

Little is known about the impact of surgical treatment on body image and health outcomes in older breast cancer patients. The purpose of this article is to evaluate whether concordance between treatment received and treatment preferences predicts posttreatment body image and whether body image, in turn, affects mental health in older women with breast cancer 2 years after treatment. A longitudinal cohort of 563 women who were 67 years old or older and who had stages I and II breast cancer were surveyed by telephone at 3, 12, and 24 months after surgery. All women were clinically eligible for breast conservation. Body image was measured using questions adapted from the Cancer Rehabilitation Evaluation System-Short Form, and mental health was evaluated using a Medical Outcomes Study subscale. Body image was an important factor in treatment decisions for 31% of women. Women who received breast conservation had better body image 2 years after treatment than women who had mastectomies (P <.0001). Women who preferred breast conservation but received mastectomy had the poorest body image. Using generalized estimating equations, we found that body image, in turn, predicted 2-year mental health. Body image is important for many older women, and receiving treatment consistent with preferences about appearance was important in long-term mental health outcomes. Health professionals should elicit preferences about appearance from women and provide treatment choices in concordance with these preferences. Enhancing shared decision making has the potential to improve mental health in older breast cancer survivors.

Measuring outcomes in plastic surgery: body image and quality of life in abdominoplasty patients.

Abdominoplasty is an increasingly common aesthetic surgery procedure that has yet to be evaluated using the most recently developed and psychometrically sophisticated measures of body image and quality-of-life outcomes. This study prospectively evaluated 30 consecutive female abdominoplasty patients, preoperatively and postoperatively, using measures of body image, psychological investment in appearance, and general psychosocial functioning. One-way repeated-measures (pretest versus posttest) analyses of variance revealed significant positive postsurgical changes on the Appearance Evaluation subscale of the Multidimensional Body-Self Relations Questionnaire. Mean scores for the questionnaire's Body Areas Satisfaction Scale improved postoperatively (p < 0.001). Scores for the Body Exposure and Sexual Relations Questionnaire also improved significantly (p < 0.001) postoperatively. These findings indicate significant improvements in body image outcome, including positive changes in patients' evaluations of their overall appearance, their average body image dissatisfaction, and their experiences of self-consciousness and avoidance of body exposure during sexual activities. As predicted, no changes were seen on any measure of psychological investment in appearance or on patients' reports of general psychosocial functioning (self-esteem, satisfaction with life, or social anxiety).

Better cosmetic results and comparable quality of life after skin-sparing mastectomy and immediate autologous breast reconstruction compared to breast conservative treatment

Preoperative chemotherapy (PCT) can be used in large primary breast cancer to facilitate breast conservative surgery (BCS). Cosmetic results of BCS are influenced by the size of the residual tumour, relative to the size of the breast. After mastectomy, immediate breast reconstruction (IBR) with autologous tissue provides excellent cosmetic outcome and has proven to be safe in breast cancer patients. Besides improving overall and disease free survival, Quality of Life (QoL), body image and cosmetic outcome are also important issues after treatment for breast cancer. In this study, Health-Related-Quality of Life (HRQL) and body image were evaluated, in patients treated with PCT, followed by BCS, or skin-sparing mastectomy (SSM) and perforator-flap breast reconstruction. Additionally, clinical observers assessed cosmetic outcome. All participants were evaluated by the Medical Outcomes Study (MOS) 36-item Short Form Health Status Survey (SF-36, 36 items) and a study-specific questionnaire. An external panel evaluated standardised photographs of the breasts. For all patients, norm-based scores of physical and mental health state are comparable with the general population, except for vitality (VT) score, which is somewhat lower. No significant differences can be observed between both groups. The majority of the patients were satisfied with the appearance of their breasts. The cosmetic results, assessed by the clinical team, were significantly better for patients having IBR, compared to BCS. The mean score was 7.5/10 for IBR, versus 6.0/10 for BCS ( p<0.0001). Breast conserving treatment or mastectomy with reconstruction may yield comparable results of QoL, but cosmetic outcome is better after SSM and perforator-flap reconstruction. Patients must be offered both options, and clinicians should stress that both are equally effective.

Clinical follow-up after bilateral risk reducing ('prophylactic') mastectomy: mental health and body image outcomes.

In Manchester, approximately 120 women at > or = 1:4 lifetime risk of breast cancer have considered preventative surgery since 1992. Women treated within the Manchester protocol receive two genetic counselling sessions, a psychological assessment and a surgical consultation pre-operatively and annual follow-up post-operatively. The vast majority of women have breast reconstruction. Since 1996, mental health and body image have been assessed in women attending annual follow-up using self-report questionnaires: the 28-item General Health Questionnaire (GHQ) and 10-item Body Image Scale (BIS). Women with high scores are assessed by clinical interview together with a proportion who have no significant problems. Between 1995 and 1999, 76 women completed surgery. Ten were awaiting post-operative review and 60 (91%) attended for follow-up of whom 45 (75%) were interviewed. Questionnaire data were available for 52 (79%) women, mean age 40.8 years (range 27-58). Six women were gene mutation carriers and of these three had had breast cancer. One additional patient was affected but had not been genetically tested. Eight (17%) of 47 women with assessments in the first post-operative year scored in the 'caseness' range on the GHQ: the mean GHQ score was 3.8 (S.D. 6.7), range 0-25. Results were comparable with those for women attending the Family History Clinic for risk assessment. The mean score on the BIS was 5.1 (S.D. 5.5), range 0-25, comparable with scores for women undergoing conservative surgery for breast cancer. Twenty-one percent of women reported no negative change in body image following surgery (i.e. zero questionnaire summary scores) and the majority of changes reported were of minor degree (item scores 0 or 1). The most frequently reported changes were in sexual attractiveness (55%), feeling less physically attractive (53%) and self-consciousness about appearance (53%): a third of women felt less feminine to a minimal degree. These results appeared stable over time. A minority of women had more serious psychological or body image concerns, usually in relation to surgical complications: they received further psychiatric intervention. For the majority of women there is no evidence of significant mental health or body image problems in the first 3 years following Bilateral Prophylactic Mastectomy (BPM), but women who have complications warrant additional psychological help. Careful pre-operative preparation and long-term monitoring are advocated in this new field of cancer prevention.

Up and running: Interventions in exercise psychology

Exercise psychology is a relatively new field which seeks to understand the psychological and social factors which influence physical activity participation and physical fitness, with a view to preventing attrition and promoting greater exercise adherence. Over 21 per cent of Irish adults currently take no exercise at all (Departments of Health and Education, 1996) and it is estimated that 50 per cent of people who are actually motivated to begin an exercise programme drop out within the first six months (Dishman, 1988). Body image represents a significant area for research in exercise psychology as the perceptions and feelings we have about our bodies often influence the selection of physical activities or they can cause us to avoid particular activities or exercise situations. Two exercise intervention studies which focus on body image outcomes are described in this article. The first study involved six obese children who were assigned personal trainers for an eight week programme of physical activity a...

Autogenes Training und Funktionelle Entspannung: Ein Vergleich vegetativer Steuerungsprozesse

In this meta-analysis, we evaluated the effectiveness of dance movement therapy1 (DMT) and the therapeutic use of dance for the treatment of health-related psychological problems. Research in the field of DMT is growing, and 17 years have passed since the last and only general meta-analysis on DMT (Ritter & Low, 1996) was conducted. This study examines the current state of knowledge regarding the effectiveness of DMT and dance from 23 primary trials (N = 1078) on the variables of quality of life, body image, well-being, and clinical outcomes, with sub-analysis of depression, anxiety, and interpersonal competence. Results suggest that DMT and dance are effective for increasing quality of life and decreasing clinical symptoms such as depression and anxiety. Positive effects were also found on the increase of subjective well-being, positive mood, affect, and body image. Effects for interpersonal competence were encouraging, but due to the heterogenity of the data remained inconclusive. Methodological shortcomings of many primary studies limit these encouraging results and, therefore, further investigations to strengthen and expand upon evidence-based research in DMT are necessary. Implications of the findings for health care, research, and practice are discussed.