Body Image-related Cognitive Fusion Research Articles

Early Maladaptive Schemas, Cognitive Fusion, and Anabolic-Androgenic Steroid Use Attitudes: The Mediating Role of Muscle Dysmorphia in Iran

In recent decades, the interest in having an ideal body in men has caused a pathological tendency to be muscular, followed by a tendency to use anabolic-androgenic steroids (AASs). This study was designed to evaluate the mediating role of muscle dysmorphia in the relationship between early maladaptive schemas and body image-related cognitive fusion with the tendency to use AAS in male athletes. Out of the total number of men referring to fitness clubs in Isfahan, Iran, 474 men were evaluated using a multistage random cluster sampling method. The questionnaires used in this research included the Muscle Dysmorphic Disorder Inventory, Cognitive Fusion Questionnaire—Body Image, Young Schema Questionnaire—Short Form, and Prototype Willingness Model Questionnaire. The results demonstrated that the relationship of AAS use with body image-related cognitive fusion and the three maladaptive schemas with the mediation of muscle dysmorphia is significant. The present study provides significant implications in the discussion of prevention and treatment of AAS addiction.

Thought-shape fusion in residential eating disorder treatment: Cognitive defusion as a mediator between thought-action fusion and treatment outcome.

An understudied cognitive bias within eating disorder (ED) psychopathology is Thought-Shape Fusion (TSF), which involves irrational beliefs about the likelihood and moral implications of feared outcomes related to shape, weight, and food. This phenomenon has received less attention within the context of ED treatment, with little known about potential processes of change to address TSF and ultimately promote ED recovery. We propose cognitive defusion as a process of change, a metacognitive process that emphasizes observing thoughts objectively rather than appraising thoughts as absolute truth. We explored whether cognitive defusion, that is, reductions in body image-related cognitive fusion, mediated the relationship between trait-level TSF and treatment outcomes in a transdiagnostic ED sample of adult and adolescent females (N=130) presenting to residential care. We found that reductions in body image-related cognitive fusion mediates the association between trait-level TSF at baseline and ED severity at discharge. However, when the sample was separated into adolescent and adult subgroups, these results only remained significant for adolescents. These findings underscore the relevance of targeting cognitive defusion as a potential mechanism to address the impact of trait levels of TSF cognitions on ED psychopathology.

How does the experience of shame impact body dysmorphic symptomatology? Exploring the role of mindfulness and body image-related cognitive fusion

Shame has been considered a core component of body dysmorphia-related symptomatology. However, literature concerning the emotion regulation processes that underlie the association between these two constructs seems to be scarce. Therefore, the main aim of this cross-sectional study was to explore the role that mindfulness and body image-related cognitive fusion has on the relationship between the experience of shame and body dysmorphia-related symptomatology Additionally, biological sex differences concerning the studied variables were explored. Three hundred and twenty-seven participants (male and female) above 18 years old completed an online survey with self-report measures to assess shame experiences, mindfulness, body image-related cognitive fusion and body dysmorphia-related symptoms. Results indicated that female participants presented higher body dysmorphia-related symptomatology when compared with males. A path analysis was conducted suggesting that, while controlling for the effect of age and BMI, the experience of shame had a direct effect on body dysmorphia-related symptomatology, as well as an indirect effect through mindfulness and body image-related cognitive fusion. This model presented a good fit, explaining 56% of the variance of body dysmorphia-related symptomatology. Also, findings from a multi-group path analysis revealed that the relationship between these variables is invariant across males and females. These findings have important research and clinical implications, supporting the importance of targeting mindfulness and cognitive defusion skills when working in the context of Body Dysmorphia.

Examining a mediation model of body image-related cognitive fusion, intuitive eating, and eating disorder symptom severity in a clinical sample.

This study sought to explore the associations between Intuitive Eating (IE), eating disorder (ED) symptom severity, and body image-related cognitive fusion within a clinical sample. IE was also examined as a possible mediator in the relationship between body image-related fusion and ED symptoms. This study includes cross-sectional analyses with data from 100 adult females and 75 adolescent females seeking residential treatment for an ED. Self-reported demographic information, ED symptoms, IE behaviors, and body image-related cognitive fusion were collected from participants within the first week of treatment following admission to the same residential ED treatment facility. ED symptom severity was significantly negatively associated with three of the four domains of IE; unconditional permission to eat, reliance on hunger and satiety cues, and body-food choice congruence. A significant mediational effect of IE on the relationship between body image-related fusion and ED symptoms through IE behaviors was observed (β = 11.3, SE = 0.003, p < 0.001). This effect was only observed for the unconditional permission to eat (β = 0.13, p = 0.003) and reliance on hunger and satiety cues (β = 0.10, p = 0.005) domains of IE when the domains were subsequently analyzed individually. Unconditional permission to eat and reliance on hunger and satiety cues appear to be particularly influential domains of IE in the relationship between body image-related fusion and ED symptom severity. It is possible that changes in these IE domains may be mechanisms through which body image-related fusion influences ED symptoms. Future longitudinal research is needed to better understand the relationship between body image-related cognitive fusion and IE and the potential for targeting these constructs specifically in the context of ED treatment. Level V, cross-sectional analysis from descriptive study.

Confirmatory factor analysis and measurement invariance of the Cognitive Fusion Questionnaire-Body Image in a clinical eating disorder sample

Individuals with eating disorders (EDs) may be particularly susceptible to body image related cognitive fusion (i.e., excessive entanglement with one’s body image related thoughts such that they unduly influence on behavior). The Cognitive Fusion Questionnaire-Body Image (CFQ-BI) is the only existing measure of this construct, yet its psychometric properties have not been examined within a clinically diagnosed ED sample. The current study used confirmatory factor analysis and explored measurement invariance, construct validity, and incremental validity of the CFQ-BI when used with adolescent (n = 75) and adult (n = 100) females admitting to residential ED treatment. A modified version of the single-factor structure of the CFQ-BI best fit the data and configural, metric, and scalar invariance were supported across age groups (i.e., adolescents or adults) and ED behavioral presentations (i.e., restrictive behaviors or binge/purge behaviors). Adults’ and individuals with binge/purge behavioral presentations reported significantly more body image related fusion compared to adolescents and adults, respectively. Body image related psychological flexibility and ED severity were both significantly correlated CFQ-BI scores in expected directions. These findings suggest the CFQ-BI is a valid measure for assessing body image related fusion among adolescent and adult females with varying ED behavioral presentations. Implications and future research directions are discussed.

A comprehensive model of disordered eating among aesthetic athletic girls: Exploring the role of body image-related cognitive fusion and perfectionistic self- presentation.

The incidence of disordered eating among athlete populations is considerably higher than in the general population. Less well understood is the body image-related emotional processes that might lead to disordered eating attitudes and behaviours, specifically among aesthetic athletic girls. Thus, the aim of the present study was to explore the role that body image-related cognitive fusion plays in disordered eating, and the mediating role of body image-related perfectionist self-presentation on this relationship, in aesthetic athletic girls. This study comprised 142 young female athletes from aesthetic sports, who completed self-report measures. A path analysis was conducted to explore the proposed theoretical model, while controlling for age and zBMI. The path model revealed an excellent fit and explained 71% of the severity of disordered eating. Results showed that body image-related cognitive fusion influences disordered eating behaviours, through the mechanism of body image-related perfectionist self-presentation, even when controlling for age and zBMI. Findings suggested that, in aesthetic athletic girls, the entanglement in body image-related thoughts may be associated with the need to present a perfect body image to others, which may lead to disordered eating attitudes and behaviours, adopted as a means to control weight and body shape. The present study highlights the relevance of body image-related processes in disordered eating and suggests the importance of educational programmes that target the development of more adaptive emotion regulation strategies concerning body image in athletes, particularly from aesthetic sports.

The Mediator Role of Body Image-Related Cognitive Fusion in the Relationship between Disease Severity Perception, Acceptance and Psoriasis Disability.

Psoriasis is a long-term skin disorder without a cure, whose patients are particularly susceptible to mental health diseases. Using a sample of patients diagnosed with psoriasis, this study aimed to: (1) identify the clinical and positive psychological variables that contribute the most to psoriasis disability and (2) assess the mediator role of body image-related cognitive fusion in the relation between disease severity perception and acceptance and self-compassion, on one hand, and psoriasis disability on the other. This is an initial cross-sectional exploratory study, with 75 patients diagnosed with psoriasis (males 52%; mean age 54.99 ± 13.72) answering a sociodemographic and a clinical questionnaire, the Psoriasis Disability Index (PDI), the Cognitive Fusion Questionnaire—Body Image (CFQ-BI), the Acceptance and Action Questionnaire—II (AAQ-II), and the Self-Compassion Scale (SCS). Descriptive and inferential statistics were used to characterize and assess the measures and the final model used. Through path analysis and a hierarchical multiple linear regression, it was found that the variables that significantly contributed to psoriasis disability were years of education, impact on social life and body image, explaining 70% of the variance. Body image-related cognitive fusion was a significant mediator in the relationship between disease severity and acceptance, and psoriasis disability. The implications of this study are considered to be extremely relevant, since it will allow additional information to be provided to psoriasis patients, appropriated to their educational level, aiming to reduce distorted perceptions of disease severity and intervene in the ability to accept this specific and important chronic health condition.

Body image-related cognitive fusion and disordered eating: the role of self-compassion and sad mood.

The extent to which body image-related thoughts are endorsed and drive behaviors, a process known as Body Image-Related Cognitive Fusion (BI-CF), is an important contributor to disordered eating. Moreover, negative mood and negative self-referential processes (e.g., low self-compassion) have been reportedly associated with disordered eating; however, their associations with BI-CF are not known. The aim of this study was to investigate, among young adults, the association between (1) BI-CF and disordered eating attitudes and behaviors (2) BI-CF and self-compassion, and (3) whether sad mood influences BI-CF. Participants completed online questionnaires that assessed BI-CF, self-compassion, negative affect, cognitive reactivity and disordered eating (N = 601). A subsample (n = 51) underwent an in-lab session in which they were exposed to a validated psychological sad mood induction task followed by the assessment of BI-CF. 67.8% of variation in disordered eating was accounted for by BI-CF while controlling for covariates. Self-compassion was the strongest predictor of BI-CF levels, irrespective of other eating disorder or depression risk factors (p < 0.001). Increases in sad mood did not influence levels of BI-CF. The endorsement of body image-related thoughts seems to play an important role in disordered eating. Compassionate self-responding may have positive influences on reducing negative body image-related thoughts. Furthermore, BI-CF appears to be a relatively stable phenomenon, irrespective of change in mood state. Results offer implications for the improvements in prevention and intervention models targeted towards disordered eating through self-compassion and cognitive defusion. Part I:Level V, cross-sectional descriptivestudy. Part II: Level I, experimental study.

The central role of body image in the explanation of the engagement in disordered eating attitudes and behaviors

Shame is a universal emotion, that has been emphasized as a pathogenic phenomenon in well-being and mental health. In fact, although shame has been considered an adaptive defensive response, higher levels of this painful emotion are strongly associated with different mental health conditions. The current study aimed to test whether the association of external shame with eating psychopathology would be explained by the mechanisms of body image-related cognitive fusion, psychological inflexibility, and also dietary restraint. A path analysis testing a mediational model was conducted in a sample of 787 women from the general community, aged between 18 and 51 years old. The tested model accounted for 71% of the variance of eating psychopathology and revealed an excellent fit to the data. Results demonstrated that external shame's impact on disordered eating attitudes and behaviors is indirect, carried through increased body image-related cognitive fusion, psychological inflexibility related to physical appearance, and dietary restraint. These findings seem to support the association between shame and eating psychopathology. Furthermore, these data add to literature by suggesting that individuals who present higher levels of shame may present increased tendency to engage in dietary restraint and other maladaptive eating behaviors, through higher levels of body image-related psychological inflexibility and cognitive fusion. The current study seems to hold important clinical implications, highlighting the importance of developing intervention programs in the community which target shame and body image-related maladaptive attitudes and behaviors and, in turn, promote adaptive emotion regulation strategies (e.g., acceptance abilities).Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cognitive fusion: Maladaptive emotion regulation endangering body image appreciation and related eating behaviours

Body image-related cognitive fusion is described as the perception that undesired and distressing internal events related to body image are reliable representations of reality. This maladaptive emotion regulation process is known for its impact on human suffering, namely eating psychopathology. On the contrary, body appreciation is a positive body image construct, defined as an attitude of acceptance and affection toward one's body image characteristics, despite some level of dissatisfaction. Although body appreciation associates negatively with several pathogenic processes, its relationship with body image-related cognitive fusion is still unexplored. The present study intended to analyse the power of body image related cognitive fusion regarding its impact on body appreciation, and also on the engagement in disordered eating. The study's sample comprised 308 women, aged between 18 and 35. A path model tested the mediator role of body image related cognitive fusion in the relationship between body image dissatisfaction and body appreciation, and eating disorders symptomatology, controlled for the effect of body mass index.The tested model accounted for 67% of the variance of disordered eating. Body image related cognitive fusion appeared as a significant mediator of the association between body dissatisfaction and body appreciation. Body appreciation presented a significant direct effect on eating disorders symptomatology. These findings highlight the disturbing effect of cognitive fusion related to body image on the construction of a positive body image, presenting an impact on the engagement in disordered eating. In this line, cognitive fusion may be a pertinent target in clinical practice and also within eating disorders prevention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Ashamed and Fused with Body Image and Eating: Binge Eating as an Avoidance Strategy.

Shame is a significant predictor of symptomatology severity of BED patients. Shame significantly impacts binge eating, even controlling for depressive symptoms. Shame significantly predicts body image-related cognitive fusion and eating concern. Body image-fusion and eating concern mediate the link between shame and binge eating. Binge eating may be seen as an avoidance strategy from negative self-evaluations.

Falling in the traps of your thoughts: The impact of body image-related cognitive fusion on inflexible eating

Literature has shown that young women present high rates of body dissatisfaction, independently of their weight. Therefore, dieting may emerge as a strategy to control one's body image. Nonetheless, it also seems to be a source of great suffering rather than a solution.The aim of the present study was to explore what variables explain the inflexible engagement in eating rules. Our hypothesis is that an inflexible eating pattern results not exclusively from weight and body dissatisfaction and shame but mainly from emotional regulation processes (such as body image-related cognitive fusion).The sample of the present study comprised 659 female college students, aged between 18 and 25years old, who completed self-report measures.Results revealed that the majority of the normal-weight participants desired to lose weight and to have a thinner body shape. Findings from the path analyses demonstrated that the effects of weight dissatisfaction and shame on the inflexible adhesion to eating rules were fully mediated through the mechanism of body image-related cognitive fusion. Furthermore, the effect of body dissatisfaction was partially operated by this process. This model was controlled by BMI and explained a total of 36% of inflexible adhesion to eating rules.In conclusion, these findings suggest that it is when a woman gets fused and entangled with her body image-related thoughts that these unwanted inner events most impact on her eating rules. This study thus offers important new data for research and clinical practise in the field of body image and eating difficulties.

Getting entangled with body image: development and validation of a new measure.

Several studies have highlighted the role of cognitive fusion on human suffering and a wide range of psychopathological conditions. Namely, this process has been regarded as a core aspect in eating disorders. Nevertheless, the study of cognitive fusion on eating psychopathology is scarce and a measure that specifically concerns body image was still to be created. The present study aimed therefore at developing and validating such measure, the Cognitive Fusion Questionnaire - Body Image (CFQ-BI). The current study was conducted using different samples of both genders, collected in the general and student populations. The dimensionality of the CFQ-BI was tested through an exploratory factor analysis and a confirmatory factor analysis (CFA). The scale's internal reliability and other psychometric qualities were also analysed. The CFQ-BI's final structure was one-dimensional and comprised 10 items that assess body image-related cognitive fusion. This final structure explained a total of 73.41% of the variance. The adequacy of the questionnaire was corroborated through a CFA which revealed that CFQ-BI presents good global and local adjustment values and goodness-of-fit indices. Results also showed that the CFQ-BI holds a very good internal consistency (α = .96), convergent, divergent and temporal reliabilities, and is able to discriminate cases from non-cases of eating psychopathology. The CFQ-BI was thus established as a short, robust, and reliable measure of body image-related cognitive fusion. This new measure may correspond to a significant contribution to research and clinical practice in the field of body image and eating-related difficulties. A new measure of body image-related cognitive fusion (CFQ-BI) was developed. The CFQ-BI was proved to be a short, robust, and reliable measure. Body image-related cognitive fusion was strongly linked to eating psychopathology. CFQ-BI may be useful in eating psychopathology's research and clinical practice.

Body image-related cognitive fusion as a main mediational process between body-related experiences and women’s quality of life

Although the experience of body image has been considered an important indicator of women's psychological quality of life (QoL), it has also been suggested that the impact of unwanted body-related experiences on QoL may be mediated by emotional regulation processes. The aim of the current study was therefore to explore for the first time the role of body image-related cognitive fusion on these associations. This study comprised 779 young females who completed self-report measures. A path analysis was conducted to explore whether BMI, body dissatisfaction and feelings of inferiority based on physical appearance would impact on psychological QoL through body image-related cognitive fusion. The model explained 39% of psychological health, and revealed an excellent fit. Results showed that BMI did not directly impact on psychological health. Furthermore, the effects of increased body dissatisfaction and feelings of inferiority based on physical appearance on psychological health were fully and partially mediated by body image-related cognitive fusion, respectively. These findings suggest that the presence of body image-related negative experiences does not necessarily lead to impairment in women's QoL, which is rather dependent upon one's ability to observe these unwanted experiences as transient and subjective. Therefore, intervention programmes aiming at increasing women's QoL should focus on targeting emotional regulation processes in order to develop the ability to pursue life goals and values, even in the presence of unwanted experiences concerning body image.

Turning eating psychopathology risk factors into action. The pervasive effect of body image-related cognitive fusion

Body image dissatisfaction and unfavourable social comparisons are significant risk factors to eating psychopathology. Nevertheless, the impact of these negative experiences depends on the cognitive and emotional processes involved. Previous research has shown that cognitive fusion is a nuclear process linked to psychological inflexibility, but its role on body image and eating difficulties remains unclear. This study aims to explore a model of the mediational role of body image-related cognitive fusion (CF-BI) on the relationship between body dissatisfaction, unfavourable social comparisons, and eating psychopathology in a sample of 345 female students. Results from path analyses show that the impact of unfavourable social comparisons on eating psychopathology is fully mediated by CF-BI. Moreover, CF-BI also revealed a mediational effect on the relationship between body image dissatisfaction and the severity of eating symptoms, in spite of the fact that a direct effect of body dissatisfaction still exists. The tested model highlights the crucial role that cognitive fusion, in the specific domain of body image, plays in the relationship between risk factors and the severity of disordered eating attitudes and behaviours. Furthermore, these findings present empirical support for the relevance of addressing acceptance and cognitive defusion techniques to prevent and treat eating disorders.

The impact of body image-related cognitive fusion on eating psychopathology

Recent research has shown that cognitive fusion underlies psychological inflexibility and in consequence various forms of psychopathology. However, the role of cognitive fusion specifically related to body image on eating psychopathology remained to be examined.The current study explores the impact of cognitive fusion concerning body image in the relation between acknowledged related risk factors and eating psychopathology in a sample of 342 female students.The impact of body dissatisfaction and social comparison through physical appearance on eating psychopathology was partially mediated by body image-related cognitive fusion. The results highlight the importance of cognitive defusion in the treatment of eating disorders.