The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations

Swami V 1 , Tran US 2 , Barron D 3 , Afhami R 4 , Aimé A 5 , Almenara CA 6 Show all authors , Alp Dal N 7 , Amaral ACS 8 , Andrianto S 9 , Anjum G 10 , Argyrides M 11 , Atari M 12 , Aziz M 13 , Banai B 14 , Borowiec J 15 , Brewis A 16 , Cakir Kocak Y 17 , Campos JADB 18 , Carmona C 19 , Chaleeraktrakoon T 20 , Chen H 21 , Chobthamkit P 22 , Choompunuch B 23 , Constantinos T 24 , Crumlish A 25 , Cruz JE 26 , Dalley SE 27 , Damayanti D 28 , Dare J 29 , Donofrio SM 27 , Draksler A 30 , Escasa-Dorne M 31 , Fernandez EF 32 , Ferreira MEC 33 , Frederick DA 29 , García AA 34 , Geller S 35 , George A 24 , Ghazieh L 36 , Goian C 37 , Gorman C 25 , Grano C 38 , Handelzalts JE 35 , Horsburgh H 39 , Jackson T 40 , Javela Delgado LGJ 41 , Jović M 42 , Jović M 43 , Kantanista A 15 , Kertechian SK 36 , Kessels L 44 , Król-Zielińska M 15 , Kuan G 45 , Kueh YC 46 , Kumar S 47 , Kvalem IL 48 , Lombardo C 38 , Luis López Almada E 49 , Maïano C 5 , Manjary M 47 , Massar K 44 , Matera C 50 , Mereiles JFF 33 , Meskó N 51 , Namatame H 52 , Nerini A 50 , Neto F 53 , Neto J 54 , Neves AN 55 , Ng SK 56 , Nithiya DR 57 , Omar SS 58 , Omori M 59 , Panasiti MS 60 , Pavela Banai I 14 , Pila E 61 , Pokrajac-Bulian A 62 , Postuvan V 30 , Prichard I 63 , Razmus M 64 , Sabiston CM 65 , Sahlan RN 66 , Sarfo JO 67 , Sawamiya Y 52 , Stieger S 68 , SturtzSreetharan C 16 , Tee E 32 , Ten Hoor GA 44 , Thongpibul K 69 , Tipandjan A 70 , Tudorel O 71 , Tylka T 72 , Vally Z 73 , Vargas-Nieto JC 74 , Vega LD 75 , Vidal-Mollón J 19 , Vintila M 71 , Williams D 76 , Wutich A 16 , Yamamiya Y 77 , Zambrano D 74 , Zanetti MC 78 , Živčić-Bećirević I 62 , Voracek M 2

Affiliations 

  • 1 School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Serdang, Malaysia. Electronic address: viren.swami@anglia.ac.uk
  • 2 Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
  • 3 Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
  • 4 Department of Art Studies, Tarbiat Modares University, Tehran, Iran
  • 5 Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
  • 6 Institute for Research on Children, Youth, and Family, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
  • 7 Midwifery Department, Munzur University, Tunceli, Turkey
  • 8 Federal Institute of Education, Science, and Technology of Southeast Minas Gerais, São Barbacena, Brazil
  • 9 Department of Psychology, Islamic University of Indonesia, Yogyakarta, Indonesia
  • 10 Department of Social Sciences and Liberal Arts, Institute of Business Administration, Karachi, Pakistan
  • 11 School of Health Sciences, Neapolis University Paphos, Paphos, Cyprus
  • 12 Department of Psychology, University of Southern California, Los Angeles, United States
  • 13 Department of Social Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
  • 14 Department of Psychology, University of Zadar, Zadar, Croatia
  • 15 Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poznań, Poland
  • 16 School of Human Evolution and Social Change, Arizona State University, Tempe, United States
  • 17 Midwifery Department, Ege University, İzmir, Turkey
  • 18 Department of Food and Nutrition, School of Pharmaceutical Science of São Paulo State University, São Paulo, Brazil
  • 19 Department of Research Methods and Diagnosis in Education, University of Valencia, Valencia, Spain
  • 20 Division of Psychology, Faculty of Liberal Arts, Thammasat University, Pathumthani, Thailand
  • 21 School of Psychology, Southwest University, Chongqing, China
  • 22 Division of Psychology, Faculty of Liberal Arts, Thammasat University, Pathumthani, Thailand; School of Psychology, University of Kent, Canterbury, United Kingdom
  • 23 Department of Educational Psychology and Counseling, Faculty of Education, Khon Kaen University, Khon Kaen, Thailand
  • 24 Department of Psychology, Panteion University of Athens, Athens, Greece
  • 25 School of Psychology, Ulster University, Coleraine, Northern Ireland, United Kingdom
  • 26 Department of Psychology, University de los Andes, Bogotá, Colombia
  • 27 Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
  • 28 Department of Psychology, Ahmad Dahlan University, Yogyakarta, Indonesia
  • 29 Department of Psychology, Chapman University, Orange, United States
  • 30 Slovene Centre for Suicide Research, Andrej Marusic Institute and Department of Psychology FAMNIT, University of Primorska, Koper, Slovenia
  • 31 Department of Anthropology, University of Colorado Colorado Springs, United States
  • 32 Department of Psychology, HELP University, Shah Alam, Malaysia
  • 33 Federal University of Juiz de Fora, Juiz de Fora, Brazil
  • 34 Department of Education, University of Almeria, Almeria, Spain
  • 35 School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo, Yaffo, Israel
  • 36 Department of Human Resources, Saint Joseph University, Beirut, Lebanon
  • 37 Department of Social Work, West University of Timișoara, Timișoara, Romania
  • 38 Department of Psychology, Sapienza University of Rome, Rome, Italy
  • 39 School of Social Sciences, University of Southampton, Southampton, United Kingdom
  • 40 Department of Psychology, University of Macau, Taipa, China
  • 41 Department of Psychology, Universidad del Rosario, Bogotá, Colombia
  • 42 Department of Marketing Management and Public Relations, University of Belgrade, Belgrade, Serbia
  • 43 Department of Plastic and Reconstructive Surgery, School of Medicine, University of Belgrade, Belgrade, Serbia
  • 44 Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
  • 45 School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
  • 46 Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
  • 47 Department of Psychology, D.A.V. College, Muzaffarnagar, India
  • 48 Department of Psychology, University of Oslo, Oslo, Norway
  • 49 Faculty of Humanities, Universidad Católica Campus Itapúa, Encarnación, Paraguay
  • 50 Department of Education, Languages, Intercultures, Literatures, and Psychology, University of Florence, Florence, Italy
  • 51 Department of General and Evolutionary Psychology, Institute of Psychology, University of Pécs, Pécs, Hungary
  • 52 Department of Psychology, University of Tsukuba, Tsukuba, Japan
  • 53 Department of Psychology, University of Porto, Porto, Portugal
  • 54 Department of Psychology, Catholic University of Brasília, Taguatinga, Brazil
  • 55 Division of Research, Physical Education College of the Brazilian Army, Rio de Janeiro, Brazil
  • 56 Physical Education Unit, Chinese University of Hong Kong, Hong Kong, China
  • 57 Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeth, India
  • 58 Department of Dermatology, Venereology, and Andrology, Alexandria University, Alexandria, Egypt
  • 59 Department of Psychology, Ochanomizu University, Tokyo, Japan
  • 60 Santa Lucia Foundation, Scientific Institute for Research and Healthcare, Rome, Italy
  • 61 School of Kinesiology, University of Western Ontario, Ontario, Canada
  • 62 Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
  • 63 College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
  • 64 Institute of Psychology, Marie Curie-Skłodowska University, Lublin, Poland
  • 65 Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
  • 66 Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
  • 67 Department of Nursing, All Nations University College, Koforidua, Ghana
  • 68 Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria; Department of Psychology, Research Methods, Assessment, and iScience, University of Konstanz, Konstanz, Germany
  • 69 Department of Psychology, Faculty of Humanities, Chiang Mai University, Chiang Mai, Thailand
  • 70 Indira Gandhi Government General Hospital and Postgraduate Institute, Puducherry, India
  • 71 Department of Psychology, West University of Timișoara, Timișoara, Romania
  • 72 Department of Psychology, Ohio State University, Columbus, United States
  • 73 Department of Psychology and Counseling, United Arab Emirates University, Al Ain, United Arab Emirates
  • 74 Department of Psychology, Fundación Universitaria Konrad Lonrez, Bogotá, Colombia
  • 75 Department of Psychology, Universidad Latina de Costa Rica, San José, Costa Rica
  • 76 College of Health Solutions, Arizona State University, Phoenix, Arizona, United States
  • 77 Department of Undergraduate Studies, Temple University Japan, Tokyo, Japan
  • 78 Department of Physical Education, São Judas Tadeu University, São Paulo, Brazil
Body Image, 2020 Mar;32:199-217.
PMID: 32032822 DOI: 10.1016/j.bodyim.2020.01.006

Abstract

The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η2 = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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