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A test of the resource security and the body mass index reference point hypotheses of body dissatisfaction amongst adolescents in eight countries

Mellor D, Fuller-Tyszkiewicz M, McCabe MP, Ricciardelli LA, Skouteris H, Mussap AJ

Ethn Health, 2014;19(5):548-64.
PMID: 24261816 DOI: 10.1080/13557858.2013.857761

OBJECTIVE: This study aimed to identify cultural-level variables that may influence the extent to which adolescents from different cultural groups are dissatisfied with their bodies.
DESIGN: A sample of 1730 male and 2000 female adolescents from Australia, Fiji, Malaysia, Tonga, Tongans in New Zealand, China, Chile, and Greece completed measures of body satisfaction, and the sociocultural influences on body image and body change questionnaire, and self-reported height and weight. Country gross domestic product and national obesity were recorded using global databases.
RESULTS: Prevalence of obesity/overweight and cultural endorsement of appearance standards explained variance in individual-level body dissatisfaction (BD) scores, even after controlling for the influence of individual differences in body mass index and internalization of appearance standards.
CONCLUSIONS: Cultural-level variables may account for the development of adolescent BD.
KEYWORDS: GDP; adolescents; body dissatisfaction; culture; sociocultural influences

Matched MeSH terms: Body Image/psychology*
Eating disorders in the Far East

Tsai G

Eat Weight Disord, 2000 Dec;5(4):183-97.
PMID: 11216126

OBJECTIVE: To investigate eating disorders (EDs) prevalence rates among Asian populations and identify characteristics that distinguish them from their Western counterparts.
METHOD: Potential references were identified through an English-language literature search using Medline, Psychinfo, Dissertation Abstracts (1966 to 1999) and through extensive manual searching of textbooks, reviews and reference lists.
RESULTS: The majority of studies related to EDs were conducted in Japan and China and a few were conducted in Singapore, Malaysia, Taiwan, and Korea whereas there was none in the Philippines, Laos, Vietnam, Cambodia, Myanmar, Indonesia and Thailand. Prevalence rates in Japan range from 0.025 to 0.030% for anorexia nervosa (AN) and from 1.9 to 2.9% for bulimia nervosa (BN). Community studies in China have found the AN prevalence to be 0.01% and BN rates ranging from 0.5% to 1.3%. These rates are lower than ED rates in the West (particularly the U.S. and Britain). Body dissatisfaction (BD) and dieting rates, however, were similar to those in the West. BD rates ranged from 68% (Taiwan) to 81% (Korea) and dieting rates ranged from 34% (Taiwan) to 68% (Japan). Sociocultural and developmental risk factors were relevant to this population.
CONCLUSIONS: EDs in Asian populations have received little attention because they have been predominantly viewed as associated with Western culture. Classified by many as a "culture-bound syndrome" of the West, they may really be a culture-change syndrome.

Matched MeSH terms: Body Image*
Weaker implicit interoception is associated with more negative body image: Evidence from gastric-alpha phase amplitude coupling and the heartbeat evoked potential

Todd J, Cardellicchio P, Swami V, Cardini F, Aspell JE

Cortex, 2021 10;143:254-266.
PMID: 34482968 DOI: 10.1016/j.cortex.2021.07.006

Interoception refers to the processing of internal bodily stimuli, while body image refers to appearance-related perceptions, affect, and cognitions. Previous research has found that body image is associated with self-reported and behavioural indices of interoception. Here, we extended this research by examining associations between measures of positive (i.e., body appreciation, functionality appreciation) and negative body image (i.e., body shame, weight preoccupation) and two electrophysiological indices of interoceptive processing, namely the heartbeat evoked potential (HEP) and gastric-alpha phase-amplitude coupling (PAC), in a sample of 36 adults. Significant negative associations were identified between the indices of negative body image and the interoception variables. Specifically, more negative HEP amplitude and lower gastric-alpha PAC were both associated with greater body shame and weight preoccupation. However, no significant associations were identified for the indices of positive body image. These findings extend previous work by demonstrating that there are significant associations between negative body image and previously unexplored components of cardiac and gastric interoception. This, in turn, could have important clinical applications, such as the HEP and gastric-alpha PAC both serving as biomarkers of negative body image.

Matched MeSH terms: Body Image
Psychological Factors and Cardiovascular Disease Risk Factors as Mediators of the Relationship between Overweight/Obesity and Cognitive Function among School Children in Kuala Lumpur, Malaysia

Tung SEH, Mohd Nasir MT, Chin YS, Zalilah MS, Zubaidah JO, Yim HS

Child Obes, 2019 01;15(1):56-62.
PMID: 30339034 DOI: 10.1089/chi.2018.0066

BACKGROUND: Recent research suggests that a negative relationship exists between adiposity and cognitive function in children. However, limited information is known on how they are related. This study aimed to examine the mediators of the relationship between overweight/obesity and cognitive function among school children in Kuala Lumpur, Malaysia.
METHODS: This is a cross-sectional comparison study whereby 225 overweight/obese children matched for age, sex, and ethnicity with 225 normal weight children participated in this study. Body image dissatisfaction, disordered eating, and depressive symptoms were assessed through a self-administered questionnaire. Blood pressure was measured, whereas blood was drawn to determine insulin, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid profiles. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated using glucose and insulin levels. Wechsler's Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess cognitive function in children. Ordinary least square regression analysis was conducted to determine the direct and indirect relationships between weight status and cognitive function.
RESULTS: A negative relationship was found between overweight/obesity with cognitive function. Overweight/obese children were on average 4.075 units lower in cognitive function scores compared to normal weight children. Such difference was found through mediators, such as body image dissatisfaction, disordered eating, depression, systolic blood pressure, triglycerides, HOMA-IR, and hs-CRP, contributing 22.2% of the variances in cognitive function in children.
CONCLUSION: Results highlight the important mediators of the relationship between overweight/obesity and cognitive function. Consequently, future interventions should target to improve psychological well-being and reduce cardiovascular disease risk for the prevention of poorer cognitive performance in overweight/obese children.

Matched MeSH terms: Body Image/psychology
Masculinities and ethnicities: Ethnic differences in drive for muscularity in British men and the negotiation of masculinity hierarchies

Swami V

Br J Psychol, 2016 Aug;107(3):577-92.
PMID: 26592864 DOI: 10.1111/bjop.12162

Although relatively little is known about ethnic differences in men's drive for muscularity, recent theoretical developments suggest that ethnic minority men may desire greater muscularity to contest their positions of relative subordinate masculinity. This study tested this hypothesis in a sample of 185 White, 180 Black British, and 182 South Asian British men. Participants completed self-report measures of drive for muscularity, need for power, adherence to traditional cultural values, and ethnic group affiliation. Taking into account between-group differences in body mass index, results indicated that White men had significantly lower drive for muscularity than Black and South Asian men, who were not significantly different from each other. In addition, greater need for power was significantly associated with higher drive for muscularity in ethnic minority, but not White, men. Greater adherence to traditional cultural values, but not ethnic group affiliation, was associated with lower drive for muscularity in all ethnic groups. These results suggest that ethnic minority men may desire greater muscularity as a means of negotiating masculinity and attendant ideals of appearance.

Matched MeSH terms: Body Image*
Is the hijab protective? An investigation of body image and related constructs among British Muslim women

Swami V, Miah J, Noorani N, Taylor D

Br J Psychol, 2014 Aug;105(3):352-63.
PMID: 25040005 DOI: 10.1111/bjop.12045

Previous studies have reported equivocal findings concerning the impact of wearing a hijab, or Islamic head- and body-cover, on Muslim women's body image. Here, we sought to examine that impact using a larger sample of Muslim women than has been relied upon and a wider range of body image measures. A total of 587 British Muslim women completed a battery of scales assessing their frequency and conservativeness of hijab use, body image variables, attitudes towards the media and beauty ideals, importance of appearance, and religiosity. Preliminary results indicated that 218 women never used the hijab and 369 women used some form of the hijab at least rarely. Controlling for religiosity, women who wore the hijab had more positive body image, lower internalization of media messages about beauty standards, and placed less importance on appearance than women who did not wear the hijab. Among women who wore the hijab, hijab use significantly predicted weight discrepancy and body appreciation over and above religiosity. These results are discussed in terms of the possible protective impact among British Muslim women of wearing the hijab.

Matched MeSH terms: Body Image/psychology*
Sociocultural influences on strategies to lose weight, gain weight, and increase muscles among ten cultural groups

McCabe MP, Busija L, Fuller-Tyszkiewicz M, Ricciardelli L, Mellor D, Mussap A

Body Image, 2015 Jan;12:108-14.
PMID: 25497878 DOI: 10.1016/j.bodyim.2014.10.008

This study determined how sociocultural messages to change one's body are perceived by adolescents from different cultural groups. In total, 4904 adolescents, including Australian, Chilean, Chinese, Indo-Fijian, Indigenous Fijian, Greek, Malaysian, Chinese Malaysian, Tongans in New Zealand, and Tongans in Tonga, were surveyed about messages from family, peers, and the media to lose weight, gain weight, and increase muscles. Groups were best differentiated by family pressure to gain weight. Girls were more likely to receive the messages from multiple sociocultural sources whereas boys were more likely to receive the messages from the family. Some participants in a cultural group indicated higher, and others lower, levels of these sociocultural messages. These findings highlight the differences in sociocultural messages across cultural groups, but also that adolescents receive contrasting messages within a cultural group. These results demonstrate the difficulty in representing a particular message as being characteristic of each cultural group.

Matched MeSH terms: Body Image/psychology*
Factor structure and psychometric properties of the Body Appreciation Scale among adults in Hong Kong

Ng SK, Barron D, Swami V

Body Image, 2015 Mar;13:1-8.
PMID: 25523745 DOI: 10.1016/j.bodyim.2014.10.009

Previous research has suggested that the factor structure of Body Appreciation Scale (BAS), a widely-used measure of positive body image, may not be cross-culturally equivalent. Here, we used confirmatory factor analysis to evaluate the conceptual equivalence of a Chinese (Cantonese) translation of the BAS among women (n=1319) and men (n=1084) in Hong Kong. Results showed that neither the one-dimensional nor proposed two-dimensional factor structures had adequate fit. Instead, a modified two-dimensional structure, which retained 9 of the 13 BAS items in two factors, had the best fit. However, only one of these factors, reflective of General Body Appreciation, had adequate internal consistency. This factor also had good patterns of construct validity, as indicated through significant correlations with participant body mass index, self-esteem, and (among women) actual-ideal weight discrepancy. The present results suggest that there may be cultural differences in the concept and experience of body appreciation.

Matched MeSH terms: Body Image/psychology*
Body image and personality among British men: associations between the Big Five personality domains, drive for muscularity, and body appreciation

Benford K, Swami V

Body Image, 2014 Sep;11(4):454-7.
PMID: 25113287 DOI: 10.1016/j.bodyim.2014.07.004

The present study examined associations between the Big Five personality domains and measures of men's body image. A total of 509 men from the community in London, UK, completed measures of drive for muscularity, body appreciation, the Big Five domains, and subjective social status, and provided their demographic details. The results of a hierarchical regression showed that, once the effects of participant body mass index (BMI) and subjective social status had been accounted for, men's drive for muscularity was significantly predicted by Neuroticism (β=.29). In addition, taking into account the effects of BMI and subjective social status, men's body appreciation was significantly predicted by Neuroticism (β=-.35) and Extraversion (β=.12). These findings highlight potential avenues for the development of intervention approaches based on the relationship between the Big Five personality traits and body image.

Matched MeSH terms: Body Image/psychology*
Sexuality and the drive for muscularity: evidence of associations among British men

Swami V, Diwell R, McCreary DR

Body Image, 2014 Sep;11(4):543-6.
PMID: 25201097 DOI: 10.1016/j.bodyim.2014.08.008

Previous studies have documented associations between sexuality and body image, but the directionality of this association is unclear among men. This study examined whether men's drive for muscularity can be considered a correlate of their sexuality. A community-based sample of 292 heterosexual men from London, UK, completed a survey consisting of measures of drive for muscularity, sociosexuality, sexual assertiveness, sexual esteem, and sexual sensation seeking. A multiple regression analysis showed that greater drive for muscularity was predicted by more unrestricted sociosexuality (i.e., a greater proclivity for short-term, transient relationships), greater sexual sensation seeking, and greater sexual assertiveness, once the effects of participant age and body mass index had been accounted for. Possible avenues for intervention based on a sex-positive approach are discussed in conclusion.

Matched MeSH terms: Body Image/psychology*
Judging the differences between women's attractiveness and health: is there really a difference between judgments made by men and women?

Stephen ID, Perera AT

Body Image, 2014 Mar;11(2):183-6.
PMID: 24405818 DOI: 10.1016/j.bodyim.2013.11.007

Perceived weight in the face and body size have been shown to be significant predictors of both attractiveness and health. Studies looking at the relationship between attractiveness, perceived health, and perceived weight in faces have found that individuals prefer a lower weight for attractiveness than for apparent health. Here, a group of twenty-four Asian participants were allowed to manipulate the apparent body mass indices (BMIs) of full-length photographs of young Malaysian Chinese women to enhance their perceived healthiness and attractiveness. Results showed that both men and women differentiated between attractiveness and health by preferring a lower BMI for attractiveness than health, suggesting a consistency in the preferred ideal BMI for attractiveness and healthy appearance across both sexes. Results also suggested that BMI provides important cues to judgments of attractive and healthy appearance.

Matched MeSH terms: Body Image/psychology
Social dominance orientation predicts drive for muscularity among British men

Swami V, Neofytou RV, Jablonska J, Thirlwell H, Taylor D, McCreary DR

Body Image, 2013 Sep;10(4):653-6.
PMID: 23954197 DOI: 10.1016/j.bodyim.2013.07.007

The present study tested the hypothesis that men's drive for muscularity would be associated with their valuation of domination, power, status, and aggression over others. A community sample of 359 men from London, UK, completed measures of drive for muscularity, social dominance orientation, right-wing authoritarianism, trait aggression, and need for power, as well as their demographic details. Bivariate correlations showed that greater drive for muscularity was significantly correlated with most of the measures and their subscales. However, in a multiple regression analysis, the only significant predictor of drive for muscularity was support for group-based dominance hierarchies (Adj. R(2)=.17). These results suggest that men's drive for muscularity is associated with a socio-political ideology that favours social dominance.

Matched MeSH terms: Body Image/psychology*
Fulltext Translation and validation of the Malay Acceptance of Cosmetic Surgery Scale

Swami V

Body Image, 2010 Sep;7(4):372-5.
PMID: 20807682 DOI: 10.1016/j.bodyim.2010.07.005

The present study examined the psychometric properties of a Malay translation of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005). A total of 373 Malaysian women completed the ACSS along with measures of ideal-actual weight discrepancy, body appreciation, sociocultural attitudes toward appearance, self-esteem, life satisfaction, and demographics. Results showed that the Malay ACSS was best reduced to a two-factor solution, although an overall score of all 15 ACSS items showed the highest internal consistency. Results also showed that this overall score had good discriminant and divergent validity. It is expected that the availability of a Malay version of the ACSS will stimulate cross-cultural research on the acceptance of cosmetic surgery.

Matched MeSH terms: Body Image*
Sociocultural influences on body dissatisfaction and body change behaviors among Malaysian adolescents

Mellor D, McCabe M, Ricciardelli L, Yeow J, Daliza N, Hapidzal NF

Body Image, 2009 Mar;6(2):121-8.
PMID: 19195942 DOI: 10.1016/j.bodyim.2008.11.003

Little research on body dissatisfaction and body change behaviors, and the sociocultural influences on them, has been undertaken in non-Western contexts. The current study investigated these variables and the relationships between them among a sample of 529 Malaysian high school students (103 Malays, 344 Chinese and 82 Indians), who completed a set of measures in classroom settings. Chinese girls were more dissatisfied with their bodies than Chinese boys, but no gender difference was found for Malay and Indian participants. Girls were more likely to engage in behaviors to lose weight, and boys were more likely to engage in behaviors to increase muscle. The influence of sociocultural factors on body dissatisfaction and body change behaviors was limited and varied across both sex and ethnicity. Findings are discussed in relation to Western research, and it is concluded that cultural nuances need to be considered when investigating these phenomena.

Matched MeSH terms: Body Image*
Factor structure of the Body Appreciation Scale among Malaysian women

Swami V, Chamorro-Premuzic T

Body Image, 2008 Dec;5(4):409-13.
PMID: 18640882 DOI: 10.1016/j.bodyim.2008.04.005

The present study examined the factor structure of a Malay version of the Body Appreciation Scale (BAS), a recently developed scale for the assessment of positive body image that has been shown to have a unidimensional structure in Western settings. Results of exploratory and confirmatory factor analyses based on data from community sample of 591 women in Kuala Lumpur, Malaysia, failed to support a unidimensional structure for the Malay BAS. Results of a confirmatory factor analysis suggested two stable factors, which were labelled 'General Body Appreciation' and 'Body Image Investment'. Multi-group analysis showed that the two-factor structure was invariant for both Malaysian Malay and Chinese women, and that there were no significant ethnic differences on either factor. Results also showed that General Body Appreciation was significant negatively correlated with participants' body mass index. These results are discussed in relation to possible cross-cultural differences in positive body image.

Matched MeSH terms: Body Image*
Which body features are associated with female adolescents' body dissatisfaction? A cross-cultural study in Australia, China and Malaysia

Mellor D, Waterhouse M, Mamat NH, Xu X, Cochrane J, McCabe M, et al.

Body Image, 2013 Jan;10(1):54-61.
PMID: 23228484 DOI: 10.1016/j.bodyim.2012.10.002

This study investigated how dissatisfaction with various aspects of the body is associated with overall body dissatisfaction among female adolescents in Western and Asian cultures. Data used in the study were obtained from 58 Malaysian Malays, 95 Malaysian Chinese, 242 Chinese from China, and 81 non-Asian Australians aged 12-19 years (M=15.72, SD=1.72) who were recruited from high schools. Participants completed a questionnaire assessing dissatisfaction with their body overall, and dissatisfaction with varying aspects of their body. Malaysian Chinese were the most dissatisfied with their bodies. After controlling for body mass index (BMI), age and dissatisfaction with weight/shape, upper, middle and lower body, and muscles, dissatisfaction with the face was positively correlated with overall body dissatisfaction among Malaysian Malays and Australians. These findings demonstrate the importance of using assessment measures that address all possible areas of body focus as well as being tailored to the relevant culture.

Matched MeSH terms: Body Image/psychology*
Translation and validation of a Bahasa Malaysia (Malay) version of the Functionality Appreciation Scale

Swami V, Todd J, Aspell JE, Mohd Khatib NA, Toh EKL, Zahari HS, et al.

Body Image, 2019 Sep;30:114-120.
PMID: 31238276 DOI: 10.1016/j.bodyim.2019.06.001

The Functionality Appreciation Scale (FAS; Alleva et al., 2017) is a 7-item measure of an individual's appreciation of their body for what it can do and is capable of doing. To date, its psychometric properties have not been examined beyond the parent study and outside English-speaking samples. To rectify this, we examined the psychometric properties of a Bahasa Malaysia (Malay) translation of the FAS. An online sample of 815 Malaysia citizens completed a Malay translation of the FAS, along with validated measures of body appreciation, weight discrepancy, drive for muscularity, perceived pressure from and internalisation of appearance ideals, self-esteem, and trait mindfulness. Exploratory factor analyses supported a 1-dimensional factor structure of FAS scores, which was upheld using confirmatory factor analysis. FAS scores were also invariant across sex and there was no significant sex difference in scores. Construct validity was generally supported through significant associations with the additional measures included in the study. Incremental validity was also established insofar as functionality appreciation predicted self-esteem over-and-above the variance accounted for by other body image measures. The availability of the Malay FAS will be of use to scholars in Malaysia, but establishing cross-linguistic invariance will be an important next step.

Matched MeSH terms: Body Image/psychology*
Factor structure and psychometric properties of a Bahasa Malaysia (Malay) translation of the Body Appreciation Scale-2 (BAS-2)

Swami V, Mohd Khatib NA, Toh E, Zahari HS, Todd J, Barron D

Body Image, 2019 Mar;28:66-75.
PMID: 30594001 DOI: 10.1016/j.bodyim.2018.12.006

The 10-item Body Appreciation Scale-2 (BAS-2) is a widely-used measure of a facet of positive body image. Here, we examined the psychometric properties of a Bahasa Malaysia (Malay) translation of the BAS-2 in a community sample of Malaysian Malay and Chinese adults (N = 781). Participants completed the Malay BAS-2 alongside demographic items and measures of subjective happiness, life satisfaction, actual-ideal weight discrepancy (women only), drive for muscularity (men only), and internalisation of appearance ideals. Exploratory factor analyses with a Malay subsample indicated that BAS-2 scores reduced to a single dimension with all 10 items in women and men, although the factor structure was similar but not identical across sex. Confirmatory factor analysis indicated that the one-dimensional factor structure had adequate fit following modifications. BAS-2 scores were partially scalar invariant across sex (with no significant sex differences) and ethnicity (Malay participants had significantly higher body appreciation than Chinese participants), as well as had adequate internal consistency. Evidence of construct and incremental validity was also provided through associations with additional measures and the prediction of subjective happiness over-and-above other variables, respectively. The availability of the Malay BAS-2 should help advance research on the body appreciation construct in Malay-speaking populations.

Matched MeSH terms: Body Image/psychology*
Psychometric properties of the Breast Size Rating Scale (BSRS) in Brazilian university women

Junqueira ACP, Laus MF, Sousa Almeida S, Braga Costa TM, da Cunha MCF, Swami V

Body Image, 2019 Mar;28:34-38.
PMID: 30530154 DOI: 10.1016/j.bodyim.2018.11.004

The present study examined the psychometric properties of a Brazilian Portuguese translation of the Breast Size Rating Scale (BSRS). A total of 194 Brazilian university women completed the BSRS along with measures of body satisfaction, body appreciation, weight discrepancy, and attitudes toward societal appearance ideals. They also had their actual bra size and body mass indices (BMIs) objectively measured. Results indicated evidence of adequate convergent validity insofar as greater breast size dissatisfaction was significantly associated with greater weight discrepancy, higher BMI, lower body appreciation, lower body satisfaction, greater use of information from society about appearance ideals, greater perceived pressure from society about appearance ideals, and greater internalisation of general and athletic appearance ideals, respectively. In our sample, 20.6% of women reported no breast size dissatisfaction, 65.5% desired a larger breast size, and 13.9% desired a smaller breast size. Findings demonstrate that BSRS scores are psychometrically sound and that breast size dissatisfaction is common among Brazilian women.

Matched MeSH terms: Body Image/psychology*
Taking it apart and putting it back together again: Using Item Pool Visualisation to summarise complex data patterns in (positive) body image research

Swami V, Furnham A, Horne G, Stieger S

Body Image, 2020 Sep;34:155-166.
PMID: 32593946 DOI: 10.1016/j.bodyim.2020.05.004

Issues of construct commonality and distinguishability in body image research are typically addressed using structural equal models, but such methods can sometimes present problems of interpretation when data patterns are complex. One recent-developed tool that could help in summarising complex data patterns is Item Pool Visualisation (IPV), an illustrative method that locates item pools from within the same dataset and illustrates these in the form of single or nested radar charts. Here, we demonstrate the utility of IPV in visualising data patterns vis-à-vis positive body image. Five-hundred-and-one adults from the United Kingdom completed seven widely-used measures of positive body image and data were subjected IPV. Results demonstrated that, of the included measures, the Body Appreciation Scale-2 provided the closest and most precise measurement of a core positive body image construct. The Functionality Appreciation Scale and the Authentic Pride subscale of the Body and Appearance Self-Conscious Emotions Scale tapped more distal aspects. Our results also highlight possible limitations with the use of several other instruments as measures of positive body image. We discuss implications for research aimed at better understanding the nature of positive body image and interpreting complex data patterns in body image research more generally.

Matched MeSH terms: Body Image/psychology*

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