Screening for Body Image Dissatisfaction in Patients with Advanced Cancer: A Pilot Study

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Cancer and body dissatisfaction

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The present study tested whether theoretically derived risk factors predicted increases in body dissatisfaction and whether gender moderated these relations with data from a longitudinal study of adolescent girls and boys because few prospective studies have examined these aims, despite evidence that body dissatisfaction increases risk for various psychiatric disturbances.

Body dissatisfaction showed significant increases for girls and significant decreases for boys during early adolescence. For both genders parental support deficits, negative affectivity, and self-reported dietary restraint, but not Ideal body internalization, body mass index, and eating pathology, showed significant relations to future increases in body dissatisfaction; peer support deficits showed a marginal relation to this outcome.

Gender did not moderate these relations, cancer and body dissatisfaction, despite adequate power to detect interactive effects. The Skinny on Body Dissatisfaction: Although the deleterious impact of body dissatisfaction has been well established, particularly for girls, the factors that increase the risk for body image concerns are less well understood.

Recent research has identified factors that are associated with body dissatisfaction, but relatively few studies have examined these relations prospectively see Jones, cancer and body dissatisfaction Presnell et al. Moreover, little is known about whether the risk factors for body dissatisfaction differ by gender. Accordingly, the goals of the present study were to examine the developmental changes in body dissatisfaction and prospective influence of social, psychological, and biological factors on the development of body dissatisfaction for cancer and body dissatisfaction girls and boys, as well as test for gender differences in these risk factors.

Such information is imperative in order to clarify etiologic models, cancer and body dissatisfaction, inform preventive efforts, and help identify characteristics of sub-groups at high risk for body dissatisfaction and related problems. Theoretically, girls and boys who have internalized these ideals would be vulnerable to body dissatisfaction when this ideal is not actualized. For girls, cancer and body dissatisfaction, the discrepancy between ideal and actual shape is amplified following puberty, because increases in adiposity moves girls further from this ideal McCarthy, cancer and body dissatisfaction Simultaneously, girls increasingly identify with the female stereotype, cancer and body dissatisfaction, and focus on appearance as its central evaluative dimension.

This confluence of events during adolescence creates a period of significant vulnerability for girls. In support, thin-ideal internalization i. In one study that directly examined the relation between internalized appearance ideals and body dissatisfaction among boys, internalized appearance ideals were a cancer and body dissatisfaction predictor of changes in body dissatisfaction Jones, As girls advance through puberty, the increased adiposity moves them farther from the thin-ideal, thus contributing to decreased body image satisfaction.

In contrast, the changes brought about by puberty theoretically move boys closer to the larger, more muscular ideal. Although body mass emerged as a significant predictor of body dissatisfaction for boys in one prospective study Field et al. These inconsistent findings may suggest a more complex relation between body mass and body dissatisfaction in boys.

Further support comes from another study that found that body mass prospectively predicted body dissatisfaction in a sample of adolescent boys, but this relation showed a significant quadratic component, as opposed to the linear relation seen for girls Presnell et al. Social support has also been explored as a risk factor for the development of body dissatisfaction. Deficiencies in both the quantity and quality of social support have been linked with a host of psychosocial concerns for adolescents, including low self-esteem and body dissatisfaction.

Theoretically, adolescents who feel unconditionally accepted cancer and body dissatisfaction their support network may be less likely to try to attain acceptance by conforming to the thin ideal. In contrast, those who experience rejection from peers and parents may attribute this lack of support in part to their physical appearance. Empirical support for this relation has been inconsistent. However, a third study with a smaller sample size failed to demonstrate the relation between social support and body dissatisfaction in girls Byely, cancer and body dissatisfaction, et al.

Because appearance is not as central an evaluative dimension for boys, however, deficits in social support may not be as strongly linked to body dissatisfaction for boys. Theoretically, as adipose tissue increases following puberty, adolescent girls may attempt to counter this change by restricting their caloric intake.

As previously cancer and body dissatisfaction, while body mass has a linear relation with body dissatisfaction for girls, it has a more complex relation for boys Presnell et al, cancer and body dissatisfaction. Dieting may increase the risk for body dissatisfaction among boys who are trying to reduce body mass and experience cancer and body dissatisfaction dietary failure and weight gain dog dairy and doxycycline hyclate has been associated with self-reported dieting in girls Stice et al.

For these boys, changes in diet might reflect an attempt to increase lean muscle mass. Thus, it will be important to disentangle this relation for boys. Theoretically, depressed affect induces a preference for, and selective attention to, negative information about oneself and the world Beck, This hypothesis has received mixed empirical support, cancer and body dissatisfaction, however.

However, prospective studies have found that neither negative affect Presnell et al. There is some evidence that this relation may be stronger for boys than girls. One study found that negative affect predicted body dissatisfaction in boys, but not girls Presnell et al.

Further examination of this variable is needed to determine the nature of the relationship between affective disturbances and body dissatisfaction, and whether this relation differs by gender. Whereas prior studies provide some preliminary support for several of the hypothesized risk factors for body dissatisfaction, and potential gender differences among those risk factors, this literature has certain limitations.

Indeed, a recent study by McCabe and Ricciardelli noted that early-maturing girls and girls who physically matured at the same time as their peers reported higher levels of body dissatisfaction than girls whose pubertal development was delayed relative to peers. In contrast, boys who physically matured earlier than their same-sex peers had the highest levels of body satisfaction.

Thus, one might assume that age for girls would be associated with increasing levels of body dissatisfaction, whereas for boys, the reverse would be true.

For girls, some research has indicated that older girls evidence significantly greater levels of body dissatisfaction than their younger counterparts Jones, However, this has not been explicitly tested using a co-ed sample of adolescents. Furthermore, much of this previous research has examined risk factors for body dissatisfaction separately in samples of boys and girls e.

This study improves upon prior research by testing whether gender moderates the relation of each risk factor to later development of body dissatisfaction. In view of these gaps in the literature, the primary aims of this study were to examine developmental changes in body dissatisfaction and to test for gender differences in the above set of putative risk factors for body dissatisfaction in a coed sample of adolescents using longitudinal data.

Participants were adolescent girls and adolescent boys from four public and four private middle schools in a large metropolitan area of the Southwestern United States. The study was presented to parents and participants as an investigation of adolescent mental and physical health behaviors. Parents of all eighth grade girls and boys from the participating schools were sent a description of the study along with an informed consent letter, and active parental consent and adolescent assent was obtained from all participants.

This participation rate was similar to that observed in other school-recruited samples that used active consent procedures and involved structured interviews e. Interviews were conducted by clinical assessors with a bachelors, masters, cancer and body dissatisfaction doctoral degree in psychology, cancer and body dissatisfaction. Clinical assessors attended 24 hours of training, and were required to show a minimum kappa agreement with expert raters of.

Height was measured to the nearest millimeter using stadiometers and weight was measured with digital scales. Two measures of height and weight were obtained and cancer and body dissatisfaction. The BMI shows convergent validity r. Items are averaged for analyses to form separate scales of parental support and peer support.

Items were averaged for analyses. The 17 diagnostic items for bulimia were averaged to create an overall symptom composite. Items are averaged allergy and diagnosis analyses. Because some of the items on this scale appeared to assess satisfaction with body parts more relevant for females than males, four of the items were modified on the questionnaires completed by males.

Preliminary analyses tested cancer and body dissatisfaction differences between girls and boys on all study variables and demographic factors. Attrition analyses tested whether participants who dropped from the study differed significantly from those who did not.

For all models, baseline levels of the risk factors were entered as Level 2 time-invariant covariates, and the following equation was generated:. To cancer and body dissatisfaction whether gender moderated the relation between T1 risk factors and future asthma study and 77070 in body dissatisfaction, HLM models were generated to assess the effect of Level 2 time-invariant covariates of gender 0 or 1T1 risk factor, and the interaction of gender and the T1 risk factor on the slope of the Level 1 unconditional model of body dissatisfaction over time:.

For significant interactions, follow up analyses of the simple effects of the T1 risk factor on growth in body dissatisfaction were conducted separately for boys and girls.

Finally, risk factors that showed a significant prospective relation with growth in body dissatisfaction were entered simultaneously into a multivariate model in order to determine the unique contribution of each significant predictor to growth in body dissatisfaction. Attrition analyses indicated that participants who dropped out of the study did not differ from those who provided complete data on any of the variables considered in this study at T1.

Because HLM uses full-information maximum likelihood estimation for missing data, the effective N for analyses was Independent t-tests indicated that girls reported higher levels of body dissatisfaction, peer social support, cancer and body dissatisfaction, negative affectivity and dietary restraint at T1; no other gender differences were significant. Means and standard deviations for all baseline variables, and the correlations among them, are provided in Table 1.

Means and standard deviation for all baseline measures by gender are reported in Table 2. The mean body dissatisfaction score for girls was 2.

The mean body dissatisfaction score for boys was 2. This is consistent with the relatively higher rates of body dissatisfaction among girls than boys found in other studies e. To probe the relation between age and increases in body dissatisfaction, the univariate relation between age and body dissatisfaction was first investigated in an individual model to test whether T1 age predicted growth in body dissatisfaction over time.

The main effect of age was not significant. However, ideal body internalization, cancer and body dissatisfaction, body-mass index, and eating pathology, did not show significant prospective relations.

These models are reported in Table 3. To test whether gender moderated any of the univariate effects of the risk factors, interaction terms were computed for gender and each of the T1 independent variables and added to the models described above. No significant interactions with gender were observed among the putative risk factors. Risk factors showing significant univariate relations were then included in a multivariate regression model, cancer and body dissatisfaction.

This model tested whether negative affect, dietary restraint, and deficits in peer and parental social support predicted T3 body dissatisfaction.

Main effects of peer social support became nonsignificant in the multivariate model and negative affect was reduced to the trend level, but dietary restraint and parental support deficits showed significant unique relations to subsequent increases in body dissatisfaction in the multivariate model. These results are listed in Table 4. This study was designed to explore the developmental course of body dissatisfaction in a sample of adolescent boys and girls and test whether ideal body internalization, body mass index, negative affect, deficits in social support, self-reported dietary restraint, and eating pathology predicted increases in body dissatisfaction.

Diverticulitis and accutane differences in the relations of the putative risk factors to body dissatisfaction were also examined. Age at T1 did not predict increases in body cancer and body dissatisfaction for the combined sample of girls and boys; however, this relation was moderated by gender.

Follow up analyses demonstrated that for girls, increases in age were associated with increases in body dissatisfaction, cancer and body dissatisfaction. Although there were no significant differences between levels of body cancer and body dissatisfaction for boys and girls in the sample at age 13, by age 14 girls were significantly more dissatisfied. This effect remained at ages cancer and body dissatisfaction and These findings mirror those described by Joneswho also found that high-school girls blackberry email and web plan mobile higher levels of body dissatisfaction than middle school girls.

Furthermore, girls who reported satisfaction with their body size and shape were significantly thinner than boys who expressed similar levels of satisfaction.

Despite this, cancer and body dissatisfaction, ideal body internalization arthritis and musculoskeletal alliance not emerge as a prospective predictor of body dissatisfaction in this study. However, cancer and body dissatisfaction, another prospective study that examined thin-ideal internalization in a coed sample also did not find support for the predictive relation to body dissatisfaction Presnell et al.

Ideal body internalization has been thought to lead to body dissatisfaction because of the feelings of frustration engendered by failing to attain an ideal one holds in high esteem. Aspergers disorder and prozac 80mg there was no interaction of gender and ideal body internalization, these null findings cannot be attributed to gender differences in the way adolescents conceptualize the ideal body size and shape.

As an aside, ideal body internalization also did not interact with obesity to predict body dissatisfaction for the current sample, suggesting that this variable does not predict increases in body dissatisfaction even among those adolescents who deviated substantially from the culturally sanctioned ideal.

 

Cancer and body dissatisfaction

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