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Given the prevalence of body dissatisfaction among young people, which tends to persist into adulthood, a need exists for large-scale interventions that address this problem. Film has been identified as a resource that is well-suited to large-scale dissemination, which can achieve broad impact and reach. Embrace Kids, a film aimed at improving young people's body image, is one such resource. To evaluate the film's impact on body image, 55 children (M = 10.59, SD = 1.49) and 47 adults (M = 43.75, SD = 8.54) were recruited from the Australian general public to complete a brief survey before and after viewing the film. After viewing the film, significant increases in state body appreciation, state functionality appreciation and state self-compassion were reported for children (d = 0.46 - 0.61) and adults (d = 0.88 - 1.08). They supported the safety of the film by indicating that it did not make them more concerned about their appearance. Findings provide initial support for the film as a scalable intervention that can be safely task-shifted to non-professional audiences. Future research directions include comparing the effect of Embrace Kids against a control film, and testing the longitudinal impact of the film on trait body image., Competing Interests: Declaration of Competing Interest None. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Eating disorders (EDs) are serious, deadly disorders that emerge in adolescence and early adulthood. Further, reported incidences of EDs are increasing worldwide. As such, accessible, affordable, and effective early intervention and prevention efforts are critical. The Body Project is a well-established ED prevention program with demonstrated success at reducing ED symptom severity and the risk of onset of EDs in young females. However, it has not yet been formally evaluated in an Australian population, nor have the benefits of the treatment for young people of all genders been thoroughly investigated. This protocol paper outlines the design for a study which aims to investigate the outcomes and feasibility of the Body Project as a brief ED prevention program within an Australian youth mental health service: headspace Camperdown. This pragmatic trial will compare outcomes between a Body Project treatment group and a Treatment-as-usual control group. Primary outcomes include body image concerns, ED symptomatology and general psychological distress, measured pre- and post-treatment, and at one-month follow-up. All young people attending headspace Camperdown for care are eligible for participation in the trial. The Body Project program is comprised of four group-based 1.5 h sessions run over 4 consecutive weeks. Overall, a trial of the Body Project as an ED prevention program is warranted to investigate the outcomes of the intervention in this sample and will provide valuable information about the feasibility for widespread implementation of the treatment as part of a stepped-care approach to intervention for EDs at youth mental health service locations across Australia. ANZCTR Trial Registration Number: ACTRN12623000695606 (registered 29 June 2023). [ABSTRACT FROM AUTHOR]

Discusses social construction of the body through schooling, in particular physical education and sports. Suggests examination of the effects of these programs on young people. Argues that common practices often serve to alienate young people from their bodies, rather than educating them. (Contains 23 references.) (NB)

Background: Risk factors represent a range of complex variables associated with the onset, development, and course of eating disorders. Understanding these risk factors is vital for the refinement of aetiological models, which may inform the development of targeted, evidence-based prevention, early intervention, and treatment programs. This Rapid Review aimed to identify and summarise research studies conducted within the last 12 years, focusing on risk factors associated with eating disorders. Methods: The current review forms part of a series of Rapid Reviews to be published in a special issue in the Journal of Eating Disorders, funded by the Australian Government to inform the development of the National Eating Disorder Research and Translation Strategy 2021–2031. Three databases were searched for studies published between 2009 and 2021, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, or population studies). Data pertaining to risk factors for eating disorders were synthesised and outlined in the current paper. Results: A total of 284 studies were included. The findings were divided into nine main categories: (1) genetics, (2) gastrointestinal microbiota and autoimmune reactions, (3) childhood and early adolescent exposures, (4) personality traits and comorbid mental health conditions, (5) gender, (6) socio-economic status, (7) ethnic minority, (8) body image and social influence, and (9) elite sports. A substantial amount of research exists supporting the role of inherited genetic risk in the development of eating disorders, with biological risk factors, such as the role of gut microbiota in dysregulation of appetite, an area of emerging evidence. Abuse, trauma and childhood obesity are strongly linked to eating disorders, however less conclusive evidence exists regarding developmental factors such as role of in-utero exposure to hormones. Comorbidities between eating disorders and mental health disorders, including personality and mood disorders, have been found to increase the severity of eating disorder symptomatology. Higher education attainment, body image-related factors, and use of appearance-focused social media are also associated with increased risk of eating disorder symptoms. Conclusion: Eating disorders are associated with multiple risk factors. An extensive amount of research has been conducted in the field; however, further studies are required to assess the causal nature of the risk factors identified in the current review. This will assist in understanding the sequelae of eating disorder development and in turn allow for enhancement of existing interventions and ultimately improved outcomes for individuals. Plain English summary: Research into the risk factors associated with eating disorders (EDs) is necessary in order to better understand the reasons why people develop EDs and to inform programs which aim to reduce these risk factors. In the current study we reviewed studies published between 2009 and 2021 which had researched risk factors associated with EDs. This study is one review of a wider Rapid Review series conducted as part the development of Australia's National Eating Disorders Research and Translation Strategy 2021–2031. The findings from this review are grouped into nine main risk factor categories. These include (1) genetics, (2) gastrointestinal microbiota and autoimmune reactions, (3) childhood and early adolescent exposures, (4) personality traits and comorbid mental health conditions, (5) gender, (6) socio-economic status, (7) ethnic minority, (8) body image and social influence, and (9) elite sports. Further research is needed to better understand the relationship between the risk factors, in particular the ways in which they may interact with each other and whether they cause the ED or are just associated with the ED. [ABSTRACT FROM AUTHOR]

It is important that scales that evaluate body image and related attitudes and behaviors are both reliable and valid to evaluate these constructs in different countries. This paper introduces a series of five papers that examine the measurement invariance of multiple scales for men and women across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain, and the US). The papers examined measures of: sociocultural influences (i.e., appearance-related pressures) on strategies to lose weight/increase muscle; internalization of the thin/muscular ideal; body image; personality constructs; body change strategies to increase muscles and lose weight; and eating regulation. Measurement invariance was generally well-established across the eight countries. One or more items were removed in some scales for some countries to establish invariance. Factor loadings were equivalent across countries and refined scales demonstrated acceptable levels of reliability. The most frequent difference in the scales was in the item intercepts across groups, although most item intercepts were equivalent across groups. This series of papers makes an important contribution to the body image literature by demonstrating the validity of measures of body image, disordered eating, and sociocultural factors that can be used to better understand the relationship between these variables across different countries., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: Despite the risks involved, the use of drugs for recreational purposes is prevalent and generally well accepted. However, there is sparse research to explore the drivers of this phenomenon. Method: Semi-structured interviews were conducted with lay field observers of the recreational drug scene. The data were analyzed using ground theory to provide a framework for understanding motivators underpinning recreational drug use. Two ascribed benefits underpinned recreational drug use: 1) improved social connectedness and 2) enhanced performance. This paper reports on the relationship between drug use and performance enhancement. Results: Recreational drugs were used with the aim of enhancing performance in a number of ways, including to improve endurance, appearance, confidence, and personality. The majority of participants reported that drug taking offers personal and social benefits that outweighed the risks. Discussion and conclusions: In contrast to much of the literature, this study found that people perceived recreational drug use to have a range of positive effects that they wanted to take advantage of. This important finding adds to our understanding of the “pulling power” of drugs. Ultimately, the study highlights a need to rethink the preoccupation in drug strategies with negative physical, mental, and social outcomes as this would seem to be disconnected from actual experience and may result in a credibility gap for prevention education. [ABSTRACT FROM AUTHOR]

palacios-ceña d., losa-iglesias m.e., álvarez-lópez c., cachón-pérez m., reyes r.a.r., salvadores-fuentes p. & fernández-de-las-peñas c. (2011) Patients, intimate partners and family experiences of implantable cardioverter defibrillators: qualitative systematic review. Journal of Advanced Nursing 67(12), 2537-2550. Abstract Aim. This paper is a report of an interpretive review of qualitative research on how an implantable cardioverter defibrillator affects adult recipients and their significant others. Background. An implantable cardioverter defibrillator detects pathological cardiac rhythms and automatically converts the rhythm with electrical counter shocks. Data sources. A systematic literature search was conducted for qualitative research papers published between January 1999 and January 2009. PubMed, Medline, ISI Web of Knowledge and CINAHL databases were searched with the following key words: internal defibrillator, implantable defibrillator and qualitative research. Review Methods. Twenty-two papers were included. The Critical Appraisal Skills Programme and Prompts were used to appraise studies. Thematic analysis and synthesis approaches were used to interpret evidence. Findings. People with an implantable cardioverter defibrillator were found to experience physical, psychological and social changes. Shocks produce fear and anxiety, affecting relationships and sexual relations. The use of support groups and the use of the Internet are important in helping adjustment to an implantable cardioverter defibrillator. Women's responses to an implantable cardioverter defibrillator appear different than men's responses and include concerns about physical appearance and relationship issues. Postdischarge follow-up and educational programmes are still underdeveloped. Conclusion. Patients need additional education, support and follow-up care after hospital discharge. Patients and significant others benefit from collaboration between patient associations and healthcare professional societies. Future research is needed to identify the specific challenges that women recipients face. [ABSTRACT FROM AUTHOR]

Objectives: Weight‐based stigma is often experienced by individuals who are overweight and obese, and is associated with a range of deleterious physical and mental health outcomes. Research is lacking on the mechanisms through which these relationships occur. This paper examines two potential mechanisms: internalised weight stigma and self‐compassion. Method: A sample of 147 overweight and obese Australian females aged between 18 and 45 years completed a series of self‐report questionnaires measuring: experienced weight stigma, internalised weight stigma, self‐compassion, psychological distress, body shame, loneliness, and life satisfaction. Results: Internalised weight stigma mediated the relationship between experienced weight stigma and body shame such that greater experienced weight stigma led to greater internalised weight stigma, which in turn led to greater body shame. Additionally, self‐compassion mediated the relationship between experienced weight stigma and several psychosocial factors such that greater experienced weight stigma led to lower self‐compassion, which led to greater psychological distress, higher perceived loneliness, and lower satisfaction with life. Conclusions: Findings support previous research indicating that internalised weight stigma plays a mediating role in the relationship between experienced weight stigma and adverse outcomes. This study extends upon prior research by investigating previously unexamined outcome variables and exploring the simultaneous mediating role of self‐compassion. The findings suggest that both internalised weight stigma and self‐compassion each play a different but important role in the way in which weight stigma impacts on overweight and obese women. Results from this study have implications in terms of psychological intervention for overweight and obese individuals in clinical practice. [ABSTRACT FROM AUTHOR]

In the past decades, public health has increasingly addressed what has been called the children's obesity 'epidemic', most notably through large-scale initiatives promoting physical activity. Through a discourse analysis the current paper critically examines such efforts in Canadian and Australian public health. Public health websites in Canada and Australia were examined for information concerning children's health, physical activity and obesity and explored for how these issues were represented in the discourse. Bacchi's (2009) 'What's the problem represented to be?' approach to discourse analysis guided our interrogation of the taken-for-granted assumptions underlying Canadian and Australian public health discourse, the ideological and political influences involved in its construction, and the knowledge base upon which it rests. The article calls for critical reflection on how children's physical and leisure activities are being advanced. [ABSTRACT FROM AUTHOR]

Too many Australians suffer from poor body image and eating disorders. The Israeli, French and Norwegian Governments have created body image legislation to try to address this: it responds to concerns that the countless images of thin women people see can contribute to poor body image. By contrast, Australia does not have a Body Image Law: it has a voluntary code that the advertising industry generally does not follow. This article argues that Australia should enact a Body Image Law that reflects health evidence that body image needs to be improved. The Body Image Law would require disclaimers on images that were not retouched, create a specialised government body to evaluate images and attract civil penalties for breaching it. The authors believe that this is the first Australian article to suggest an Australian Body Image Law of this kind. [ABSTRACT FROM AUTHOR]

This paper contributes to sport, sociology and the body literature by exploring the ‘exposure and effect’ of culture, in particular bodily practices placed on three adolescent swimmers immersed in the Australian swimming culture using an ethnographic framework. The research reported is particularly notable as it addresses two distinct time points in the swimmers’ lives. The first section explores the adolescent experiences of three female swimmers within the cultural context of Australian swimming by articulating some of the specific body practices and ‘memes’ (ideas, symbols and practices) that they were exposed to and/or engaged within relation to the body. The second section of this paper focuses on the same three swimmers in the ‘present day’, some 10–30 years after being immersed in the Australian swimming culture as adolescents. It excavates their body practices and the relationships they now have with their body, and thus pursues the sustained impact of the body practices and ‘memes’ they were exposed to as adolescents. Analysis employs concepts drawn mainly from Foucault, particularly his thesis in regard to ‘disciplinary power’, ‘regulation’ ‘classification’ and ‘surveillance’. At a club (amateur) and National level, Australian swimming is revealed as an institution, a site and culture where particular techniques of power have become concentrated and have been brought to bear on individuals in systematic ways, with sometimes damaging effects arising for athletes’ long-term health and well-being, particularly if the individuals concerned continue to engage with cultural practices in regard to the body post-career. [ABSTRACT FROM PUBLISHER]

This paper offers a performative autoethnography in order to make transparent-in-context relationships and research data arising from an ethnocinematic doctoral study entitled: ‘Cross-marked: Sudanese Australian Young Women Talk Education’. The performative structure of this paper reflects contemporary developments in qualitative and education research that acknowledge researchers/educators as gendered, sexualized, and racialized. From these subjectivities we engage in communities of practice in ways that are both intercultural and intergenerational and, as such, experimental performative narratives are increasingly considered to be both ‘reliable’ data while simultaneously troubling notions of reliability. This paper explores these productive contradictions as they appeared to the educator-author at a Sudanese beauty pageant in Melbourne, Australia, and the implications for her own sense of race, refugeity and sexual identity that this scene evoked. This and other texts that are created to be spoken aloud are ‘performance ethnographies about self and society’, and as such they blend layers of past and present in provocative ways. [ABSTRACT FROM PUBLISHER]

According to researchers, between 20% and 25% of patients with a stoma will experience significant psychological symptoms. With the trend of early discharge and the increasing numbers of patients requiring surgery, it is very easy for health professionals to focus on just the physical wellbeing. The inadvertent impact is serious. Are we failing to meet our patients' psychological needs? This paper will explore and discuss anxieties held by patients with a stoma, with a particular focus on body image, sexuality and how we as health professionals can support and empower patients on their health care journey. [ABSTRACT FROM AUTHOR]

Purpose: To examine how the Australian media portrays the childbearing body through the use of celebrity stories in women's magazines. The study aimed to provide insight into socially constructed factors that might influence women's body image and expectations during pregnancy and the early postnatal period., Method: Media content analysis was used to analyse 25 celebrity stories about the childbearing postnatal body (images and texts) collected from Australia's three leading women's magazines between January and June 2009 (n=58)., Findings: A variety of persuasive textual and visual messages were elicited. The major theme representing how the postnatal body was constructed was labelled 'Bouncing back'; the focus of this paper. The social messages inherent in the magazine stories were that women need to strive towards regaining a pre-pregnant body shape with the same effort one would employ when recovering from an illness. Three specific sub-themes that promoted weight loss were identified. These were labelled 'Racing to bounce back', 'Breastfeeding to bounce back' and 'Pretending to bounce back'. A fourth sub-theme, 'Refusing to bounce back: Celebrating my new body', grouped together stories about celebrities who appeared to embrace their changed, but healthy, postnatal body., Conclusions: The study highlighted the expectations of the postpartum body in relation to speedy return to the pre-pregnant state. Understanding how these portrayals may contribute to women's own body image and expectations in the early postpartum period may better assist maternity health care providers to engage with women in meaningful discussions about this important time in their lives and challenge notions of ideal body types. Assisting women to accept and nurture themselves and have confidence in their ability as a new parent is a crucial element of quality maternity service provision., (Copyright © 2011 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

The objectification of women's bodies in western culture creates special emphasis on women's representations of embodied aspects of themselves. I argue that women's satisfaction with their bodies is likely to have particularly strong implications for other embodied aspects of self: in this case, representations of their sexual selves. This paper examines the relationships between women's body satisfaction, their sexual self-schemas, and components of subjective well-being in a sample of 91 Australian women aged between 18 and 68. Body satisfaction and dimensions of women's actual sexual self-schemas predicted satisfaction with life, positive and negative affect. The relationships between body satisfaction and both positive affect and satisfaction with life were partially mediated by the positive dimensions of sexual self-schemas. This finding suggests that at least some of the negative consequences associated with body dissatisfaction are due to the negative implications of body dissatisfaction for women's beliefs about their sexual selves.

This paper investigates social transitions, constructions of masculinity and coping among men in commercialized gay spaces, such as nightclubs and dance parties ('the gay scene'). The findings are derived from two qualitative studies involving individual samples of 24 and 12 younger (aged 19 to 36) same-sex attracted men living in Melbourne, Australia. The analysis recasts 'coming out' into the gay scene as a passage into a 'new world' and a 'new self'. On the scene, notions of selfhood are challenged and men enter various states of liminality as they (re)construct themselves. New ways of performing the self can be tried on through ritualized behaviours, including performing various masculinities. While successful performances of masculinity can promote social acceptance, those who express less valued forms of masculinity can struggle harder. Internalized homophobia influences rituals on the scene, and men reported feeling like perpetual outsiders, regardless of the success of their performances. The emotional dangers to selfhood lurking in performance and ritual are explored, as well as the ways that men find to prevail. Invariably, liminality ends, and the men who do well approach themselves, the rituals and the performances with insight.

Background: The majority of breast cancer patients will experience some level of emotional distress, with some patients having long‐term psychological maladjustment. Personal and social resources play a role in recovery yet the interplay between these factors warrants further examination. This study aimed to investigate the interaction of psychosocial factors impacting women in their breast cancer trajectory, at 2 years or less following diagnosis (stages I‐III). Design A longitudinal cohort study approach was used in this study. Methods: The sample consisted of n = 49 participants. Data were collected between June 2013 and October 2013 and followed for 12 months across the trajectory of the disease. Results: The mean age was 56.6 years (SD 11.6 years). Most participants had stage I or stage II breast cancer. Time (over three time points—4 weeks, 6 months, and 12 months) after diagnosis was significantly associated with the body image (P = .003) and age (P = .004). Conclusion: Older women with breast cancer reported less concern regarding body image than their younger peers. These findings suggest that posttreatment younger women may require access to psychological support posttreatment. SUMMARY STATEMENT: What is already known about this topic? The majority of breast cancer patients experience some level of emotional distress, with some patients having long‐term psychological maladjustment.Personal resources (ie, self‐image, optimism, and perceived control) and social resources (ie, social support) play a central role in recovery.The interplay between the personal and social resources is not well known particularly in the first 2 years postdiagnosis What this paper adds? Older women with breast cancer reported less concern regarding body image than their younger peers.Older women also experienced more positive future perspectives when compared with younger women.Younger women appeared less adaptive psychologically. The implications of this paper: There are known psychological impacts for women who have breast cancer, and nurses are well placed within their scope of practice to undertake routine mental state examination of these patients.Younger women who have breast cancer in particular may require additional psychological supports during the first 2 years postdiagnosis. [ABSTRACT FROM AUTHOR]

Summary This paper reports on the findings of studies that were conducted as part of the Pacific Obesity Prevention in Communities project. The studies evaluated the types of messages that adolescents received in relation to body image, physical activity and eating. The participants were male and female adolescents from Fiji (two cultural groups), Tonga, New Zealand (Tongans) and Australia (European Australians). Three studies were conducted: interviews with 48 adolescents (24 male, 24 female) from each cultural group, questionnaires with 600 adolescents (300 male, 300 female) from each cultural group and the perceptual distortion study with 100 adolescents (50 male, 50 female) from the two cultural groups in Fiji and European Australians. The results demonstrate that parents, peers, the media, as well as religious influences impact on the type of body valued by adolescents in each of the cultural groups, as well as their levels of body satisfaction. These influences also shape the type and volume of food consumed, and the type and frequency of physical activity. The results of these studies highlight the major role played by the broader societal values in shaping the nature of the messages that adolescents receive in relation to their body size, eating and physical activity. [ABSTRACT FROM AUTHOR]

This paper describes key findings of a study exploring how a cohort of 16 rural Australian women aged over 60 years think, feel and respond to the prevalence of sexualised imagery in the media. The qualitative research framework was informed by Feminist Standpoint Theory. Participants in three focus groups responded to semi-structured questions and prompts, interspersed with viewing examples of sexualised images. Five strong thematic categories emerged: concern for the harmful impacts of sexualised images on the vulnerable, the media's portrayal of sexual content with a focus on physical appearance and youth, descriptions of the impact of viewing sexualised images, moderators of the impact of sexualised images on well-being, and marginalisation of women in the media. Findings from this research indicate that sexualised images in the media do have an impact on older women's self image and mental health in numerous ways and in a range of situations. Emotional impacts included sadness, anger, concern, envy, desensitisation, marginalisation, and discomfort that their appearance was being judged by others. A strong sense of self apart from appearance, feeling valued by family and community, ignoring or overlooking media content, and being aware that media images are not real and attainable helped buffer the link between sexualised images and well-being. Another important finding is that the impact is variable: women may experience different responses to similar sexualised content depending on a range of social, health and lifestyle factors affecting them at any given time. [ABSTRACT FROM AUTHOR]

Childhood trauma has long been implicated in the development of anorexia nervosa and is known to impact more women than men. Still, less is known about the meaning women attribute to food and bodily practices and how they contribute to feminine subjectivity. In this article, we examine the subjective experiences of women with histories of childhood abuse and anorexia and women who did not develop an eating disorder. Through a visual narrative analysis of eight body maps and narratives, we identified five themes: "time and the body have a way of showing what matters," "femininity and family," "sexual subjectivities and food meanings," "voices, dissociation, and sexual subjectivities," and "religion and healthism." In women with anorexia, specific eating and bodily practices reconstructed the traumatic events to align with the available cultural discourses related to health, religion, and family and had implications for their feminine and sexual subjectivities and self-worth. This research showcased how arts-based methodologies add value and advance knowledge about the role of culturally available representations in the development of anorexia and has implications for therapy and prevention of anorexia. [ABSTRACT FROM AUTHOR]

Objective: To develop and internally validate risk prediction models for adolescent onset and persistence of eating disorders. Methods: N = 963 Australian adolescents (11–19 years) in the EveryBODY Study cohort completed online surveys in 2018 and 2019. Models were built to predict 12‐month risk of (1) onset, and (2) persistence of a DSM‐5 eating disorder. Results: Onset Model. Of the n = 687 adolescents without an eating disorder at baseline, 16.9% were identified with an eating disorder after 12 months. The prediction model was based on evidence‐based risk factors for eating disorder onset available within the dataset (sex, body mass index percentile, strict weight loss dieting, history of bullying, psychological distress, weight/shape concerns). This model showed fair discriminative performance (mean AUC =.75). The most important factors were psychological distress, weight and shape concerns, and female sex. Diagnostic Persistence Model. Of the n = 276 adolescents with an eating disorder at baseline, 74.6% were identified as continuing to meet criteria for an eating disorder after 12 months. The prediction model for diagnostic persistence was based on available evidence‐based risk factors for eating disorder persistence (purging, distress, social impairment). This model showed poor discriminative performance (mean AUC =.65). The most important factors were psychological distress and self‐induced vomiting for weight control. Discussion: We found preliminary evidence for the utility of a parsimonious model for 12‐month onset of an eating disorder among adolescents in the community. Future research should include additional evidence‐based risk factors and validate models beyond the original sample. Public Significance: This study demonstrated the feasibility of developing parsimonious and accurate models for the prediction of future onset of an eating disorder among adolescents. The most important predictors in this model included psychological distress and weight and shape concerns. This study has laid the ground work for future research to build and test more accurate prediction models in diverse samples, prior to translation into a clinical tool for use in real world settings to aid decisions about referral to early intervention. [ABSTRACT FROM AUTHOR]

Objective: Engaging in romantic relationships in adolescence may inadvertently increase participation in appearance culture and the risk for eating pathology. Little research has considered this effect, particularly as it relates to adolescents' gender identity and sexual attraction. Therefore, this study examined the associations among relationship status, gender, and sexual attraction in adolescents' eating pathology. Methods: Data from the first wave of the EveryBODY study, a large sample of Australian adolescents aged 11–19 years (n = 3262, Mage = 15.00, 53.80% girls), were used. Participants reported their relationship status and eating pathology (fasting, purging, binge eating, driven exercise, steroid use, and shape/weight concerns) using an online survey. Results: Logistic regressions adjusting for age and BMI percentile revealed that romantic relationships were associated with higher adjusted odds (AORs) for reporting clinical frequency/severity threshold of fasting, purging, steroid use, and shape and weight concerns (AORs: 1.34–3.68). Relative to boys, girls had higher adjusted odds of reporting clinical frequency/severity threshold of all eating disorder features (AORs: 1.47–7.40), except for steroid use for muscle gain. Adolescents who reported same‐sex attraction, were unsure of their sexual attraction, or did not endorse any sexual attraction had greater adjusted odds of reporting clinical frequency/severity threshold of fasting, purging, and shape and weight concerns (AORs: 1.35–1.83) than those with only other‐sex sexual attraction. Interactions among relationship status, gender, and sexual attraction were nonsignificant. Conclusions: Romantic experience emerged as a novel correlate for adolescents' eating pathology. Future research should uncover the contextual factors within relationships that may contribute to this association. Public Significance: The initiation of romantic relationships is normative during adolescence. However, adolescents' romantic desirability is often determined by their physical appearance, increasing the risk for eating pathology. Among a large sample of Australian adolescents, romantic involvement was associated with greater likelihood of clinical threshold eating pathology for adolescent boys and girls, regardless of sexual attraction. It is urgent to identify the factors within romantic relationships that are associated with eating pathology. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including comorbid anxiety, mindfulness-integrated cognitive behaviour therapy (MiCBT) and schizophrenia.

Body dissatisfaction is distressing and a risk factor for adverse consequences including eating disorders. However, data pertaining to the prevalence of body dissatisfaction in adolescence, a key period for its emergence, are lacking. This is a substantial barrier to tailored assessment and early intervention. This study addresses this gap and provides the prevalence of body dissatisfaction and associations with depressive symptoms and body change strategies. Adolescent boys (n = 367; Mage = 12.8, SD = 0.7) and girls (n = 368; Mage = 12.7, SD = 0.7) completed measures of body dissatisfaction and depressive symptoms with established cut-off levels. They also completed measures of dietary restraint and strategies to increase muscle size. Of boys and girls, 37.9% and 20.7%, respectively experienced moderate, and 6.8% and 19.6% experienced clinically significant body dissatisfaction, with higher rates among girls than boys and among adolescents aged 13 and 14 than aged 12. More than one-quarter of boys (26.70%) and one-third of girls (33.15%) reported subthreshold depressive symptoms or possible, probable or major depressive episodes. Girls revealed a higher prevalence of possible-, probable-, or major depressive episode than boys. Relative to those with no or low body dissatisfaction, adolescents with clinically significant body dissatisfaction were 24 times more likely to also report possible-, probable-, or major depressive episodes. Among boys and girls, clinically significant body dissatisfaction was associated with higher levels of dietary restraint and engagement in strategies to increase muscle size. Greater attention to identification and early intervention for body dissatisfaction is needed, especially for girls. [ABSTRACT FROM AUTHOR]

Background: We sought to provide the first point prevalence estimates of muscle dysmorphia (MD), a form of body dysmorphic disorder characterized by a preoccupation with perceived insufficient muscularity, in adolescents. Methods: Data were taken from a survey of 3618 Australian adolescents (11.172–19.76 years; 49.3% girls). Measures captured demographic characteristics, symptoms of MD and eating disorders, psychological distress and functional impairment. Diagnostic criteria for MD developed by Pope et al. (1997, Psychosomatics , 38(6), 548–557) were applied, entailing preoccupation with insufficient muscularity causing significant levels of distress or disability that cannot be better accounted for by an eating disorder. Results: The point prevalence of MD was 2.2% [95% confidence interval (CI) 1.6–3.0%] among boys and 1.4% (95% CI 0.9–2.0%) among girls. Prevalence was not associated with gender (V = 0.031) or socioeconomic status (SES) (partial η 2 < 0.001), but was marginally associated with older age (partial η 2 = 0.001). Boys with MD were more likely than girls with MD to report severe preoccupation with muscularity (V = 0.259) and a weight-lifting regime that interfered with their life (V = 0.286), whereas girls with MD were more likely to report discomfort with body exposure (V = 0.380). Conclusions: While future epidemiological research using diagnostic interviews is needed to verify these estimates, the findings suggest that MD is relatively common from early to late adolescence. Gender differences in MD prevalence may be minimal; however, the symptom profile appears to diverge between boys and girls. These findings provide a platform for future, analytical research designed to inform clinical and public health interventions. [ABSTRACT FROM AUTHOR]

The rise of the 'obesity epidemic' in Western societies has led to an increased public gaze on obese individuals. Yet there is limited research that explores through qualitative methods the increased impact it has had on obese individuals' perceptions of self, body image and coping strategies, using their own words. This paper presents the findings of interviews with a community sample of 142 obese adults in Australia. We examined how obese individuals felt about themselves and their bodies, what influenced these feelings, and the subsequent coping strategies employed. While participants were able to identify many positive characteristics about their inner self, the vast majority used negative language to describe their physical appearance. Many participants described feelings of 'guilt', 'shame' and 'blame' associated with their weight. Coping strategies included striving for perfection in other areas of their life, social isolation, maximising aspects of their appearance and 'fat' acceptance. This study shows that, while different groups of obese adults experience, cope with and compensate for the influence of weight-based stereotyping in many different ways, they still feel an unrelenting otherness and difference associated with their weight. [ABSTRACT FROM AUTHOR]

The present study aimed to analyze the Psychological scientific production about eating disorders and body image in adolescents from 2003 to 2007. The process became with an computerized search at the PsycInfo's database, for it was used as keywords "body image", "eating disorders", and "adolescence". From this search were extracted the abstracts and complements, which were organized into thematic categories purposed by Bardin (2008). The results allowed to identify that the number of publications remained stable over the years which has being analyzed, as well as United States and Australia were the countries that had the majority of articles published. The empirical studies had stress and were published in specialized papers of the area, as the Eating Disorders: The Journal of Treatment and Prevention and the Eating and Weight Disorders. Among the subjects studied, there were highlights for the assessment of eating disorders' risk factors, emphasizing the females and adolescent population. [ABSTRACT FROM AUTHOR]

People with limited or no bladder or bowel control, who have had a stoma to manage elimination, have a particular awareness of the proximity of the sites of pleasure and excretion. Drawing on interviews and related ethnography conducted in Australia from 1998 to 2001, this paper explores how men and women with permanent continence problems negotiate their sexuality around their bodily unreliability. Pleasurable sex, idealized, involves losing control. People who are incontinent or rely on a stoma, however, must monitor their bladder and bowel, disguising the stoma and bag and controlling their body in sex as in other circumstances. The need to negotiate bodily boundaries with established partners, or to disclose to new sexual partners, results in self-consciousness and social unease, and people need to reconstruct notions of privacy and dignity so that breaches in bodily control do not undermine the sexual relationship. For many, the stoma undermines self-esteem and body image, while its management confuses the status of the individual as "normal" and the partner as carer or lover. [ABSTRACT FROM AUTHOR]

Self-objectification has been implicated in the development of body image disturbances and disordered eating among adults and adolescents. Empirical research exploring these associations among children is limited. Given body image and eating disturbances have been observed in a significant proportion of children, elucidating the factors associated with these disturbances among members of this population segment is important to informing prevention and intervention efforts. Accordingly, we cross-sectionally examined the association between self-objectification and body image and eating disturbances in 219 Australian 6- to 11-year-olds (57% classified as female children; average age = 8.37 years, SD = 1.42). Significant associations were observed between measures of self-objectification and body surveillance; body surveillance and both body shame and weight/shape concern; and weight/shape concern and dietary restraint. Results suggest early interventions targeting poor body image may need to address self-objectification, although further research is needed to firmly establish self-objectification as a risk factor for poor body image in children. Practitioners could utilize resources specifically developed for children, which encourage positive body esteem, build body confidence, support healthy relationships with food and exercise, and promote activities encouraging individuals to be attuned to how their bodies feel rather than how they look. [ABSTRACT FROM AUTHOR]

Objective: Increasing numbers of young Australian men are training and dieting to attain high muscle mass and low body fat and using steroids and performance and image enhancing drugs to expedite this process. This study explored men's identification with a muscularity‐centred subculture and what contributes to the pursuit of masculine body image defined by muscularity. Method: Participants were 14 young men who (a) weight‐trained >3 times per week, (b) used bodybuilding supplements daily, and (c) used/had used steroids/other performance and image enhancing drugs. Results: Interview analysis identified precipitating (e.g., low self‐confidence), perpetuating (e.g., social media pressures), and resultant factors related to strict regime adherence, including simultaneous recreational drug use. This range of influences gives support to a sociocultural framework for explaining the development and maintenance of striving for a muscular ideal among this cohort. Conclusions: Understanding the factors contributing to the attainment of a muscularity‐defined masculine body image is important given the risky health behaviours young men may engage in to reach this ideal. [ABSTRACT FROM AUTHOR]

Issue Addressed: This research explored the use of "fat talk" by early childhood educators and their awareness of their potential influence on the developing body image of young children.Methods: Mixed methods comprising focus groups, telephone interviews and demographic surveys with 44 early childhood educators Australia-wide.Results: Findings showed many educators in this research recognised that they had a role to play in the development of children's body image, though some were unsure when body image began to develop. Educators engaged widely in "fat talk," in the vicinity of children or other educators, and accepted such talk as normal.Discussion: "Fat talk" features in the workplace and is commonly used by early childhood educators. Its influence on the development of body image on young children did not appear to be well understood by early years' educators or of a concern to them.Conclusions: Since body image develops in children from around three years of age, the role of early childhood educators in its development should not be overlooked. SO WHAT?Relevance To Health Promotion: Body image is a misunderstood public health concern, with long-term impacts on weight, mental health and physical health. Promotion of positive body image and the early recognition of body image disturbance are crucial, as children who exhibit body dissatisfaction in their formative years have a greater risk of severe body image disturbance as they progress through childhood and adolescence. Since early childhood educators spend significant time with children, encouraging them to avoid engaging in "fat talk" and instead to promote positive body image is warranted. [ABSTRACT FROM AUTHOR]

Background: The extent and implications of muscle building protein supplement use among adolescents is relatively unknown. This study aimed to describe the prevalence of protein powder, creatine, and anabolic steroid use in a sample of 14-16 year-old boys in Australia, and the predictors of actual use, and intentions to use protein powder.Methods: Data were obtained from questionnaires with Australian adolescent boys aged 14-16 years from one independent boy's school in Melbourne (N = 237). Hierarchical linear and logistic regressions were used to determine the predictors of intentions, and actual use of protein powder.Results: 49.8% of boys reported current use of, and 62% intended to use protein powder; 8.4% used creatine, and 4.2% used anabolic steroids. Higher levels of drive for muscularity, participation in weight training, and playing a greater number of sports were significant predictors of higher current use and intentions to use protein powder, but age, BMI, body esteem, and ethnicity were not.Conclusions: Prevalence of muscle building supplement use was relatively high among this adolescent population. This research has implications for intervention and prevention programs to educate young boys about muscle building supplements to reduce negative physical and psychological health effects of their use. [ABSTRACT FROM AUTHOR]

Background: Very few programs aimed at improving body image among adolescent boys have been effective, and there is still no clear evidence as to what will work for universal prevention of eating disorders and body dissatisfaction with this group. We combined two previously efficacious programs and used a design thinking framework to optimise program content alongside potential end-users including adolescent boys, teachers, parents, and experts. Goodform is a four-session universal program that aims to reduce body dissatisfaction and prevent the use of muscle-building supplements among 14-to-16 year old adolescent boys.Methods/design: Goodform will be trialled using a cluster randomised controlled trial (RCT) conducted in Australian schools, with Year 9 boys as participants. The intervention is teacher-delivered. Data will be collected at three time points: baseline, post-intervention, and follow-up (2 months). Three primary outcome constructs will be examined, including body dissatisfaction (Male Body Attitudes Scale-Revised) and attitudes towards appearance and performance enhancing substances (APES; Outcome Expectations for Steroid and Supplement Use, Intentions to use APES) and actual use of APES at each time point. Three secondary outcome constructs will be examined, which are social norms for APES (adapted Peer Norms Scale), negative body talk (Male Body Talk Scale), and internalisation of and pressure to attain appearance ideals (Sociocultural Attitudes Towards Appearance Questionnaire-4 Revised). Internalisation of appearance ideals will also be examined as a mediator of change in primary outcomes. Teachers will provide data on adherence to lessons, student engagement/enjoyment, and understanding of the content.Discussion: The GoodForm RCT will trial a novel, generalizable, and extensively developed program intended to improve boys' body image and reduce actual and intended APES use. We anticipate that it will provide a novel contribution to the field of boys' body dissatisfaction prevention.Trial Registration: This trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry on May 14th 2019, registration number ACTRN12619000725167. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including epistemological and theoretical developments, empirical studies, policy perspectives, and curriculum initiatives in social work education.

Although attention-deficit/hyperactivity disorder (ADHD) is associated with eating disorders (EDs), it is unclear when ED risk emerges in children with ADHD. We compared differences in body dissatisfaction and weight control behaviour in children with/without ADHD aged 12–13 years concurrently, and when aged 8–9 and 10–11 years, to determine when risk emerges. We also examined differences by ADHD medication status at each age. This study uses waves 1–5 from the Longitudinal Study of Australian Children (n = 2323–2972). ADHD (7.7%) was defined at age 12–13 years by both parent- and teacher-reported SDQ Hyperactivity–Inattention scores > 90th percentile, parent-reported ADHD diagnosis and/or ADHD medication treatment. Children reported body dissatisfaction and weight control behaviour at 8–9, 10–11 and 12–13 years. Children with ADHD had greater odds of body dissatisfaction at ages 8–9 and 12–13 years. Comorbidities drove this relationship at 8–9 but not at 12–13 years [adjusted odds ratio (AOR): 1.6; 95 % CI 1.1–2.4; p = 0.01]. At 12–13 years, children with ADHD had greater odds of both trying to lose and gain weight, regardless of BMI status. Comorbidities drove the risk of trying to lose weight in ADHD but not of trying to gain weight (AOR 2.3; 95% CI 1.1–4.6; p = 0.03), which is likely accounted for by ADHD medication treatment. ADHD moderately increases body dissatisfaction risk in children aged 8–9 and 12–13 years. Clinicians should monitor this and weight control behaviour throughout mid-late childhood, particularly in children with comorbid conditions and those taking ADHD medication, to reduce the likelihood of later ED onset. [ABSTRACT FROM AUTHOR]

Understanding how young women experience pornography is a modern imperative in promoting sexual health. There has been, until now, no Australian research exploring what pornography means to women in relation to sexual pleasure. We conducted in-depth interviews with 27 women from around Australia. A thematic analysis of their accounts, supported by narrative theory, revealed that pornography both enhanced and interfered with pleasure. Women described pornography's contributions to the enhancement of pleasure through solo pleasure, shared viewing with partners, discovering new sexual preferences, and reassurance about body appearance. Pornography was constructed as interfering with pleasure through its misrepresentation (of bodies, sexual acts, and expression of pleasure), women's concern for actors' wellbeing, and its disruption of intimacy. Accounts were consistent with women's place in a culture that subordinates female pleasure to male pleasure. It was evident in women's accounts that pornography plays complex, dynamic roles in the production of pleasure, acting in the domains of physiology, psychology, relationships, ethics, society, and culture. [ABSTRACT FROM AUTHOR]

Objective: Despite known associations between eating disorders and obesity, little is known about the current prevalence of symptoms of eating disorders across the weight spectrum. This study therefore aimed to estimate the population prevalence of eating disorder symptoms in relation to weight status in adolescents. Method: The sample comprised 3,270 participants (14–15 years; 52% boys) drawn from Wave 6 of the Longitudinal Study of Australian Children. Symptoms of anorexia nervosa (AN) and bulimia nervosa (BN) were assessed using self‐report on the Branched Eating Disorder Test. This measure identifies clinically significant symptoms in the past 3 months according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Using study‐derived cross‐sectional population weights, the prevalence of each symptom was estimated for the total population and by sex and weight status. Results: The estimated population prevalence was high (14.3–25.7%) for body image symptoms such as fear of weight gain and overvaluation of body weight but lower (0.5–3.7%) for behavioral symptoms such as binge eating and compensatory behaviors. Symptoms were more prevalent among adolescents with overweight or obesity. Although most symptoms tended to have higher prevalence among girls than boys, boys with obesity had higher prevalence of binge eating and excessive exercise than girls with obesity. The overall estimated population prevalence for AN and BN was 0.20% and 0.10%, respectively. Discussion: The study highlights a need for clinicians to be cognizant of disordered eating behaviors regardless of weight status and has implications for both eating disorder and obesity prevention and intervention. [ABSTRACT FROM AUTHOR]

University years are a period of increased morbidity and mortality, associated with negative health behaviours and corresponding poor mental health (MH) status amongst students. With this said, the aim of this research was to determine the level of influence a number of predictive factors have on Australia's university students' MH status. A cross-sectional study design, consisting of an online survey was implemented. Psychometric measurement components were based on adopting Bronfenbrenner's socio-ecological model approach to collecting descriptive statistics. This approach was concerned with investigating patterns of association between three predictive factors [social emotional wellbeing (SEWB), physical activity (PA) levels and sporting club (SC) involvement], against four domains (personal, university, home and community). This study identified that 25% (n =  571) of participants (n =  2326) indicated that they have been diagnosed with a MH disorder. Specifically, gender, age, negative health behaviours, lower levels of PA and SC involvement and poor SEWB, were found to be significantly and positively associated (p <  0.05 *, p <  0.01 **) with a MH diagnosis. Importantly, findings from this study indicate that there are significant (positive/negative) associations between the identified predictive factors and participants' MH status. Findings from this study will go towards informing current and future Student Health Service policies, practices and infrastructure allocation that address MH status amongst university students. [ABSTRACT FROM AUTHOR]

Sexual esteem is the positive regard for and confidence in an individual's capacity to experience their sexuality in a satisfying and enjoyable way. Body esteem is the overall positive or negative evaluation of one's body. Physical disability can have an adverse impact on both of these constructs. This project aimed to study the sexual esteem and body esteem in people with spinal cord damage (SCD). A comprehensive survey (August 2013-June 2014) was conducted of people with SCD (n = 154) living in the community, Australia. The survey included the Physical Disability Sexual and Body Esteem (PDSBE) scale. There were 146 participants who completed the PDSBE scale. Most were male (n = 100, 68.5%), average age of 47.9 years (SD = 13.5) and a median of 11 years (IQR 4-20) post SCD. The mean PDSBE score was 22.2 (SD = 7.9). There was a moderate correlation (r = 0.35) between the total PDSBE score and quality of life as a whole (P = .001) and a weak correlation (r = 0.22) with function (P = 0.01). There was no significant influence of gender or sexual orientation on PDSBE scores. However, people with non-traumatic SCD and paraplegia tended to have higher scores (non-traumatic SCD mean 25.8 [SD = 6.7] vs traumatic SCD mean 21.0 [SD = 8.0], P = .002; paraplegia mean 23.4 [8.1] vs tetraplegia mean 20.6 [7.5], P = 0.04). The mean PDSBE scores for the people with SCD in this study were lower than that reported for non-SCD disabled (mean 25.9, SD = 9.2). Sexual and body esteem are psychological-sexual constructs that complement existing outcomes used when evaluating the impact of SCD. [ABSTRACT FROM AUTHOR]

Objective: Fear of negative evaluation has been proposed as a transdiagnostic factor associated with the development of eating disorders and has been shown to relate to disorders of body image, especially those with weight/shape concerns such as eating disorders and muscle dysmorphia. The current study aimed to investigate whether fear of negative evaluation was a transdiagnostic factor of disorders diagnostically characterized by weight/shape concerns. The study examined whether fear of negative evaluation was associated with higher odds for meeting criteria for an eating disorder and/or muscle dysmorphia, especially those disorders diagnostically characterized by weight/shape concerns. Method: Data were used from a subgroup of the first wave of the EveryBODY study, a longitudinal investigation of eating disorders and body image concerns among Australian adolescents (N = 4,030). Participants completed measures on demographics, weight/shape concerns, disordered eating, psychological distress, muscularity concerns, and fear of negative evaluation. Results: Findings revealed that fear of negative evaluation was associated with higher odds of meeting criteria for any eating disorder but significantly more so for those characterized by weight/shape concerns diagnostically, as well as binge‐eating disorder. Similar results were found for muscle dysmorphia. Discussion: The findings suggest that fear of negative evaluation constitutes a transdiagnostic feature for developing and/or maintaining an eating disorder. [ABSTRACT FROM AUTHOR]

Objectives: To determine if patients with cleft lip and/or palate (CL/P) from a Western Australian (WA) cohort were more dissatisfied with their body esteem than a normative non-cleft cohort, and identify demographic variables that may have significant associations with body esteem. Design: Questionnaire study using the Body-Esteem Scale (BES) and Cleft Research Questionnaire (CRQ). Participants: Self-selected participants from a Western Australian CL/P population across 3 age groups (n=359). Main outcome measures: The BES is comprised of 3 factors: BE-Appearance, BE-Weight and BE-Attribution. Study mean BES factor scores were compared to normative non-cleft scores. Regression analysis was used to determine significant associations within each age group between BES factor scores and CRQ variables of: gender, self-reported body weight category, cleft type and importance of facial appearance rating. Results: Study mean BE-Attribution scores were significantly lower than the normative scores and significantly lower than the mean BE-Appearance and BE-Weight factor scores within the same age groups of this study. Having a cleft type of lip and palate, being overweight, and placing a high importance on facial appearance had significant negative associations with BES scores. Maintaining a normal body weight and placing a lower level of importance on facial appearance had significant positive associations. Gender had no significant associations. Conclusion: In this study, the attribution aspect of body esteem had a greater negative impact on patients than their appearance and body weight. This has important implications for clinical treatment and support of patients. [ABSTRACT FROM AUTHOR]

Childhood emotional abuse (CEA) is the least researched but most common and psychologically harmful form of child abuse. While there is a robust body of feminist research into the gendered discourses framing child sexual abuse, domestic violence, and rape and sexual assault, there has been little feminist examination of CEA. This article reports on the findings from two interview studies with women who have backgrounds of CEA exploring how this form of abuse is constituted through gendered discourses, practices, and power relations. The studies were framed by McNay’s theoretical concept of situated intersubjectivity, which attends to both the discursive and material bases of gender oppression. Discourse analysis was used to examine the gender discourses and practices in women’s narratives of CEA. Based on the analysis of the interviews, CEA is theorized as a gender practice that is often concerned with imposing a traditional femininity on daughters, but it is also shown to encapsulate contradictions about contemporary femininities where rights to autonomy and independence sit in some tension with traditional expectations. The article adds to feminist theorization by considering how the gender discourses and practices constituting CEA and other forms of violence against women intertwine with structural gender power relations and considers the implications of these insights for social work practice. [ABSTRACT FROM AUTHOR]

The article offers information on the report on outcomes of sexual and gender minority in the cancer survivors. Topics discussed include information on the risk of inferior outcomes in the Lesbian, gay, bisexual, transgender, or intersex (LGBTI) people with cancer; discussions on the depression and social difficulties with survivors who identify as cisgender and heterosexual; and the information on the treatment provided to such people by the health care professionals.